Snapping Shoulder
Shoulder snapping or popping is a very common complaint. A grinding sensation in the shoulder is even more common. The shoulder is a very complex joint so there are many structures that can snap, pop or click when they are injured or inflamed. The shoulder contains muscles, bones, tendons, cartilage, and a bursa. Those tissues interact and move upon one another like a complex ballet. Often times the clicking or popping you feel is simply normal because all of these structures are moving on one another. Rest assured, the majority of sounds or sensations coming from your shoulder are often not a cause for concern.
Can this be normal?
Sometimes the popping or grinding in the shoulder is because something is inflamed or damaged. When our tendons become inflamed they swell. That swelling can tighten the spaces available for all those complex structures in the shoulder which might cause popping or grinding with certain motions.
The most common causes of painful 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?
Most of you are worried about the sounds your joints are making. It’s a natural concern. You’re not sure if it’s normal or not. Some of you have pain and want to know what’s causing the pain and the new sensation.
Read on… I’m going to try to help you sort through whether or not your popping or grinding shoulder is mostly “normal” or is it due to something that should be looked at further. In another post, I describe the things to look for to know if you had a serious shoulder injury.
Shoulder Anatomy
The shoulder is a very complex joint composed of bone, cartilage, ligaments, tendons, and two different tissues that line the inside of our shoulder joint. We call those tissues that line the inside of the spaces the Synovium and the Bursa. If any of these structures are injured or simply inflamed (and thus thicker), the smoothly functioning shoulder can pop, snap or click. These “injuries” can be due to everyday use, a sports injury, chronic repetitive stress due to sports, or significant trauma from a fall or accident. Most of this inflammation will subside on its own.
Should I be worried about my shoulder popping?
Most of the time the clicking or snapping in the shoulder 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. For most of you, painless snapping or clicking of the shoulder is not an issue to worry about. For many of you, the popping or clicking may eventually subside over time, or you may simply get used to it.
Painless clicking and popping usually do not require any treatment at all.
Painful shoulder popping
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 serious shoulder injury. Here are some situations when the noise coming from your shoulder could signify a problem.
- If your shoulder was injured and it is now sliding in and out of place (dislocating), it may snap or pop.
- if the biceps tendon is moving around too much or dislocating from its groove.
- If the rotator cuff was injured or torn.
- If the labrum of the shoulder was torn.
- 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 (often bursitis)with your shoulder blade or scapula.
- if you have calcific tendonitis, the inflammation could make the shoulder click or grind.
Here is my latest video…
Causes of painful clicking or popping in the shoulder:
Labral Tears or SLAP lesions :
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 the shoulder and cause a pop or a snap. People with painful popping or their shoulder dislocates due to a labral tear may respond to physical therapy. If after therapy your shoulder continues to dislocate, or has a painful catching or popping you may consider an arthroscopic 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. Labral tears cause different symptoms based on where the labral tear is. For example. SLAP lesions typically do not allow the shoulder to dislocate, but it can cause popping or catching. Tears in the front or back of the labrum can cause dislocations of the shoulder.
- Labral Tears – is Surgery Necessary
- Do Labral Tears Require Surgery?
- See this discussion to learn more about SLAP lesions.
Biceps Tendon and Snapping in the front of the shoulder.
The biceps tendon is a long tendon coming up into the front of shoulder from the arm. It normally sits in a groove in the front of the humerus or arm bone. Over time that biceps tendon can develop inflammation from overuse. That might cause a feeling of grinding or pain. Snapping in the front of the shoulder can be caused by the biceps tendon rolling out of the groove it sits in on the front of the arm bone. Biceps instability and biceps tendonitis are very common causes of snapping and pain in the front of the shoulder. A painful biceps tendon can usually be treated with anti-inflammatory medications or injections placed with an ultrasound machine. An unstable biceps tendon that causes painful popping may require surgery to stop the biceps from dislocating out of its groove.
Rotator Cuff Tears
As you can see in the picture about, a rotator cuff tear can cause abnormal sensations 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(bursitis). We call that inflammatory process bursitis. When bursitis is present in the shoulder then the bursa is swollen and will cause clicking or grinding.
