Shoulder Impingement Evidence: confirmed

Neer Impingement Test Special Test

Orthopedic Physical Examination & Clinical Assessment Guide

Neer Impingement Test Orthopedic Special Test

What is it used for?

  • Diagnosing Subacromial Impingement (Supraspinatus/Biceps tendon overuse).

How to Perform

  • Position: Patient seated.
  • Action: Examiner stabilizes the scapula with one hand to prevent rotation.
  • Movement: Passively and forcibly elevate the patient's arm in the scapular plane with the arm internally rotated (thumb down).

Interpretation of Results

  • Positive Test: Pain in the anterior-lateral shoulder (Greater Tuberosity jamming against the acromion).

Diagnostic Accuracy

  • Sensitivity: 75-89%
  • Specificity: 30-48%

Clinical Context & Limitations

The Neer Impingement Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.

Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Shoulder region, combining the Neer Impingement Test with complementary examination tests significantly improves overall diagnostic confidence.

References

  • Magee, D. J. (2021). Orthopedic Physical Assessment.

Further Clinical Exploration

Hawkins-Kennedy Test
Shoulder Examination

Hawkins-Kennedy Test

Coracoid Impingement Sign
Shoulder Examination

Coracoid Impingement Sign

Internal Rotation Resistance Stress Test (IRRST)
Shoulder Examination

Internal Rotation Resistance Stress Test (IRRST)

Empty Can Test (Jobe's)
Shoulder Examination

Empty Can Test (Jobe's)