Which test is associated with impingement of the rotator cuff - specifically the supraspinatus or the long head of the biceps tendon?

• A. Neer Test
• B. Hawkins-Kennedy Test
• C. Internal Rotation Resisted Strength Test
• D. Clunk/Jerk Test

Answer: (A)

Impingement of the rotator cuff under the acromial arch, particularly the supraspinatus tendon and often the long head of the biceps tendon, is best identified by a test that compresses these structures during forward elevation. In the Neer test, the patient sits or stands while the examiner stabilizes the scapula and passively moves the arm into full forward flexion with the arm internally rotated. This motion narrows the subacromial space and pinches the tendons under the tip of the acromion, reproducing pain if impingement is present. The pattern of pain during this maneuver points to impingement involving the supraspinatus and sometimes the long head of the biceps tendon, making it a classic screening maneuver for subacromial impingement.

Hawkins-Kennedy also aims to provoke impingement, but by flexing the elbow and shoulder to 90 degrees and then internally rotating, it stresses the same subacromial tissues in a different plane. Internal Rotation Resisted Strength Test focuses on the subscapularis muscle, not impingement of the supraspinatus or biceps tendon. Clunk/Jerk tests are geared toward labral pathology, not impingement.