Physical Therapy Assistant Practice Exam

During the Neer impingement test, what is the primary source of pain if the test is positive?

1. Compression of the greater tuberosity against the anterior acromion

2. Stretching of the rotator cuff muscles

3. Inflammation of the biceps tendon

4. Bruising of the acromion process

The correct answer is: Compression of the greater tuberosity against the anterior acromion

The Neer impingement test is designed to assess the presence of shoulder impingement, often related to conditions affecting the rotator cuff or subacromial space. When this test is positive, the primary source of pain is due to the compression of the greater tuberosity against the anterior acromion. This occurs during shoulder flexion with internal rotation, which narrows the space between the acromion and the greater tuberosity of the humeral head. If there are inflamed tendons or structures within the subacromial space, such as the supraspinatus tendon or the subacromial bursa, this compression will precipitate pain. The positive test indicates that either structural changes or inflammation is leading to this mechanical compression during the movement. While stretching of the rotator cuff muscles and inflammation of the biceps tendon can be related to shoulder pain, they are not the primary mechanisms assessed by the Neer test. Bruising of the acromion process is less relevant as the test focuses on the dynamics of movement between the greater tuberosity and the acromion rather than direct injuries or contusions. Therefore, understanding the mechanism of compression helps clarify why this source of pain is the focal point