Internal impingement and SLAP lesions

Abstract

Internal impingement is the most common cause of posterior shoulder pain in overhead throwing athletes. Anterior instability, posterior capsular tightness, and humeral retroversion were proposed to explain the pathomechanics. History of the patient is the most important step in diagnosis. Anterior instability, posterior shoulder pain, and positive impingement tests are frequently present. MRI is also valuable in aiding diagnosis by detecting the radiological changes and SLAP lesion. Conservative treatment of these patients should focus on restoration of normal shoulder kinematics and range of motion while preserving glenohumeral stability. Surgical treatment is reserved for patients who are unresponsive to conservative treatment. Arthroscopic debridement, SLAP lesion repair, capsular reconstruction, and derotation osteotomy are options in surgical intervention. © Springer-Verlag Berlin Heidelberg 2012.