Diagnostic pitfalls in shoulder impingement syndrome in overhead athletes: a narrative review

Jaxon S. Boley; Matthew Majer; Dona Hasou

doi:10.18203/issn.2455-4510.IntJResOrthop20261242

Authors

Jaxon S. Boley American University of the Caribbean School of Medicine, Sint Maarten
Matthew Majer American University of the Caribbean School of Medicine, Sint Maarten
Dona Hasou Randolph Health, Asheboro, North Carolina

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20261242

Keywords:

Sports medicine, Overhead athletes, Shoulder instability, Diagnostic pitfalls, Internal impingement

Abstract

Shoulder impingement syndrome is a frequently assigned diagnosis in overhead athletes presenting with shoulder pain, yet it often serves as a nonspecific label rather than a precise explanation of symptoms. In this population, impingement complaints are more commonly secondary to altered glenohumeral mechanics, scapular dyskinesis, instability, or kinetic chain dysfunction rather than primary structural narrowing of the subacromial space. As a result, misdiagnosis is common and may lead to prolonged symptoms, ineffective rehabilitation, or unsuccessful surgical intervention. This narrative review examines common diagnostic pitfalls encountered in the evaluation of shoulder impingement syndrome in overhead athletes, discusses the limitations of imaging, and emphasizes the importance of sport-specific clinical assessment. A structured diagnostic algorithm is proposed to improve diagnostic accuracy and guide management in this challenging patient population.

Author Biographies

Matthew Majer, American University of the Caribbean School of Medicine, Sint Maarten

Student

Dona Hasou, Randolph Health, Asheboro, North Carolina

Hospitalist Medical Director

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