Posterior Internal Impingement

The un-common but common shoulder

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Nerdy post of the day!

Shoulder “Impingement” is a common issue we deal with in clinic. We tend to see quite a lot of sub-acromial impingement/external impingement. So it was a nice change this morning dealing with something a little different.

Posterior internal impingement of the glenohumeral joint is a cause of shoulder complex pain. Internal impingement is characterised by posterior shoulder pain when a client/athlete has their shoulder in end of range abduction with external rotation, for example, a fielder throwing in cricket. Impingement in this position is caused between the supraspinatus and or infraspinatus with the glenoid rim. This is known as Posterior internal impingement (PII). The pain is caused by the compression of the tendons into the bony prominence of the glenoid.

Often these clients can have greater laxity on the affected shoulder so rehab is focused on strengthening around the shoulder and improving shoulder stability and scapular dyskinesia/weakness.

TOP TIP: Due to the shoulders seeming complexity, during assessments, is it important to remember some shoulder pain can be radicular (radiating) and originates from the cervical spine so it is important to clear any neck issues before focusing in on the shoulder.


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