Review assessments on the go with our e-book or app and solidify your clinical reasoning in our online course: Course: bit.ly/PTMSK Book: bit.ly/GETPT App: physiotutors.com/app
4th year med student here, you guys are really amazing! Thank you so much for high quality videos, these make studying much more interesting and also performing the tests on my own easier. I hope you keep making good quality content and I will definitely be following you.
the different test names for ligamens and muscle injuries .. are confusing as heck even for a general internist - this short review is fantastic and I for one appreciate that you include the sensitivity and specificity of each test in the beginning - its fantastic work! thank you :)
thank you from medical graduate preparing for exam , i was just solving question about rotator cuff tendinopathy and came across your video while searching for video for impingement tests .
Ur all videos is so superb verty easily understandable soo precious..i loved it .thank u for uploading tgis kind of videos u helping infinite students through this .
The videos u guys make are on point💯 Thankyou so much! Could u please go in a bit detail and elaborate on the mechanism of the tests? Because visualizing while u explain will work wonders.
Thanks a lot! Yes we do this in our videos though this is already quite old and our videos have evolved over the time. Essentially you are narrowing the Subacromial space in this testing position and encroach structures (tendons, bursae) within said space thus provoking any existing irritation
thank you for your videos.I am a physical therapist and have benefited a lot from your video. Can I forward it to other places so that my peers can also learn from it?No Charge
Thanks a lot for the video. It helps a lot. One question: what is the difference between internal impingement and subacromial impingement? Love from Turkey 💕
Subacromial impingement is an outdated word as the theory that something impinges is probably not correct. Therefore, we should rather call the condition subacromial pain syndrome (SAPS), which is referring to pain in any structure underneath the acromion. Internal impingement is an actual impingement of the supraspinatus or infraspinatus between the humeral head and glenoid rim.
No diagnosis based on one test, if indeed you suspect Subacromial pain Syndrome (check our Video on the SAPS cluster) you can try rotator cuff strengthening. We have a five part series on our channel on specific exercises
Hi thanks for your videos. In your video Shoulder Impingement Explained, you describe 2 types of Internal Impingement one is Anteroposterior Glenoid Impingement in which the patient reports pain with shoulder flexion and internal rotation. Why then will the Hawkins Kennedy Test be negative with internal impingement? Thanks in advance!
Anterosuperior impingement rarely occurs and is not described in the article of Cools et al. (2008) due to its low prevalence. We can very well imagine that the Hawkins-Kennedy test is provokative in anterosuperior impingement as it occurs in the late phase of the throwing motion. Cools et al. (2008) focus on posterosuperior impingement, which occurs in the late cocking position of throwing, which is maximal external rotation, horizontal abduction, and, depending on the specific sport discipline, a certain amount of abduction. This is a completely different position than the Hawkins-Kennedy test. Therefore it becomes clear why she expects the HK test to be negative in posterosuperior impingement.
I have Tendonosis acromion type 3 shoulder impingement. How rare is it to have this in BOTH shoulders relatively quick, less than a year apart? Can this be caused by sleeping w/ arms above head? Great videos. Keep up the awesome job and thanks for spreading the word to help people like myself! Thanks again!!!
Shoulder impingement is as a theory does not have evidence really. It's rather a rotator cuff +-bursa+-biceps tendon issue. It's not uncommon to have that in both shoulders in a short time and sleeping overhead does not cause it. Causation is mutlifactorial.
Sub acromial area has bursea and tendons passing through it ,how do we know whether the pain comes from inflamed bursea or ligament or muscle tendon,capsule????
I dislocated my arm and fractured my greater tuberosity 5 months ago. I have pain when doing the hawkins test, mostly im okay its just when abducting my arm in certains ways that it hurts and i get weakness. Do you know if it generally gets better on it's own?
@@th3w4ynetr4in9 damn. Sorry to hear that. Yeah, this is a reoccurring ache I’ve always gotten from heavy bench or pull ups. Usually resting for a few weeks works. I think I’ve narrowed it down to the lower part of the rear delt. I’m trying out the sleeper stretch. We’ll see
@@th3w4ynetr4in9 I’ve been doing the “sleeper stretch” the past two days and I’m basically out of pain and not bothered by the empty can test. Gonna wait another week to get under the barbell just to play it safe. Crazy, because I’ve been in pain for the last month. Turns out I think it was my rear delt. Highly recommend giving it a shot. Search TH-cam for a video called “posterior shoulder impingement” by The Muscle Doc.
