Internal Rotation Shoulder Impingement

Shoulder joint pain can be very uncomfortable, making it challenging to perform the activities you love—including sports. One possible cause of shoulder joint pain is internal shoulder impingement. This article looks at what this condition is, the symptoms, and how it can be treated.

If you think you might be feeling the effects of internal shoulder impingement, contact Dr. Benjamin W. Szerlip, DO. We can provide expert orthopedic treatment to patients in Austin, Texas.

What is Internal Shoulder Impingement?

Internal shoulder impingement happens when the rotator cuff muscles in your shoulder repeatedly touch the upper part of the shoulder socket. These muscles play a major role in stabilizing and centering your arm bone within the socket.

The repetitive contact can result in wear and tear on both the muscles and the surrounding tissue. This can lead to issues such as fraying or partial tearing of the rotator cuff muscles, as well as potential damage to the upper part of the shoulder socket.

As a consequence, individuals with this condition may experience pain and restricted movement in the affected shoulder.

How Does Internal Shoulder Impingement Occur?

Internal shoulder impingement often occurs in athletes who perform repetitive overhead movements. The point of impingement is when your shoulder is in maximum abduction and external rotation.

You may also be at risk of internal shoulder impingement if you have glenohumeral joint instability, restricted range of motion, or scapular dysfunction.

Symptoms of Internal Shoulder Impingement

Internal shoulder impingement may cause the following symptoms:

  • Loss of strength in your rotator cuff
  • Increased pain experienced during sports or activities involving throwing motions, particularly evident during the late cocking phase, or engaging in vigorous movement patterns
  • Shoulder stiffness
  • Discomfort that radiates across the back part of your shoulder

How is Internal Shoulder Impingement Diagnosed?

Diagnosis of internal shoulder impingement begins with a consideration of your medical history and physical evaluation of your injury. Your physical examination may include:

  • Tests assessing the range of motion to identify potential excessive external rotation and reduced internal rotation
  • Determining if there is pain with palpation along your rotator cuff. 

You will also need to tell your doctor of any additional pain and symptoms you may be experiencing. You may also require an MRI scan to accurately diagnose internal impingement and assess any potential complications related to internal impingement.

Treatment Options for Internal Impingement

Conservative options are often tried first to treat internal impingement. Conservative treatment includes:

  • Rest and/or stop the activities that aggravate the condition (particularly throwing)
  • Ice
  • Non-steroidal anti-inflammatory medications
  • Physical therapy
  • Posterior capsule stretching
  • Corticosteroid injections

You may be recommended for surgical treatment if there is little to no response to these conservative methods. Surgical treatment may also be required if you have:

Surgical treatment is usually performed arthroscopically. Surgical treatment is usually performed arthroscopically. This minimally invasive procedure uses a small camera and tiny instruments. There are a variety of procedures that can be performed to treat the specific cause of your shoulder pain.

Shoulder arthroscopy procedures include the following:

Your diagnosis will help your doctor determine the best treatment for you.

Possible Surgical Complications

All surgical procedures have the potential for some complications. Specific complications that could arise with internal impingement surgery include the following:

  • Extended recovery time before resuming overhead activities if healing is delayed
  • Potential injury to the axillary nerve
  • Risk of progressing to full-thickness rotator cuff tears if only partial tear debridement is undertaken

Book an Appointment Today

If you suspect that you are suffering from internal impingement, schedule an appointment with Dr. Benjamin W. Szerlip, DO today! Dr. Szerlip provides orthopedic shoulder care to patients throughout Austin, Texas, and beyond.

Don’t let shoulder pain hold you back from the things you love. Contact us for treatment today!


Medically reviewed by Benjamin W. Szerlip DO