Internal impingement is the presence of pathology on the undersurface of the rotator cuff. Symptoms include shoulder pain with throwing movements and a diffuse pain in the posterior shoulder region. The condition may be diagnosed by physical examination, x-rays, or MRI scans. Conservative treatment options include physical therapy with posterior capsule stretching and rotator cuff strengthening exercises. Operative treatment options include arthroscopic debridement, anterior stabilization, and posterior capsule release.