Why Does My Shoulder Pop, Crack and Click?

By Dr. Joseph Mejia, DO, FAAPMR, RMSK
Medical Director, Performance Ortho

In over 15 years of clinic practice treating everything from sports injuries to advanced spine conditions, one of the most common questions I am asked is, “why does my shoulder pop or click?” At Performance Ortho, shoulder conditions are the third most common condition we treat, behind knees and spine.

First, we should define popping or clicking, so we are all on the same page. Medically, this is called crepitus, and it is defined by an audible or tactile sound or sensation with movement of a joint, that can be painful or pain free. Pain free crepitus(popping) is generally benign and could indicate tendon movement or gas being released from the joint, but is not a significant medical concern. Painful crepitus could be a sign of serious shoulder condition that should be properly evaluated, diagnosed and treated.

To understand common shoulder conditions and treatments, it will first be beneficial to have a basic understanding of shoulder anatomy.

The Shoulder Anatomy

The shoulder is not one joint – it is a team of 3 joints working together. Take a look:

• Glenohumeral joint-it is where the upper arm(humerus) fits into the socket of the scapula (shoulder blade), to create a ball and socket joint.
• Acromioclavicular (AC) Joint– it is where the collar bone meets the top of the shoulder blade
• Sternoclavicular (SC) Joint-it is where the collar bone meets the breastbone.

That’s just the bones—add to that a complex network of ligaments, muscles, tendons, and cartilage structures like the labrum. Together, they work in harmony to enable dynamic movement, flexibility, and joint stability, allowing you to perform even the most demanding activities of daily life. A rule of thumb in orthopedics is, joints with a lot of dynamic movement often have high risk of potential injury.

3 Most common Causes of Painful Shoulder Popping

There are many diagnoses and conditions that could result in painful shoulder crepitus (popping). It is not the intent of the article to dive into all, but rather to give the reader a high-level understanding of the most common conditions and when medical intervention is appropriate.

• Damage to tendons or ligaments– tendons connect muscle to bone and ligaments connect bone to bone. When one or more of the rotator cuff tendons becomes inflamed, torn or scared, abnormal movement patterns take root, which over time creates abnormal stress and strain on those structures and ultimately pain, inflammation and crepitus.
• Cartilage Damage or Arthritis– damage to structures inside the joint like joint cartilage or the shoulder labrum results in uneven surfaces that rub together, often creating loose pieces of cartilage that “float” around the joint creating painful clicking and locking.
• Abnormal Joint Instability – When ligaments undergo repeated stress or injury, they can become overstretched, leading to excessive joint movement and instability. Another cause of joint instability is imbalance in the muscles required to properly secure shoulder movements. Weakness in muscles necessary for scapular (shoulder blade) stability are essential for properly functioning rotator cuff muscles. When the shoulder’s ligaments or muscles become weak, the three joints of the shoulder complex can no longer stay properly aligned or move in sync. This instability often leads to excessive movement, resulting in clicking, popping, or clunking sensations.

How is shoulder popping diagnosed?

As with most medical conditions, a thorough patient examination and review of prior injury history is essential. Shoulder evaluation typically includes digital X-rays to assess bone structure and joint alignment, along with diagnostic ultrasound to examine muscles, tendons, ligaments, and cartilage for signs of inflammation, tears, or other damage.

MRI imaging is always beneficial in more advanced cases, but often is not necessary in cases that do not present as complex or severe. At performance Ortho, all diagnostic testing is done in house on your initial visit, expect for MRI, patients will have a clear understanding of the diagnosis and course of action on day one.

Treatment options

Treatment options available to patients range from simple approaches like activity modification to surgery and everything in between. For our purposes, I will discuss the most common and effective non-surgical options to manage painful shoulder crepitus as well as touch on surgical options.

Non-surgical options:

• Rehabilitation– After examination and “clean” imaging of the shoulder, if it is determined that primary driver of painful shoulder crepitus is due to weakness in the shoulder muscles or poor posture, this is considered fairly simple presentation that should respond well to 4-6 weeks of physical or occupational therapy. If the patient fails to progress am MRI of the shoulder may be warranted.
• Regenerative injections-such as platelet-rich plasma (PRP)/ stem cell therapy – Patient that are diagnosed with more complex shoulder conditions like a torn labrum or rotator cuff tendon damage, more advanced non-surgical treatments like regenerative medicine may be a  viable option, to help with joint instability and soft tissue damage. Both PRP and stem cell treatments are proven to reduce inflammation, enhance the body’s natural production of collagen to increase soft tissue strength and repair tears in tendon/ligaments.
• Combination of treatments-For patients that are experienced more complex or chronic conditions a combination for rehabilitation and regenerative injection therapy has proven to be the most effective treatment approach to resolve shoulder pain and return patients to full function.

Surgical Options

Surgical options vary based on patient presentation, overall health of the patient and the patients desire for surgical interventions.

• Arthroscopic Debridement –minimally invasive procedure to “clean” the joint by removing diseased tissue, loose cartilage and scar tissue. Commonly 1-2 months o rehabilitation is prescribed post procedure.
• Arthroscopic Tightening –minimally invasive procedure where the ligaments and other structures are surgically cinched. Typically, more involved than a debridement procedure, requiring generally 2-3 months of rehabilitation.
• Joint Replacement –More advanced procedure, whereby the shoulder joint is replaced with a prosthetic device. This procedure is recommended when the patient has advanced arthritis of the glenohumeral joint (ball and socket). Typically, an extensive procedure with 3-6 months of rehabilitation post operative.

A little bit more about Regenerative Medicine-PRP/Stem Cell

At Performance Ortho, regenerative medicine treatments—such as stem cell therapy and platelet-rich plasma (PRP)—are considered when more conservative options haven’t provided the desired relief. These advanced therapies are often ideal for patients with complex orthopedic conditions who wish to avoid surgery or have been told they are not candidates for surgical intervention.

Stem cell- are adult stem cells derived directly from the patient. These cells have the ability to change into any cell that they are injected to, including cartilage cells.

• Shown to regenerate cartilage
• Reduces inflammation
• Support tissue healing

PRP-derived from a simple blood draw from the patient, prepared and reinjected to injured or damaged tissue, like knee cartilage.

• Causes a release of growth factor in the body
• Provided valuable blood nutrients for cartilage repair
• Reduce swelling, pain and stiffness.

Performance Ortho is a pioneer in the field of Regenerative Medicine, performing over 5,000 stem cell and PRP procedures since 2013.

If you’re struggling with shoulder pain, crepitus or osteoarthritis and want to explore options beyond surgery, our team at Performance Ortho is here to help. Discover how advanced, non-surgical treatments like PRP and stem cell therapy can get you back to doing what you love.

Meet Your Expert: Dr. Joseph Mejia

Dr. Mejia is a triple board-certified specialist in Pain Management, Physical Medicine & Rehabilitation, and Sports Medicine. With over a 15 years of experience, he has helped thousands of patients restore function, reduce pain, and avoid unnecessary surgery.

He currently serves as Medical Director at Performance Ortho, with offices in Watchung, Branchburg, Somerset, and Hillsborough, NJ.

Here’s how to get started:

• Call or Request a Visit-908 756-2424
  Reach our Patient Access Team or use our quick online form to schedule a consult.
• Get a Personalized Evaluation
  We’ll assess your knee health, review past treatments, and explore regenerative options tailored to you.
• Start Moving Again — with Less Pain
  Begin your custom care plan and take the first steps toward restored mobility and lasting relief.