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A New Look at Shoulder Pain in Overhand Athletes

Pain along the back of the shoulder is a common problem in overhand athletes. The problem could be a torn rotator cuff (RC). It could be frayed edges on the rim of cartilage called the posterior labrum (PL). Sometimes both problems are present at the same time.

Doctors are looking for a test to help identify posterior RC or PL tears. In this study the posterior impingement sign (PIS) was tested. Patients were divided into two groups by injury type, either contact or noncontact. Each athlete was tested using the PIS. Then the shoulder was examined using an arthroscope. This tool allows the doctor to look inside the joint and see what's going on.

The authors report that the PIS doesn't work for everyone. It's most accurate when used with young, overhand athletes. They present with a gradual onset of posterior shoulder pain. In this group, a positive PIS indicates a partial tear in the RC or PL. Using the test with older adults isn't advised. Degenerative changes from aging can be the real problem.

References: Keith Meister, MD, et al. The Posterior Impingement Sign: Diagnosis of Rotator Cuff and Posterior Labral Tears Secondary to Internal Impingement in Overhand Athletes. In The American Journal of Orthopedics. August 2004. Vol. 33. No. 8. Pp. 412-415.

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