Name two provocative tests for shoulder impingement.

• A. Hawkins-Kennedy and Neer
• B. O'Brien's and Speeds
• C. Empty can and drop arm
• D. Neer and Finkelstein

Answer: (A)

Shoulder impingement provocative tests work by putting the subacromial space under compression to reproduce pain from the rotator cuff tendons and bursa being pinched under the acromion. The Hawkins-Kennedy test does this by flexing the elbow to 90 degrees, pronating the forearm, then guiding the arm into further flexion with internal rotation. This movement narrows the space beneath the acromion and compresses the supraspinatus tendon, so painful reproduction points to impingement.

The Neer test achieves the same goal through a different route: with the scapula stabilized, the arm is passively moved into full forward flexion in the scapular plane, which stuffs the rotator cuff tendons under the anterior acromial arch. Pain elicited during this maneuver suggests impingement of subacromial structures.

Other options target different issues. For example, tests like O’Brien’s are used more for identifying SLAP lesions of the glenoid labrum, while Speeds tests focus on bicipital tendinopathy. The empty can test assesses supraspinatus function or tendinopathy but is not primarily an impingement-provocation maneuver, and the Finkelstein test is a wrist/thumb condition.