Shoulder Injuries

internal impingement

Internal impingement is one of the problems seen in thrower’s shoulders. If the shoulder goes too far in ER/extension during the cocking phase (i.e. elbow behind the chest with the shoulder externally rotated) the rotator cuff will get pinched inside the shoulder (impinged internally)between the glenoid and humerus. This can result in some partial tearing of the rotator cuff which can progress to a serious tear. The internal impingement is made worse by an unstable shoulder, SICK Scapula, and also by loss of internal rotation (GIRD, see below). Since most of these risk factors can be addressed by physical therapy and improving throwing mechanics, surgery can be avoided if it is detected early enough.