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A 25-Year-Old Recreational Softball Athlete with Internal Impingement

  • Anirudh K. Gowd
  • Gregory L. Cvetanovich
  • Joseph N. Liu
  • Nikhil N. VermaEmail author
Chapter

Abstract

Overhead athletes are a unique and challenging patient population because their sport is so taxing on the glenohumeral joint. From performing overhead activity throughout the adolescent, teenage, and collegiate years, the athlete develops several adaptations to increase external rotation of the arm. In consequence, the thrower’s paradox results in anterior laxity and posterior contracture of the shoulder’s capsule. Often this is asymptomatic, but over time, posterior contracture can lead to internal impingement of the glenohumeral joint on to the posterosuperior aspect of the rotator cuff and posterior labrum. Resulting pathologies often require management and sometimes surgery. The following case-based review illustrates the anatomic and physiologic changes that may result in symptoms of internal impingement, techniques to evaluate and diagnose pathology, and appropriate management.

Keywords

Internal impingement Overhead athlete Thrower’s shoulder Posterior labrum 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Anirudh K. Gowd
    • 1
  • Gregory L. Cvetanovich
    • 2
  • Joseph N. Liu
    • 3
  • Nikhil N. Verma
    • 1
    Email author
  1. 1.Department of Orthopedic SurgeryRush University Medical CenterChicagoUSA
  2. 2.Department of Orthopedic SurgeryThe Ohio State University Wexner Medical CenterColumbusUSA
  3. 3.Department of Orthopedic SurgeryLoma Linda University Medical CenterLoma LindaUSA

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