Describe the Hawkins Kennedy test protocol.

• A. With shoulder flexed to 90 degrees and elbow flexed to 90 degrees, the examiner stabilises the elbow and forcibly internally rotates the humerus.
• B. With arm abducted to 30 degrees, the examiner externally rotates the humerus.
• C. The patient performs resisted forward flexion with the arm at the side.
• D. The examiner applies traction while the arm is extended.

Answer: (A)

Subacromial impingement is being evaluated, focusing on whether the space under the acromion is compressing the rotator cuff tendons and subacromial bursa. In this protocol, the arm is brought to 90 degrees of forward flexion with the elbow bent at 90 degrees, and the examiner stabilizes the elbow while passively rotating the humerus inward. This internal rotation tightens the space under the coracoacromial arch and can pinch the supraspinatus tendon and surrounding structures. If this maneuver reproduces the patient’s familiar shoulder pain, it suggests impingement or rotator cuff pathology, making it the best description of the Hawkins-Kennedy test.

The other options describe different shoulder maneuvers that don’t match this impingement test: external rotation with a small degree of abduction targets a different provocative position; resisted forward flexion is a strength/functional test rather than a passive impingement maneuver; and applying traction with the arm extended relates more to stability or other joint structures rather than subacromial space impingement.