Crunching sound in shoulder while climbing

Last Friday when I was climbing at an outdoor rock wall, I went to make a move and could hear my right shoulder crunch then my arm fell limp. I spit off, got lowered to the ground, and was already able to move it again. I had a good bit of pain in my outer shoulder, near the joint to my arm. So I stretched it for a few minutes, and had a decent range of motion but not complete range without shooting pain. I ended up belaying for a while and taking a break seemed to help, and I eventually tried the route again and was successful. I belayed a bit more, stretched it a little more, and went to do a different route when I felt it crunch again. It didn't completely go limp this time, but there was enough pain where I let go of the hold. Came back down, and packed it in for the day. I tucked my arm into my shirt to help keep it mostly immobilized, and that seemed to help, and I'm still able to move it, but certain actions cause a lot of pain. These actions include, reaching to the passenger side to roll my window down, putting on deodorant in my left pit, pulling open doors with my right arm, and a few random others.

I planned on going to the doctor's yesterday but got out of work later than expected so I wasn't able to. I'm hopefully going today, as long as work lets me leave on time. I thought I would try to get opinions on how bad my shoulder is here before I head into the doctor's and they do x-rays and tell me I can't climb for two months. Thanks all

Let a real doctor, preferably an orthopedist, diagnose it. You will get a better diagnosis than from a bunch of climbers on the Internet.

Good point. I guess we'll see what the doc says later today.

sounds like a torn labrum, but i'm not a doctor.

Bone spurs in rotator possibly. I have crunching in mine, and it's a torn labral and spurs in the rotator. I have surgery coming up. You probably need to get an MRI to see what's going on. X-rays will show some of what is up; but the MRI tells all. Good luck.

I, too, have the crunching in my shoulder, but I went to go get a diagnosis a month after I started getting the crunching sound with pain. My orthopedic doctor (who luckily is also a climber) didn't even need an MRI to diagnose it as a labrum tear, and the MRI proved his suspicion to be true.

My advice to you: see a doctor, and make sure it's an orthopedic doctor and/or specialist. I went to my PCP first, and my injury was diagnosed as tendonitis. I got two cortisone shots neither of which did anything. I then couldn't handle the pain anymore so I decided to see my orthopedic doctor. I had to decide between surgery and PT, so I endured 3 months of pretty demanding PT. I am so glad I decided to go that route. It really depends on you, though. Surgery was too hard for where I'm at in my life, and considering I'm only 20, I am trying to staying away from surgery until I absolutely need it.

I hope it heals fast whatever it is!

Might be gangrene...

Savvy Buik wrote:I, too, have the crunching in my shoulder, but I went to go get a diagnosis a month after I started getting the crunching sound with pain. My orthopedic doctor (who luckily is also a climber) didn't even need an MRI to diagnose it as a labrum tear, and the MRI proved his suspicion to be true. My advice to you: see a doctor, and make sure it's an orthopedic doctor and/or specialist. I went to my PCP first, and my injury was diagnosed as tendonitis. I got two cortisone shots neither of which did anything. I then couldn't handle the pain anymore so I decided to see my orthopedic doctor. I had to decide between surgery and PT, so I endured 3 months of pretty demanding PT. I am so glad I decided to go that route. It really depends on you, though. Surgery was too hard for where I'm at in my life, and considering I'm only 20, I am trying to staying away from surgery until I absolutely need it. I hope it heals fast whatever it is!

Thanks Savvy, instead of just going to the urgicare place I'll find an orthopedic doctor to have them look at it. I'm only 24 so I'm trying to avoid surgery as well.

Morgan Patterson wrote:Might be gangrene...

Yessss, I'm gunna die...

