Posterior Internal Impingement Test: How to Check for Impingement

The Posterior Internal Impingement Test is a specific orthopedic test used to assess for impingement in the posterior-superior aspect of the shoulder, common in overhead athletes. Click the sections below for details on how to perform it.

1. Purpose

The primary purpose of this test is to **test for** posterior-internal impingement (also called posterosuperior impingement). This occurs when the supraspinatus and infraspinatus tendons and the posterior labrum are compressed between the humeral head and the posterior-superior glenoid rim, a common finding in throwing athletes.

2. How to Perform

1. The patient is positioned in supine (lying on their back).
2. The examiner stands beside the patient's affected shoulder.
3. The examiner passively brings the patient's shoulder into 90 to 110 degrees of abduction.
4. The examiner then applies maximal external rotation to the shoulder, bringing it into the "late cocking" phase of throwing.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test (indicating an issue) is:

• Reproduction of the patient's deep, posterior, or posterosuperior shoulder pain. This suggests impingement of the posterior rotator cuff and/or labrum.

Negative Sign (Test is NEGATIVE):
A negative test is the absence of posterior pain in the test position, or the presence of only anterior pain (which may suggest a different issue like instability).