Internal Impingement of Shoulder

Question 1

What are causes of internal impingement and what is the pathophysiology?

Answer 1

Causes:

1) tightness of posterior of IGHL
2) anterior micro-instability

Impingement of posterior undersurface of supraspinatus tendon on the posterosuperior glenoid rim; occurs during late cocking and early acceleration phases

Question 2

What can be seen in an AP radiograph of a pt with internal impingement?

Answer 2

Bennett lesion (glenoid exostosis)

Question 3

In a patient with internal impingement and a PASTA lesion, at what point would arthroscopic repair be indicated?

Answer 3

> 50% tear

Question 4

Sleep stretch is designed to address what anatomic structure?

Answer 4

Posterior inferior glenohumeral ligament