Impingement problems in the athlete.

In summary, there is a delicate balance between the mobility and the stability of the shoulder joint. The young athlete involved in overhand sports is at risk for injury, and must be clinically evaluated and treated differently from the rest of the population. Shoulder impingement and instability are a continuum of abnormalities, beginning with instability and progressing to subluxation, impingement, and, finally, rotator cuff tear. Thus, it is crucial to deal with the core of the problem, (that is, the instability) before dealing with the impingement. A kinesiologic repair is desirable. If that fails, or if there is anatomic damage, an anatomic repair is done. The anterior capsular labral reconstruction is a surgical procedure designed with biomechanical and kinesiologic principles in mind. A rehabilitation program is initiated immediately after surgery. The rehabilitation program is just as important as the surgery.