INSTABILITY AND IMPINGEMENT IN THE ATHLETES SHOULDER

The competitive athlete who participates in a sport requiring overhead motion depends on a shoulder with optimal function. An acute episode of injury or a gradual onset of symptoms in the shoulder can affect th e athlete's ability to perform. An understanding of shoulder anatomy a nd function is essential, and an accurate diagnosis of the underlying pathology is critical for planning treatment options. The correct diag nosis may be less clear when the athlete presents with an insidious on set of shoulder pain. A detailed history and physical examination, as well as an evaluation of the overhead motion and onset of pain, is imp ortant when the diagnosis of instability or impingement is considered. Rehabilitation of the rotator cuff often succeeds in alleviating symp toms and restoring function. Surgery is considered when symptoms and d iminished function persist despite appropriate nonoperative treatment. Operative repair or reconstruction must be anatomical in nature. Post operative rehabilitation is equally important in this setting, and a m otivated athlete helps to ensure success.