- 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 dislocations are a common cause of popping in the shoulder. Especially posterior instability where the ball is moving backward on the socket.
If the ligaments in the shoulder were injured from an acute injury, the shoulder becomes 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 dislocation surgery.
Loose Bodies
Shoulder Arthritis
Rest assured that the majority of shoulder snapping or clicking is *normal*. If you have pain, or if you are concerned –or certainly if you’re 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.
Jean Edwards
I have been diagnosed with a MRI I have a tear anterior posterior to my upper bicep. When I was at work 3 weeks ago something popped and I instantly had excruciating pain, Something in my scapula popped way out and now it is swollen in the back underneath my arm behind my shoulder. I have had intense pain and will be seeing my Ortho March 26 th. . I have never felt so much pain in all my life. What else could I have injured? I work in a factory and very repetitive lifting 5 lb bags of wings. I have worked in a factory for 27 years. Also it is black and blue in a different area where my scapula popped out. Please tell me possibly what else I could have done. My shoulder is also popping and cracking noises. But the MRI said it is in contact. Please tell me what else I could have injured.
Howard J. Luks, MD
sorry Jean… without examining you I can not say for sure.
Sabrina Sanchez
Hi, I’m 21 and two days ago I had fallen off, I’m embarrassed to say, a bounce house at my friends party. I had landed on my shoulder with all my weight, and thats a lot of weight, and it was extremely painful and I heard a pop. A sharp pain ran down my whole arm and I wasn’t able to use my arm for a bit. I am accident prone, so, despite my friends concerns, I didn’t see a doctor. It’s only been two days since then and the pain is almost entirely gone already, though I’m sure I shredded some muscles that day from all my vigorous playing(I continued to play despite my injury because I may not be the sharpest tool in the shed). However, if I’m jarred, if I raise my arm high enough and move it in a different direction, or if I try to lift anything of any substantial weight, I’ll feel a sharp pain and hear a popping sound. I’m just curious if, in your opinion, I NEED to see a doctor or if you think it is fine healing on its own. I’m a college student that lives in California and Healthcare isn’t cheap, so if I can avoid it without causing any severe, permanent damage to my shoulder, I will. And also, if maybe you think I should just get a brace and just try to avoid using it for a while? These are the thoughts I had on my own, but of course a second opinion is always warranted. If you think I may have a more serious issue and should see a doctor, I will.
Howard J. Luks, MD
Sabrina… I wish I could be of more help. But without examining you I can’t tell you if you damaged anything important. Many injuries will heal over time, some injuries might not and might require an evaluation sooner rather than later.
I hope you recover soon
Kyle
Hey there my name is Kyle am 17 when I was 14 I was working out one day and then dropped to the floor while doing pushups cause there was a blinding pain in my right shoulder now When I started working out at 16 the pain seemed to return a little now 17 the pain really kills me at times cause my shoulder pops when rotating and now my right shoulder has dropped lower than the left am not one who is always sagging or sitting inn proper always trying to correct that. The pain has gotten worse.
Howard J. Luks, MD
Hi Kyle…
Time for you to see a good shoulder doctor… Your shoulder should be examined, and perhaps an MRI would be useful too.
Good Luck
Lisa
Hi. I am a 52 year old female with frozen shoulder that started last summer without injury.. I have had an x ray and ultrasound that came back both negative. I have just been able to do exercises at home without excruciating pain. I am getting more range in my movement but have noticed a clicking sound when doing the exercises, propeller and pendulum. Should I be concerned.
Howard J. Luks, MD
Not typically a concern… clicking after an inflammatory issue (frozen shoulder) is very common
Mike
I have popping and clicking in my right shoulder front and top of it and it’s painful I’ve also noticed even after stretching and warming up I can only throw a baseball for about 5-10 times before my entire arm feels dead and I lose strength in the throws
Howard J. Luks, MD
Painful popping of the shoulder should be looked at by a sports medicine doctor that specializes in shoulder disorders. Popping and pain in a thrower often means that the labrum and /or the biceps is bothering you.