Physical Rehabilitation Medicine/Shoulder injury


I was involved in a car accident in March, and two days after the accident I went to an urgent care for x-rays. Nothing showed up on the x-rays, and as a college student, I put off further investigating until the end of the semester. Long story short, I started at a chiropractor's office, had an MRI, and have been in physical therapy once a week since July. (The MRI didn't reveal any tear to the rotary cuff) I still have shoulder pain, sometimes dull and achy, other times so severe that I have to take Tylenol. My ROM is better thanks to my therapist, but I'm concerned about the persistent pain. In addition, there is a continuous clicking/popping pain in the shoulder. Often this clicking is audible to others, and it feels as if something is shifting. It is visible at times too. Any ideas as to what is going on? The shoulder is visibly different than the other one, and I am at a loss of what else to do. I'll likely be seeing my therapist next week, but wondered if I could suggest anything? It's hard to research shoulder pain as a multitude of things can be causing pain. Thank you for your time and response. I appreciate it.

Dear Autumn,
Shoulder injuries can involve the shoulder socket itself or some of the other parts that contribute to arm motion.  There is a joint between the collar bone and a part of the shoulder blade called the A-C joint ( acromio-clavicular joint).  That may be involved but I would think your PT or Chiropractor or the x-ray would have showed if that was injured.  Clicking can come from the muscles on the back underneath the shoulder blade.  Often in car accidents, the muscles around the shoulder as well as elsewhere brace to protect you.  The bracing may not stop even though time has passed.  You may have pain from the muscles and they may not be sequencing properly with movement.

I have a detailed description about this in my Consumer Guide to Recovery from Car Accidents which you can locate on my website.

I hope this helps you.  Please ask those who you are working with to further evaluate you.  You can also seek the input of an orthopedic Doctor.


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Rachel Katz, PT, SEP


I have expertise working with recovery from car accidents, RSD/CRPS, neck and back pain and chronic pain. I can answer questions about pain that is not responding to expected patterns of recovery. I can address pain issues that are associated with traumatic events, and veteran associated pain issues. If you have had abuse or periods of significant stress in your life, your pain issues may be more complicated. I authored A Consumer Guide for Recovery from Car Accidents which discusses many aspects of injury recovery as all as specific detail about PTSD, traumatic brain injury, and protective involuntary muscle spasm. The link is: I can't answer questions regarding pain medications, or some specifics related to surgical interventions.


I have over 30 years experience as a Physical Therapy clinician. I taught swimming in Michigan and skiing in Aspen. I have experience in analyzing movement patterns and muscle control. I treat all areas of pain in the body including headaches, neck pain, back pain, shoulder injuries, plantar fasciitis, nerve compression, and knee pain. I have had personal experience with chronic pain, RSD, car accident injuries, PTSD, and traumatic brain injury (TBI). Muscle spasm and pain is a common component of injury and response to traumatic stress. Posture patterns and habits of how your body is often used can also contribute to pain. Restoration of movement and the senses that enable you to feel it are key. Rachel developed and implemented a stress reduction program for inmates within the Boulder County jail's drug and alcohol recovery program in 2005-2006 based on trauma healing principles from Dr. Peter Levine.

Rachel holds a BS in PT from the University of Colorado Health Sciences Center. She has over 30 years experience as a clinician. She has over 1500 hours of post graduate continuing education in many Manual Therapy and Exercise approaches. She completed her training in Somatic Experiencing under Dr. Peter Levine in 2000. This 3 year program trains therapists in treating traumatic stress conditions. Rachel has developed a body of work integrating her training and unique insights into complex pain issues. She is the developer and instructor for Sensory-Motor Manual Therapy, which is a State approved 2 day work shop for Massage Therapists through the Boulder College of Massage Therapy.

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