There has been much controversy surrounding the issue of shoulder pain and the overhand athlete. Several hypotheses have been suggested as to the cause of the shoulder pain--subacromial impingement, anterior capsular laxity, internal or posterosuperior impingement, traction injury, and scapular imbalance. Treatment for the patient depends on the specific cause of the pain. As always, a full routine of nonoperative therapeutic measures should be administered before resorting to surgical intervention.