Causes of Shoulder Pain and Popping

Causes of Shoulder Pain and Popping

Have you ever wondered why your shoulder pops?

I get this question quite a lot.  There are several reasons for this very common issue. Unlike the hip where the socket is deep, in the shoulder the its very shallow, more of a slightly concave surface. Because of this layout the shoulder is a complex and inherently “unstable” joint meaning that without the muscles and ligaments it would completely dislocate. While this gives us a lot of motion to do thinks like throw it comes with a price.

It is comprised of bone, ligaments, cartilage, and tendons that allow for the ease of movement in so many different directions.  This is also why the shoulder is a commonly injured joint that results in pain.

Before assuming the worst, ask yourself…

  • Is the popping painful?
  • Has there been a recent injury of the shoulder resulting in any shoulder pain?
  • Does my shoulder feel stable?
  • Is it accompanied by any weakness?

Clicking and popping may occur for many reasons.  If it is painless, it can be just a harmless joint noise known as crepitus.  But if it is associated with pain it may be due to soft tissue damage or degenerative arthritis from years of wear and tear.  This occurs when the cartilage that protects the bone has worn down and is now rough.  The joint is no longer smooth and increased friction can develop making the joint rub together like two pieces of sand paper.  The result is increased joint inflammation and shoulder pain.  If left untreated, it can continue to progress causing loss of motion, strength, and eventually inability to use the arm.

Sometimes clicking and popping can be due to repetitive over use of the shoulder resulting in bursitis and tendinitis.  These conditions occur from too much of the same activity that causes swelling in bursa and rotator cuff tendons.  The bursae are fluid filled sacs that cushions the shoulder.  The tendons are the cords that connect the muscle to the bone. The rotator cuff tendons become worn down slowly over time much like the sole of a shoe that eventually wears apart.  If left untreated, the result is a tearing of the rotator cuff tendon causing increased pain, inability to sleep, lost motion, decreased strength, and inability to use the arm with many daily activities.

 

 

Shoulder pain and impingement occurs when the space between the top of the shoulder blade (called the acromion) and the top of the upper arm bone (called the head of the humerus) is narrowed due to swelling and inflammation.  This causes a pinching of the rotator cuff tendons and bursa.  If left untreated, this too can lead to fraying or tearing of the rotator cuff tendons and lost function in the shoulder.

Shoulder instability occurs when the head of the upper arm bone (humerus) moves too much in relation to the socket.  In many cases, the ligaments which hold the bones together are too loose.  This laxity can be genetic or traumatic in origin.  The result is additional damage to the cartilage (labrum) of the shoulder and increased pain and weakness.  If left untreated, the episodes can increase in severity and frequency.  This can cause increase your risk of developing arthritis.

 

Treatment of Shoulder Pain & Popping

 

 

One of our licensed physical therapists will perform an initial examination to identify the cause of the pain.  At Synergy  Physical Therapy and Wellness, one of our main goals is teaching our patients with shoulder pain how to address the issue to find a permanent solution whenever possible.  Several tests are performed to identify the problematic areas in strength, flexibility, and muscle function.

  1. Protection of the shoulder can be necessary to prevent further damage. This may include rest for a period of time and education about activities and movements to avoid.
  2. Flexibility activities to increase mobility without pain or discomfort are included. These should be gentle and progressive with emphasis on proper mechanics of the shoulder.
  3. Progressive strengthening exercises for different muscle groups. Examples include specific rotator cuff exercises and shoulder blade strengthening (known as scapular stabilization).
  4. Advanced techniques such as massage, mobilizations, manual therapy under the expert supervision of the physical therapist can be effective ways to decrease shoulder pain.

In addition to the above treatments, Synergy Physical Therapy & Wellness and Wellness utilizes Microcurrent Point Stimulation and the ML830 Cold Laser.

Microcurrent Point Stimulation is a highly effective tool to relieve  pain. It uses very low levels of therapeutic energy applied to specific points in the body to instantly relief pain. This is the complete opposite of “TENS” which in my experience only results in very short term pan relief if any relief at all. This is important because effective pain relief makes everything else we do such as movements, hands on therapy and stretching, much easier and effective. CLICK HERE TO LEARN MORE

The 830Laser uses light energy to decrease pain, decrease inflammation and increase tissue healing.  This treatment does not wear off like heat, ice, or medications.  If you don’t re-injure the area, the pain should not return. Our clinic.

The first step is to educate you in methods  to help yourself through activity modification and joint protection followed by exercises and hands on techniques to permanently alleviate your pain.  We are experts in how to deal with shoulder pain and popping. This is a problem we deal with on a regular basis with a very high success rate.

At Synergy Physical Therapy & Wellness and Wellness, we are committed to helping you live a healthy and pain free life.   We always work closely with your physician and insurance company to make sure you have the best care available.  Be wary of other physical therapy clinics who use treatments such as heat, ice, and ultrasound as these treatments do not address the root cause of the shoulder pain and problem and wear off.

As we age, maintaining health and independence becomes a top priority. Strength training, a type of resistance exercise often overshadowed by cardio or flexibility exercises, is a cornerstone of healthy aging. Whether you’re in your 30s or 80s, incorporating strength training into your routine can help you live a longer, more vibrant life. Here’s why everyone needs to embrace strength training and how to overcome common barriers to getting started.

1. Avoiding Frailty

Frailty, marked by reduced strength, endurance, and physical function, is a growing concern with age. According to the National Institute on Aging, frailty increases the risk of falls, disability, and hospitalization. For women, who face a higher risk of osteoporosis, frailty can also lead to fractures with prolonged recovery. Strength training combats frailty by building muscle mass and bone density. 

