“Did Your Sternum and Shoulder Click after Heart Surgery?” Asks Dale

I just received a great email from Dale about sternum and shoulder clicking after open heart surgery.

Dale writes, “Hi Adam – I had my surgery on November 2, 2009. The surgeon replaced my bicuspid aortic valve (with a bovine tissue valve), the root aorta, and grafted a large piece of my ascending aorta. I have a question… I have some very occasional clicking in my sternum. However, I also have clicking in my right shoulder. It has become more intense, frequent and uncomfortable. Is this normal? Thank you for both the book and this blog! Dale Pfeiffer”

Diagram Of Chest Incision For Heart Surgery

This email from Dale brought back some distinct memories from my early recovery.

Like Dale, I did experience sternum clicks from time-to-time as my sternum healed. In fact, one night I had Robyn (my wife) listen to my chest – as it clicked – to confirm that I wasn’t going crazy. To ensure the “clicking” was not problematic, I discussed this noise with Dr. Starnes, my surgeon, who calmed my fears with two words, “That’s normal.”

Unlike Dale… I did not experience any clicking or pain in my shoulder. However, after I started cardiac rehab, I did meet several patients, including Ted, that often complained of shoulder pain.

What is very interesting about the timing of Dale’s email, is that two other emails in my inbox – from Brian J. and Craig R. – are also asking about the exact same issue… shoulder pain.

That said, I did some quick research. It appears that shoulder pain, like chest pain, is normal for patients. According to the University of Southern California Keck School of Medicine, “Some heart valve replacement surgery patients experience pain in their chest and shoulder areas and become alarmed thinking it may be angina. This pain is usually due to muscle and bone aches.”

Still, I am curious to know how many, if any, of our patient readers can relate to Dale’s, Brian’s and Craig’s shoulder pain. So, my questions to you are, “Did you experience sternum clicking? Did you experience shoulder clicking? What about shoulder pain?”

To leave a comment, please click here. In advance, thanks for your help in our discussion of this topic!

Scroll down to see over 190 comments about this topic.

Keep on tickin!

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.

To learn how Adam has helped millions of people with heart valve disease, watch Adam's video, subscribe to his free newsletter, or visit his Facebook, or Twitter pages.

  • Robin

    I had a mitral valve repair via medial sternotomy in 8/2011, at age 57. I did experience sternal “clicking” for about 3 months post-op, but no pain associated with the clicking. It was more just “alarming” when it happened. And it usually happened when I was repositioning in bed.

    Thank goodness I never experienced any shoulder pain or clicking. There was enough to deal with, without those two issues!

    I consider myself fully healed, without any residual issues. My cardiologist states that my mitral regurg is “zero to trace.” All of my pre-op symptoms have resolved. (Shortness of breath, palpitations, chest pain, lower extremity edema)

  • Ros

    Yes Marilyn, Welcome to week 3. I think there should an inclusion into the booklet of what happens next in regards to the shoulder pain in week3. However, I think they don’t because it can be very serious and its not for us to second guess. Your surgeon needs to know and you need to be reassured that its all part of the long slow process.
    Make sure you are not using your elbows at all to get in and out of bed. Cross the arms across the chest and rotate. Find a good physiotherapist to massage the shoulders. Do take the pain killers but be aware that they do allow for bad posture so when they wear off ….ouch!

  • Jim McLeod

    Good Day Everyone, I had triple bypass May 28, 2013 and everything worked out well…did have a couple of times where i felt like going to emergency room with just not feeling right, but everytime just waited and i did feel better. All testing after surgery -stress, echo cardiogram, and holter monitor showed normal results, taking a low dose of lopressor metololpol 1/4 of 25mg and a aspirin per day. Have been back to work full force which work is contracting/construction which is phyical labor. My problem now is pain that has seemed to have started in the left side of my neck and now in my left shoulder and also i have had pressure and ringing in both my ears since surgery, my doctor states he does not think these problems have anything to do with the heart surgery. Just over 3 months out from surgery there is still some numbness at incision area which i would assume normal, Two mammary arteries and one leg vien was used for my triple, does anyone know by rerouting chest mammary arteries create or cause problems like shoulder/neck pain? Best Regards, Jim

  • Yvonne

    I am five weeks out from open-heart (bypass) surgery. No clicking but lots of shoulder pain! Especially right side.

