Neer Impingement Sign

Jo Gibson, 2005

Dr Neer developed this test based on his observations during shoulder surgery. He reported that the critical area for degenerative tendonitis and tendon ruptures was focused on the supraspinatus tendon and at times involved the anterior infraspinatus and occasionally the long head of biceps. Elevation of the arm in external or internal rotation causes critical areas to pass under the coraco-acromialligament or anterior acromion.

Test

The examiner performs maximal passive abduction in the scapula plane, with internal rotation, whilst stabilising the scapula.

Positive

Pain located to the sub-acromial space or anterior edge of acromion

False positive

Internal impingement Macdonald et al (2000)

• Bankart 25%
• SLAP 46.1 %

Research

Valadie' s paper demonstrated soft tissue contact with the medial acromion and contact between the articular surface of the rotator cuff and anterior- superior glenoid rim.

• Sensitivity = 88.7%
• Specificity = 30.5%
• Reliability = 98%