The Journal of Bone and Joint Surgery (American). 2009;91:2719-2728.
doi:10.2106/JBJS.I.00409
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Current Concepts Review

Internal Impingement of the Shoulder in the Overhead Athlete

Mark C. Drakos, MD1, Jonas R. Rudzki, MD1, Answorth A. Allen, MD1, Hollis G. Potter, MD1 and David W. Altchek, MD1

1 Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021. E-mail address for M.C. Drakos: mdrakos{at}yahoo.com

Investigation performed at the Department of Sports Medicine, Hospital for Special Surgery, New York, NY

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Internal impingement of the shoulder refers to a constellation of pathologic conditions, including, but not limited to, articular-sided rotator cuff tears, labral tears, biceps tendinitis, anterior instability, internal rotation deficit, and scapular dysfunction.

Physiologic adaptations to throwing include increased external rotation, increased humeral and glenoid retroversion, and anterior laxity, all of which may predispose an individual to internal impingement.

Nonoperative treatment should always be attempted first, with a focus on increasing the range of motion and improving scapular function.

When an operative intervention is chosen, it is important to address microinstability in order to have a good outcome and prevent failure.


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