A 2021 study in the Journal of Clinical Medicine found that resistance training significantly improved muscle strength and reduced frailty markers in older adults. For women, this is especially critical, as stronger muscles and bones reduce the risk of osteoporotic fractures. Exercises like weightlifting, bodyweight workouts, or resistance bands enhance physical resilience, making daily tasks like carrying groceries or climbing stairs safer and easier.

(Want to know more about osteoporosis and PT’s role in it’s prevention and treatment? Check out our previous article for more information: Osteoporosis, Osteopenia, and Physical Therapy

2. Staying Able to Do the Things You Love

Strength training ensures you can keep enjoying activities like gardening, hiking, or playing with grandkids. According to an article in Harvard Health Publishing, muscle strength can begin to decline by about 1-2% per year after age 35 due to sarcopenia, also known as age-related muscle loss. This muscle loss accelerates as our bodies age. This loss can limit your ability to perform daily tasks or pursue hobbies, particularly for women who may experience accelerated muscle loss during menopause due to declining estrogen levels. 

Regular strength training preserves functional capacity, and benefits multiple domains of health. A  2019 study published in Frontiers in Physiology showed that resistance exercise not only improved musculoskeletal health, but also helped patients manage chronic conditions like cardiovascular disease and diabetes (Mcleod et al., 2019). Older adults who participated consistently in resistance strength exercise maintained better mobility, overall health, and independence than those who did not. Additionally, the same study found that those using light weight or only body weight while strength training was just as effective as heavy weights (McLeod et al., 2019). The most important factor of strength training for healthy aging is finding a routine that is suited to your body and your ability. A consultation with a physical therapist can help you find the right routine and guide you through proper exercise form to ensure your exercise is preventing injury, not causing it.  Strength training empowers you to stay active, healthy, and independent.

3. More Muscle Mass Equals Improved Blood Sugar Control

Building muscle isn’t just about strength—it’s about metabolic health. Muscle tissue helps regulate blood sugar by improving insulin sensitivity, which is vital for preventing or managing type 2 diabetes, a condition more prevalent with age (Mcleod et al., 2019). Increased muscle mass enhances glucose uptake, reducing blood sugar spikes. This is particularly important for women, who may face increased risks for diabetes complications. Researchers have found that  resistance training improved glycemic control in older adults with type 2 diabetes (Mcleod et al., 2019). In their review of resistance exercise and blood sugar management, resistance exercise performed for 8 weeks resulted in clinical improvements in A1C management and improvements in insulin resistance. These findings are relevant not just to individuals living with diabetes, but also those with insulin resistance, metabolic disorders, or a family history of diabetes. More muscle mass means greater glucose storage capacity, supporting overall metabolic health. Even moderate strength training, like lifting weights twice a week, can make a significant difference.

Common Barriers to Starting Strength Training

Despite its benefits, many hesitate to start strength training. Here are common barriers and solutions:

  • Lack of Knowledge: Many feel intimidated by unfamiliar exercises. 
    • Solution: Start with simple bodyweight moves like squats or push-ups. Online resources from the American Council on Exercise (ACE) offer free beginner guides, or consult a certified personal trainer for a tailored program.
  • Fear of Injury: Older adults, especially women with lower bone density, may worry about getting hurt. 
    • Solution: Begin with low weights or resistance bands under professional guidance. A 2018 study in Journal of Strength and Conditioning Research confirms supervised strength training is safe and effective for all ages when done correctly.
  • Time Constraints: Busy schedules can make exercise feel daunting. 
    • Solution: Short, 20-minute strength workouts 2-3 times per week still deliver impactful benefits, per American College of Sports Medicine guidelines.
  • Gym Intimidation: Gyms can feel overwhelming for beginners. 
    • Solution: Try home workouts with minimal equipment or join small group classes for older adults, which foster a supportive environment. Women-only classes can also provide a comfortable starting point.

Getting Started with Strength Training

To reap the benefits, aim for 3 sessions per week. Focus on compound movements—exercises that work multiple muscle groups at once, like squats, deadlifts, lunges, assisted pull-ups, and pushing-pressing motions. These maximize efficiency and functional strength. Start with light weights, resistance bands, or bodyweight exercises, gradually increasing intensity.

Safety Tip: Deadlifts, a powerful and functional movement, we commonly integrate this into out-patient rehabilitation strategy, but it does require proper technique to avoid injury. Begin with no weight, using a broomstick or similar tool to master form under a skilled coach’s guidance before adding weight. This is especially important to protect against lower back strain or injury.

Always consult a healthcare provider before starting a new exercise program, especially if you have chronic conditions like osteoporosis, chronic low back pain or shoulder problems. If you do struggle with any of these, one of our physical therapists can design a program tailored to your needs, and we’re here to support you every step of the way. If you are free from chronic conditions or pain a skilled coach or trainer can also be a great fit to get you started safely.

Strength training isn’t just for bodybuilders—it’s for everyone who values aging gracefully, staying active, and feeling their best. By building strength now, you’re investing in a healthier, more independent future.

References:

Harvard Health. (2023, February 14). Age and muscle loss. https://www.health.harvard.edu/exercise-and-fitness/age-and-muscle-loss

Mcleod, J. C., Stokes, T., & Phillips, S. M. (2019). Resistance Exercise training as a primary Countermeasure to Age-Related Chronic Disease. Frontiers in Physiology, 10. https://doi.org/10.3389/fphys.2019.00645

Talar, K., Hernández-Belmonte, A., Vetrovsky, T., Steffl, M., Kałamacka, E., & Courel-Ibáñez, J. (2021). Benefits of Resistance training in Early and late Stages of Frailty and sarcopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. Journal of Clinical Medicine, 10(8), 1630. https://doi.org/10.3390/jcm10081630

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