Shoulder clicking

[madiyaan]

Hello all:

About myself: reasonably atheletic 24 year old male.

My shoulder started clicking about 8 months back (perhaps it was clicking even before that, but I started noticing it at that time). There was no pain associated. I did suffer from two neck cricks around that time, which got over in 2 days each. One of the neck cricks was caused by me sleeping in a weird position, and the other was caused by me trying to do a military press with a lot of weight. In both these neck cricks, I felt pain in my neck and shoulder blade (towards the medial side). There was no audible pop or click.

The shoulder specifically clicks when I have my thumb pointing downwards, and do a lateral raise.

Dumbbell Lateral Raise

The amount of weight does not matter. It even clicks if I have no weight. There is a series of audible clicks sound when the upper arm makes a 120 degrees angle with my torso to about 150 degrees. If I do the same movement (i.e. raise my hands laterally) but start externally rotating my arms so that the thumbs point forward, the clicking sound decreases. If the thumbs are pointing upwards, it completely disappears.

If I instead change my arms so that they are pointing forward and raise my hands, there is no clicking. Moving my arms to my sides and doing raises gradually increases the clicking until the maximum clicking, which happens when my arms are slightly behind me.

I hope this 3D motion of when the clicking happens is clear. Note that there is no pain with the clicking. I did do heavy military and bench pressing around the time the clicking started, so it could be a repetitive injury or something.

There is no clicking in my right shoulder, which is my dominant shoulder.

I went to my GP who told me that "a lot of people have joint clicking" and that if there is no pain, just do rest and it will be fine. I have been resting for a month (normally I do pull ups and push ups daily). Can someone on this forum tell me what I may have? Also, who should I go to for a checkup? A regular doctor, a chiropractor, a sports physician, orthopedic surgeon or physiotherapist? I need to first diagnose the problem and then see my options.

Regards,

[CenteredHealth]

From the description you have given us, it sounds like the joint that is clicking is your AC joint. It is located on top of the shoulder where the clavicle meets the scapula, a search in google will give decent diagrams and descriptions. A simple way to confirm this would be to palpate this joint during the previous described motion and see if it is in fact the joint responsible for the clicking.

Repetitive clicking can be a sign of and may lead to joint dysfunciton down the road. One thing I would suggest is to never perform lateral dumbell raises in the above described mannor (thumbs down). It puts too much stress on the AC joint and the sensitive rotator cuff underneath. There are plenty of safe exercises out there to target specific muscles without risking injury.

As far as weightlifting goes, I would play it conservatively. Powerlifting is by no means the most healthy choice of exercise as it pushes our body's structure to its limits and usually beyond. In my yonger days I was a bodybuilder myself and had sustained several injuries due to overlifting, too much weight, poor lifting mechanics, etc. I would advise perfect to near-perfect form when lifting as this will minimize any potential injury and maximize the effects of the exercise.

To see a Physio or to not to see a Physio, that is the question... There are some who will say that if there is no pain then no, you absolutely do not need to see a Physio for this problem. I am of the philosophy that an ounce of prevention is worth a pound of cure. Therefore, it may not be a bad idea to seek some professional help regarding your shoulder and neck. A Physio skilled in musculoskeletal dysfunctions and who can identify biomechanical and muscular imbalances, may be invaluable in assisting you design an appropriate routine of safe exercises and ones to avoid. Good luck

[thomas bibu]

[b][FONT="Verdana"

Hi dear,

Generally a painless shoulder click rarely indicates a shoulder pathology, though I should confess that a painful click in patients under 25, shoulder clicking is most likely related to instability problems. In normal subjects, even a strong or forceful eccentric contraction of the muscle groups can also produce an audible click.

The 3 common factors of shoulder click are;
a. thickened bursa, b. loose bodies, c. glenoid labral tear.
To ascertain, specialized clinical examination coupled with radiography (X-ray, MRI) is essential.

Since yours is a painless click, I would rather advice you to first seek the help of a professional physiotherapist and look forward to a progressive program of rotator cuff strengthening, stop all the present exercises you do.

Following a 4 to 6 week STRICT exercise regimen, if your shoulder continues to click or tends to become painful, please seek the opinion of an Orthopedic surgeon, trained in shoulder to further assess: clinical/radiological/visual-scopy.

All the best.

Cheers,

Thomas