Microinstability and internal impingement in overhead athletes

Clin Sports Med. 2013 Oct;32(4):697-707. doi: 10.1016/j.csm.2013.07.006. Epub 2013 Aug 20.

Abstract

A complex interplay exists between the static and dynamic stabilizers in the glenohumeral joint, especially in overheard athletes who need a shoulder hypermobile enough to perform overhead activity yet stable enough to prevent joint subluxation. Concomitant shoulder pathologies commonly occur in the setting of microinstability and internal impingement. Before any surgical intervention, a 3- to 6-month course of conservative measures should first be attempted, with exercises focused on rotator cuff and scapular stabilizer strengthening combined with posterior capsule stretching. If surgery is needed, arthroscopic suture plication with treatment of concomitant lesions has been shown to provide the best clinical outcomes.

Keywords: Arthroscopic suture plication; Internal impingement; Labral debridement; Microinstability; Rotator cuff.

Publication types

  • Review

MeSH terms

  • Arthroscopy
  • Athletes*
  • Baseball / physiology*
  • Combined Modality Therapy
  • Exercise Therapy
  • Humans
  • Joint Instability* / diagnosis
  • Joint Instability* / physiopathology
  • Joint Instability* / therapy
  • Magnetic Resonance Imaging
  • Orthopedic Procedures
  • Shoulder Impingement Syndrome* / diagnosis
  • Shoulder Impingement Syndrome* / physiopathology
  • Shoulder Impingement Syndrome* / therapy
  • Shoulder Joint / physiopathology*
  • Shoulder Joint / surgery
  • Suture Techniques
  • Tennis / physiology*
  • Treatment Outcome