(The Classic “Thrower’s Shoulder”)
Welcome to The Arm Doc—where athletes, weekend warriors, and busy professionals get answers for nagging shoulder pain. If every serve, pitch, or overhead lift sets off a deep ache in the back of your shoulder, you might be dealing with internal impingement. Below is a quick-read guide to help you understand the problem, spot the warning signs, and see how we get players back in the game—fast and safely.
What exactly is internal impingement?
When the arm is cranked into its maximum abduction + external rotation (think late-cocking in a baseball pitch or racquet serve), the undersurface of the rotator-cuff tendons (supraspinatus + infraspinatus) can pinch against the back-upper rim of the socket and posterior labrum. A little “kiss” is normal in high-level throwers; years of repetition, poor mechanics, or tight tissue turns that kiss into painful grinding.
Who gets it?
High-risk sports | Classic scenario | Why it happens |
Baseball / softball pitchers | Young, highly active arm; sudden drop in velocity or control; posterior shoulder ache | Combo of extreme motion, micro-tears, tight posterior capsule, and tired scapular muscles |
How your shoulder adapts—and then complains
Normal “performance” adaptations | Pathologic changes that hurt |
● Extra external rotation | ● Posterior capsule tightens → lost internal rotation (GIRD) |
Red-flag symptoms
- Deep, hard-to-pinpoint pain in the back of the shoulder
- Sharp stab during the late cocking phase of throwing/serving
- Need for a long warm-up before the arm “loosens”
- Drop in pitch speed, serve power, or accuracy
- Clicking or a catch deep in the joint
- Noticeably less internal rotation compared with the other arm
On-site diagnosis at The Arm Doc
- Shoulder motion audit – We measure true IR/ER, total arc, and scapular control.
- Provocative tests – Posterior impingement sign & Jobe relocation to pinpoint the “kissing” spot.
- High-resolution ultrasound or in-office MRI referral – Spots partial articular-sided cuff tears, SLAP lesions, cysts, or a Bennett spur.
- Kinetic-chain screen – Core, hips, and thoracic spine all checked; weak links up the chain overload the shoulder.
You’ll leave the first visit with crystal-clear answers—no round-robin referrals.
Game-changing, non-surgical care
Focus area | What we do | Why it works |
Posterior capsule stretch | Daily sleeper & cross-body stretches; manual therapy | Restores lost IR ➜ reduces “pinch” angle |
Rotator-cuff & scapular re-balance | Serratus “plus” push-ups, prone “T/Y,” band ER/IR at 90° | Re-centers humeral head; off-loads cuff |
Kinetic-chain power | Core planks, hip drives, medicine-ball throws | Transfers energy from legs ➜ arm, sparing shoulder |
Throwing-mechanics tune-up | Video analysis + coach feedback | Fixes hyper-angulation & late arm lag |
Load management | Graduated return-to-throw or serve plan | Heals tissue without losing conditioning |
Most committed athletes feel marked relief in 4-6 weeks and start a controlled throwing progression by week 8-10.
When surgery makes sense
If a player still can’t perform after an aggressive 3-4-month rehab, we consider minimally invasive options:
- Arthroscopic debridement of frayed cuff/labrum (“clean-up”)
- Partial-thickness cuff repair when > 50 % of tendon is involved
- SLAP repair or biceps tenodesis for unstable superior labrum
- Posterior capsule release for stubborn GIRD
Our fellowship-trained surgeons use camera-guided, suture-anchor techniques that protect the axillary nerve and respect the demands of overhead sport.
Recovery roadmap after scope (typical)
- Week 0-2 Arm sling only for comfort; start wrist/elbow moves
- Week 2-4 Passive then active-assist shoulder range; gentle sleeper stretch
- Week 4-8 Light band strengthening; scapular control drills
- Week 8-12 Advance to weighted ER/IR, plyo-ball tossing
- After week 12 Gradual mound work / serving program with radar feedback
Expect full competitive return 4-6 months post-op (sometimes sooner after simple debridement).
Why serious throwers choose The Arm Doc
- Sports-specialised therapists on site – coordinated care every visit
- Pitch-count & serving analytics – we blend biomechanics with medical science
- No-wait imaging – same-day ultrasound & priority MRI slots
- Pro-level protocols – our algorithms mirror what MLB, ATP, and NCAA programs use
- Personal playbook – you get a printed and digital plan with milestones, stretch sheets, and video links
Don’t let “thrower’s shoulder” bench your season. Click BOOK NOW or call 555-ARM-DOCS for an expert evaluation today. With the right plan, you’ll be back to full velocity—and pain-free—in record time.
Call to Action
If you have pain, book an appointment to be reviewed by Prof Imam or another member of our specialist team at The Arm Clinic. Early specialist care helps prevent long-term issues. Visit www.TheArmDoc.co.uk or book your consultation today. Phone: 020 3384 5588 | Email: Info@TheArmDoc.co.uk
Disclaimer
This information is for general educational purposes and should not be used as a substitute for professional medical advice. Consult a healthcare professional for individual guidance on your condition and treatment options.
This page was last clinically updated in May 2025
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