After undergoing shoulder surgery, particularly a rotator cuff repair, it’s not uncommon to notice new sensations or
sounds coming from your shoulder joint. One of the most frequently asked questions relates to the clicking and
popping that some people experience post-surgery. As a triple board-certified orthopedic surgeon and sports medicine
specialist, I, Dr. David Guyer, have heard these concerns many times. In this blog, we’ll delve into the possible
causes of these sounds, why they generally aren’t cause for alarm, and when it might be advisable to seek further
medical evaluation. Whether you’re recovering from a procedure or simply curious, understanding these bodily signals
can help set your mind at ease and assist you on your path to recovery.

Understanding Post-Surgery Clicking

Clicking or popping sounds in the shoulder can be unsettling, especially after undergoing surgery. Many patients wonder
if these sounds indicate a problem with their healing process. However, as an orthopedic surgeon, I can assure you
that these sounds are often a normal part of shoulder recovery.

First, it’s essential to understand that clicking and popping can occur in the shoulder joint both before and after
surgery. This type of sound is typically not a major concern for orthopedic surgeons. The shoulder is a complex joint
with many components that work together to provide a wide range of motion. Sometimes, these components move in a way
that produces a sound, which is generally harmless.

Potential Causes of Clicking:

• Inflammation or Thicker Bursa: The bursa, a small fluid-filled sac that acts as a cushion between
  bones and soft tissues, can become inflamed. This inflammation can cause a clicking sound as the shoulder moves.
• Abnormal Mechanics: Post-surgery, the shoulder might be moving awkwardly due to stiffness or muscle
  weakness. This can temporarily alter the mechanics of the joint and lead to clicking sounds.
• Breaking Through Stiffness: After surgery, the shoulder often experiences stiffness. As you regain
  range of motion and flexibility, you might hear popping sounds as the shoulder begins to move more freely.
• Arthritis and Cartilage Wear: Though not usually the case immediately post-surgery, significant
  arthritis or wear and tear on the cartilage lining can sometimes cause clicking sounds.

It’s worth noting that during the surgical procedure, doctors focus on repairing the underlying structural issues
rather than eliminating clicking sounds. It’s not uncommon for these sounds to persist after the surgical intervention.

When to Consult Your Doctor:

While clicking is often benign, there are certain situations where you should consult your doctor:

• Persistent Pain: If the clicking is accompanied by pain that doesn’t improve with time or
  rehabilitation, it may signal a more significant issue.
• Significant Swelling or Redness: These could indicate an infection or other complication that
  requires medical attention.
• Loss of Function: If the clicking is associated with a loss of shoulder function or stability,
  further evaluation is necessary.
• Persisting Sounds: If the clicking persists months into your rehabilitation and is accompanied by
  other symptoms, it might be wise to have an orthopedic evaluation to rule out any complications.

Rehabilitation and Beyond:

During the rehabilitation phase, you might experience muscle weakness and limited motion, contributing to the sounds you
hear. It’s crucial to follow the rehabilitation protocol prescribed by your physical therapist or surgeon to ensure a
smooth recovery.

Here are some general tips to support your recovery and potentially reduce clicking:

• Strengthen Shoulder Muscles: Work with your physical therapist on exercises that target the
  shoulder muscles. Strengthening these can improve joint stability and mechanics.
• Maintain Flexibility: Gentle stretching can help reduce stiffness and improve your shoulder’s range
  of motion.
• Proper Technique: Pay close attention to the techniques you use during exercises or daily
  activities to reduce strain on the shoulder.
• Monitor Progress: Keep track of your progress and make notes of any specific movements that
  trigger clicking. This can help your medical team assess your condition more effectively.

Conclusion:

Experiencing clicking and popping sounds after shoulder surgery, such as a rotator cuff repair, is often not a cause for
alarm. While unsettling, these sounds are typically a normal part of the healing process, indicating that your body is
adapting and recovering. However, if the clicking is persistent and accompanied by other concerning symptoms, don’t
hesitate to seek medical advice for peace of mind and to ensure there are no underlying issues.

Finally, embrace the recovery process with positivity and patience, knowing that your body is working hard to heal and
regain its full function. With proper rehabilitation and care, you can look forward to a strong and sound shoulder in
the months to come.