Which test specifically provokes shoulder impingement with forward flexion and internal rotation?

• A. Neer test
• B. Hawkins-Kennedy test
• C. Cozen's test
• D. Phalen's test

Answer: (A)

Impingement tests work by narrowing the space under the acromion to reproduce pain when the rotator cuff tendons are irritated. The Neer test specifically uses a passive forward elevation with the scapula stabilized and the arm in internal rotation, which pushes the humeral head under the coracoacromial arch and narrows the subacromial space. This position directly provokes impingement of the supraspinatus tendon, so pain reproduced during this maneuver is a classic sign of impingement. The Hawkins-Kennedy test also targets impingement but through a different mechanics—elevating the arm to about 90 degrees with the elbow flexed and then internally rotating to compress the structures—so it isn’t the described forward-flexion with internal rotation pattern. Cozen’s test and Phalen’s test assess elbow and wrist/hand conditions, not shoulder impingement.