Who gets internal impingement?
The shoulder is a common source of injury in both elite level and recreational swimmers. External or outlet impingement occurs most commonly in masters level swimmers (over 40 years old) and can be associated with a full thickness rotator cuff tear. Internal impingement develops in young, active athletes involved in repetitive overhead activities. The most common athletes who get impingement are throwers (baseball pitchers, football quarterbacks) and swimmers. Diagnosis History and physical examination are the keys to diagnosing internal impingement. Athletes complain of shoulder pain and may or may not complain of stiffness. Range of motion and rotator cuff strength are important physical exam findings. Swimmers and throwers tend to have increased shoulder external rotation and decreased internal rotation as a result of training demands. This lack of internal rotation can cause shoulder problems and is called GIRD (Glenohumeral Internal Rotation Defecit). Internal rotation deficits ar
