Athletic Training & Sports Medicine Center

Range of Motion for the Shoulder Joint

Motion	Examiner Position	Model Position	Examiner Instruction	Hand Placement	Muscles Involved	Possible Substitutions	Things to Note
Flexion	Standing behind test shoulder of patient	Short Sitting; hand / forearm pronated, elbow slightly flexed	Passive ROM have patient relax and the examiner causes the motion Active ROM examiner should demonstrate motion and then have model mimic the motion Resistive ROM Patient should resist examiner's overpressure in extension and/or examiner should resist patient as they move through flexion	Passive ROM Moving hand above elbow, posterior side Stabilizing hand at shoulder Active ROM Patient does motion Resistive ROM Resistance hand over distal humerus above elbow Stabilizing hand on patient shoulder	Deltoid (anterior and middle), supraspinatus Others: Pectoralis major, coracobrachialis, bicpes brachi	Biceps brachii - avoid by keeping hand/forearm pronated Upper Trapezius - keep shoulders from elevating Pectoralis Major' watch for horizontal adduction Trunk Extension- keep patient from leaning back to assist flexion Shoulder girdle elevation-
Extension	Stand @ test side Resistance applied just above elbow	Prone with arms @ side Shoulder in internal rotation, palm up	Passive ROM have patient relax and the examiner causes the motion Active ROM examiner should demonstrate motion and then have examiner complete motion Resistive ROM Patient should resist examiner's overpressure in flexion and/or examiner should resist patient as they move through extension	Passive ROM Table stabilizes, moving hands at elbow and wrist Active ROM Patient causes motion Resistive ROM Stabilizing body against table Resistance hand at distal humerus (above elbow)	Latissimus dorsi Teres major Posterior Deltoid	Trunk rotation- stabilize body / shoulder with table and watch for movement	If you wish to isolate Latissimus Dorsi: PT position: prone with head facing test side Examiner position: @ side grasping just above wrist Have pt hike shoulder
Abduction	Behind patient	Short sitting with arm at side, elbow in slight flexion	Passive ROM have patient relax and the examiner causes the motion Active ROM examiner should demonstrate motion and then have examiner complete motion Resistive ROM Patient should resist examiner's overpressure in adduction and/or examiner should resist patient as they move through abduction	Passive ROM One hand to stabilize shoulder Other hand at elbow to move patient into abduction Active ROM Patient causes motion Resistive ROM Resistance hand just above lateral elbow Stabilizing hand at shoulder / scapula	Middle deltoid Supraspinatus Others: Biceps brachii	Biceps brachii - if used, the shoulder will externally rotate and the elbow will flex	Turning face away from test side eases tension on the trapezius and supraspinatus becomes easier to palpate Deltoid and supraspinatus work together Watch for shoulder elevation or lateral flexion to assist with abduction
Adduction	Behind patient	Short sitting with arm at side, elbow in slight flexion	Passive ROM have patient relax and the examiner causes the motion Active ROM examiner should demonstrate motion and then have examiner complete motion Resistive ROM Patient should resist examiner's overpressure in abduction and/or examiner should resist patient as they move through adduction	Passive ROM One hand to stabilize shoulder Other hand at elbow to move patient into adduction Active ROM Patient causes motion Resistive ROM Resistance hand just above medial elbow Stabilizing hand at shoulder / scapula
Horizontal Abduction	standing at test side Alternate position: Stand at test side; support forearm under distal surface and other hand over posterior surface just superior to axilla	Prone position with shoulder abducted 90 degrees and forearm of table with elbow flexed Alternate position: Short sitting	Passive ROM have patient relax and the examiner causes the motion Active ROM examiner should demonstrate motion and then have examiner complete motion Resistive ROM Patient should resist examiner's overpressure in horizontal adduction and/or examiner should resist patient as they move through horizontal abduction	Passive ROM Active ROM Resistive ROM	Deltoid (posterior) Others : Infraspinatus Teres Minor	long head of triceps - to avoid, maintain elbow flexion
Horizontal Adduction	Stand at side of shoulder to be tested	Supine, shoulder abducted 90 degrees, elbow flexed 90 degrees Alternate: Clavicular head: shoulder 60 degrees abduction, elbow flexed Sternal head: 120 degrees shoulder abduction with elbow flexed	Passive ROM have patient relax and the examiner causes the motion Active ROM examiner should demonstrate motion and then have examiner complete motion Resistive ROM Patient should resist examiner's overpressure in horizontal abduction and/or examiner should resist patient as they move through horizontal adduction	Passive ROM Active ROM Resistive ROM	Pectoralis Major
Internal Rotation	Standing at side to be tested	Prone with head turned toward test side, shoulder abducted 90 degrees with arm fully supported by table Alternate Position: Short sitting, elbow flexed 90 degrees close to body for stabilization	Passive ROM have patient relax and the examiner causes the motion Active ROM examiner should demonstrate motion and then have examiner complete motion Resistive ROM Patient should resist examiner's overpressure in external rotation and/or examiner should resist patient as they move through internal rotation	Passive ROM Hand at wrist and elbow; take patient through motion Alternate position: Stabilizing hand at lateral elbow and motion hand at lateral wrist Active ROM examiner should demonstrate motion and then have examiner complete motion Resistive ROM Resistance hand over palmar surface of wrist, stabilizing hand between elbow and table Alternate position: Stabilizing hand over superior shoulder and other hand over medial wrist	Subscapularis Pectoralis Major Latissimus Dorsi Teres Major Others: Deltoid (anterior)
External Rotation	Stand at side to be tested	Prone with head turned toward test side, shoulder abducted 90 degrees with arm fully supported by table Alternate Position: Short sitting, elbow flexed 90 degrees close to body for stabilization	Passive ROM have patient relax and the examiner causes the motion Active ROM examiner should demonstrate motion and then have examiner complete motion Resistive ROM Patient should resist examiner's overpressure in extension and/or examiner should resist patient as they move through external rotation	Passive ROM Hand at wrist and elbow; take patient through motion Alternate position: Stabilizing hand at lateral elbow and motion hand at medial wrist Active ROM examiner should demonstrate motion and then have examiner complete motion Resistive ROM Resistance hand over dorsal surface of wrist, stabilizing hand between elbow and table Alternate position: Stabilizing hand over superior shoulder and other hand over lateral wrist	Infraspinatus Teres Minor Others: deltoid (posterior fibers)