Hawkins-Kennedy Test: How to Assess Shoulder Subacromial Impingement

If the Neer test sounds familiar, the Hawkins-Kennedy test is its almost inseparable "sibling": both aim to reproduce subacromial impingement, but from a different angle. Many clinical protocols apply them together because, combined, they sharpen the suspicion of impingement considerably.

What does this test measure?

The Hawkins-Kennedy test aims to reproduce impingement of the subacromial structures (especially the supraspinatus tendon and subacromial bursa) by bringing the shoulder to 90° of flexion and internally rotating the humerus, which reduces the space between the humeral head and the coracoacromial arch.

Equipment needed

• None

Test protocol

1. The subject stands or sits, relaxed
2. Position yourself in front of or beside the subject
3. Passively raise the subject's arm to 90° of shoulder flexion with the elbow bent at 90°
4. From that position, internally rotate the shoulder (bringing the forearm toward the body, as if "pushing down" the hand)
5. Observe whether pain appears during internal rotation
6. Repeat on the contralateral side to compare

Common mistakes

• Not maintaining 90° of shoulder flexion before rotating (if the arm is lower, the test loses sensitivity)
• Performing the movement with excessive force, generating pain from capsular stretch rather than true impingement
• Not comparing with the healthy side, making it hard to assess whether the response is "normal" for that person

How to interpret the result

Result	Interpretation
No pain during internal rotation	Negative
Pain during internal rotation at 90° of flexion	Positive — suggests subacromial impingement (supraspinatus, subacromial bursa)

Like the Neer test, Hawkins-Kennedy has high sensitivity but limited specificity: a positive points to impingement but doesn't distinguish well between tendinopathy, bursitis, or even acromioclavicular pathology. That's why its value increases when combined with other tests.

Remember: it's a screening test, not a diagnosis.

Relationship with other tests

• Neer's test — both assess subacromial impingement from different angles; if both are positive, the suspicion of impingement is reinforced considerably
• Jobe's test — useful for specifically assessing the strength and integrity of the supraspinatus once impingement has been detected

Why tracking it matters

A shoulder with subacromial impingement often improves with programming changes (volume of overhead pressing, scapular control, thoracic mobility), but to know whether those changes are working you need a point of comparison. In Movalytics you can log the result of the Hawkins-Kennedy test (positive/negative) alongside other shoulder tests and track its evolution across assessments.

Frequently asked questions

Are Hawkins-Kennedy and Neer the same test? No, although they're looking for something similar. Neer raises the arm in flexion with sustained internal rotation; Hawkins-Kennedy brings the arm to 90° and rotates internally from there. They're considered complementary. What if Hawkins-Kennedy is positive but Neer is negative (or vice versa)? This can happen and doesn't invalidate the assessment. Each test has different sensitivity depending on the specific structure affected; that's why a battery of tests is recommended, not just one. Does this test diagnose a rotator cuff tear? Not directly. A positive indicates impingement, which may or may not coexist with a tear. Confirming the state of the tissue requires imaging (ultrasound or MRI). Note: this test is an indicative screening tool and does not replace a medical diagnosis or imaging study.