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Understanding Internal Impingement

Shoulder injuries among athletes are not uncommon, but athletes involved in throwing sports and overhead reach activities (baseball, volleyball, etc.) might experience a common injury known as internal impingement. If you’re suffering from shoulder pain related to this issue, here’s a brief overlook of what internal impingement is, how it’s treated, and what your recovery might be like.

IASM, the Institute for Arthroscopy and Sports Medicine, provides comprehensive care to those seeking help in the Pacific Heights area of San Francisco, California. Lead physician Dr. Jeffrey Halbrecht has extensive experience in sports medicine and shoulder injury treatment. Internal impingement requires unique diagnostic, surgical, and recovery care, and the doctors and staff at IASM can make sure your treatment goes as smoothly as possible. 

Internal impingement basics 

Internal impingement, also called “throwers’ shoulder,” is a rotator cuff injury. Impingement refers specifically to the pinching of the rotator cuff tendon. This occurs when the underside of this tendon gets pinched in the socket joint of the shoulder, usually due to a small tear in the rotator cuff. Over time, this repeated pinching can lead to chronic shoulder pain and permanent tendon damage.

Sports and occupational risks

This injury is common in athletes who regularly use a powerful overarm movement. The motion puts a great strain on the entire shoulder, which can lead to internal impingement and the telltale pinching pain in the dominant shoulder. 

Baseball pitchers most frequently report shoulder pain related to internal impingement, but other overhead athletes have been known to suffer from it as well, including: 

This pain can also be caused by an occupation, such as being a painter, carpenter, or window washer who continually works with arms raised. If you have shoulder pain caused by internal impingement, you typically experience pain in the back (posterior) of your shoulder, and this pain will worsen if you put your arm up like you’re going to throw a ball overhand or hammer a nail in at shoulder height.  

Treatment options

Diagnosing internal impingement can be difficult, and it usually requires a skilled orthopedic surgeon in the Bay Area. We perform physical examinations and MRI scans to determine whether this specific injury is present. If Dr. Halbrecht believes you’re suffering from internal impingement, he'll follow up with you and begin discussing possible treatment. 

Luckily, internal impingement rarely causes severe damage to the shoulder, and most athletes are able to perform well after recovery. Rehabilitation exercises strengthen the area, and those with persistent pain usually respond well to arthroscopic surgery followed by rehabilitative physical therapy.

If you’re suffering from shoulder pain that worsens during throwing, internal impingement might be the root issue. Get in touch with Dr. Halbrecht by calling 415-233-7996, or by booking online using IASM’s contact page.

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