Shoulder clicking or popping is common but can be somewhat unsettling. The shoulder is complex consisting of multiple muscles, joints, tendons, ligaments, and bursa. So, the cause of clicking or popping can be varied. So, what are the possible causes of shoulder clicking or popping, and when should you worry? Is shoulder clicking and pain more concerning?

The most common cause of shoulder clicking or popping

Generally, clicking or popping without pain is often harmless. Scientists have found that the most common cause of clicking in joints is the bursting of gas bubbles in the joint fluid as the joint moves. Also, as we age, the joint surfaces become a little less smooth, meaning they rub against each other with movement leading to clicking, popping, or cracking. But, overall, painless clicking or popping can usually be ignored.

Cause of painful clicking or popping shoulder 

However, if you have painful clicking or popping, you need a more specific diagnosis:

Snapping biceps tendon 

biceps tendonitis shoulder

The biceps muscle forms two tendons close to the shoulder – the long and short heads. The long head passes through a narrow groove before entering the shoulder joint. Overuse can cause inflammation of the biceps tendon leading to pain and grinding as you move your shoulder. In addition, the biceps tendon may become unstable and move out of the groove, causing snapping or popping.

Generally, biceps tendonitis is treated with anti-inflammatory measures, rehab, and injections. A Snapping biceps tendon causing pain might need surgery to stop it from dislocating from the groove.

Rotator cuff problems

rotator cuff injury

Rotator cuff tendonitis can lead to subacromial bursitis. So, moving the arm upwards above the head can cause rubbing of the bursa against the bony acromion, causing clicking or grinding. Also, if a rotator cuff tendon tears, loose ends of the tendon can rub against the shoulder ligaments or cartilage, leading to popping or clicking.

Treatment of rotator cuff problems can vary depending on whether you have tendonitis or a tear. For example, rotator cuff tendonitis will respond to rehab and an injection, whereas a full rotator cuff tear might need surgery.

Shoulder labral tear

Trauma to the shoulder, either through a fall or shoulder dislocation, can damage the cartilage lining or labrum. Damage to the labrum leads to loosening of the shoulder joint, meaning the ball of the joint can move forwards or backward over the edge of the socket. When the ball falls back into place, it causes a pop or snaps, often with pain. A SLAP tear is a special type of labral tear located at the top of the shoulder joint. While SLAP tears don’t often produce overt instability, it usually causes popping or snapping.

Treatment of labral tears varies depending on the severity of symptoms and the location and extent of the labral tear. In mild cases, rehab can help prevent movement. However, a surgical repair might be needed in more severe cases (such as recurrent subluxation or dislocation).

Shoulder arthritis 

shoulder arthritis

Shoulder joint arthritis means roughing and loss of the cartilage surface. Movement of the shoulder leads to rubbing of the surfaces causing clicking or popping. In some cases of shoulder arthritis, loose bodies form in the joint. These loose bodies can prevent normal movement of the joint producing mechanical symptoms such as popping, clicking, or catching.

Treatment of shoulder arthritis includes medication, rehab, and injeciton therapy.

Acromioclavicular joint swelling or arthritis

Pathology in the acromioclavicular joint can lead to shoulder clicking. First, trauma to the joint after falling onto an outstretched hand can lead to tearing of the ligaments and rupturing of the AC joint meniscus. Second, young people who like lifting heavy weights at the gym can lead to distal clavicular osteolysis, which can produce clicking. Finally, older people develop AC joint arthritis causing a grinding or popping with the movement of the shoulder.

Snapping shoulder blade

Sometimes, snapping or popping can arise from the shoulder blade or scapula. In addition, overuse from overhead activities such as swimming, weight training, or baseball can lead to swelling of the small sac or bursa between the shoulder blade and the rib cage.

Ususally, we recommend an MRI scan of the scapula to exclude rare causes of a snapping shoulder blade such as osteochondroma.

Generally, treatment is rehab based. Sometimes, we use injections into the bursa to help with pain and snapping.

When to see a doctor about shoulder clicking

If you have pain or developed shoulder clicking or popping after a fall or injury, we suggest you see a specialist doctor. They will assess your shoulder and perform further imaging such as an X-ray, dynamic ultrasound, or MRI. These investigations will often clarify the cause and direct treatment appropriately.

Frequently asked questions about shoulder clicking and pain:

Can shoulder bursitis cause clicking?  

Yes. Generally, bursitis is secondary to rotator cuff tendonitis. If the bursa becomes inflamed, shoulder movement can cause a click or pop.

Does frequent clicking or popping of the shoulder lead to further joint damage? 

Not necessarily. Most causes of painless clicking are due to the bursting of gas bubbles in the joint with the movement of the shoulder. However, some reasons, such as a labral tear, can lead to movement of the shoulder, which could precipitate further damage.

Final word from Sportdoctorlondon regarding shoulder clicking 

Most cases of shoulder clicking, popping, or grinding is harmless. However, if you get pain with these symptoms, we suggest you see a specialist sports doctor who can assess your shoulder, clarify the diagnosis and recommend the appropriate treatment.

Related conditions: 

Dr. Masci is a specialist sport doctor in London. 

He specialises in muscle, tendon and joint injuries.