  • pete

    I have snapping in my sternum.
    Just started 12 years after CABG.
    Stops if I change position.

  • Paul Wright

    Hi Adam

    I had a triple bypass in March 2011. Initially I suffered the clicking in the should and the sternum . This has now cleared but I do suffer pain in both shoulders (which started about a year ago)and have to have physio which helps. I go to a cardio rehab gym each week to build muscle but the aches still remain. The pain level varies day to day from 1 (ache) to 7 (pain) when moving my arms.

  • e upshaw

    Yes, I had clicking in my chest during the first month of my recovery. My greatest pain has come from my left shoulder…I had no shoulder pain until 6 weeks after my surgery…very annoying…pain pills really don’t work..I’m honestly very miserable…I’ve had 2 check ups concerning my shoulder pain…they had solutions..smh….I’m 35 years old, I’m use to bwing active, I understand the healing process..bur there seems to be no solid solutions for shoulder pain after surgery. ..please help!!!

  • bob

    My shoulders killed me for almost 9 months. Clavicle collar bone what ever you want to call it. Finally just went away on it’s own but it hurt like hell. No doctors even address this. There are many many things they can do to make this better post operative. Including never putting you in a bed after you get out of the operating room. A recliner is far easier on you. They damn near killed me moving me around in the bed. After I got in a chair, I never got back in the bed again. I refused to get back in the bed.

  • Lu Anne

    I had surgery in May 2008. My aortic valve was replaced with a St. Jude Mechanical valve and an aortic aneurysm was also repaired. I did have some clicking pain; however they thing that hurt me the most was my shoulder. In fact, the pain meds I took were not from the chest incision pain but the shoulder. Now I still experience the shoulder pain, everyday. I have ultra sounds seen a neurologist and still the pain is there. The thing that has helped me the most is my massage therapist. She makes it more easy to manage. I have often wondered why and if was related to surgery but none of my doctors will even discuss that possibility.

  • Patti

    I’m having the worse shoulder pain (left) of my life. Started last night; 4 weeks after OVR; and still miserable this morning. Came here to check on it, believing it probably was a normal occurrence. Had to take pain pill and am still hurting.

  • steve packard

    my turn to share, I just had my aortic valve replaced 1/8/2014 I felt that I had the best care at scripps la jolla ca. After three weeks, yes I have shoulder pain across my back and it is more pain than my incision and sternum mending back together .I fell like I was streched out and my shoulders were rolled back and when they cut my sternum in half I thought that my heart popped out they changed the valve in mid air and put it back in and I was done. I am three weeks out and still have back shoulder pain. although I had the best care at scripps la jolla and the follow up care is going well . My heart dose not hurt anymore and my breathing is going well my sternum fells like it is a bruise healing and yes I get just a little clicking if I move in the wrong direction although every week it gets less and less. I go for walks 10 to 15 min or intill my body says lets take a brake and rest you do not want to over do it in the first few weeks, I am in my third week out and I am felling better each day and getting stronger.I guess the back pain will get better in time as I heal I put on Icy Hot pain relief cream and It really helps with the pain. other than the pain I am glad to be here with a new out look on life. I get to spend more time with my grand children and not walk around with a sore heart or not be here at all. Thanks scripps hosp, for giving me a extended life remember your next breath is our feuture. Steve

  • judy

    I love this website & blog it’s so informative. I was worried about a pain in my shoulder, I had a smilar pain after my aortic valve replacement which came back a few days ago 8 weeks later as it sems from others this is quite normal I’ll stop worrying & keep doing what I am doing
    Thanks

