Range of motion / goniometry of shoulder

assessment of 3 things during functional movement and straight plane gross motion

1. quantitative: how much motion exists

2. qualitative: what is the "quality" of the motion

3. symptom response: does the motion reproduce any of the subject's symptoms

pattern of functional movement screening

bilateral

1. hand behind head

2. hand to contralateral scapula

3. reach behind the back

reaching hand behind the head

measure spine level of middle finger to spinal level

assess: shoulder: elevation and external rotation, elbow/forearm: flexion and supination

reaching hand to contralateral scapula

assess how far onto scapula of middle finger

shoulder: flexion, horizontal flexion and internal rotation elbow/forearm: flexion and pronation

reaching hand behind the back

measure level of thumb up the spine

assess: shoulder: extension and internal rotation, elbow/forearm: flexion and pronation

straight plane gross motion assessment

bilateral comparison

shoulder complex flexion/extension

shoulder complex elevation/abductions

internal and external rotation at side

internal and external rotation at 90 degrees (elevation/abduction)

normal values for shoulder flexion

0-180

shoulder flexion

subject position: standing/supine

axis: approx. 1-inch distal to lateral acromion

stationary arm: mid axillary arm: rib cage

movable arm: lateral epicondyle of elbow

compensation for shoulder flexion

trunk extension (leaning back)

scapular elevation

normal values for shoulder extension

0-60 degrees

shoulder extension

subject position: standing or supine or prone

axis: approx 1 inch distal to lateral acromion

stationary arm: mid axillary line

moveable arm: lateral epicondyle of elbow

compensations for shoulder extension

may lean forward

normal values for shoulder elevation (abduction)

0-180 degrees

shoulder elevation (abduction)

subject position standing or supine

axis: approx 1 inch inferior to posterior or anterior acromion

stationary arm perpendicular to floor or parallel to sternum

moveable arm: anterior or posterior humerus

compensation for shoulder elevation (abduction)

side bending

scapular elevation (AKA shrug sign)

normal values for shoulder external rotation

0-60

shoulder external rotation

subject position: standing

axis: olecranon process

stationary arm: in sagittal plane

moveable arm: ulnar surface of forearm to the ulnar syloid process

compensations for external rotation

trunk rotation

external rotation at 90 degrees

subject position : supine with shoulder at 90

axis: olecranon process of elbow

stationary arm: perpendicular to floor

moveable arm: ulnar surface of forearm

normal values for external rotation at 90 degrees

0-90

normal values shoulder internal rotation at 90

composite: 0-70

limited: 0-45

internal rotation

subject position: supine with shoulder at 90 degrees

axis: olecranon process of elbow

stationary arm: perpendicular to floor

moveable arm: ulnar surface of forearm to the ulnar styloid process

compensation for internal rotation

scapular elevation

normal values for horizontal adduction/flexion

0-135 degrees

horizontal adduction/flexion

subject position: sitting with shoulder abducted to 90 degrees with palm down

axis: superior acromion

stationary arm: in frontal plane of body

moveable arm: superior humerus, lined up with lateral epicondyle

compensation for horizontal adduction

trunk rotation

normal values for horizontal abduction/extension

0-60 degrees

horizontal abduction/extension

subject position: sitting with shoulder abducted to 90 degrees making a fist with palm down

axis: superior acromion

stationary arm: in frontal plane of body

moveable arm: superior humerus, lined up with lateral epicondyle