Home > Shoulder Physiotherapy > Blog > Clicking Shoulder Physiotherapy

Clicking Shoulder Physiotherapy

Clicking shoulder is a common complaint with swimmers where the shoulder ‘clicks’ with movement or with load/strain. Clicking shoulders is also common in individuals who engage in activities or sports with lots of overhead arm motion eg:

  • housewives, secretaries
  • sports eg tennis, badminton etc

Inflammation is a symptom and becomes a cause

Clicking shoulder condition is often is misdiagnosed/mistaken as

  • rotator-cuff impingement or
  • tendinitis (inflammation)

But this is just half the story - impingement is a symptom, like inflammation is a symptom.

They're more often than not, NOT causes that led to the inflammation in the first place. You see, rotator-cuff injuries and inflammation can be caused by direct damage or disease in the shoulder such as:

  • torn ligament
  • torn muscle
  • bone spurs that can irritate nearby structures

shoulder Clicking due to Directional Instability

More often than not, inflammation in our rotator cuff is first caused by shoulder joint instability ie -

  • the shoulder (glenohumeral) joint may be too loose in multiple directions (medically termed as multi-directional instability) or
  • loose in a specific direction (medically termed as uni-directional instability).

For multi-directional instability (MDI),

excessive movement of the head of the humerus (the ‘ball’ end of the bone in your  upper arm) which causes it to grind/rub/scrape against the cartilage that helps hold the shoulder joint together (labrum).

Over time, this rubbing and scraping gradually wears out the cartilage and the tendons nearby.

The ‘clicking’ sound  in the shoulder comes from the head of the humerus popping in and out slightly from the shoulder joint.

Multi-direction instability happens due to shoulder capsule laxity and unfortunately is often genetic in nature.

For uni-directional instability (UDI)

this condition is much more common in individuals who participate in lots of overhead throwing sports like badminton, tennis and baseball pitchers, and more often than not, tends to occur in one arm.

The most common direction is for the humerus head to shift/move forward. Unlike multi-directional instability which has genetic dispositions (see left), uni-directional instability is basically caused by a few key muscles losing control of the joint and failing to holding it stable.

In most cases, it is the muscle holding the head of the humerus (subscapularis) that allows the shoulder to roll forward excessively, over-stretching the shoulder joint.

Similar to the case of MDI, the cartilage wears out and nearby tendons get impinged or pressed on.

Is it Multi-Directional Instability or Uni-Directional Instability?

An experienced sports doctor/physician or senior sports physiotherapist will be able to perform a battery of assessments and tests to confirm which diagnosis best describes your specific shoulder problem.

What can we do now?

If the patient/individual needs to work or athletes has to compete or has an upcoming competition, then what we will recommend and focus on for the short term includes physiotherapy interventions such as

Long-term Management for unstable shoulders

For the medium to long-term, we senior physiotherapists will need to correct the issue of shoulder instability by improving the muscular control of the joint and overall body stability.

Muscular control for stability includes and involves BOTH muscle activation as well as strength.

It is vitally important that our muscle can activate at the right timing/time - a strong muscle that does not activate during the right time/timing...unfortunately is not much better than a weak muscle.

The muscle training work will focus on increasing direct control of key stability muscles, which are:

  • Transversus Abdominus for the upper body and general body stability (trunk and core)
  • Lower Trapezius and Serratus Anterior for the scapula (back of shoulder and upper back)
  • Subscapularis for the head of the humerus

Back to Top

book an appointment today
(or check your pains / injuries)

Phoenix Rehab Physio Services

Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.


Patients who sustained injuries to their elbows, forearms, hands, wrists (sprains and fractures) and fingers, usually will benefit / require Hand Therapy to

  1. manage and decrease hand pains
  2. improve range of motion, strength and dexterity
  3. increase the function of their hand following injuries or post-operations

Commonly treated hand pain injuries includes


Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility and breathing.

It is a system of safe and effective exercises, which meet specific individual needs, to treat a wide range of injuries and conditions.

You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.


  • Cupping TCM
  • Auricular Therapy TCM
  • Herbal TCM Medicine & Supplementation


Sports and deep tissue release massage helps to increase nutrient-rich blood flow to tired, tight and tense muscles to accelerate recovery and  shorten downtime / recovery period required.

It also prevents muscles from scar tissue micro-tears (and potential ruptures), and increases muscle performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.

Read the benefits of regular deep tissue release therapy here.


All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).

See our entire team here with introductions and their specializations.

At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.

Follow up sessions are inline to provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.

do Tell Your Family, Friends And Colleagues About Us =)

We appreciate you as our valued clients and want you to know that the # 1 way we grow as a clinic / brand is through word of mouth referrals from valued patients like yourself.

We prefer not to rely on advertising - instead, we prefer and appreciate the goodwill and positive reinforcement from patients. When you have the chance, please tell your family, friends and physicians about the positive results and experience you have had in our physio clinics.

book an appointment today
(or check your pains / injuries)

Recent Articles

  1. Adele Ang Principal Physiotherapist Singapore

    Jun 29, 22 08:32 AM

    Adele is a registered physiotherapist with over 25 years of experience including treating national athletes as well as recreational athletes having worked in Singapore Sports Council and Singapore Spo…

    Read More

  2. Achilles Tendon Pain Physiotherapy

    Feb 03, 22 04:05 AM

    Achilles tendon pain is very common among recreational and elite sportspeople. But it is also common among sedentary individuals

    Read More

  3. Tendonitis Physiotherapy & Hand Therapy

    Feb 03, 22 12:16 AM

    Tendonitis, tendinopathy and tendinosis are all tendon injuries and treated by physiotherapists and hand therapists

    Read More

  4. Cervical Spondylosis Physiotherapy

    Jan 11, 22 02:01 AM

    Cervical spondylosis is a general term to describe the degenerative condition in the neck which results in pain and other symptoms

    Read More

  5. Tendon Pain Tendinopathy Physiotherapy

    Jan 07, 22 12:28 AM

    Tendinopathy (tendon injuries) can develop in any tendon of the body and has many names such as tendinitis and it can be treated with good tendon physiotherapy

    Read More

  6. The importance of staging and compression in tendinopathy physio

    Dec 15, 21 01:47 AM

    Tendon problems are common in runners and can become a persistent issue if not properly treated.

    Read More

  7. Tendon Pain Physiotherapy and Hand Therapy

    Dec 14, 21 11:23 PM

    Pain and pathology in a tendon, known as tendinopathy, is a common injury in athletes that can be difficult to manage. Physio and hand therapy can help healing

    Read More

  8. Tendon Injuries Physiotherapy, Hand Therapy, TCM & Massage

    Dec 07, 21 01:31 AM

    We use the world’s best tendon recovery programs through cutting edge treatment techniques for all tendon injuries (and tendon injuries differ accordingly)

    Read More

  9. Physiotherapy and Hand Therapy at Tampines Singapore

    Nov 28, 21 12:08 AM

    Phoenix Rehab Physiotherapy and Hand Therapy at Tampines Singapore

    Read More

  10. Mallet Finger Tendon Injury Rupture Hand Therapy

    Nov 17, 21 12:30 AM

    Mallet finger is an injury to the thin tendon that straightens the end joint of a finger or thumb.

    Read More