  • Rosemary Sutherland

    Hi Judy,
    I just read your comment. Frequent, yes, Probably ok, yes. Ignore it , NO. When I phoned the GP they took it very seriously, when I was sent back to the surgeon he and all the medical staff took it very seriously.
    We are the patients on this blog – let the professionals tell you its OK.
    PS Its two years on for me and I couldn’t be happier. :)

  • michael

    Hello
    I am 51 and just about 7 weeks after a bypass surgery I had a birth defect that was seriouse God was apparently with me for 51 years !! Thaanks God.. I am now having terrible discomfort lying on my sides.y arms are numb and after a while i get most of the feeling back. I am noticing my mobility is impaired and i am SOB. My incision is very sensative and i too have had shoulder poping and i feel some sternal movement as well as my collar bones. In the morning i wake up and my neck is swollen. There is a bone that seems to be up to high…I am sure maybe it is just because things take time to settle down.. . i am easily SOB I have tried to be very careful in moveemnts. I am now feeling even more like i am swollen in my chest and my abdomen feel very hard. I have a big belly as well which i need to lose… i really feel like i am having more pain then in the hospital. it is very uncomfortable to type and i can’t touch my shoulders and also after using the mens room i find it very hard and extremely apinful to reach and clean up… i am also having a lot of like a band like feeling down my L arm leaning forward is very painful.. . I also feel fuzzy and forgetful. anyone feel that… I have anxiety andd epression and i am trying to keep it at bay. I am a nurse case manager and i really don’t feel well. My cardiologist ofcourse said your body had a trama. I have other chronic pain and i have degeeration in my nech and this surgery has really upset that.. anyone have suggestions. I feel like i am going backwards not forward. Rehab has been canceled 3 times but next date is march 10th. I am currently not working and not being paid and i am not going to be able to do ther rehab as i cannot afford it. I have been blessed the hospital has covered me for 1 year although copays for many things. Money is dwindling and my stress level is rising.. Should i get a labotomy..lol I am trying to be posiitve but currently i know i can’t deal withtyping/ stressful calls. can’t hold the phone long enough… what have others done to improve there well being?

  • Carol

    I had aortic valve replacement in October 2013. All healed well and had no sternum clicking or other problems. However, I do have some mild shoulder pain which I don’t consider normal as compared with pre-surgery condition.

  • Sarah

    I am about 4, almost 5 years post op. I had an aortic valve replacement, and one year later a follow-up operation to remove as many of the wires and as much scar tissue as they could. I have done physical therapy, medications, and yet the pain is still constant daily. I’m only.29, and each year the pain seems more tolerable.. but I don’t imagine it magically disappearing.

  • Donna Bisaillon

    I am one month after open heart by pass suegery, I have right shoulder pain and have a large lump in my mid upper chest,it is also sore.

  • Melissa

    Hello, I had mitral valve repair in January, 2014, and am currently experiencing left shoulder pain which seems to worsen when I take a deep breath. It came on several weeks after surgery and was intially accompanied by back pain. The back pain has left. I was wondering how long to expect this shoulder pain to continue? Its does interfere with my sleep.

