The Neer and Hawkins impingement signs are commonly used to diagnose subacromial pathologies such as subacromial bursitis, rotator cuff tendinitis, and the rotator cuff tear.
The Neer Impingement Test may be a test designed to breed symptoms of structure impingement through flexing the shoulder and pressure application. Symptoms should be reproduced if there’s a drag with the supraspinatus or musculus biceps brachii. This test is additionally related to the Hawkins-Kennedy Test and Jobe’s Test. The Neer and Hawkins impingement signs are commonly wont to diagnose subacromial pathologies like subacromial bursitis, structure tendinitis, and structure tear. The clinical usefulness of both signs has been reported.
Hawkins-Kennedy test: Forcefully internally rotate a 90° forwardly flexed arm, causing the supraspinatus tendon to impinge against the coracoacromial ligamentous arch. Note: Pain and a grimacing countenance indicate impingement of the supraspinatus tendon, indicating a positive Neer/Hawkins impingement sign.
Dr. Neer developed this test supported his observations during shoulder surgery. He reported that the critical area for degenerative tendonitis and tendon ruptures was focused on the supraspinatus tendon and sometimes involved the anterior infraspinatus and infrequently the long head of the biceps. Elevation of the arm in external or internal rotation causes critical areas to pass under the coracoacromial ligament or anterior acromion.
Test
The examiner performs maximal passive abduction in the scapular plane, with internal rotation, whilst stabilizing the scapula.
Positive
Pain located to the sub-acromial space or anterior edge of the acromion
False-positive
Internal impingement Macdonald et al (2000)
– Bankart 25%
– SLAP 46.1 %
Research
Valadie’s paper demonstrated soft tissue contact with the medial acromion and contact between the articular surface of the rotator cuff and anterior- superior glenoid rim.
Sensitivity = 88.7%
Specificity = 30.5%
Reliability = 98%
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