Authors: A Gupta, L Funk

References: JBJS(Br), Vol 87-B, Issue SUPP II, 161.

The diagnosis of subacromial impingement of the shoulder is generally a clinical diagnosis, with no well defined diagnostic criteria. A number of tests have been described. Neer and Hawkins signs are the most common with reported sensitivities for subacromial impingement of 75% and 92% respectively.

The senior author was taught another impingement test by Mr S Copeland during his Fellowship in Reading, UK. The Copeland Impingement test is an extension of the Neer’s impingement sign, where abduction in the scapula plane with the shoulder in internal rotation causes mid-arc pain which is abolished with abduction in external rotation.

In a retrospective study we analysed the clinical data of twenty-nine patients diagnosed with subacromial impingement of the shoulder. The diagnosis was determined by the clinician’s final diagnosis. This was based on the clinical findings and response to a subacromial injection (Neer’s Test). The clinical tests included were: Hawkin’s test, Mid-arc impingement pain, Neer’s sign, Neer’s test and the Copeland impingement test. The sensitivity and specificity of each test was determined and the values statistically analysed for any significance.

The Copeland test was the most sensitive, with 95% sensitivity. Using the Wilcoxon’s signed ranks test the Copeland test was significantly more sensitive than the Neer’s and Hawkin’s tests for subacromial impingement.

In conclusion the Copeland test is an effective clinical test in the diagnosis of subacromial impingement and more sensitive than the traditional tests.

Link to Journal Article 


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