User:Jwil224/Hawkins-Kennedy Impingement Test

Purpose
Hawkins-Kennedy Impingement Test is a clinical test to diagnose shoulder impingement.

Procedure
The patient is sitting or standing and the shoulder, elbow, and wrist are relaxed in the anatomical position. The examiner stands in front of or on the side of involved side of the seated patient with one hand grasping the subject’s elbow and the other hand grasping the subject’s wrist, both on the test arm.

Mechanism
With the elbow flexed, the glenohumeral joint is elevated to 90 degrees in the scapular plane. At this point, the humerus is passively internally rotated until painful or scapular rotation is felt or observed. This reproduces the symptoms of rotator cuff impingement.

Results
A positive test is shoulder pain and apprehension with motion, especially near the end of the range of motion. This means a pathology is present in the rotator cuff group (especially the supraspinatus) or the long head of the biceps brachii. The motion of the test impinges these structures between the greater tuberosity and the inferior side of the acromion process.

Adverse Effects
If this is the only positive test for impingement, further evaluation of the AC joint should occur, because a level of cross-arm adduction can occur and may be painful in those with AC pathology. If the humerus is brought in toward the sagittal plane, the chance of eliciting a false-positive result secondary to acromioclavicular (AC) joint pathology heavily increases. Finally, this test tends to be the most sensitive for assessing subacromial impingement.

History
Hawkins and Kennedy described this test in 1980 as an alternative test for supraspinatus outlet impingement.