Snapping shoulder

Shoulder snapping and poppingShoulder snapping or popping is a very common problem.  The shoulder is a very complex joint so there are many structures that can snap, pop or click when injured or inflamed.   The most common causes of shoulder popping include rotator cuff tears, bursitis, labral tears, biceps tendon problems and arthritis.  I see between 5-10 patients a week who are simply in my office because they want to know – Why does my  shoulder snap, click and pop? 

The shoulder is a very complex joint composed of bone, cartilage, ligaments, tendons, and two different linings we call the synovium and the bursa.     If any of these structures are injured, the smoothly functioning shoulder can pop, snap or click.   These “injuries” can be simply due to everyday use, chronic repetitive stress of due to sport injuries and significant trauma.

Should I be worried if my shoulder pops?

Most of the time the clicking or snapping is due to everyday use and changes that occur over time within our joints.  As we age this causes some of the surfaces to roughen —thus when they rub against one another they will snap, click, or pop within the shoulder.    In the majority of circumstances  painless snapping or clicking of the shoulder is not an issue to worry about.    Painless clicking and popping usually does not require any treatment at all. By the time I see you in the office, many have tried various remedies.  I have seen many different shoulder compression sleeves. I’ve also seen many of you try Glucosamine .  If your shoulder hurts when it pops, or if the popping and snapping started after an injury then you should consider an examination by an Orthopedic Surgeon.  Below is a discussion of the most common causes of painful shoulder snapping and popping.

Clicking or popping of shoulder may start soon after an injury.  That might mean that you have sustained a “significant” shoulder injury. There are occasions when popping or snapping could signify a problem in your shoulder.

  • If your shoulder was injured and it  is now sliding in and out of place (instability), it may snap or pop.
  • If the rotator cuff was injured or torn, the torn edge could snap or pop. Or…
  • If the labrum of the shoulder was torn,  your shoulder may also snap or pop.
  • A piece of cartilage has torn loose and you have a “loose body” getting caught in the shoulder.
  • If the snapping is in the back of the shoulder, it could be an issue with your shoulder blade, or scapula.

 

Causes of painful clicking or popping in the shoulder.

 

Labral Tears or SLAP lesions 

Shoulder Dislocations

This is a picture showing a labrum tear with exposed bone. The metal probe is resting on the labrum.

The shoulder is composed of two main bones, the ball and the socket.  The shoulder is similar to a golf ball sitting on a golf tee.  Imagine that the golf tee has a rubber washer sitting around the edge.  That is exactly what the labrum is in the shoulder. It is a rim of cartilage around the socket of the shoulder. It serves as an attachment for the ligaments, and it helps the ball of  the shoulder stay in position.  If the labrum or cartilage in the shoulder is torn a result of an injury or repetitive stress (pitching), then the labrum may have been torn from the bone  If the labrum is torn it can catch in shoulder and causing a pop or a snap.   Click here to learn more about labral tears.  People with painful popping due to labral tears who do not respond to physical therapy or rest may require an arthroscopy or surgery on the shoulder to repair the labrum  ( see picture below).  A SLAP lesion is simply a tear of the top of the labrum in the shoulder.  See this discussion to learn more about SLAP lesions.

Repair of labrum to stop shoulder dislocations

This is the same labral tear once it has been repaired and stitched back to the bone.

Rotator Cuff Tears

Larger rotator cuff tearAs you can see in the picture about, a rotator cuff tear can cause popping snapping or clicking in the shoulder.  If the rotator cuff tendons are torn then there is a loose edge within the shoulder that can catch on other ligaments or structures in the shoulder.  This may lead to painful snapping or popping. In addition, a rotator cuff tear, or rotator cuff tendinosis can cause a secondary inflammation in the shoulder.  We call that inflammatory process a bursitis. When bursitis is present in the shoulder then the bursa is swollen and will cause clicking or popping.   Click here to help determine if you have a rotator cuff tear?   Click here to learn more about the treatment of rotator cuff tears. 

Shoulder Dislocations

Shoulder DislocationShoulder dislocations are a common cause of popping in the shoulder.  If the ligaments in the shoulder were injured from an acute injury, the shoulder become loose and start dislocating. This can lead the ball of the shoulder to slide up or over the edge of the socket.   When the ball then falls back into place it may cause snapping or popping.   This section on shoulder dislocations delves further into detail on shoulder instability.  For more information. Click here to learn more about shoulder dislocations

 

Loose Bodies 

Loose bodies can cause shoulder snapping and poppin

This is the picture of a loose body in the shoulder and can serve as an obvious case of popping or catching.

Arthritis

Arthritis, by definition is the loss of cartilage or the cushioning on the ends of our bones.  If the cartilage in the shoulder is rough, thinning or absent, the surfaces of the shoulder will be rough and therefore cause clicking, snapping and popping.

Notice that the cartilage here is literally peeling off the bone underneath. These flaps or pieces can cause clicking and popping.

Rest assured that the  majority of shoulder snapping or clicking is *normal*.  If you have pain, or if you are concerned –or certainly if your snapping or popping started after an injury –you should be evaluated by an Orthopedic Surgeon trained in Sports Medicine to examine you and determine why your shoulder is popping or clicking.   An MRI might be necessary to see if the shoulder labrum is torn, if you have loose bodies floating around, if the biceps tendon is unstable or if osteoarthritis of the shoulder is present.

 

Video on Causes of Shoulder Snapping or Popping