Physical Exam

Neer Impingement Sign

also known as Neer test

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Video coming September 2026

How to Perform

Stand to the side of the patient, stabilize the scapula with one hand, and with the other hand passively raise the arm into full forward flexion with the forearm pronated (palm down). A positive test is pain in the anterior or lateral shoulder near end-range.

How to Interpret

Rotator Cuff Tear

Neer impingement sign positive

Rule in

Minimally helpful

Rule out

—

Evidence:Limited

Subacromial Impingement

Neer impingement sign positive

Rule in

Minimally helpful

Rule out

Somewhat helpful

Evidence:Strong

Supraspinatus Tendinopathy

Neer impingement sign positive

Rule in

Not helpful

Rule out

Not helpful

Evidence:Limited

References

Zhao Q, Palani P, Kassab NS, Terzic M, Olejnik M, Wang S, Tomassini-Lopez Y, Dean C, Shellenberger RA. Evidence-based approach to the shoulder examination for subacromial bursitis and rotator cuff tears: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2024 Dec 19;25(1):1028. doi:10.1186/s12891-024-08144-z. PMID 39702033. PMC11660602.
Zhao Q, Palani P, Kassab NS, Terzic M, Olejnik M, Wang S, Tomassini-Lopez Y, Dean C, Shellenberger RA. Evidence-based approach to the shoulder examination for subacromial bursitis and rotator cuff tears: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2024;25(1):1028. doi:10.1186/s12891-024-08144-z. PMID 39702033. (Closest source; pools the Neer test for RCT and SIS, not for this specific target.)
Zhao Q, Palani P, Kassab NS, Terzic M, Olejnik M, Wang S, Tomassini-Lopez Y, Dean C, Shellenberger RA. Evidence-based approach to the shoulder examination for subacromial bursitis and rotator cuff tears: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2024;25(1):1028. PMID: 39702033.
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.
Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972;54(1):41-50.