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Shoulder injuries in athletes continue to pose diagnostic and therapeutic challenges for the treating physician. Overhead athletes have a predisposition for shoulder injuries because of repetitive use in extremes of motion. Improved understanding of the role of the scapula and its contribution to pathologic shoulder conditions has improved the rehabilitation of the overhead athlete's shoulder. Advances in arthroscopy have led to the discovery of superior labral and biceps anchor injuries, internal impingement, and subtle glenohumeral instability. Improved arthroscopic techniques have made it possible to successfully manage some of these complex injuries in the athlete's shoulder. Most recently, thermal treatment of lax capsular tissue has been introduced as a possible adjunct in the treatment of the symptomatic overhead athlete.