Neer Impingement Test

The Neer Test also considered as Neer Impingement Test is one of the ways used to determine shoulder impingement syndrome. This condition is definitely caused by the inflammation and compression of the tendons of the rotator cuff muscles when they go through the subacromial space.

Indication for the Neer Impingement Test

The Neer Test is indicated for patients who present with symptoms suggestive of shoulder impingement syndrome, such as:

• Anterior shoulder pain.
• Pain that increases with overhead work.
• Restricted shoulder mobility, it is one of the common joints which people stand loose.It referred to the Body Control where weakness was seen in the muscles of the shoulder.

How to Perform the Neer Impingement Test

To perform the Neer Test, the physiotherapist follows these steps:

1. Positioning: The position of the patient is seated or standing for this procedure.
2. Starting Position: The physiotherapist immobilizes the patient’s scapula to avoid movement of the scapula.
3. Passive Elevation: The patient stands in the doorway with the backward curve of the elbow facing the physiotherapist and lies the hand on the opposite shoulder while the physiotherapist places the patient’s hand on the patient’s opposite shoulder and<|reserved_special_token_274|> flexes the elbow passively and brings the patient’s arm to the scapular plane and internally rotates it.
4. Observation and Palpation: The maneuver is done and the patient’s response together with the reaction of the patient in terms of pain or discomfort is taken note of by the physiotherapist.

Assessment Outcome of Neer Impingement Test

• Positive Test: There is some discomfort, which could be in the form of pain, in the anterior or lateral shoulder when the patient’s arm is passively lifted during the evaluation for shoulder impingement.
• Negative Test: There is no discomfort felt by the patient, pointing out that the extent of shoulder impingement is rather low.

Differential Diagnosis with Neer Impingement Test

The Neer Test is useful for differentiating shoulder impingement syndrome from other shoulder pathologies, such as:

• Rotator cuff tears.
• Adhesive capsulitis (frozen shoulder).
• Biceps tendonitis.
• Glenohumeral joint arthritis.
• Acromioclavicular joint pathology.

Related Neer Tests

• Hawkins-Kennedy Test
• Empty Can Test
• Drop Arm Test
• Lift Off Test
• Speed’s Test
• Yergason’s Test

Evidence Based Physiotherapy 

The literature review has shown that research evidence supports the inclusion of the Neer Test in an overall examination of shoulder impingement syndrome. When integrated with other clinical assessment tools, the test when used in conjunction with an MRI or ultrasound, significantly improves the diagnostic outcome.

Possible areas of study for future physiotherapy research may include diagnosis and imaging technologies that are even more accurate, dynamics of imaging modalities and discharge modification plans for the shoulder impingement syndrome. A patient specific rehabilitation program also has been highlighted in research focusing on strength training, scapular stabilization, manual therapy, and self-care education regarding activity modification and ergonomics.

More and more studies are indicating that integrated application of proprioceptive training, kinetic chain exercises and neuromuscular re-education in patients with SIS is beneficial and favorable for enhancing the clinical results. Future studies are needed to better define the treatment algorithms, enhance nonsurgical management, and promote the patients’ well-being based on evidence-based practices.