The shoulder is one of the most mobile joints in the body with a lot of anatomical structures around it. It is also said to be the most unstable joint of the body because of its hypermobility.
At some time in our life, we may hear a sound coming from our shoulder while moving, stretching, or being in a position for a long time. The question is, “Is it normal to hear these sounds?”
What Causes The Shoulder To Pop, Click And Crack?
There are a lot of anatomical structures at the shoulder joint. Most of these structures play a role in the pop, click and crack sounds we hear. Some of the causes of these abnormal sounds are:
The shoulder is made up of 3 bones; the clavicle, scapula and the humerus. These bones come together to form the shoulder joint and are covered by the hyaline cartilage.
A fluid-filled sac which is known as a bursa is found at your joints. The bursae lubricate the bones at the joints as they move on each other to reduce friction.
When this bursa gets inflamed, it causes a “pop” sound when you move your shoulder. Bursitis, which is inflammation of the bursae, may also cause pain and warmth around the shoulder joint.
2. Moving Tendons
Tendons join muscles to bones. After staying in a position for a long time like fixing a bookshelf or painting a house, you may hear a click or crack sound.
This sound may be due to the tendons going back into position and as they do so, they rub against the bones which produce the sounds.
3. Labral Tear
The labrum is a soft tissue found at the shoulder joint. It is located between the head of the humerus and the glenoid cavity of the scapula and joins other structures like the ligaments and muscles to stabilize the joint. You can say they are ‘pillows’ for the surfaces of the bones at the joints.
A labral tear can lead to partial dislocation of the shoulder joint. One of the signs of a labral tear is hearing a pop-like sound.
This tear is usually accompanied by difficulty moving the shoulder joint, pain, clicking and popping sounds which may occur from the movement of the head of the humerus in and out of the glenoid fossa.
Studies have shown that when we ‘crack’ our knuckles, bubbles form in the synovial fluid of the bursae (a process called cavitation) and the sounds we hear may be due to the popping of these bubbles found in the fluid-filled sac.
5. Muscle Weakness
Muscles around the shoulder joint stabilize the joint and ensure it is in place. When these muscles get weak, they lose the strength to maintain the bones in the appropriate position which may cause the bones to make a “pop” sound.
Crepitus is a sound that occurs from joints rubbing against each other. This is usually associated with arthritis which is a condition that affects the articulating surfaces of the bones at the joint.
In arthritis, the cartilage that allows for easy movement of the bones over themselves wears away which leads to the bones touching themselves.
Are These Sounds Serious?
These sounds are signs and symptoms of conditions that affect the anatomical structures at the shoulder joint.
Most times, these sounds act as a warning or caution sign. Let us imagine a man doing a lot of over-the-head jobs and the pop sound is heard, it is a way of the body signaling to him to slow down, rest or stretch.
Sometimes it may be something less serious like cavitation, but when the cause of the sound is not addressed at that time, it may lead to a serious condition.
See a doctor or a physiotherapist to assess the shoulder. Diagnostic tests such as an X-ray or MRI will be recommended to rule out and pinpoint the major cause of the joint sound.
How Can These Sounds Be Avoided And Treated?
Like I mentioned earlier, the sounds may be a signal to rest or stretch.
When you hear the sounds, do not try and move the shoulder joint looking for pain, rest the shoulder joint for a while or if you feel pain, you can wear a shoulder support or arm sling to reduce movement at the shoulder joint depending on the cause of the injury.
If there is associated pain or swelling with the sound, do not rush to massage the shoulder or move it around expecting to hear the sound again. Instead, crush ice in a damp towel or an ice pack and place around your shoulder joint for 15 minutes.
This can be done 3 to 4 times a day, every 4 hours.
Analgesics or pain-relieving medications can be taken orally or topically. Some of these topical ointments come in form of gels and have diclofenac, ibuprofen or ketoprofen as its active ingredient.
4. Postural Education
Our posture is very important when it comes to joint sounds.
The shoulder is connected to the upper back. We have hobbies or jobs that tend to put us in an awkward position like carpentry work or typing and writing for long periods of time.
Abnormal posture to the upper back places a lot of strain on the shoulder joint.
In order to avoid this, a physiotherapist will educate you on proper posture.
To ensure you have a proper posture, ensure:
- Your head and neck is straight and not tilted to the front or back
- Your stomach is tucked in and by this, I do not mean you should hold your breath. This stabilizes the lower back and keeps it straight while standing or sitting.
- You roll your shoulders back. The shoulders are the reigns of the body, and like the reigns on a horse are used to control the horse, the shoulders control the body.
- When sitting, your feet are placed firmly on the ground and your knees and hip are bent at 90 degrees.
5. Stretching Exercises
These exercises can be done for shoulder sounds that are not accompanied by pain or swelling. Ensure you see a doctor or a physiotherapist before you do any exercises as it may cause more harm to the injured anatomical structure if there is any.
Cross Arm Stretches
- This can be done while sitting or standing
- Place your left arm across your body to point towards the right
- Place your right hand on the elbow of your left arm
- Pull the left elbow with your right hand towards your chest
- Hold for 10 seconds and repeat on the other arm
Upper Back Stretches
- This can also be done sitting or standing
- Bend your elbows and form a fist with both hands
- Let your fists touch each other in front of your chest
- Take your elbows to the back
- You will feel the stretch in your shoulders
- Hold for 5 seconds and release
Over-The-Head Shoulder Stretches
- Stretch your two hands over your head interlocking your fingers
- Twist your wrist in such that your palm faces the ceiling
- Hold for 10 seconds and release
6. Strengthening Exercises
- You can place a pillow or a rolled up towel under your right armpit
- Contract your muscles to keep the pillow or towel in place under your armpit
- Hold for 10 seconds and release
- Repeat with the other shoulder
- While standing, stretch your arms out parallel to the ground
- Slowly rotate your arms moving only with the shoulders
- Do 5 – 10 circles clockwise and then anti-clockwise
Wall Push- Ups
- Stand in front of a wall with your palms touching the wall and your elbows bent
- This can be done in front of an open door with your palms on either side of the doorframe
- Do a push up on the wall as you will do a push up on the floor
- Repeat 10 times
Joints may make sounds which can be normal. It may also be a sign that something is wrong at that point in time, probably due to poor positioning or sleeping on the shoulder joint. However, if they become more frequent and are associated with pain and swelling, see a doctor or a physiotherapist to ensure it is not anything serious.