The Hawkins Kennedy Test is a physical examination maneuver healthcare professionals use to evaluate individuals experiencing shoulder pain. It serves as a diagnostic tool to help identify the potential source of shoulder issues. This test is a component of a comprehensive assessment performed by a trained medical professional.
Understanding Shoulder Impingement
The Hawkins Kennedy Test primarily assesses shoulder impingement syndrome, a condition where structures within the shoulder become pinched. This pinching often occurs in the subacromial space, a narrow area beneath the acromion (a bony projection of the shoulder blade). Within this space, the rotator cuff tendons, particularly the supraspinatus tendon, and the subacromial bursa (a fluid-filled sac) are located.
Shoulder impingement can arise from repetitive overhead activities (e.g., in sports like swimming or baseball) or occupations requiring frequent arm elevation. Anatomical variations, such as a curved acromion, can narrow the subacromial space, making some individuals more prone to impingement. Inflammation of the rotator cuff tendons (tendinitis) or bursa (bursitis) also causes swelling, reducing the space and leading to compression.
Individuals with shoulder impingement experience pain that worsens with overhead arm movements or reaching behind their back. The pain often feels dull but can be sharp during certain motions, and may radiate from the front of the shoulder down the arm. Weakness, tenderness, and difficulty sleeping (especially when lying on the affected side) are also common symptoms.
Performing the Hawkins Kennedy Test
A healthcare professional performs the Hawkins Kennedy Test with the individual seated or standing. The examiner flexes the patient’s arm forward 90 degrees at the shoulder, with the elbow bent 90 degrees. The examiner then supports the arm and passively rotates it inward.
This maneuver reduces the space between the humeral head (upper arm bone) and the acromion. If structures like the supraspinatus tendon or subacromial bursa are inflamed or compressed, this internal rotation pinches them. This test should only be performed by a trained medical professional.
Interpreting the Test Results
A positive Hawkins Kennedy Test result is indicated by the reproduction of shoulder pain during the maneuver. The pain is felt at the front or side of the shoulder, suggesting soft tissue compression within the subacromial space. Conversely, a negative result means the test does not provoke pain.
While a positive test suggests shoulder impingement, it is not a definitive diagnosis on its own. The test is a diagnostic indicator used with other physical examination tests, a review of the patient’s medical history, and an assessment of reported symptoms. This comprehensive approach helps healthcare providers arrive at an accurate diagnosis and develop a treatment plan.
Beyond the Test: Next Steps
If the Hawkins Kennedy Test is positive and shoulder impingement is suspected, further diagnostic steps confirm the condition and identify contributing factors. Imaging studies are recommended. X-rays can reveal bone spurs or abnormal acromion shapes narrowing the subacromial space. Magnetic resonance imaging (MRI) or ultrasound provides detailed views of soft tissues, identifying inflammation or tears in the rotator cuff tendons or bursa.
Treatment for shoulder impingement typically begins with conservative measures. These may include rest from activities that aggravate the shoulder, physical therapy to strengthen shoulder muscles and improve range of motion, and anti-inflammatory medications like NSAIDs to manage pain and swelling. Corticosteroid injections into the subacromial space can also help reduce inflammation and pain. If conservative treatments do not provide sufficient relief, surgical intervention, such as subacromial decompression (acromioplasty), may be considered to create more space for the tendons and bursa.