Symptoms

Shoulder cracking; Cracked in the shoulder

Shoulder cracking; Cracked in the shoulder


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Shoulder cracking: causes and treatment

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

Symptoms

Cracking, snapping, rubbing, jumping or crackling noises are referred to as shoulder crackling, which occur in the area of ​​the shoulder during certain movements such as shoulder or arm circles, shoulder lifting or head movements. These noises occur in many people and are usually not of any concern unless they are accompanied by pain or weakness in the arm.

Painful shoulder cracking can occur temporarily or permanently, accompanied by rubbing noises as well as pain and / or restricted movement. Affected people often have problems with everyday activities such as putting on or washing their backs, so that the complaints have a significant impact on the quality of life and are extremely uncomfortable.

Anatomy of the shoulder joint

The shoulder consists of different structures: the clavicles and the shoulder blades together form the shoulder girdle, the shoulder joint itself is formed by the shoulder blade and the humerus. The so-called shoulder roof (acromion) and the raven beak process (coracoid) are part of the shoulder blade as protrusions.

Unlike many other joints, it is not a large number of ligaments in the shoulder joint that provide stability, but rather certain muscles with their tendons, which together are referred to as a 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 leaf muscle). The rotator cuff covers the shoulder joint like a roof.

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

The location and type of noise provide first indications

If cracking noises occur in the area of ​​the shoulder, the cause can affect the tendons, the muscles, the articular cartilage or the bony structures. Shoulder cracking can occur at the level of the shoulder blade, deep in the joint, on the side, in front or on the back. Often the sound is tendon snapping when it occurs on the side or on the back of the shoulder. Then either the external rotators or the supraspinatus tendon, which runs along the side of the upper arm, trigger the noise. The biceps tendon can also be affected if the shoulder crack occurs laterally or in 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 occur relatively frequently and are initially no cause for concern. However, if there are other complaints such as pain and restricted movement, there may 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 wear-related damage that begins, for example, with small tears (ruptures) in the tendon fibers and can lead to complete tendon tear. The rotator cuff, the tendon plate of the shoulder twist and the biceps tendon are particularly affected by the wear. Therefore one speaks of the rotator cuff syndrome or the biceps tendon syndrome. Those affected mostly suffer from pain and restricted movement. Inflammation of the tendons and / or bursae occurs. Limescale deposits or adhesions in the joint can stiffen the shoulder.

Cracking shoulders during fitness training

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

Diagnosis

If there is a crack in the shoulder accompanied by pain and / or restricted movement, a doctor should be consulted. The causes listed here are just a selection of possible triggers for clicking and snapping noises in the shoulder area. In addition, there are numerous other causes that can only be determined or ruled out as part of a medical examination. The doctor first asks questions about the patient's medical history, in order to get an indication of the cause of the symptoms, if necessary, in the case of previous illnesses such as rheumatism. There is also an in-depth examination of the musculoskeletal system and the shoulder. The exact location of the complaints plays an important role.

Further diagnostic methods

As a rule, X-ray images of the shoulder are first created for further examination. Changes in the shoulder blade can be made visible or excluded. Depending on the findings, a computed tomography (CT) and / or magnetic resonance imaging (MRI) can then be carried out. With CT, bony changes such as spurs, curvatures, poorly healed fractures or bone tumors can be detected. The MRI makes it easier to visualize soft tissues. For example, changes in the bursa or soft tissue tumors can be diagnosed. In addition, nerve damage can also be considered as the cause of painful shoulder cracking. These can be recognized by measuring the nerve conduction speed and muscle activity (electrophysiological diagnostics).

Treatment options for shoulder cracking

If there are no side effects such as pain or restricted movement, appropriate exercise 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 if 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 are anti-inflammatory and analgesic medications and a special physiotherapy ("shoulder school") in which those affected learn how to avoid unfavorable, recurring movements and postures or to practice better alternatives. Depending on the cause of the symptoms, shock wave therapy, electrotherapy and acupuncture can be helpful. A visit to the osteopath can also make sense, as he assesses and treats shoulder problems 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. The arthroscopy of the shoulder blade in the context of a shoulder joint mirroring, with which, for example, spurs, lime deposits, bursitis and disruptive scar strands can be removed, is considered a relatively gentle procedure. (ag, vb; updated on January 28, 2019)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Graduate Editor (FH) Volker Blasek, Dr. med. Andreas Schilling

Swell:

  • 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 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 July 9, 2019), MSD
  • Ronald Thomschke: Shoulder-Neck Training, Steffen Verlag, 2nd edition, 2017


Video: Shoulder Pain and Popping SHORT u0026 LONG TERM FIX! (July 2022).


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