Shoulder cracking; Crack in the shoulder

Shoulder Cracking: Causes and Treatment

Cracking noises in the shoulder are often worrisome for those affected, but in many cases harmless. The cracking of the shoulder usually occurs in certain movements and the causes can be diverse or are not yet finally clarified. Depending on where exactly the noise occurs, signs of wear and other illnesses can also be considered triggers. The cracking in the shoulder can be accompanied by pain and restricted mobility.

contents

• Shoulder Cracking: Causes and Treatment
• symptoms
• Anatomy of the shoulder joint
• Location and type of the sounds give first hints
• When should a crack in the shoulder be treated?
• Shoulder cracking during fitness training
• diagnosis
• Treatment options for shoulder cracking

symptoms

Shoulder cracking refers to cracking, snapping, rubbing, bouncing or crackling noises that occur in the area of ​​the shoulder during certain movements, such as shoulder or arm circles, shoulder lifts or head movements. These sounds occur in many people and are usually not alarming, unless they go hand in hand with pain or weak strength in the arm.

A crackling sound in the shoulder is usually no cause for concern. If, however, pain, restriction of movement or muscle weakness are added, a medical examination of the causes should be made. (Image: Romario Ien / fotolia.com)

Painful shoulder cracking can be temporary or permanent, accompanied by rubbing, pain and / or movement restrictions. Patients often have problems with everyday activities, such as putting on or washing their backs, so that the symptoms result in a significant reduction in quality of life and are perceived as extremely unpleasant.

Anatomy of the shoulder joint

The shoulder is made up of different structures: the clavicles and the shoulder blades together constitute the shoulder girdle, the shoulder joint itself is formed by the shoulder blade and the humerus. The so-called shoulder roof (Akromion) and the Rabenschnabelfortsatz (Coracoid) belong as bony prominences to the scapula.

Unlike many other joints, the shoulder joint does not provide a variety of ligaments but rather certain muscles with their tendons for stability, collectively referred to as the rotator cuff. These include the supraspinatus muscle, the infraspinatus muscle, the teres minor muscle, and the subscapularis musculature. The rotator cuff covers the shoulder joint like a roof.

The muscles run from the scapula to the humerus where their tendons attach. In relation to the strong forces and stress acting on the shoulder joint and its surrounding structures during movement, the ligaments are relatively weak. Therefore, the muscles of the rotator cuff are primarily responsible for the stability. The shoulder joint is the most flexible ball joint in the human body.

The shoulder joint is complex and represents the largest ball joint in humans. (Image: bilderzwerg / fotolia.com)

Location and type of the sounds give first hints

If there are clicks in the area of ​​the shoulder, the cause may be the tendons, the muscles, the articular cartilage or the bony structures. Shoulder cracking can occur at the level of the scapula, deep in the joint, at the side, in front or at the back. Often, the noise is tendon snap when it occurs laterally or at the back of the shoulder. Then either the external rotators or the supraspinatus tendon, which runs laterally on the upper arm, trigger the noises. Likewise, the biceps tendon may be affected if the shoulder cracking occurs laterally or forward. Sounds that become noticeable in the scapula around the shoulder blade may be due to hardening of the muscles under the shoulder blade as the scapula moves over the muscles.

When should a crack in the shoulder be treated?

Cracking or clicking noises in the area of ​​the shoulder occur relatively frequently and are initially no cause for concern. However, if additional symptoms, such as pain and disability, are added, there could be a disease or wear and tear on the shoulder. For example, clicks in the area of ​​the shoulder can also be an indication of the so-called rotator cuff syndrome (PHS, periarthropathia humeroscapularis), which summarizes various symptoms. These are wear-related damages, which may start with small cracks (ruptures) in the tendon fibers, for example, and may lead to complete tear of the tendon. Especially the rotator cuff, the tendon plate of the shoulder rotator and the biceps tendon are affected by the wear. Therefore one speaks of rotator cuff syndrome or biceps tendon syndrome. Patients usually suffer from pain and restricted mobility. It causes inflammation of the tendons and / or the bursa. Lime deposits or adhesions in the joint can lead to stiffening of the shoulder.

Frequent and painful shoulder cracking while exercising may indicate irritated tendons. (Image: Kzenon / fotolia.com)

Shoulder cracking during fitness training

If the crunching and cracking in the shoulder increases during exercises in the gym, such as bench presses, this may indicate a state of irritation of the tendons that spread the upper arm. First, it should be ensured under trained guidance that the exercise is performed ergonomically. Even a temporary reduction of the training weights can spare the tendons. If additional pain occurs, the family doctor should be consulted. As a rule, this first tries to eliminate the problem by using anti-inflammatory drugs, physiotherapy or massages from the world. If the complaints persist, a referral to the orthopedist usually takes place.

diagnosis

For shoulder cracking, which is accompanied by pain and / or movement restrictions, a doctor should be consulted. The causes listed here are just a selection of possible triggers for pops and pops around the shoulder. In addition, there are many other causes that can only be determined or excluded in the context of a medical examination. The doctor first asks questions about the medical history, in order to obtain an indication of the cause of the complaints, if any, in previous illnesses such as rheumatism. In addition, a thorough 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-ray images of the shoulder are first created for further examination. Thus, changes on the scapula can be made visible or excluded. Depending on the findings, computed tomography (CT) and / or magnetic resonance imaging (MRI) can be performed. CT reveals bony changes such as spurs, curvatures, poorly healed fractures, or bone tumors. MRI makes it easier to visualize soft tissue. For example, bursa changes or soft tissue tumors can be diagnosed. In addition, nerve damage as a cause of painful shoulder cracking into consideration. These can be detected by measuring nerve conduction velocity and muscle activity (electrophysiological diagnostics).

The causes of painful cracking in the shoulder can be manifold. (Image: New Africa / fotolia.com)

Treatment options for shoulder cracking

If there are no accompanying symptoms such as pain or restricted mobility, it is often appropriate to use appropriate exercise such as stretching exercises. The therapy of painful shoulder cracking depends on the underlying cause. Basically, if possible, non-surgical treatment is preferred.

Treatment for inflammation

Inflammation of the tendons or bursae is usually a temporary protection of the shoulder arranged. In addition, there is the gift of anti-inflammatory and analgesic drugs and a special physiotherapy ("shoulder school") in which the affected learn how to avoid unfavorable, recurring movements and attitudes or rehearse better alternatives. Depending on the cause of the complaints shock wave therapy, electrotherapy and acupuncture can be helpful. A visit to the osteopath may also be useful as it assesses and treats shoulder discomfort in a holistic context.

Treatment of bony and mechanical causes

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