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Carol, I know that in the elbow the arm catches along the path of flexion the way a ratchet would in a machine. This really has to to with rigidity and the effect that the doctor can feel on examination. This is probably not something the patient would notice. Shoulder pain has many different causes but I will say this was one of my husband's very early symptoms and he spent much time and treatment in a neuro's office being treated for shoulder pain to no avail. Much later on that arm became very rigid and did not move but the pain did diminish and has never returned. We had no answer to the long gone shoulder pain or the lack of movement but several years later as the symptoms advanced it became apparent to even the casual observer that this was Parkinson's. He then went to the family dr who finally made the diagnosis because it was plain as the nose on his face so to speak and in checking for rigidity he stated that Bill had the "cog wheel" effect in his elbow which he said was a classic sign for Parkinson's as well as an excellant response to Sinement. Jackie ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn