Neer Test for Subacromial Shoulder Pain (SAPS)

In the 1970s and 80s, Neer coined the term “subacromial impingement syndrome”. According to his theory, impingement occurs on the tendinous portion of the rotator cuff by the coracoacromial ligament and the anterior third of the acromion.

According to Reviews by Hegedus et al in 2012 and Gismervik et al. in 2017, the Neer test has a Sensitivity of 59-72% and a specificity of 6%which is why we give it a weak clinical value as a stand-alone test.

To perform the Neer test, the patient is in sitting position. You’re going to stand behind the patient and use one hand to stabilize the patient’s scapula.

Then bring the arm into maximal passive shoulder flexion. Some authors suggest placing the arm into internal rotation to bring the greater tubercle towards the coracoacromial ligament, though Neer’s original description does not state this.

The test is considered positive in case of the reproduction of the patient’s familiar shoulder pain.

Other common tests for subacromial pain syndrome (SAPS) are:

• Hawkins-Kennedy Test
• Painful Arc Sign

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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Hegedus EJ, Goode AP, Cook CE, Michener L, Myer CA, Myer DM, Wright AA. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. British journal of sports medicine. 2012 Nov 1;46(14):964-78.

Gismervik SØ, Drogset JO, Granviken F, Rø M, Leivseth G. Physical examination tests of the shoulder: a systematic review and meta-analysis of diagnostic test performance. BMC musculoskeletal disorders. 2017 Dec;18(1):1-9.

Neer CS. Impingement lesions. Clinical Orthopaedics and Related Research®. 1983 Mar 1;173:70-7.