  • Kerry

    Being 16 months out from surgery now, I can address several comments that I see. First and foremost, the shoulder pain does ease, but it does take some time. One of the best things that I found was simply a stretching and massaging of the shoulder area. It really seemed to take the edge off and rushes blood to that affected area. There are times that I still have a bit of pain, but it seems as though when I do stretching exercises, it makes a world of difference. Example, lay your neck to the left and right for 10-15 seconds each way and pull gently with your appropriate hand. Other times pull forward while your head is bent toward your shoulder. Another great one that helped me was to stand straight, pull your shoulders back like you are holding a walnut between your shoulder blades. Then drop your shoulder blades down and hold it there for 5 seconds. This helps to open up the very narrow passage that the affected nerve travels through. Rolling your shoulders also helps. I still do these stretches on a regular basis.
    Concerning the clicking, after 16 months, there are times I still do this. Not near as much now, but occasionally it will still happen. This could simply be a cartilage issue is what my doctor said.
    The raised knot in the upper part of the chest is fairly normal. I had that too, and it is beginning to slowly go down.
    As far as the incision discomfort, use Mederma! You may not think it is doing anything but I promise you that after a period of time it makes a difference. Here is how I know.
    I too was still having a lot of pain in my chest area. During the spring and summer, as I tried to get more active, the pain got much worse. This brought on a serious case of depression and I am usually an incredibly positive individual. it got to the place where I had wished I had never had my surgery. Aneurysm/aortic valve & root replacement. My surgeon told me I might have lived a couple more months, that’s how close I was. But even though I knew about the depression, I was not ready for the pain that I was still feeling. I told my GP and surgeon, but they told me to take it easy. I finally pushed the issue with the surgeon’s nurse and she ordered me an X-ray. They called me back and told me I had a broken wire in my chest. Upon having another surgery, I actually had 2 of my sternal wires that were broken and really doing a number on my chest and general well being. The same day as the surgery, I told them I felt great and wanted out now. I left the hospital and went with my family out to eat! So if you are still in pain in your chest, have it checked out. I lived with mine from December to October.
    Hope some of this information helps.

  • john brown

    I had a bypass in NOV 2013 I have lots of clicking and pain in my chest. I have been back to see my surgeon and he has told me I may have to have steel plates screwed into my chest bones. at the moment I am waiting to have a scan. Fingers crossed we can get things sorted out. Date now March 17 2014.

  • Leslie

    My name is Leslie and I am a 47 years young and I had double bypass 2/6/14. I too am having this clicjpking or popping when I bend over to wash my hands or brush my teeth? Sometimes if I sit just right or move it will happen. I also have shoulder pain on the back side and it’s below the cuff…I feel like I need a massage bad and it feels like I’ve been impaled and I feel heat it’s very hard to sleep. The cardio thoracic doctor wants to see me again on the 23 he said something about a possible revision? Please tell me that doesn’t mean cutting me open again??? I sure hope not ;)

  • michael ventola

    Leslie a revision could mean that however they say give it a while. t has been since Dec3rd and i feel like i can’t breathe like something is on my chest pushing..comstant popping in the arms and pain in the mid chest and upper chest. i have felt pain in my sternunm when i brush teeth or bend over Unfortunetly i have found you get few answers after the fact… 3 months now i have a hard time holding up my arms or head. I am told things take time. Well it started 4-6 weeks then 6-9 then 9-12 now people say you should be fine…. I am more short of breath now than i ever was. I would bring a pen and papaer and write things down.. I also think everyone is different On this blog some people have suffered for 18 months…. Get informed, ask about a massage and maybe a chiropractor, Make sure you talk with your surgeon first. i am not able to do chiropractor but i have heard it helps get your bones back in order. Ice as well helps alot. Motrin if you can take it……. I wish you luck. I am now unemployed as it has been 3 months and my employer can’t wait forever. I will probably have a cat scan in june if this persists. I Hope things go well for you!! Mike

  • Leslie

    Thanks Mike…one day at a time I guess?? I keep forgetting I’m not 100% sometimes and am ready to go go go however I get tired now and nap each day. Yes, I need a massage I will ask about that. I feel I am better than I was before and I know that muscles and nerves will heal and cause their own strange feelings, but I just don’t like the way my chest feels or SOUNDS. I really can’t wrap my mind around what they actually did to my body..I try not to read on Google because it freaks me out oh speaking of which, let me tell you this, this is horrible….two years ago my husband had triple bypass he did great, but the third day, he threw a clot on the brain stem and died…….then I had to go thru the exact same surgery with the same dr. Isn’t that ironic? Anyway, everyone has their own story ya know? But thanks for all your info and I wish you all the blessings and healing and stay positive….your not walking alone….God Bless… Leslie