So, I did some research regarding shoulder impingement and affected people always seem to have pain in the anterior part of the shoulder. What if the Hawkins Kennedy and the Neer Test are positive for me but I feel pain in the posterior part (the posterior capsule if I'm not mistaken?) Would this still be an impingement or something else? Perhaps a Posterior Joint Capsule Contracture? I would appreciate any kind of help.
Could also be a posterosuperior impingement (internal impingement). Your posterior contracture can be assessed by internal rotation in 90° of abduction and cross-body adduction...have a look at the Stenvers Test V and our video on GIRD.
hello i love your videos thank you for that ! I have learned that the hawkins test's purpose is testing the impingement between the greater tuberosity and the coraco-acromial ligament. (and not the subacromial impingement) what do you think ?
You're welcome Fred! Could be both, the acromion and the coracohumeral ligament. That's why in sugery (who does not perform better than sham btw) they often resect the CHL as well. Have a look at this blog post from Adam Meakins: thesports.physio/2016/09/11/shoulder-decompression-coming-under-more-pressure/ What we are surely doing is to provoke a sensitized supraspinatus or bursa with this test and then it still has limited diagnostic accuracy.
What's the test called when you do it yourself, You take the position at 0:46 place your other arm on top(hand on elbow and elbow on the back of the hand) and then push the elbow on top down. That causes pain in the back of the shoulder. I'm looking it's name so i can search more.
In this position the head of the humerus is rolling cranially and gliding caudally in the joint according to the Kaltenborn rule. Many patients with subacromial pain will find this provokative as in case of an impaired caudal glide, the tubercle major might abut against the roof of the acromion
Currently in a DPT program now (year 1), some of these test we are learning to do in supine as opposed to standing/sitting; would supine be preferred since it is gravity eliminated? What are your thoughts?
Hi Courtney, which tests are you referring to in particular? For the Hawkins-Kennedy and Neer it doesn't matter as these are passive tests. Have a look at our video "Why 'Can' tests suck" to see why certain tests should better be done in different positions.
I'm not a physio, but doesn't this test for shoulder impingement look almost identical to a sleeper stretch? Based on this could the sleeper stretch 'cause' impingement?
Yes indeed it does look like the sleeper stretch. The HK test aims to compress structure in the subacromial space, so the same would occur (to a lesser extent) in the sleeper stretch. Sleeper stretch is not performed in 90° abduction. But to work on stretching posterior shoulder structures, rather include eccentric internal rotation exercises. Check our late SAPS rehab videos for ideas
For instance this test is a test for the Shoulder region. Can you do all of them for this region under a heading on your channel for Shoulder region, Cervical region, Elbow Forearm Wrist region, Lumbar region, Hip/Coxal region, Knee region, leg ankle & foot region...?
+2reasons check our channel and playlists We have over 200 videos for different body regions. It's all there already If you check our website here: www.physiotutors.com/assessment You find a list of every region
+Saad Sohail are u a baseball or cricket player? Then it would be a normal adaption to throwing. Are u experiencing shoulder pain because of it? If yes the sleeper's stretch or horizontal adduction stretch can help you but you will have to perform it several times per day.
No diagnosis should be made based on a single test. For any personal health or rehab questions we recommend to consult with our partners at yourphysio.online for a remote physiotherapy consultation.
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Review assessments on the go with our e-book or app and solidify your clinical reasoning in our online course:
Course: bit.ly/PTMSK
Book: bit.ly/GETPT
App: physiotutors.com/app
I love ur 90 second videos, I rely on ur videos to study
Happy to hear! Stay critical though!
4th year med student here, you guys are really amazing! Thank you so much for high quality videos, these make studying much more interesting and also performing the tests on my own easier. I hope you keep making good quality content and I will definitely be following you.
Hey! cool to see that our videos are being watched by Med Students as well 😎
We won't stop uploading. that's for sure
Hi can you please tell me about your 4 Yrs experience?
what would you like to know? working as a GP now, doing some acutology as well, life is good!@@kajamohideen237
I like how you inform with specificity and reliability. cut to the chase, nice video!
+Mias Mama thanks a lot. We feel like this should be the norm as not every test is created equal ;)
I adore you guys. You've saved my life these past 18 months!
I am a primary care NP and your videos are wonderful. THank you.
the different test names for ligamens and muscle injuries .. are confusing as heck even for a general internist - this short review is fantastic and I for one appreciate that you include the sensitivity and specificity of each test in the beginning - its fantastic work! thank you :)
Happy to hear that also MDs are following us and can appreciate our videos!
thank you from medical graduate preparing for exam , i was just solving question about rotator cuff tendinopathy and came across your video while searching for video for impingement tests .
Ur all videos is so superb verty easily understandable soo precious..i loved it .thank u for uploading tgis kind of videos u helping infinite students through this .
Thanks for cutting the BS and going straight to the point! Well appreciated!
Ur welcome King B!
Thank you for these awesome videos! Getting ready for a musculoskeletal physical assessment exam and these are a life saver.
Your videos are short and time saving...
And really helpful
👍👍👍
The videos u guys make are on point💯 Thankyou so much! Could u please go in a bit detail and elaborate on the mechanism of the tests? Because visualizing while u explain will work wonders.
Thanks a lot! Yes we do this in our videos though this is already quite old and our videos have evolved over the time. Essentially you are narrowing the Subacromial space in this testing position and encroach structures (tendons, bursae) within said space thus provoking any existing irritation
I'm a 4th yr Med student, thanks so much for your videos!
thanks!
Your videos are really helpful. Practical demonstrations are easy understanding. Very helping in my studies and clinical practice.
Thank you.
Appreciate it, you're welcome!
WOW you're videos have been so helpful for MSK examinations. :O You guys are the best
Thanks, that's our goal!
thanks a lot for your videos, the best explanation for medical students
Appreciate it! And great to see that there are also medical students watching!
How do I treat a shoulder pinched nerve plz 🙏 😢
thank you for your videos.I am a physical therapist and have benefited a lot from your video. Can I forward it to other places so that my peers can also learn from it?No Charge
Thank you Guys
Excellent video
Thank you for this video ❤
These are helpful. Thank you!
Thanks
Thanks a lot for the video. It helps a lot. One question: what is the difference between internal impingement and subacromial impingement?
Love from Turkey 💕
Subacromial impingement is an outdated word as the theory that something impinges is probably not correct. Therefore, we should rather call the condition subacromial pain syndrome (SAPS), which is referring to pain in any structure underneath the acromion.
Internal impingement is an actual impingement of the supraspinatus or infraspinatus between the humeral head and glenoid rim.
@@Physiotutors thank you so much
@@Physiotutors why is it negative in internal impingement ??
This is smtng that makes my learning easy...thanks physiotutors😄
That's the goal - happy to hear!
thank you.
Thanks for the vids ! Nice drum and bass beats there also 🎉
You bet!
I tested positive. Do you know how I can resolve it?
Thanks a lot 😊
Great video. So what should be done if the test is positive? Thank you.
No diagnosis based on one test, if indeed you suspect Subacromial pain Syndrome (check our Video on the SAPS cluster) you can try rotator cuff strengthening. We have a five part series on our channel on specific exercises
*Very helpful*
Glad we can help
Hi thanks for your videos. In your video Shoulder Impingement Explained, you describe 2 types of Internal Impingement one is Anteroposterior Glenoid Impingement in which the patient reports pain with shoulder flexion and internal rotation.
Why then will the Hawkins Kennedy Test be negative with internal impingement? Thanks in advance!
Anterosuperior impingement rarely occurs and is not described in the article of Cools et al. (2008) due to its low prevalence.
We can very well imagine that the Hawkins-Kennedy test is provokative in anterosuperior impingement as it occurs in the late phase of the throwing motion.
Cools et al. (2008) focus on posterosuperior impingement, which occurs in the late cocking position of throwing, which is maximal external rotation, horizontal abduction, and, depending on the specific sport discipline, a certain amount of abduction.
This is a completely different position than the Hawkins-Kennedy test. Therefore it becomes clear why she expects the HK test to be negative in posterosuperior impingement.
Thank you!
I have Tendonosis acromion type 3 shoulder impingement.
How rare is it to have this in BOTH shoulders relatively quick, less than a year apart?
Can this be caused by sleeping w/ arms above head?
Great videos. Keep up the awesome job and thanks for spreading the word to help people like myself!
Thanks again!!!
Shoulder impingement is as a theory does not have evidence really. It's rather a rotator cuff +-bursa+-biceps tendon issue.
It's not uncommon to have that in both shoulders in a short time and sleeping overhead does not cause it. Causation is mutlifactorial.
Watch our video on subacromial pain syndrome rehab - you'll benefit from them!
Just wondering, what does it mean if it doesn't hurt but feels uncomfortable?
That's pretty common, but considered a negative test.
very good
I have pain when doing this do I need surgery? What shall I do to cure it
nice video indeed &it seems that Dr .kai have impingement
Muchísimas gracias por la explicación y la traducción, ha sido muy didáctico.
De nada Pedro! We are happy that our friends have helped us with translating!
suiiii
Thank you! That movement looks painful as hell though
i think you are johnny sins of physiotherapy 😁😁 anyways you are doing a great job :-)
Honestly had to look up who that was haha! Thanks I guess...glad you like our content and thanks for following!
Hi, what is the treatment for it?
Have a look at our SAPS rehab series
Thank you, your videos are extremely useful and practical😍
Sub acromial area has bursea and tendons passing through it ,how do we know whether the pain comes from inflamed bursea or ligament or muscle tendon,capsule????
Please tell the Reference Of Book Which shows This is the Right Way to Perform the Test ! As Evidence based practice
Check the video description
really helpful! thanks!
You’re welcome
If you get pain during those test, it means you have external rotator cuff problems?
I dislocated my arm and fractured my greater tuberosity 5 months ago. I have pain when doing the hawkins test, mostly im okay its just when abducting my arm in certains ways that it hurts and i get weakness. Do you know if it generally gets better on it's own?
Do more videos.... Pls
Thankyou so much....your content is really helpful for students as well as for novice therapists. Big thumbs up
Glad you think so!
What dose sensitivity & specificity means ?
Doesn't the location of the pain matter? For example I currently experience great pain during this test but its located around the teres minor
Same here! Did you ever figure it out?
@@deejayspillz not rly still hurts after training, but the MRI was not rly out of the ordinary
@@th3w4ynetr4in9 damn. Sorry to hear that. Yeah, this is a reoccurring ache I’ve always gotten from heavy bench or pull ups. Usually resting for a few weeks works. I think I’ve narrowed it down to the lower part of the rear delt. I’m trying out the sleeper stretch. We’ll see
@@th3w4ynetr4in9 I’ve been doing the “sleeper stretch” the past two days and I’m basically out of pain and not bothered by the empty can test. Gonna wait another week to get under the barbell just to play it safe. Crazy, because I’ve been in pain for the last month. Turns out I think it was my rear delt. Highly recommend giving it a shot. Search TH-cam for a video called “posterior shoulder impingement” by The Muscle Doc.
So, I did some research regarding shoulder impingement and affected people always seem to have pain in the anterior part of the shoulder. What if the Hawkins Kennedy and the Neer Test are positive for me but I feel pain in the posterior part (the posterior capsule if I'm not mistaken?) Would this still be an impingement or something else? Perhaps a Posterior Joint Capsule Contracture? I would appreciate any kind of help.
Could also be a posterosuperior impingement (internal impingement).
Your posterior contracture can be assessed by internal rotation in 90° of abduction and cross-body adduction...have a look at the Stenvers Test V and our video on GIRD.
hello i love your videos thank you for that !
I have learned that the hawkins test's purpose is testing the impingement between the greater tuberosity and the coraco-acromial ligament. (and not the subacromial impingement) what do you think ?
You're welcome Fred!
Could be both, the acromion and the coracohumeral ligament. That's why in sugery (who does not perform better than sham btw) they often resect the CHL as well. Have a look at this blog post from Adam Meakins: thesports.physio/2016/09/11/shoulder-decompression-coming-under-more-pressure/
What we are surely doing is to provoke a sensitized supraspinatus or bursa with this test and then it still has limited diagnostic accuracy.
Good work boys, very nice demonstration!👌
Sie sind echt gut muss ich sagen! ❤❤❤
What's the test called when you do it yourself, You take the position at 0:46 place your other arm on top(hand on elbow and elbow on the back of the hand) and then push the elbow on top down. That causes pain in the back of the shoulder. I'm looking it's name so i can search more.
Don't know to be honest.
Thx for the video and thank the Army for my damaged shoulder, elbow and cervical neck issues. 😂😂😂 😢sigh
Can you explain what's the point in sitting the patient instead of standing ?
+Henri Giles no difference. Patient may also be standing.
