In briefActivities such as pitching, swimming, and serving a tennis ball, which involve overhead movement of the arm, can cause pain around the shoulder. Rotator cuff impingement syndrome is confusing for physicians to diagnose, so the physical examination must be done systematically. Young athletes with the syndrome usually have an insidious onset of soreness in the shoulder that becomes more severe if they continue the offending activity. Treatment revolves around decreasing inflammation, increasing shoulder function, and correcting the cause of the problem. With proper diagnosis and treatment, nonsurgical treatment is successful and allows most patients to return to their previous level of activity.