Shoulder pain with crunching

The rotator cuff is a common source of pain in the shoulder. Pain can be the result of Tendinitis or the rotator cuff tendons can be irritated or damaged. Bursitis is also common. The bursa can become inflamed and swell with fluid causing pain.

When you raise your arm, the space between the acromion and rotator cuff narrows and the acromion can rub against (or “impinge” on) the tendon and the bursa, causing irritation and pain.

The quadrangular space is an intersection of the triceps muscle, the teres major and teres minor muscles and subscapularis. The axillary nerve gets caught in a “traffic jam” between the muscles causing limited movement from sore, tight muscles. Heat may temporarily alleviate pain but produce more swelling, further limiting motion. If ice is tolerable, it is the preferred choice for any swelling in the body.

Crepitus is the medical term used to describe a grinding, crackling or grating sensation and/or sound in the body. It is most commonly used to describe joint cracking, such as knee joint cracking or grinding.

Crepitus is a prominent symptom of arthritis and particularly common in arthritis of the knee joint. This symptom occurs because as arthritis causes the cartilage in the affected joint to degenerate, the cushioning function of the cartilage is lost and the bones tend to grind against one another.

If this is occurring in both shoulders, likely your neck and thoracic spine are playing a big role in the pain and numbness going down into your hands. It is possible that the biomechanics of your shoulders are exacerbating muscle tension, restricting nerves contributing to the sensations you have.

Often, tight pectoral muscles, both the pectoral minor and pectoral major, can pull your shoulders forward, throwing off the mechanics of all the other muscles, creating a tight capsule of the shoulder joint. I have seen this in my clinic where it presents similar to arthritis, however slow and gentle pectoral stretches, and eventually stretching the latissimus dorsi muscles will begin to alleviate the snapping, crackling and popping. Another muscle that should be looked at with similar problems would be the levator scapulae muscle which affects both your neck and shoulder biomechanics.

At the Healing Center of Scottsdale, we offer a unique treatment program with the ATM2 device. ATM2 stands for Active Therapeutic Movement which is based off of Mulligan theory, a joint mobilization technique.

Jeff Juraska, PT

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