Neer impingement test

Clinical test for shoulder impingement

The Neer impingement test is a clinical examination procedure used to assess shoulder impingement syndrome. This test is named after Dr. Charles Neer, who first described it as a method to diagnose impingement of the rotator cuff tendons and the subacromial bursa beneath the acromion of the shoulder.

Procedure

Neer impingement test being performed

The Neer impingement test is performed with the patient either sitting or standing. The examiner stabilizes the patient's scapula with one hand while passively flexing the patient's arm forward with the other hand. The arm is internally rotated, and the examiner continues to elevate the arm in the scapular plane. This maneuver compresses the greater tuberosity of the humerus against the anterior acromion, potentially reproducing pain if there is impingement.

Interpretation

A positive Neer impingement test is indicated by pain in the anterior or lateral aspect of the shoulder, suggesting impingement of the supraspinatus tendon or the subacromial bursa. It is important to note that while a positive test suggests impingement, it is not specific for the exact structure involved and should be considered alongside other clinical findings and tests.

Clinical Significance

The Neer impingement test is commonly used in the evaluation of patients with shoulder pain. It helps in diagnosing subacromial impingement syndrome, which can be caused by various factors such as rotator cuff tendinitis, bursitis, or acromioclavicular joint arthritis. Early diagnosis and management of impingement can prevent progression to more severe conditions like rotator cuff tears.

Limitations

While the Neer impingement test is a useful tool in the clinical assessment of shoulder pain, it is not definitive. False positives can occur, and the test does not differentiate between different causes of impingement. Therefore, it should be used in conjunction with other diagnostic tests, such as the Hawkins-Kennedy test, and imaging studies like MRI or ultrasound for a comprehensive evaluation.

Related pages

• Shoulder impingement syndrome
• Rotator cuff
• Subacromial bursa
• Hawkins-Kennedy test