Question
I have played softball for the past eight years.  During the time that I played in high school and was throwing everyday, I started to get pain in my shoulder and elbow. Within the past couple months my shoulder started cracking or popping whenever I moved it a certain way or if I held it in one position for a while. Now it cracks with every little move and once in a while I get pains near the base of my neck on the same side (my right shoulder).  I have had cracking in my ankles and wrists before but none of them cause any pain.  I was just wondering whether this could be an injury from softball or just a normal occurance.

Answer
Dear Angelina,

Yes this can easily be an injury that has progressed from overuse while you were playing softball.  Often we see athletes who have had sore joints, minor irritations, etc... who eventually wind up with significant degeneration or instability of a joint.

Concerning throwing athletes, this is most often at the shoulder joint because that joint is inherently unstable to allow for the great active range of motion you have there.  Improper throwing mechanisms or just too much strenuous activity (overuse) creates micro injury to the muscle, tendon, ligaments, and cartilage surfaces.  If the joint is allowed enough time to rest and repair itself, then the damage is usually minor.  But when these micro-injuries continue to be stressed, breakdown occurs in the tissue leading to degeneration, instability, or both.

You probably have some level of instability (ligament or muscle laxity) around the joint which has lead to cartilage breakdown, and possibly a small labral tear of the internal joint space (why you hear the cracking with movement).  The best way to address this issue is with a functional examination of the shoulder, and a possible imaging technique such as an MRI or Arthrogram (depending on what is found on examination)

Effective treatment can only be rendered if you have a good working knowledge of the joint mechanics and a diagnosis.  This could be with stabilization exercises and strengthening of the rotator cuff musculature, deep tissue work to include myofascial release or friction to break up adhesions and scar tissue, ultrasound, laser, or you may need a surgical repair.  Bottom line, it needs to be looked at first to determine the correct course of action.

Moreover, nutritional support will be needed to help facilitate the healing process such as glucosamine, chondroitin, MSM, pro-enzymes, etc...  Again this should be determined after the problem or offending anatomical structure has been identified.

The pain in your neck area could be related or separate...again this needs to be determined with a functional examination.  Shoulder pain can be referred to the lower neck and upper back, but the neck itself can refer pain to the shoulder and upper back.  Orthopedic tests are helpful in trying to determine the original source, but you may have dysfunction in multiple tissues for separate reasons.  

Best options for examination:  a chiropractic physician or an orthopedist who has advanced tanning in sports injury and rehab protocols.  

Good Luck Angelina,

Respectfully,
Dr. J. Shawn leatherman
www.suncoasthealthcare.net