Rotator cuff injuries in sports are usually a result of microtrauma from repetitive movements. Classic, or primary, impingement results directly from overhead motions, and secondary impingement is related to underlying shoulder instability. A variety of physical maneuvers are used to assess pain, muscle weakness, and shoulder stability. The workup also includes plain x-rays, supplemented by other imaging tests if a cuff tear is suspected. Nonoperative treatment, which may include steroid injections, is often effective for an inflamed rotator cuff tendon. Surgery is indicated if the patient has no improvement after at least 6 weeks of physical therapy.