You’re evaluating a shoulder that hurts with overhead reaching and lifting. The Hawkins-Kennedy Test is one of your quickest, most practical tools to screen for subacromial impingement—and it takes just seconds to perform.
What is the Hawkins-Kennedy Test?
The Hawkins-Kennedy Test is an orthopedic special test used to detect subacromial impingement of the shoulder. To perform it, position the patient’s shoulder in 90° of forward flexion with the elbow flexed to 90°. Then, you forcibly internally rotate the humerus, which drives the greater tuberosity against the coracoacromial ligament and the undersurface of the acromion. A positive test reproduces the patient’s familiar pain in the subacromial region.
Why the Hawkins-Kennedy Test Matters in Physical Therapy Practice
This test is a crucial part of the shoulder differential diagnosis. It helps you identify subacromial impingement syndrome, which often coincides with rotator cuff tendinopathy or subacromial bursitis. While it has good sensitivity, it’s not highly specific—so a positive test tells you impingement is likely, but you still need to rule out other causes. This directly shapes your Plan of Care: if the test is positive, you can confidently begin conservative management focused on unloading the subacromial space and restoring rotator cuff function.
What You’ll See in the Clinic
You’ll often hear your patient complain of pain with overhead activities, reaching behind the back, or throwing. During the test, watch for reproduction of that pain with a “pinching” sensation. The test is typically performed at the end of the session to avoid aggravating symptoms prematurely.
“Positive Hawkins-Kennedy on the right with pain lateral to the acromion. Patient also has painful arc with flexion. Impression: subacromial impingement with possible rotator cuff tendinopathy. Continue conservative care—manual therapy and progressive strengthening program.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Relying on this test alone. The Hawkins-Kennedy has moderate sensitivity but limited specificity—a positive result can occur with anterior instability or capsular tightness. Always combine it with the Neer test, painful arc, and resisted strength testing.
💡 Pro Tip: To reduce false positives, perform the test with the patient seated and scapula stabilized. This minimizes accessory motion and makes the subacromial space the primary area of compression. Also ask the patient to point to their exact pain location—this helps confirm the subacromial space.
Memory Aid for the Hawkins-Kennedy Test
Think “H is for Hand behind the head”—the starting position looks like the patient is scratching the back of their head. Then you push their hand down (internal rotation), which “sandwiches” the impinged structures. Another mnemonic: “Hawkins hits the high hidden tissue”—reminding you to look for painful compression in the hidden space beneath the acromion.
NPTE Connection
Expect this test to appear in questions requiring you to identify special tests for shoulder impingement or interpret a cluster of positive tests (Hawkins-Kennedy, Neer, painful arc) to support a diagnosis of subacromial impingement syndrome.
Related Physical Therapy Concepts
The Hawkins-Kennedy Test is part of a broader shoulder evaluation toolkit. It pairs naturally with the Neer Test (another impingement sign) and the Empty Can Test for supraspinatus weakness. Understanding rotator cuff tendinopathy, subacromial bursitis, and scapular dyskinesis all deepen your ability to interpret this test and build an effective Plan of Care.
Quick Reference
✓ Positive test criteria: Reproducible subacromial pain with passive internal rotation at 90° elevation ✓ Priority level: High – key screen for shoulder impingement ✓ PT Interventions/Considerations: • Combine with Neer, painful arc, and resisted tests • Assess posture and scapular control • Initiate rotator cuff and scapular strengthening • Consider manual therapy to posterior capsule • Educate on activity modification to reduce impingement positions
To wrap up: mastering the Hawkins-Kennedy Test gives you more than a yes-or-no answer—it sharpens your clinical reasoning and helps you target the right interventions from day one.