Q-man wrote:Bone spurs in rotator possibly. I have crunching in mine, and it's a torn labral and spurs in the rotator. I have surgery coming up. You probably need to get an MRI to see what's going on. X-rays will show some of what is up; but the MRI tells all. Good luck.

maybe, my Doc didn't need an MRI either. She heard my history, felt the shoulder and said "It's to be expected for you"

john strand wrote: maybe, my Doc didn't need an MRI either. She heard my history, felt the shoulder and said "It's to be expected for you"

Similar experience. The (useless) General Practitioner I went to concluded with an analysis "Shoulder pain in a climber" - the "not surprising" was inferred. With a treatment plan of rest for a month and 2400mg if Ibu a day. Didn't help. Finally the not-a-climber but very sports orientated ortho I saw correctly diagnosed the fully torn tendons which an MRI confirmed. Because of the full tear and associated separation surgery was my only really viable option. It worked and has hold up so far for 4 years on my right shoulder. Very similar experience 2 years ago on my left shoulder. Along with several other joint injuries that the GP's and urgent care guys completely mis-diagnosed. So my personal suggestion is to skip the GP and go straight to a specialist. Of course insurance along with finding the right specialist makes this not an easy task.

I did a similar thing last November. My advice would be go to a doctor sooner rather than later even if it doesn't hurt that much. It took me until about two months ago to find a physical therapist that was actually able to help after several unsuccessful bouts of physical therapy and a cortisone shot. Now I have about 85% functionality compared to pre injury and that was 9 months ago.

So a quick follow up. I went to the express care clinic my hospital has, and got a shoulder x-ray. They couldn't find anything, but recommended me for physical therapy and 600mg of ibuprofen. In order to get an MRI, there's about 6 hoops I had to jump through to get one, each one taking more than a week each to get through. So I simply took a month off from really climbing, no regular gym, taking it easy at work, etc. and it's been getting better. I'm not 100%, as my range of motion without pain is a little limited, and I have to sleep in some awkward positions (on my stomach with my right arm tucked underneath me) but I've been able to do a few boulder routes without it hurting. This weekend my girlfriend and I are returning to the outdoor wall where I got injured for some payback, and I'm hoping I can get through the day without tearing apart my shoulder. If something happens I will go and get the MRI.

Seth Jones wrote: +1 Been there and it was the motions that you describe that gave me the most trouble. Edit: It doesn't sound like yours is nearly as bad as mine was but on a side note, if you go to a chiro surgeon for an opinion, keep in mind that cutters like to cut. I had 2 docs tell me I needed surgery but found a third that recommended PT for a few months before considering surgery. I did the PT and got my shoulder back to 95% which is better than it would have been after a surgery. I've had lots of bad luck dealing with shitty doctors so do some research and get several opinions before going under the knife.

I'm going to do everything I can to keep from not working as I'm in the hiring process of several police departments and me showing up to interviews with a cast on and saying that I can perform all the physical demands of a police officer will not look so good. Also I haven't been climbing long, so I just want to get better at it without having an injury slow down that process.

Interesting this came back up today. I go to see an ortho tomorrow for my left shoulder issues. Of course, being the doom-and-gloom person that I am, I'm assuming the worst and I have some sort of connective tissue trauma requiring surgery.

Sorry to highjack, but maybe OP has some of these issues as well.

For anyone interested in armchair diagnosing, my symptoms/characteristics are these...

1) Full range of motion, at least as far as I can tell.

2) No instability, at least as far as I can tell. Hold on to this for a moment.

3) Prominent "pop" when I do a palm-down (exclusively) front shoulder raise; no pain or discomfort, just annoying and inconsistent with right arm.

4) Crunching/grinding/popping when I do a palm-down (exclusively) side lateral raise/abduct; dull tenderness through a vary narrow arc, I'd say between 90 and 110 degrees. Hard to notice the tenderness.

5) Tenderness when I rotate my shoulder back, again through a very narrow arc, somewhere between 7- and 8 o'clock.

6) Tenderness during hard gaston in same narrow arc as #5 above.

7) The greatest sensation of pain/discomfort is when I lie on my right side and do a left arm raise somewhere between straight out to the front and directly to the side.

Forgive the following engine analogy, but I don't know how to describe it another way...

