Many people notice clicking, popping or cracking when lifting their arm, reaching overhead or rotating the shoulder. Sometimes it's completely painless, while other people experience discomfort during certain movements.
At The Addison Physiotherapy, we regularly assess people experiencing shoulder clicking. Our role is to determine whether the clicking is a normal movement of the joint or whether it's being caused by an injury requiring treatment.
Key Takeaways
- Painless shoulder clicking is usually normal.
- Clicking with pain may indicate an underlying shoulder injury.
- Rotator cuff injuries, bursitis and labral tears can all cause painful clicking.
- A thorough assessment is often more useful than imaging alone.
- Physiotherapy can address the underlying cause and improve shoulder function.
What causes shoulder clicking?
The shoulder is a complex joint made up of muscles, tendons, ligaments and cartilage working together. Clicking can occur when one of these structures moves over another during shoulder movement.
Common causes include:
- Tendons moving over bony structures
- Rotator cuff tendinopathy
- Shoulder bursitis
- Labral injuries
- Shoulder instability
- Tight muscles around the shoulder
- Shoulder arthritis
In many people, clicking occurs simply because of normal movement within the joint and isn't associated with any damage.
What are the symptoms of shoulder clicking?
People commonly experience:
- When lifting the arm overhead
- During bench press or overhead press
- While swimming or throwing
- Reaching behind your back
- During shoulder rotations
If the clicking is painless and doesn't affect your strength or movement, it's often considered a normal finding.
However, clicking associated with pain, catching, locking or a feeling that the shoulder is slipping should be assessed.
When should I see a physiotherapist?
It's worth booking an assessment if:
- Clicking is accompanied by pain.
- Your shoulder feels unstable.
- You're losing strength.
- The shoulder catches or locks.
- Symptoms developed following an injury.
- Clicking is affecting your ability to exercise or work.
A physiotherapy assessment helps determine whether the clicking is harmless or related to an underlying shoulder condition.
Do I need imaging?
Usually, no.
Many people with shoulder clicking don't require imaging.
An MRI or ultrasound may be recommended if:
- A labral injury is suspected.
- The shoulder repeatedly dislocates or feels unstable.
- There is significant weakness.
- Symptoms fail to improve with rehabilitation.
Imaging should always be interpreted alongside your symptoms and clinical examination.
How is shoulder clicking treated?
Treatment depends on the cause of the clicking.
If the clicking is painless, treatment may not be required.
Treatment usually includes:
Education
Understanding why your shoulder is clicking and whether it's something that requires treatment.
Load Management
Temporarily modifying aggravating activities while symptoms settle.
Progressive Strengthening
Improving rotator cuff strength and shoulder blade control helps improve shoulder stability and often reduces painful clicking.
Return to Activity
Gradually returning to work, sport and gym exercises as shoulder strength and confidence improve.
The goal is to improve how the shoulder functions rather than simply eliminating the clicking.
Can I keep exercising?
Usually, yes.
If your shoulder clicks without pain, it's generally safe to continue exercising.
If clicking is painful, certain exercises may need temporary modification while rehabilitation is underway.
Your physiotherapist will advise which movements are appropriate and how to safely progress your training.
How long does recovery take?
Recovery depends on the underlying cause of your symptoms.
