Posterosuperior and anterosuperior impingement

Alessandro Castagna, Raffaele Garofalo, Eugenio Cesari, Marco Conti

Research output: Chapter in Book/Report/Conference proceedingChapter


Internal impingement as a form of PSI (posterosuperior impingement) and ASI (anterosuperior impingement) can be responsible of a shoulder pain and discomfort in athletes but also in non-athlete populations. There are often different pathological findings associated in this group of symptoms. Rest and physical therapy are the cornerstones of treatment. Indications for surgery include failure of conservative treatment with an inability to return to activities after a relatively long time of rehabilitation. Surgical approach is based on the specific examination findings under anesthesia. Furthermore, during arthroscopy the surgeon should carefully evaluate the entire shoulder and look for evidence of instability, biceps tendon, biceps anchor, labrum, capsule, subscapularis tendon and LHB pulley, and rotator cuff complex. Dynamic intraoperative examination can show PSI or ASI when present as well. Surgical intervention should be directed towards specific pathological lesions believed to correspond to the patient's symptoms or play a role in the complex pathophysiology of internal impingement; nevertheless arthroscopic surgical techniques are still evolving and controversial.

Original languageEnglish
Title of host publicationSports Injuries: Prevention, Diagnosis, Treatment and Rehabilitation, Second Edition
PublisherSpringer Berlin Heidelberg
Number of pages11
ISBN (Print)9783642365690, 9783642365683
Publication statusPublished - Jan 1 2015

ASJC Scopus subject areas

  • Medicine(all)


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