In either case of experiencing tenderness when I rotate my arm up, the sensation reminds of a camshaft's rotation against a valve. The tension, if you will, starts, then increases exponentially (for want of a better term), then disappears just after peak "tension".

Would this be considered instability? It certainly doesn't feel like it's going to dislocate.

I've stopped my shoulder-specific exercises in the gym, but I still climb on it, albeit with great apprehension.

I don't take ibuprofen because there's no general/chronic pain/discomfort, just the tenderness in those very narrow arcs of motion.

Again, ortho appointment tomorrow. Wish me luck! Or don't. I don't really care.

I'll wish you luck,,what's the worst that could happen..?

My shoulder never gave any "feeling" it was going to dislocate either,, but sure enough. it took very specific strengthening and band work ..never happened again

I too wish you luck greggle, I'm jealous you can go straight to an ortho. Certain motions I feel the camshaft analogy you describe, but it's mostly with a reaching back motion, such as grabbing something from my backseat while still in the driver's seat.

#4-5 relate to me, but the rest not really. I hope the ortho helps you out and you're able to avoid serious down time from climbing or surgery.

Seth Jones wrote: My ortho told me that pulling heavy stuff from the back seat while sitting in the drivers seat is one of the most common causes of torn rotator cuffs.

Well that is just some lovely news right there! I do that at least twice daily.

Just to kick in with my situation as well: Pain out near the point of the shoulder when elevating the arm, I thought it was the deltoid. PT correctly identified it as supraspinatus, one of the rotator cuff muscles that's responsible for the first ~20 degrees of elevation before the deltoid takes over. Lifting or carrying something away from me body doesn't work (though if I keep the elbow right against my side it's okay). Also rotations e.g. start with your arm at shoulder height and across your body, try to extend it out and then back against mild resistance.
So we thought it was a muscle tear. Then as it started to get better and I used it more, I realized I was having clicking and crunching noises. Suspecting labrum damage as well, I got an mri. Which says no labrum damage (hurray!) but a bone spur on the underside of the acromium (boo!). The supraspinatus has to run underneath the bone there and it was being impinged. (look up the anatomy if you're interested, too hard to explain over the 'net). Also lots of swelling, etc. So I suspect it will be surgery to clean out the bone spur (got the mri on my GP's order, haven't yet seen the shoulder specialist), but it should be a straightforward recovery.
In my case nsaids help a lot by bringing down the swelling, thus reducing the impingement. But you want to know what's going on; nsaids can inhibit healing of cartilage, tendon, ligament etc.

Eplumer400 wrote:I too wish you luck greggle, I'm jealous you can go straight to an ortho. Certain motions I feel the camshaft analogy you describe, but it's mostly with a reaching back motion, such as grabbing something from my backseat while still in the driver's seat. #4-5 relate to me, but the rest not really. I hope the ortho helps you out and you're able to avoid serious down time from climbing or surgery.

Thanks! Good luck with yours, too. Fingers crossed...

Update...

Went to the ortho this morning. Both he and his PA had me perform various movements under my own power, had me demonstrate the movements described in my lengthy post above, and they also contorted my arm into several awkward positions.

After compressing and probing my shoulder in various places while performing the above he concluded it was likely shoulder impingement syndrome. He busted out one of those fancy pose-able model dealymajiggers (real word, look it up) and showed me what he thought was happening.

He said in the absence of general/ongoing/chronic pain or discomfort, the fact I can sleep on said shoulder just fine (apparently that's a big deal!), no apparent loss of range of motion, and no apparent instability, that he would forego any imaging at this time because 1) X-rays aren't good for imaging muscular and connective tissue, and 2) because of the above there was no compelling pathology to indicate anything beyond an x-ray.

He recommended four weeks of PT, and wrote me a prescription for Naprosyn (NSAID). If there is no improvement at the end of four weeks, we'll do some imaging. So it goes, apparently. I'll update as necessary...

Good luck!

Glad to hear he doesn't seem it's too bad.