Evaluation of impingement syndromes in the overhead-throwing athlete.

OBJECTIVE: We outline impingement entities, describe the history and physical examination, and provide an overview of treatment beyond that routinely used in glenohumeral and scapulothoracic dysfunction. BACKGROUND: In the athlete, pain and dysfunction due to excessive overhead use or abnormal positioning of the shoulder is common and can result from multiple etiologies, including impingement syndromes. Primary, secondary, internal, and coracoid impingement have all been described. DESCRIPTION: These entities will be discussed, including pathology, evaluation, and treatment. CLINICAL ADVANTAGES: Incorporating a systematic evaluation and treatment of impingement syndromes optimizes care for the patient with shoulder pain.