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Neer test for subacromial impingement. The Neer impingement test is a test designed to reproduce symptoms of rotator cuff impingement through flexing the shoulder and pressure application. Symptoms should be reproduced if there is a problem with the supraspinatus or biceps brachii. [1] This test is also associated with the Hawkins-Kennedy Test ...
Hawkins–Kennedy test: a positive test indicates shoulder impingement syndrome; Empty beer can test: a positive test indicates rotator cuff tear, specifically, supraspinatus muscle tear; Drop arm test: a positive test indicates a supraspinatus tear; External Rotation test: a positive test indicates an infraspinatus or teres minor tear
On physical exam, the physician may twist or elevate the patient's arm to test for reproducible pain (the Neer sign and Hawkins-Kennedy test). These tests help localize the pathology to the rotator cuff; however, they are not specific for impingement. [16] Neer sign may also be seen with subacromial bursitis. [17]
The patient performs an isometric flexion contraction against resistance of the therapist (Speed’s Test). When the therapist’s resistance is removed, a sudden jerking motion results and latent pain indicates a positive test for bursitis. [8] Neer’s Sign: If pain occurs during forward elevation of the internally rotated arm above 90°.
The tests differ in the rotation of the arm; in the empty can test, the arm is rotated to full internal rotation (thumb down) and in the full can test, the arm is rotated to 45° external rotation, thumb up. [1] Once rotated, the clinician pushes down on either the wrists or the elbow, and the patient is instructed to resist the downward pressure.
The Hawkins–Kennedy Test is a test used in the evaluation of orthopedic shoulder injury. It was first described in the 1980s by Canadians R. Hawkins and J. Kennedy, and a positive test is most likely indicative of damage to the tendon of the supraspinatus muscle .
Jobe's test is a physical exam test that is used to detect anterior shoulder instability. It is used to distinguish between anterior instability and primary shoulder impingement. This test should be performed after the Apprehension test. [3] This test was named for Christopher Jobe. [4]
Distraction tests: positive tests are rechecked when the patient's attention is distracted, such as a straight leg raise test; Regional disturbances: regional weakness or sensory changes which deviate from accepted neuroanatomy; Overreaction: subjective signs regarding the patient's demeanor and reaction to testing