  • michael ventola

    Dear Leslie, i would certainly say that was ironic… I am so sorry for your loss. as far as looking on line. i think some info is helpful. What i have found is that the MD isn’t helpful. They should certainly be prepared to explain all the things we will have to deal with. This am i am still feeling like something is wrong in my upper sterum as well as inability to take a deep breath without forcing it. as long as i breathe i try not to worry.. Do some breathing ,pierced exhalation and that will help calm the chest. do it 10 times like almost meditating….. I hope we all feel better soon. This is a nice place to vent when you don’t get answers else where. I just got a call my dad has CA unsure what type or treatment etc God doesn’t give us more than we can handle… Sometimes i think he thinks we are all bad asses :)…God bless and feel beter soon Mike

  • Gary Z

    Michael (Feb 24), I had mitral valve repair at 62 (congenital defect) and found that the biggest post-op problem was back pain. I started walking 1 mile per day after one week and increased it to 2 after a month. Speed of walk is not important. Oxygenating the blood is a terrific healer. I forced myself to exercise/stetch/flex. The harder I worked at it the quicker the pain went away. By doing walking and exercising I avoided rehab entirely. It is counter-intuitive, but by challenging the body, I got to normal faster. Hope this helps.

  • steff

    I had a heart transplant almost 12 weeks ago and the sternum clicking is mostly gone although I have only recently been able to lie on my side and it hurts a bit! I had some arm pain but until I read this I didn’t really put 2 and 2 together and it almost gone now. I was told by my surgeon that the clicking was due to the hyper-extension of the ribs, inter-costal muscle and ligaments which means the muscle and ligaments are stretched and don’t hold the ribs firmly in the sockets so they pop in and out until the tissue recovers and tightens up again. The popping is now much reduced but the muscle is still pretty weak and swells up around the incision if I overdo the lifting or my daughters pull on my arms repeatedly or unexpectedly (they’re 3 and 5). I’m lucky that I live in country with free healthcare so I stayed in hospital for the first 6 weeks in outpatient accommodation, getting daily physiotherapy and this continues with fortnightly visits to my cardiologist for check ups, I also choose to pay for private care mainly because it is inexpensive and means you can get immediate treatment rather treatment according to need but it doesn’t cover heart transplants, so thank you public health system! I dread to think how I would cope if I had to pay for my drugs ($5000 per month) and flights/travel costs to hospital instead of getting them supplied free of charge as I need them for life.

  • Sandra

    I had quad bypass surgery 3/5/14. Everything went very well in surgery and after. Came home on day 5 with doctor’s all telling me I was doing great. This is beginning of 7th week and I am having pain in left arm and between shoulder blades, at night so severe that I cannot rest.
    My question is: Is this normal at this time and is anyone else having this problem or anything like it?
    Thanks,
    Sandra

  • john brown

    I had a bypass op in Nov 2013 and after 5 months i was still getting clicking and popping in my chest, it was decided that i would have a CT scan, which i did and the scan showed that my chest had not fused together so now i have to decide to have steel plates screwed into my chest to hold it together or live the rest of my life with my chest in two halves with all the movement, ie clicking and popping.

  • Amanda

    I had my tricuspid valve repaired two weeks ago along with a few other procedures to repair a congenital heart defect. I’m 30 years old and I’m in very good health otherwise. I have not experienced sternum clicking but I have sharp pains in my right shoulder that increase when I’m active, particularly when I’m walking.

  • Melissa

    I had heart surgery last January and still get a “popping” sound when I sneeze or cough. Pushing in with my fist helps. I also experienced severe shoulder and back pain about 3 weeks after surgery which lingered on for several weeks (no fun!). I was only allowed to take Aleve, which really didn’t seem to make much difference. I slept on a heating pad and had it draped over my shoulder when sitting, and the pain gradually went away and has never come back. I wish I would have been allowed to try a muscle relaxant, it might have stopped the pain in its tracks. I understand shoulder and back pain is fairly common after surgery, even several weeks later..

  • kavs

    Hi, All,
    I under went Bypass surgery in Nov 2007.My left arm joint gives some pain during nights at sleep.I tried with many ways to reduce but no results..All other parameters are under control.

