Why Strength Training, Not Surgery, Is the Solution to Shoulder Clicking and Popping
If you have snapping, popping, and other cracking noises in your shoulders, you might be wondering what’s causing these sounds and what you can do to get rid of them.
People often get worried when they start experiencing clicks in their shoulders. They sometimes read stories about how the source of the clicking could be labrum tears, inflamed tendons, damaged muscles, etc.—all things that sound very serious and involved to fix.
First of all, you don't need to worry. Even babies get popping and snapping in their shoulders. As a newborn, my son had audible noises come from his shoulders - but they were not at all a sign of joint problems. And he STILL gets occasional noises!
What most people (including many doctors) don’t know though is that poor positioning of your shoulder blades can lead to plenty of sound effects in your shoulders—and can be solved with some basic strength training.
What’s the medical consensus on snapping and popping in the shoulders?
The great news is that many medical sources will reassure you that snapping and popping in your shoulders is not something you need to worry much about. You don’t need to rush to the emergency room, and you don’t need treatment.
However, if you’re trying to get rid of annoying snapping and popping, you’re left wondering, “Can I stop the snapping and popping in my shoulders?” “What exercises can I do?!”
There’s typically not much medical guidance on that. Docs have a lot to do, and taking time to solve a non-life-threatening issue isn’t always a high priority. The good news is you know it’s nothing major and we’re going to get into some ideas to help you train your shoulders to make less noise later.
On the flip side, if you seek medical attention and you end up getting an MRI done to “find the cause” of the problem, you may find yourself getting a surgical recommendation. The most frequently cited and unfortunately most disturbing explanation offered by doctors is that popping and snapping is a result of a labrum tear in the shoulder joint.
The labrum is a little rubbery disc that sits between the head of the arm bone (the humerus), the ball, and the roundish/flat surface it sits in the socket (the glenoid fossa of the scapula). It is believed to be extremely important for stability of the shoulder joint.
For many years, repairing tears in the labrum has been considered the most obvious course of action when someone complains of problems in the shoulder.
That makes a non-issue into a really big invasive and expensive issue very quickly. Before you go down THAT road, though, let’s look at whether labrum tears could actually be the problem, what else might be causing your shoulder pops and snaps, and then what you can do cheaply and safely to help yourself.
Do shoulder labrum tears cause clicking in the shoulders?
What patients may not realize is that the evidence that labral tears are the cause of these symptoms is pretty weak. And this is actually a common story with many orthopedic surgeries.
The most frequently cited and unfortunately most disturbing explanation offered is that popping and snapping is a result of a labral tear in the shoulder joint.
In fact, there’s a long list of orthopedic surgeries that have been shown to be nothing more than expensive placebos offered by well-meaning surgeons (with much higher rates of complication than an innocuous sugar pill).
For a good book on this, I strongly recommend reading Surgery, The Ultimate Placebo: A Surgeon Cuts through the Evidence. Surgery to correct knee pain by addressing meniscus tears and spinal fusions for back pain are a couple examples of surgeries that enjoyed strong support from the medical community for a while and fell out of favor when further research showed that they were basically no better than placebo.
I would suggest that shoulder labral tear surgery is highly likely to be another one of those cases. You can read more about shoulder labral tears here.
Mechanically, it's unlikely that shoulder labrum tears cause clicking and snapping.
The most obvious reason I highly doubt labral tears are the primary cause (or even a cause) of clicking in the shoulder is from a basic observation about the anatomy involved and from the sounds we’re talking about.
Let’s start with the sounds. How do you create a click or a snapping sound? A click is easy, right? You knock two stiff objects together. Depending on their density, they will make clicks of varying pitch. It could be a low “clunk” or a higher “click.”
How do you create a snapping sound? Well, you can snap your fingers pretty well, can’t you? You compress your fingers together quite hard and then move them apart to create friction between the surfaces. As they slide apart, you hear the snap. So in the end, we have three ways to generate our snaps and clicks.
One involves two stiff things knocking together. One involves a compression and friction.
Can a labrum generate a pop or snap?
The labrum, as you recall from a few paragraphs ago, is a rubbery disc.
It’s not a hard, stiff object. It’s also tiny and not subject to massive compression when you’re sitting at your computer doing a shrugging motion to test for sound effects.
Based on those two observations alone, we can basically rule it out as being a generator of the clicks and snaps.
In this video, I talk more in detail about snapping and popping in the hips and shoulders and give you a visual explanation of what we just talked about.
Basically, if the labrum is just a soft rubbery disc, it seems highly unlikely that it is responsible for generating popping and snapping. Even if it’s torn and there’s a loose flap, how exactly do we think that this rubbery flap generates audible snapping and popping sounds in the shoulder?
