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Why is my shoulder clicking?

A clicking shoulder, also known as crepitations, is a fairly common presentation in association with an injury, but is it anything to worry about?

There are a number of reason why your shoulder may be clicking due to the complexity of the shoulder girdle, and the potential for overload of various structures. The shoulder girdle actually comprises of four articulations, which essentially allows us to have such a large range of movement whilst not sacrificing stability.

The most common reason is down to osteoarthritic changes where bony growths appear within the joint, and this is a result of general overuse over a number of years.

When soft tissues are injured, i.e. tendons, muscles or ligaments, there is often an inflammatory cascade where the area becomes red, swollen, and painful. If soft tissue becomes injured, it will become inflamed and will be more likely to rub over bony structures leading to an audible click. The rotator cuff muscle group in the shoulder are commonly injured which can then lead to subsequent impingement and bursitis.

Labral tears (or cartilage tears) in the shoulder can also cause clicking, but patients also report a clunking, and an unstable feeling in their arm with high levels of pain. If a labral tear is suspected then this needs to be confirmed through MRI.

Frozen shoulder can also lead to clicking, where the capsule surrounding the Gleno-humeral joint retracts and the fluid inside the joint becomes thick and sticky. Notoriously a very painful and impactful condition, it is actually self-limiting and will resolve, but it takes a number of months to improve.

It is always best to have any injury assessed by a qualified health professional, so they can effectively diagnose, educate and treat the injury accordingly. If imaging is recommended then this will be communicated and facilitated in making the appropriate referral.

A clicking shoulder doesn't always mean an injury is present, it can also be down to poor posture where the shoulders are rounded and there is general weakness of the muscles surrounding the neck and shoulders. Corrective work can be done to stretch and strengthen the affected areas to avoid overload to the area.


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