"Clunking" in collar bone area when I reach forward, one side only .

[Dochaz]

My Dr thinks this is a separate issue from PMR/GCA. But quite often when I reach my arm out to the front, only on the right, there is a kind of clunk or a point of resistance before I can reach out completely. Not painful. Just wondering if it's mechanical or connected to our condition. Left side is ok.

[DorsetLady PMRGCAuk volunteer]

Would say mechanical...and can you pinpoint roughly were it's coming from - shoulder? upper arm ?...

[Dochaz in reply to DorsetLady]

It's intermittent. Shoulder joint, I think but towards the collar bone rather than the outer region. I can hear the clunk!

[DorsetLady PMRGCAuk volunteer in reply to Dochaz]

Sorry - you did say!,,,brain not computing properly... so definitely not rotator cuff area then...which is always my first thought.

Just had a quick look online , but all things seem to mention pain....but this might shed some light - are you sure you haven't strained it/overstretched it?

shoulder-pain-explained.com...

[Dochaz in reply to DorsetLady]

Thanks for the link. Most probably arthritis. No pain, no excess repetitive movements (knitting maybe, but not in excess). I'm just happy it's not PMR-related as I have got back down to 7 mg after a minor flare and am feeling good otherwise.

[PMRpro Ambassador]

I just managed to elicit a clunk from that area when moving my left arm - I suspect the attachments of soft tissue to bone ...

"The clavicle is an S-shaped bone that is anchored by strong ligamentous attachments on both its medial and lateral ends.

Muscular attachments to the clavicle include the sternocleidomastoid, pectoralis major, and subclavius muscles proximally and the deltoid and trapezius muscles distally. "

shown in glorious technicolour here:

anatomyzone.com/upper-limb/...

and lax muscles etc results in shoulder instability

physio.co.uk/what-we-treat/...

"When the arm is placed in certain positions, the bones within the shoulder joint may slip or ‘subluxation’. This is a clunking sensation as the bones within the shoulder joint move excessively on one another. "

If it isn't painful - put it down to advancing age and wear and tear ...

[Dochaz in reply to PMRpro]

Good to know! Thanks ❤️

[Hidden in reply to Dochaz]

I've been experiencing a really bad cracking sound in neck/shoulder area (left side for me) Some days are worse than others....sometimes gives me headaches. Turning my head from left to right is painful too. I don't think it has anything to do with PMR. However, after all this time I decided to get a face to face with doc. I do know I have worn 4 and 5 discs in my neck, from an X-ray taken a few yrs ago. Like PMR has said could be wear and tear. When it cracks I think other people can hear it too.

[Dochaz in reply to Hidden]

I get cracks or popping sounds too, knees too, and I know other people can hear them, but the clunking is different... more an internal sensation and not as "noisy"!Let me know what your doc says!

[MiniSpec in reply to Hidden]

Have you tried seeing a chiropractor? My missus and I both went to see one for a while due to cracking or popping in mainly our neck joints. He told us it was due to pockets of air in the joints, and by clever manipulation he was able to clear these so that the noises went away, and turning our heads became quieter and less painful.

[Hidden in reply to MiniSpec]

Problem is finding a good one. My friends son many yrs ago had to see one....completely messed him up and needed 3 lots of surgery on his neck.

[MiniSpec in reply to Hidden]

Oh dear! I hope your friend's son reported him to the authorities for the damage done? Did he also sue the practitioner for compensation?

[Hidden in reply to MiniSpec]

He had to sign a disclaimer, so got nothing. Really good job with HSBC in Hong Kong at the time, so company's insurance paid for his surgery. He still suffers to this day as surgery was done out there.

[Blearyeyed]

As an experienced " clunker" ( I have Ehlers Danlos Syndrome) it does sound like laxity , or less elasticity in the joint , especially if their is no pain.In fact , I found more of my " clunks" returned when I was in control of my inflammation but still taking steroids , which can make joints more lax because of the effect on collagen production making tendons less elastic , and muscle mass is lower , which can also happen as you are less active with PMR.

