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Related Experiment Videos

The athlete's shoulder

F W Jobe1, M Pink

  • 1Department of Orthopaedics, University of Southern California, School of Medicine, Los Angeles.

Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists
|April 1, 1994
PubMed
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Shoulder instability in young athletes often leads to impingement and rotator cuff tears. "Inside impingement" is common, with rehabilitation as the first treatment, followed by arthroscopic labral repair (ACLR) and rehab if needed.

Area of Science:

  • Orthopedics
  • Sports Medicine
  • Biomechanics

Background:

  • Shoulder instability is a primary issue in young, overhand-throwing athletes.
  • Impingement and rotator cuff tears are common consequences of this instability.
  • Two primary impingement mechanisms exist: 'outside' (older, nonathletic) and 'inside' (younger, athletic).

Purpose of the Study:

  • To differentiate impingement mechanisms in young athletes.
  • To outline treatment strategies for shoulder instability in this population.

Main Methods:

  • Review of classic impingement theories.
  • Description of the 'inside impingement' mechanism.
  • Discussion of treatment pathways.

Main Results:

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  • 'Inside impingement' involves the cuff undersurface pinching the posterosuperior glenoid labrum in young athletes.
  • Rehabilitation is the initial treatment of choice.
  • Arthroscopic labral repair (ACLR) combined with rehabilitation is effective when conservative treatment fails.

Conclusions:

  • Understanding the 'inside impingement' mechanism is crucial for treating young athletes.
  • A stepwise approach, starting with rehabilitation and progressing to ACLR if necessary, yields successful outcomes.