One of the most common pathological condition in overhead throwing-athletes is posterior shoulder pain due to internal impingement. It basically occurs due to the compression of the rotator cuff tendon between the greater tubercle of the humerus and the posterior upper corner of the glenoid. The main problem of this pathological process is degeneration in the anatomical and physiological structure of the shoulder with repetitive shoulder abduction and compelling external rotation movements. Overhead throwing athletes generally complain of shoulder stiffness, the need for prolonged warming up, poor performance and posterior shoulder pain. Physical examination findings are internal rotation limitation in the shoulder joint and posterior shoulder pain caused by posterior compression test. In these patients, rotator cuff tears, labrum lesions and Bennett`s lesion (glenoid exocytosis) can be seen in MRI and radiographs. Since the results of surgical treatment are unpredictable, conservative methods such as posterior capsule stretching exercise and anti inflammatory treatment should be the first line. It is very important to determine the actual pathology in patients who will undergo surgical treatment.