5 Different kinds of shoulder pops and snaps
In my experience pop and snaps can happen all around the shoulder joint and upper back. Funny story: one time, a Rolfer (think of this as a massage therapist who’s obsessed with posture) was working on my chest and anterior shoulder muscles. He snuck his fingers under my pecs and lifted the pec minor up and away from the ribs. There was a loud and audible POP!
We both found it a little disturbing—neither of us having ever heard something so loud come from directly out of a muscle. It felt as if the muscle had been stuck to my rib cage.
This experience and other similar ones make me think pops can also be the result of muscle tissue becoming “unstuck/unglued” from bones or other tendons. Of course I have no way to verify that until I can get my hands on some expensive medical devices or someone else starts doing some medical research on the topic (though, I feel like this should be pretty low on society’s medical research priority list), but there was no way it was a labrum, and there was no way it was from within the shoulder joint! Here are a few of the different places I’ve experienced shoulder pops, clicks, snaps:
1. Front of the shoulder
Sometimes I’ll get one or two loud pops or snaps in the front of the shoulder, near the anterior deltoid and pec major and pec minor attachments. Those are generally louder and have a satisfying sense of tension release. Having experienced this at least hundreds of times, at this point I can tell that this is from muscle tension build up from being at the computer for long periods.
2. Back of the shoulder
My old pops and snaps were awful, particularly on the right shoulder. Just the motion of lifting my hand and arm out to the side would result in a locking sensation at about 45 degrees. I’d have to force my way through that angle, resulting in a painful, often low-toned clunk. At higher angles, I’d also get snapping in the back of the shoulder. It was like my rotator cuff muscles were getting caught up on the scapula or on one another.
3. Inside of the shoulder
When lying on my right side, I used to get grinding sensations (not pops or snaps) at the inside of my shoulder joint.
4. In or near shoulder joint
With the sounds near the actual shoulder joint, I believe it’s tendons rubbing up against bone and other tendons.
5. Top of the shoulder blade or between the shoulder blades
If you get noises near the top of the shoulder blade or between the shoulder blades, it’s from the scapulae actually rubbing against the ribs and/or tendons around the scapulae.
2 Keys to getting rid of shoulder pops & snaps
This is the big question for people with popping and snapping in the shoulders: How do you get rid of it?
1. Keep muscles pliable with self-massage.
When your shoulders are NOT aligned well, popping and snapping is the norm. Making sure you keep muscles pliable helps maintain good alignment. Doing that requires you to put in a little maintenance work with self-massage techniques. This is particularly important if you are someone who trains a lot.
2. Build strength and control around shoulders and thoracic spine.
The other key is learning to control your thoracic spine, shoulder blade, and shoulder joint properly. You need to have good strength and coordination all around those areas to ensure smooth overall movement with a minimum of popping and snapping.
When you have trained the muscles of the shoulder to allow for good, smooth movement, the popping and snapping is transitory and is not accompanied by pain. These kind of noises do generally go away as the muscles that control the shoulder blades get used to moving the shoulder blades along an efficient path.
What kinds of exercises can you do to improve your shoulder joint positioning?
We get a lot of clients who have issues with popping and snapping in the shoulder. It’s pretty common, so it’s important to remember that it’s not a sign that you’re hopelessly broken.
One of the first steps is to start restoring your ability to control your shoulder blades. The most common missing ability for the average office worker is scapular retraction, and that’s the one I would generally focus on first. There’s a lot of bang for the buck when you improve scapular retraction.
What if the shoulder snaps and pops still don’t go away?
If they don’t go away with increased strength training and massage, there’s often too much kyphosis (c-curve) or possibly rotation in the thoracic spine. That can cause the shoulder blades to slide in an awkward path over the ribs that guarantees excess friction and poor shoulder kinematics.
If you know you have a ton of kyphosis, check out some of these videos to help you out:
Final words on snapping shoulders
If you’re trying to silence your snapping shoulders, it’s important to do two things.
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Stay calm. It’s highly unlikely surgery is a good answer for the problem. Also, know that you may never get your shoulders TOTALLY silent! Even babies have noise in their shoulders!
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Start experimenting with different exercises to increase overall control of your shoulders. This may mean learning how to retract your scapula. This may mean doing more massage work. This may mean learning how to improve your thoracic kyphosis.
We’ve seen a lot of different kinds of issues in our personal training clients, so we know that there’s a lot of ground for you to cover! Just be patient. Keep exploring and learning how to move and control your shoulders with confidence!
Want some help retraining your shoulders? Check out our program:
