Physical Rehabilitation Medicine/cracking joints



I'm hoping you can advise me on why my joints make such terrible noises...particularly my shoulders. I'm female, in my 20's, quite active. However, I have a very large bust which causes me constant pain in my neck, shoulders, upper and lower back. I haven't been to my doctor as I am an RN, and I work with a senior Physiotherapist so I asked him for advice. He told me that there's nothing really to be done apart from strengthening your core/abs (which I do already with yoga and pilates), and he told me to try and stand tall with good posture and to stick my bust out. It hasn't helped at all though if anything it's getting worse. The only thing that helps is if I 'crack' the joints. I can take my head to one side and using my hand I'll crack my neck, and then I'll roll my shoulders around and they will crack and crunch, then I'll do yoga poses to open the shoulders/twist my back and everything will crack and pop and then I'll be pain free. However it's getting to the point where I am constantly in pain and having to 'crack' everything every day. The pain is particularly bad in my neck and shoulders. I'm fairly sure it's my large bust causing the pain as if I don't wear a bra/don't wear a supportive bra the pain gets worse in the same areas, however I don't really want to have reduction surgery. Is there anything I can do? Particularly with regards to the shoulder pain? Any advice you have will be very much appreciated. Thanks for reading

Kind regards



Sorry for the late response.  This is a common problem with large-breasted women.  The extra weight changes the normal mechanics of the spine.  The cracking you do is to release the joints because they are in abnormal positions for so long.  Think of it as muscles that get tight affect the joints they cross.  That puts extra compression on joints and they need to be cracked to attempt to achieve some "space" in the joint.  I hope that makes sense.  Basically tight muscles bring two bones closer together.  If you stretch the muscles then the joints have normal space in between them.

As far as treatment other than a reduction.  I would strengthen the BACK!  Core exercise is important but strengthening the muscles of the back will assist in posture and you being able to offset the extra weight on the anterior of your body.  So...first stretch the chest (pec minor and major...look it up on the web) and THEN strengthen the back.  So you stretch the anterior side of your body (say 15 minutes) in hopes of lengthening the muscles...then strengthen the back and scapular stabilizers of the shoulder girdle.  There are a number of exercises for doing this.   I'd recommend doing 3-4 exercises for this...look up how to strengthen the:  serratus anterior, rhomboid major and minor, mid and low trapezius.  Do not strengthen the upper trapezius.  Look up those exercises and do them 2-3 times per week.  Allow yourself 6 weeks to see a difference.  I hope this helps!!!  

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Brian Neville, OTR/L, CWCE


I can answer questions about both conservative and post-operative rehabilitation for UPPER extremity injuries. These include but are not limited to: fractures, tendon repairs, tendon transfers, nerve repairs, lacerations, tenolysis procedures, TFCC injuries, repetitive motion disorders, reconstructive procedures. I have an advanced knowledge of UPPER extremity anatomy and industrial rehabilitation. I have extensive splinting skills for injuries to the upper extremity. Although not a physician or a surgeon I have worked closely with world renowned upper extremity specialists for over 10 years. I can give general information on what some of the most common upper extremity surgeries involve. I can reference those procedures as well. PLEASE DON'T ASK ME QUESTIONS ABOUT ANYTHING OTHER THAN THE NECK, SHOULDER, ARM/HAND. I'M NOT QUALIFIED AND KNOW ABSOLUTELY ZERO ABOUT BACKS/HIPS/KNEES/ANKLES/ETC. THANK YOU!!!


10+ years working closely with orthopedic and hand surgeons and their patients. I have treated patients with small lacerations to major reconstructive procedures. My knowledge base includes both conservative and post-operative rehab protocols and care for upper extremity injuries. I have treated patients all the way from day 1 post-op to return-to-work status.

Kentucky Occupational Therapy Association American Society of Hand Therapy National Nurses in Business Association Roy Matheson and Associates

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Occupational Therapist former Certified Hand Therapist (license currently inactive) Deep Physical Agent Modalities Instructor Certified Work Capacity Evaluator

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