It's worth requesting an x-ray if this is new to you , just to make sure there isn't any misalignment in the shoulder area , neck and upper spinal column.

If not , be mindful about how you do the movement to reduce the " clunk" to prevent the chance of pinching a nerve. That would feel like a quick twinge or split second of pain.

Yet , rather than being inactive, one of the best things to do is a few gentle rotation exercises to improve the elasticity and muscle strength in the area.

Nothing taxing but it will also improve your flexibility , stiffness and maintain your range of movement while recovering with PMR . You can do this while sitting in a chair or even in bed with straight relaxed back to help shake out the night niggles. First have a good few sips of water and a few deep breaths. Breath in and out slowly with the movement you do.

Gently tilt your head from side to side , as though trying to touch your ear to your collarbone , don't push it when you feel resistance in the movement , wait for a second, then smoothly and slowly go to the other side. Only do 5 per side twice a day to start .

Then, gently look up to the ceiling , when you feel the point of resistance , wait a second , smoothly and slowly move your chin down , as though to touch your chest until the resistance , wait a second , and back again . Again 5 times each way twice a day to start.

Then, gently roll the shoulders after relaxing them into a good postural place. Either with arms down by your sides , or with arms slightly raised , elbow gently bent , with the hands touching the inner shoulder area. Gently rotate the shoulders forward 5 times , rest, then back 5 times to start. Your first few rotations of this exercise you will feel the "clunk" in the collar bone or inner shoulder joint area depending where the laxity is coming from. As you get used to it you can go up to two sets of 5 rolls in each direction.

Don't then quickly move the arms if you have raised them , slowly roll the hand and lower arm back downwards , as though a spring leaf is unfurling, until the arm is gently held out with palm up.

Arms held out softly to the side with palms out , the back of the hand can be rested on a cushion if holding it out feels too resistant or slightly uncomfortable. Then to begin , lift your hand palm up from the wrist . Turn your head slightly to look at the hand that you are moving as you do it so you see your hand palm up saying hello to you. Only do three either side for the first few days , then add two more for a week , go up to 8 the next week , 8 is enough . You only do this once a day. You will feel the point of resistance at the back of the fingers , under arm and back if the collarbone.

Relax the hand down , slowly move your hands to rest on your lap then sitting in good relaxed posture , breath delibarately, a count of five seconds in then five out for a minute. Have a nice little wiggle in your seat and a good drink of water and your done.

Hope that helps , Bee

[Dochaz in reply to Blearyeyed]

Very grateful for the extremely detailed information 🙏.I do gentle Pilates twice a week and the exercises you detail are part of our warm up routine. I also do some shoulder strengthening exercises (Hasfit on YT) only using very light weights (or just body weight some days). The clunking doesn't happen every time, but I really think the exercises help enormously.I had never heard of ED syndrome. I've looked it up... I don't think that's it. Just one more thing to be aware of, though.

Best wishes and thanks again for your reply ❤️

[Blearyeyed in reply to Dochaz]

Oh, no , I wasn't suggesting you could have EDS , I was explaining why I " clunck"! 😄😄😄One thing you would benefit not doing until it's sorted us the weights. Even light ones , they increase the laxity in the tendons when there is a weakness rather than helping it. I'm not allowed to do them at all anymore, but it does mean I don't ever have to carry the shopping , so there's always a silver lining!

Take care , Bee

[Hidden in reply to Blearyeyed]

I will try all of these exercises just to get rid of headaches

[Blearyeyed in reply to Hidden]

Take it slow and steady and I hope you enjoy doing them , take care , Bee

[Hidden in reply to Blearyeyed]

thanks

[Merryfield in reply to Blearyeyed]

A good reminder to flex parts of upper body.

[Hidden]

Mine is when I move my head from side to side....cracking, not clunking LOL