Hawkins Kennedy Test – Orthopedic Shoulder Examination

What is the Hawkins Test?

The Hawkins Test (also knows as the Hawkins Kennedy Test) is one of the most common special tests used in orthopedic physical assessment and examination of the shoulder. The test is very simple to conduct and is quite reliable. The primary structure being tested is the supraspinatus tendon.

Involved Structures

• supraspinatus tendon
  – the most likely involved structure in a positive test
• subacromial bursa
• long head of biceps tendon
  – not as likely involved as supraspinatus tendon
• a-c joint
  – pain during this test may also be the result of an injury to the acromioclavicular joint

Starting Position

The test is best performed with the patient in a relaxed sitting position. The arm to be tested should be moved passively by the examiner. The examiner moves the arm of the shoulder to be tested such that the arm is in 90 degrees of forward flexion and the elbow is flexed to 90 degrees.

Test Movement

From the starting position the examiner forcefully moves the patient’s shoulder into internal rotation to the end or range of motion or until reports of pain.

Positive Test

The Hawkins Kennedy test is considered positive if pain is reported in the superior – lateral aspect of the shoulder.

Accuracy of Hawkins Kennedy Test

The Hawkins Kennedy test for shoulder impingement is commonly believed to be less accurate test for shoulder impingement than the Neer test though some studies have found the reverse to be true.

• Interexaminer reliability: 0.36-0.38
• Specificity: 62%
• Sensitivity:  92% for subacromial bursitis, 88% rotator cuff tear

References:

• Interexaminer reliability of orthopaedic special tests used in the assessment of shoulder pain
• Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome
• An analysis of the diagnostic accuracy of the Hawkins and Neer subacromial impingement signs

Video Demonstration

You may also be interested in:

• Adson’s Test – Thoracic Outlet Syndrome
• Drop Arm Test – Rotator Cuff Pathology
• Speeds Test – Long Head of Biceps Pathology