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Location: bursal side (standard subacromial location when most think of impingement). Or, external impingment), and articular side (what most would deem internal impingement).

Internal impingement is most commonly seen in overhead athletes and is typically the result of hyperlaxity in the anterior direction. As Mike Reinold has noted on several occasions,

the easiest visual I can use here is when a pitcher goes into maximal external rotation. Here, not only do you have 40+ lbs of valgus force pulling down on the elbow, but you also have quite a bit of torque at the shoulder joint as well. For intents and purposes, it’s a VERY violent act on the joint as a whole, and it’s no wonder that this is a common injury we see with many of the athletes we see.

Since it’s safe to assume that your mom isn’t throwing bullpens on the side, we c

Primary: can be thought of as generally more of a structural issue. Using the most obvious example, one can immediately look to acromial type. Type 1 vs. type 2, vs type 3.

Secondary impingement, on the other hand, is typically the result of someone’s posture. Whether we can point to specific imbalances, specific imbalances, activities,

More often than not, secondary impingement

Prima

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