Neer Test – Orthopedic Shoulder Examination

What is the Neer Test?

The Neer Test (sometimes called Neer’s Test) is a common test in orthopedic examination of the shoulder. It is used to test for subacromial impingement of rotator cuff tendons. This is also known as Subacromial Pain Syndrome or Impingement Syndrome. The test is very simple to conduct and is quite reliable. Read about rotator cuff tears.

Involved Structures

• supraspinatus tendon
• infraspinatus tendon
• subacromial bursa
• long head of biceps tendon

Starting Position

The test is best performed with the patient in a relaxed standing position. The arm to be tested should be moved passively by the examiner. The patient’s arm of the shoulder to be tested is positioned such that the arm is relaxed at the side of the body and the elbow is fully extended.

Test Movement

From the starting position, the examiner internally rotates the patient’s arm and forcefully moves the arm through the full range of forward flexion or until reports of pain.

Positive Test

The Neer test is considered positive if pain is reported in the anterior – lateral aspect of the shoulder.

Accuracy of Test

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

• Negative Likelihood Ratio = .35
• Sensitivity: 75% for subacromial bursitis, 85% for rotator cuff pathology

References:

• Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement
• An analysis of the diagnostic accuracy of the Hawkins and Neer subacromial impingement signs

Video Demonstration

>> Return to the list of Orthopedic Tests of the Shoulder

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Other tests for rotator cuff pathology:

• Empty Can (Supraspinatus) Test
• Gerber’s Lift Off Test
• Hawkins Test / Hawkins-Kennedy Impingement Test
• Painful Arc Test