Physical Exam

Hawkins Impingement Sign

also known as Hawkins-Kennedy test

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Video coming September 2026

How to Perform

Flex the patient's shoulder and elbow to 90° (arm forward, elbow bent), then forcibly internally rotate the shoulder by pressing the forearm and hand downward. A positive test is pain.

How to Interpret

Subacromial Impingement

Hawkins-Kennedy impingement sign positive

Rule in

Minimally helpful

Rule out

Somewhat helpful

Evidence:Strong

Supraspinatus Tendinopathy

Hawkins-Kennedy impingement sign positive

Rule in

Not helpful

Rule out

Not helpful

Evidence:Limited

References

Alqunaee M, Galvin R, Fahey T. Diagnostic accuracy of clinical tests for subacromial impingement syndrome: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2012;93(2):229-236. doi:10.1016/j.apmr.2011.08.035. PMID 22289231. DARE quality-assessed (NBK91532). PRISMA-style systematic review; bivariate random-effects meta-analysis; QUADAS; 10 studies, 1684 patients; arthroscopy or open surgery reference standard.
Alqunaee M, Galvin R, Fahey T. Diagnostic accuracy of clinical tests for subacromial impingement syndrome: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2012;93(2):229-236. doi:10.1016/j.apmr.2011.08.035. PMID 22289231. (Closest source; pools the Hawkins-Kennedy test for SIS, not for this specific target.)
Balevi Batur E, Bekin Sarikaya PZ, Kaygisiz ME, Albayrak Gezer I, Levendoglu F. Diagnostic Dilemma: Which Clinical Tests Are Most Accurate for Diagnosing Supraspinatus Muscle Tears and Tendinosis When Compared to Magnetic Resonance Imaging? Cureus. 2022 Jun 13;14(6):e25903. doi:10.7759/cureus.25903. PMID: 35844349. PMCID: PMC9278872. Open access, CC BY 4.0.
Hawkins RJ, Kennedy JC. Impingement syndrome in athletes. Am J Sports Med. 1980;8(3):151-158.