Quiz: Your pt. Has a "+" Neer's Test. You want to 100% Confirm Superior Shoulder Impingement, You Perform...
A. Kennedy Hawkins Test
B. Post-Inf Mob to Humeral Head
C. Drop Arm Test
***CLINCAL REASONING: I published a paper a couple years ago on shoulder issues detailing how I diagnose shoulder issues with protocols on how to fix these conditions these can be found at www.wheltonmethods.com.
The answer is “B” Mobilize the humeral head posteriorly and inferiorly. “Mobilize the humeral head posteriorly and inferiorly with the pt. in the position of pain”
I found over the years, that impingement pts. ALL had a tight posterior and/or inferior capsule throwing off the mechanics of GH joint causing an impingement. I started doing a Neer’s test and then asking the pt. to keep their arm in the position of pain and simultaneously performing a posterior and inferior humeral head glide and hold it there, the pt. would state the pain was instantly gone. This CONFIRMED to me that not only did the patient have an impingement, but it also told me the cause!
The Kennedy-Hawkins and Neer’s test are both good but I usually do the Neer’s and then joint mob to confirm as described. Remember these two tests INDICATE an impingement but doesn’t confirm nor do they tell you the cause.
The drop arm test is what I do on ALL my shoulder patients as I test myotome/MMT first to make sure there is no tear. I would not use it to confirm an impingement.
I know this is different than we learned in school but I believe if you do it this way you would see this is more accurate and produce better results, Give it a shot!
