An OrthoNeuro Orthopedic Shoulder Surgeon
Internal shoulder impingement is a condition in which there is repetitive contact between the posterior undersurface of the rotator cuff and the posterior-superior aspect of the glenoid.
Internal shoulder impingement is caused by repetitive impingement of your rotator cuff muscles. These muscles are located between your humeral head (the long bone of your arm) and the glenoid of the scapula. Your rotator cuff stabilizes your shoulder and centers your humeral head within your glenoid.
Over time, this repetitive impingement of the shoulder may result in the possible fraying (or partial tear) of your rotator cuff muscles. In addition to damaging your rotator cuff, your superior labrum can also be damaged, leading to superior labrum anterior to posterior (SLAP) lesions.
Internal shoulder impingement occurs when your shoulder is in maximum abduction and external rotation, which commonly occurs in overhead athletes during the late cocking and early acceleration phases of throwing. Athletes with repetitive overhead throwing motions (for example, baseball players) are particularly at risk.
Additionally, glenohumeral joint instability, restricted range of motion, and scapular dysfunction can also have an impact on internal impingement.
If you are experiencing internal shoulder impingement, you may have the following symptoms:
Initially, your specialist will review your medical history and thoroughly evaluate your injury. Your physical examination may include:
You will also be asked about any pain and additional symptoms you may be experiencing. An MRI may be used to assess any internal impingement complications and accurately diagnose internal impingement.
Your specialist will first try to treat internal impingement by using conservative methods. These conservative methods include:
If there is little to no response to these conservative methods, your specialist may recommend surgical treatment. Surgical intervention may also be required if you have:
Surgical treatment is usually done arthroscopically, and there are a variety of procedures that your specialist can choose from to specifically reduce your shoulder pain. These shoulder arthroscopy procedures include:
Once your specialist makes your diagnosis, and if it is determined that surgery will be required, they will discuss which procedure would be best for you.
As is the case with all surgical procedures, complications may occur. Specifically, when it comes to surgery for internal impingement, these complications may include:
If you suspect that you are experiencing the effects of internal impingement, schedule an appointment at one of our OrthoNeuro locations throughout Columbus, OH today! Our specialists look forward to helping you relieve your pain.
Special thanks to Abigail Moffit, OMS II for writing the original piece entitled “The Posterior Shoulder Pain Of The Fastball: Internal Impingement Of The Shoulder.”
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