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Internal impingement commonly occurs in overhead athletes and is very common amongst elite baseball pitchers. In which phase of throwing does this pathologic process occur?
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A 19-year-old left-hand dominant collegiate baseball pitcher has left shoulder pain with late cocking and early acceleration of the ball. His velocity has decreased over the past 2 months. Rotator cuff strength is normal, he denies symptoms of instability, and Hawkins impingement testing is unremarkable. MRI with contrast reveals no intra-articular lesions. What is the most likely physical exam finding in this patient?
Positive sulcus sign
Decreased external rotation of the affected shoulder
Positive Speed's test
Decreased abduction of the affected shoulder
Decreased internal rotation of the affected shoulder
Mineralization of the posterior-inferior glenoid has been implicated as a possible source of pain in which athletic population?
The term internal impingement is used in throwers to describe a condition where the posterior-superior glenoid labrum impinges on which structure?
The anterior rotator cuff
The posterior rotator cuff
The anterior glenohumeral ligaments
The posterior glenohumeral ligaments
The biceps tendon
Which of the following anatomic structures are in contact with internal impingement in the throwing athlete?
Humerus and posterior-superior glenoid
Humerus and anterior inferior glenoid
Humerus and acromion
Biceps and acromion
Rotator cuff and acromion
A baseball pitcher has aching pain in the posterior shoulder after throwing. On exam, he has a 30 degree internal rotation deficit and is diagnosed with internal impingement. Stretching should focus on which aspect of the joint capsule?