To perform the Hawkins-Kennedy impingement test, the shoulder should be placed in which position?

• A. 90 degrees of flexion with 70 degrees of medial rotation
• B. Neutral at the patient's side
• C. 90 degrees of abduction and 30 degrees of horizontal adduction
• D. 90 degrees of abduction and 90 degrees of external rotation

Answer: (A)

This test assesses subacromial impingement by compressing the structures under the coracoacromial arch. Position the shoulder with about 90 degrees of forward flexion and the arm internally rotated to roughly 70 degrees (often with the elbow flexed at 90 degrees). This combination narrows the subacromial space and pinches the supraspinatus tendon and bursa; if impingement is present, it reproduces pain. The other positions do not place the tissues in that compressed subacromial space, so they’re less likely to provoke impingement symptoms.