Do you ever feel like your shoulder is popping and wonder why? There are multiple reasons for this common issue. The shoulder is a complex joint with the largest and most variable ranges of motion in the body. It is comprised of bone, ligaments, cartilage, and tendons that allow for the ease of movement in so many different directions, however it runs the risk of becoming unstable when movement quality is poor. This is why the shoulder is a commonly injured joint that results in shoulder pain.
Before you assume the worst, ask yourself the following:
1) Is the popping I feel painful?
2) Has there been a recent injury of my shoulder resulting in any pain?
3) Does my shoulder feel stable?
4) Is it accompanied by any weakness?
Clicking and popping can occur for many reasons. If it is painless, it can be just a harmless joint noise known as crepitus, which is simply pressure being released from the joint. This is what occurs when you crack your knuckles. On the other hand, if it is associated with pain, something is getting irritated.
Repetitive over use of the shoulder can result in irritation/inflammation of a number of tissues within the shoulder. Two examples are bursitis and tendinitis which seem to be common sports injuries here in Bethesda. These conditions occur from movement compensations in conjunction with too much of the same activity that causes swelling in the bursa sac and rotator cuff tendons. Bursae are fluid filled sacs that cushion each joint in your body, in this case, the shoulder. The tendons are the cords that connect the muscle to the bone. The rotator cuff tendons can become worn down slowly over time much like the sole of a shoe that eventually wears apart. If left untreated, the result is a tearing of the rotator cuff tendon causing increased pain and an inability to exercise or train fully. Limitations can even progress further effecting sleep, strength, and the ability to use the arm with many daily activities.
Pain can also occur with popping due to degenerative arthritis from years of wear and tear. This occurs when the cartilage that protects the bone has worn down and becomes rough. If the joint is no longer smooth and there is increased friction, it can develop injury through the joint rubbing together like two pieces of sand paper. The result is increased joint inflammation and shoulder pain. If left untreated, this can also limit the ability to exercise and train fully.
Shoulder pain and impingement occur when the space between the top of the shoulder blade (called acromion) and the top of the upper arm bone (called head of the humerus) is narrowed due to movement compensations, eventually resulting in swelling and inflammation which further limit this space. This causes a pinching of the rotator cuff tendons and bursa. Untreated, this too can limit the ability to exercise fully and eventually interfere with day to day activities.
Shoulder instability occurs when the head of the upper arm bone (humerus) is unable to stay centered on the shoulder socket (glenoid) during movement. This places increased strain on various structures within the shoulder joint potentially irritating the cartilage (labrum) of the shoulder, resulting in increased pain and weakness. This can cause increased risk of arthritis.
Despite, everything that was just described, that is not what is important! The most important thing is to figure out why the popping, tendinitis/bursitis, arthritis, impingement or instability started in the first place.
Small rotator cuff tears, labral tears, arthritis and joint damage is common within the shoulder however there is still a great deal that you can do (without surgery) to get out of pain and back to performing the activities that you love.
The question you need to ask yourself is, “what movement compensations do I have that are irritating my shoulder?” Addressing this by seeing a quality sports physical therapist will allow you to continue to exercise and enjoy your active lifestyle. To read more great articles like this, check out www.cohenhp.com!