What is behind the impingement syndrome in athletes? Scapular dyskinesia and glenohumeral internal rotation deficit

Background Posterior impingement in athletes represents a demanding limitation especially in forms of sport involving throwing. The reason is often a glenohumeral internal rotation deficit (GIRD) or scapular dyskinesia. Objective This article presents the current state of the art in the recognition, differentiation and treatment of GIRD and scapular dyskinesia. Material and methods The focus is on the recognition and special treatment of posterior shoulder impingement. Results The throwing mechanism or similar movements lead to continuous overload of the static and dynamic structures of the glenohumeral joint, which often results in GIRD and scapular dyskinesia. The kinetic alterations of the mechanics results in an increased risk for injuries of the posterior labrum and rotator cuff. Consistent treatment schemes with a stepwise build-up show good results in professional athletes with normalization of the symptoms. Conclusion Posterior impingement is often due to GIRD or scapular dyskinesia. These pathologies must be recognized and subsequently treated in an appropriate stepwise regimen so that the fundamental mechanics can be restored. With close control good results with respect to returning to the previous activity level and the reduction of accompanying injuries are possible.