What are the Neer and Hawkins Kennedy impingement tests?
These are provocative maneuvers that are very sensitive (80%–90%) for impingement but not very specific (30%–50%). The Neer test causes pain when the patient’s shoulder is flexed forward maximally by the examiner, while the arm is internally rotated (palm down) and the shoulder is stabilized. The Hawkins–Kennedy test reinforces a positive Neer impingement test. The examiner puts the shoulder into 90 degrees of forward flexion and flexes the elbow to 90 degrees. The arm is internally rotated as if the patient is emptying a can of soda in front of themselves. Both these maneuvers compress the greater tuberosity of the humerus against the anterior acromion (Neer test) or coracoacromial ligament (Hawkins–Kennedy test) and elicit discomfort in patients who have a rotator cuff tear or impingement.