Why is my shoulder bone clicking

Shoulder cracking; Cracking shoulder

Shoulder cracks: causes and treatment

Cracking noises in the shoulder are often worrying for those affected, but in many cases they are harmless. The shoulder cracking usually occurs with certain movements and the causes can be varied or in some cases have not yet been conclusively clarified. Depending on where exactly the noise occurs, signs of wear and tear and other illnesses can also be triggers. The crack in the shoulder can be accompanied by pain and restricted mobility.

Symptoms

Shoulder cracks are cracking, snapping, rubbing, jumping or cracking noises that occur in the shoulder area during certain movements such as shoulder or arm circles, shoulder raises or when moving upside down. These noises occur in many people and are usually not a cause for concern, unless they are accompanied by pain or weakness in the arm.

Painful shoulder cracking can occur temporarily or permanently and be accompanied by rubbing noises as well as pain and / or restricted mobility. Affected people often have problems with everyday activities such as getting dressed or washing their backs, so that the symptoms result in a significant reduction in quality of life and are perceived as extremely uncomfortable.

Anatomy of the shoulder joint

The shoulder consists of different structures: the collarbones and the shoulder blades together represent the shoulder girdle, the shoulder joint itself is formed by the shoulder blade and the humerus. The so-called shoulder roof (acromion) as well as the raven beak extension (coracoid) belong to the shoulder blade as protruding bones.

In contrast to many other joints, the shoulder joint does not have a large number of ligaments but rather certain muscles with their tendons, which are collectively referred to as the rotator cuff. These include the supraspinatus muscle (upper bone muscle), the infraspinatus muscle (lower bone muscle), the teres minor muscle (small round arm muscle) and the subscapularis muscle (lower shoulder blade muscle). The rotator cuff covers the shoulder joint like a roof.

The muscles run from the shoulder blade to the humerus, where their tendons attach. In relation to the strong forces and stresses that act on the shoulder joint and its surrounding structures during movement, the ligamentous apparatus is relatively weak. The rotator cuff muscles are therefore primarily responsible for stability. The shoulder joint is the most flexible ball joint in the human body.

The location and type of noises provide initial clues

If cracking noises occur in the shoulder area, the cause can affect the tendons, muscles, articular cartilage or the bony structures. Shoulder cracks can occur at the level of the shoulder blade, deep in the joint, on the side, in front, or in the back. Often the sound is tendon snap when it occurs on the side or back of the shoulder. Then either the external rotators or the supraspinatus tendon, which runs on the side of the upper arm, trigger the noises. The biceps tendon can also be affected if the shoulder crack occurs from the side or front. Noises that are noticeable in the shoulder circle in the area of ​​the shoulder blade can be due to hardening of the muscles under the shoulder blade when the shoulder blade moves over the muscles.

When should a crack in the shoulder be treated?

Cracking or snapping noises in the shoulder area are relatively common and are initially not a cause for concern. However, if there are other complaints such as pain and restricted mobility, there could be an illness or wear-related damage to the shoulder. Cracking noises in the shoulder area can also be an indication of the so-called rotator cuff syndrome (PHS, periarthropathia humeroscapularis), which summarizes various symptoms. This is damage caused by wear and tear, which begins, for example, with small tears (ruptures) in the tendon fibers and can lead to a complete rupture of the tendon. The rotator cuff, the tendon plate of the shoulder rotors and the biceps tendon are particularly affected by wear. That is why one speaks of rotator cuff syndrome or biceps tendon syndrome. Those affected usually suffer from pain and restricted mobility. There is inflammation of the tendons and / or the bursa. Limescale deposits or adhesions in the joint can stiffen the shoulder.

Shoulder cracks during fitness training

If the crunching and cracking in the shoulder occurs more frequently during exercises in the gym, such as the bench press, this can indicate an irritation of the tendons that spread the upper arm. First of all, under trained guidance, it should be ensured that the exercise is carried out ergonomically. A temporary reduction in training weights can also protect the tendons. If you experience additional pain, your family doctor should be consulted. As a rule, the doctor first tries to solve the problem with the help of anti-inflammatory drugs, physiotherapy or massages. If the complaints persist, a referral is usually made to the orthopedic surgeon.

diagnosis

A doctor should be consulted if there is a crack in the shoulder that is accompanied by pain and / or restricted mobility. The causes listed here are only a selection of possible triggers for cracking and snapping noises in the shoulder area. In addition, there are numerous other causes that can only be determined or ruled out during a medical examination. The doctor first asks questions about the medical history in order to get an indication of the cause of the symptoms in the case of previous illnesses such as rheumatism. In addition, a detailed examination of the musculoskeletal system and the shoulder takes place. The exact localization of the complaints plays an important role.

Advanced diagnostic methods

As a rule, X-rays of the shoulder are first created for a more detailed examination. In this way, changes to the shoulder blade can be made visible or excluded. Depending on the findings, computed tomography (CT) and / or magnetic resonance imaging (MRT) can then be performed. CT can reveal changes in the bones such as spurs, curvatures, poorly healed fractures or bone tumors. Soft tissues can be better visualized with MRI. For example, changes in the bursa or soft tissue tumors can be diagnosed. In addition, nerve damage can also be a cause of painful shoulder cracking. These can be recognized by measuring the nerve conduction velocity and muscle activity (electrophysiological diagnostics).

Treatment options for shoulder cracks

If there are no side effects such as pain or restricted mobility, appropriate movement such as stretching exercises is often useful. The therapy for painful shoulder cracking depends on the underlying cause. In principle, non-surgical treatment is preferred whenever possible.

Treatment for inflammation

In the event of inflammation of the tendons or bursa, temporary protection of the shoulder is usually ordered. In addition, there is the administration of anti-inflammatory and analgesic medication as well as special physiotherapy (“shoulder school”) in which those affected learn how to avoid unfavorable, recurring movements and postures or practice better alternatives. Depending on the cause of the symptoms, shock wave therapy, electrotherapy and acupuncture, among other things, can be helpful. A visit to the osteopath can also be useful, as he will assess and treat the shoulder complaints in a holistic context.

Treatment of bony and mechanical causes

If there is a bony or mechanical cause such as a bone spur or a tumor, surgery is necessary in most cases. A relatively gentle procedure is the arthroscopy of the shoulder blade in the context of a shoulder joint mirroring, with which, for example, spurs, calcium deposits, bursitis and annoying strands of scarring can be removed. (ag, vb; updated January 28, 2019)

Author and source information

This text complies with the requirements of specialist medical literature, medical guidelines and current studies and has been checked by medical professionals.

Graduate editor (FH) Volker Blasek, Dr. med. Andreas Schilling
  • Volker Echtermeyer, Stefan Bartsch: Praxisbuch shoulder, Thieme Verlag, 2nd edition, 2004
  • Ulrich Brunner et al .: S2e guideline “Rotator Cuff”, German Society for Orthopedics and Orthopedic Surgery (DGOOC), (accessed on July 9, 2019), AWMF
  • Nikolaus Wülker et al .: Pocket textbook on orthopedics and trauma surgery, Thieme Verlag, 3rd edition, 2015
  • Alexandra Villa-Forte: Examination of the shoulder, MSD Manual, (accessed on July 9, 2019), MSD
  • Ronald Thomschke: Shoulder and Neck Training, Steffen Verlag, 2nd edition, 2017

Important NOTE:
This article is for general guidance only and is not intended to be used for self-diagnosis or self-treatment. He can not substitute a visit at the doctor.