  • christy

    I had tricuspid valve replacement two weeks ago. I originally had a repair done back in december, I almost died cause my body was in ful septic shock and I spent 17 days on life support. Due to myvinfection and all my organd failing they did a poor repair. Well six months later im already being sawed open. At the same time I dun wanna di from heart failure so I did what had ro be done. Well its been two weeks and my chest uper back shoulder and neck all hurt it frels like all my muscles are being sliced and diced with a knife. Sucks!

  • Colette McDiarmid

    I had mitral valve surgery in May this year and experienced back pain within the first week and then shoulder pain and clicking of the sternum. The back pain was determined to be muscle spams as I was supporting my arms and hunching over quite a bit. I thought the Dr. was joking when he suggested Advil for the pain. But it definitely did the trick. I also found when I came home that trying to have a shower and wash my hair and trying to get dressed for the day aggravated my back muscles. I looked for ways to ease the pain during these things or timed it so that I could sit with a hot pad on my back after I had finished. It has been getting easier with each passing day.

    With the shoulder pain that started on the left side with my first walks and I thought it was angina. Now I find my shoulders are sore when over working my arms. Neck stretching exercises the hospital gives helps out a bit. My shoulders always have clicked before and after surgery, so no real change there.

    And I did get that disgusting feeling of my sternum clicking and took me three days to figure out that if I asked for help and gave myself a break and stopped over reaching for things it subsided.

    Funny thing typing this letter while sitting in an poorly supported chair also aggravates my back and shoulders. I had bad posture to begin with and I think this will definitely be something I will have to work on in rehab.

    Hope this helps. Great Book. Could not thank you enough.

  • b venitt

    They all don’t realize they have non fusion of the sternum. I had my first open heart surgery Oct 2012. The sternum did not fuse and then was dehisced and had horizontal fractures where the metal bands had cut through. I had it rewired 3x and it opened each time. I used a different top surgeon each time. On each occasion they refused to believe it had not fused until I had a CT scan. I do not have any medical condtion which explains this. I am sure this is what all the people who complain of the same pains, poping and snapping of the sternum have. They just don’t know it. I had all the symptons, and the docs are very resistant to checking their work. Good luck all of you out there.

  • James

    (I had my surgery on June 23/2014 .
    And now I notice clicking and popping in my Sternum,I also have shoulder pain.
    Have not returned to my doctor yet because I think this is normal and there is no pain in my sternum.They tell me shoulder pain is just nerves from being on the table for so long,

    Thanks

    James

  • Nancy

    I had triple bypass surgery 3 years ago my chest never healed right Dr told me that my sternam is jointed and it wasn’t alinged right have a lot of back pain and can only sleep on left side.

  • Raj

    Raj
    I had AVR done 6/30/14. I am 49. This site was very helpful. My shoulders and back were aching too. But it goes away. Exercise does help. I lifted light weights moving my arm from side and front up to the shoulder. That really helped with my shoulder pain. It strengths shoulder muscles. Cardiac rehab does help. I still have some popping sound when I yawn and I am hoping it will soon go away.

  • Miranda

    I’m 29 and had aortic valve replacement surgery 16 days ago. While I do not experience sternum/shoulder clicking, I do experience a decent amount of pain in my right shoulder, as well as the right side of my ribs, neck, and collar bone… mostly when I take deep breaths. I was released less than 48 hours after surgery due to the rate at which I was progressing (in terms of walking, breathing exercises, etc). I’m not sure if they let me go too soon, but I can sympathize with Dale ( as well as anyone else who’s had open heart surgery) as far as the aches and pains go.

  • jill

    I understand so much now all of this has been so helpful. I’ve been trying to find out about this for over a month. I had my triple bypass 5/14 and I was very lucky with gods help I pulled through after several attempts I am only 45 and this was so unexpected but the recovery has been hard I have had blood clots in legs infections in graft sites on legs hair fell out I have terrible nueropathy and now I have back shoulder pain. And trouble breathing and all they say is it takes time to heal you have been thru a lot!!! Jill

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