Chronic shoulder pain is probably the most common upper extremity problem in recreational, competitive, and elite athletes. Obviously, this is a particular problem for athletes who rely on full function of the upper extremity for their sport. Throwing athletes, athletes involved in racquet sports, gymnasts, volleyball players, and swimmers are just a few examples of athletes who need full, unrestricted upper extremity function to perform in their sport. Even a mild degree of shoulder pain and dysfunction can result in complete disability for their respective sports.

The causes of shoulder pain in athletes are numerous. Acute injuries of the shoulder are often obvious. Shoulder dislocations and acromioclavicular joint separations are among the most frequent acute shoulder injuries. Chronic shoulder pain often has a less obvious cause. Common causes of chronic shoulder pain include chronic glenohumeral instability, rotator cuff tendon pathology, degenerative changes in the acromioclavicular joint, and labral pathology. This discussion focuses primarily on rotator cuff tendon pathology, particularly as it relates to the phenomenon of impingement. Other sources of chronic shoulder pain are discussed only in broad terms to allow differentiation from impingement problems.