Key Points

• Diagnosis of joint injuries is usually clinical based on the subcutaneous anatomy. Special care should be taken to rule out injury to associated neurovascular structures.

• Baseline imaging studies of the shoulder should always include a second tangential view of the scapula and glenoid. The best radiographic screening series is an anteroposterior view in internal rotation, AP view in external rotation, and axillary view of shoulder.

• Impingement, rotator cuff injuries, and shoulder instability are best diagnosed with a panel of clinical assessment tools rather than an isolated maneuver.

• Performance, injury prevention, and injury recovery of shoulder problems are optimized when the entire kinetic chain is addressed, including a sound base, core strength, scapular stability, antagonist capsular and muscle stretching, and classic rotator cuff-strengthening program.

The true functional shoulder joint comprises the glenohu-meral joint, scapular thoracic joint, acromioclavicular joint, and sternoclavicular joint. Problems around the shoulder can be acute or chronic and include pain, weakness, dysfunction, stiffness, and instability. To ensure optimal outcome of treatment, an accurate, anatomic-based diagnosis is necessary. Less targeted treatment regimens tend to be less successful. Several evidence-based reviews remain inconclusive regarding specific interventions when a nonspecific diagnosis such as "shoulder pain" is targeted.

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