What Is Hawkins Kennedy Impingement? | Physiotherapy

Hawkins Kennedy Impingement

Hawkins Kennedy impingement

Hawkins Kennedy test is indicative of clamping of all structures that lie between the greater tubercle of the humerus and the coracohumeral ligament. Structures affected include the supraspinatus muscle, teres minor muscle, and infraspinatus muscle.


Hawkins Kennedy test is commonly used to identify likely subacromial impingement syndrome.

Test purpose: To test the subacromial impact.

Test position: Sitting or standing.

Performing the test

The examiner sets the patient’s shoulder in 90 degrees of accept flexion with the elbow flexed at 90 degrees. Then the therapist internally rotates the patient’s arm passively. If the patient has pain with interior rotation, the test is considered positive.

Diagnostic precision

  • Understanding: 92.1
  • Specificity: 25; + LR: 1.23; -LR: 32

Importance of the Hawkins Kennedy test

Placing the patient in 90 degrees of shoulder flexion and internal rotation decreases the space between the humeral head and the lower part of the acromion process. If this space narrows, structures in the subacromial space, such as the supraspinatus tendon or the subacromial bursa, will compress and elicit a pain response.

It is significant to note that this test performed alone fixes not have good diagnostic accuracy. A clinician should use the group to identify subacromial impingement if they suspect that a patient has this syndrome. The group consists of:

  • Positive Hawkins-Kennedy impingement sign
  • Painful arch sign
  • Weak or painful manual infraspinatus muscle test.

Group diagnostic accuracy

  • If all 3 tests are positive, the + LR rises to 10.56.
  • If all 3 tests are undesirable, the -LR is .17
  • If the ⅔ tests are confident, the + LR falls to 5.01. If ⅓ are confident, the + LR is 90.

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