Why will the test be negative when a patient has an internal rotation impingement? Since you are making a horizontal internal rotation.
In this position the head of the humerus is rolling cranially and gliding caudally in the joint according to the Kaltenborn rule. Many patients with subacromial pain will find this provokative as in case of an impaired caudal glide, the tubercle major might abut against the roof of the acromion
Currently in a DPT program now (year 1), some of these test we are learning to do in supine as opposed to standing/sitting; would supine be preferred since it is gravity eliminated? What are your thoughts?
Hi Courtney, which tests are you referring to in particular?
For the Hawkins-Kennedy and Neer it doesn't matter as these are passive tests.
Have a look at our video "Why 'Can' tests suck" to see why certain tests should better be done in different positions.
I have pain in right shoulder when I do this test!
:(
Left shoulder is good
I'm not a physio, but doesn't this test for shoulder impingement look almost identical to a sleeper stretch? Based on this could the sleeper stretch 'cause' impingement?
Yes indeed it does look like the sleeper stretch. The HK test aims to compress structure in the subacromial space, so the same would occur (to a lesser extent) in the sleeper stretch. Sleeper stretch is not performed in 90° abduction. But to work on stretching posterior shoulder structures, rather include eccentric internal rotation exercises. Check our late SAPS rehab videos for ideas
@@Physiotutors appreciate the reply
How to cure subcorocoid bursitis and how to assess it???
No shoulder test is specific enough to test out a certain structure, you don't need to for treatment. Only method is imaging
nice
Can you do the tests by region so I can recommend it to student practitioners?
+2reasons im not quite sure what you mean? Which tests by region?
For instance this test is a test for the Shoulder region. Can you do all of them for this region under a heading on your channel for Shoulder region, Cervical region, Elbow Forearm Wrist region, Lumbar region, Hip/Coxal region, Knee region, leg ankle & foot region...?
+2reasons check our channel and playlists
We have over 200 videos for different body regions. It's all there already
If you check our website here: www.physiotutors.com/assessment
You find a list of every region
They also have video playlists organized by body structure. This video is included in their shoulder playlist.
Thanks UWM DPT18, no moderator needed if you have such an attentive audience!;)
My Doc said I have gird in shoulder can it be recovered from physiotherapy
+Saad Sohail are u a baseball or cricket player? Then it would be a normal adaption to throwing. Are u experiencing shoulder pain because of it? If yes the sleeper's stretch or horizontal adduction stretch can help you but you will have to perform it several times per day.
I get pain from hawkins kennedy test and the one in which the shoulder with pain gets crossed over other and you raise it? what should i do😭😭
Best thing is always to see your local physio as a diagnosis from afar is always difficult!
Is the movement passive or resisted ROM?
Passive
If I lift my elbow up at a 90 angle with my hand down and lift my elbow up I can’t do it
Hasnt there been many scientific studies that say this test is not very practical.
Can positive hawkin's test be rotator cuff?
No diagnosis should be made based on a single test. For any personal health or rehab questions we recommend to consult with our partners at yourphysio.online for a remote physiotherapy consultation.
Thank you so much for your freaking absolutely amazing videos 11/12/2018 😃😃
Glad to hear you find them helpful :)
good, except you do flexion/anteversion of the arm not elevation
+Susanna Stranzl I elevate the arm (glenohumeral joint) to 90° of flexion.
Salute test?
The shorter the video the better
that study is from 2008, the accuracy was 79%
Yocum's Test?
Yocum's Test is performed actively and goes beyond 90° of flexion
@@Physiotutors Thank you so much 😊 I could't see Yocum's test here .
In the making...
That skeleton be paying more attention than I was
REEEEEWIND
Ok, i have pain, now what?
Ignore it
Consult a physical therapist
😭😭😭😭😂😂😂😂😂
You suffer from shoulder impingement
walk it off
uh oh, I see a pain face.
👏🏻👏🏻👏🏻
michael andreas scofield
You guys are so handsome
haha thanks!
0:36, the test begins
Your patient had pain when you were doing the test. :)
Chances are you get false positives with the test toon
Üstad klonunu koymuş
Old IGN music
Really? Didn’t know that
thank you
+yasmoo Aljl De nada!;)
nice video indeed &it seems that Dr .kai have impingement
You're welcome Ebtehal. Maybe I am just a good actor?;)
Physiotutors hahaha yes you are