Elbow, Forearm, Wrist, Thumb, Fingers, and Shoulder Movements

Elbow & Forearm Movement Mechanics

Elbow Flexion

  • Range of Motion: 0-150°

  • Axis and landmark: Lateral epicondyle.

  • Stationary arm: lateral midline of humerus

  • Moving arm: Lateral midline of radius

Supination

  • Range of motion: 0-80°

  • Axis: Adjacent to distal medial ulna.

  • Landmark: Ulnar styloid

  • Stationary: perpendicular to the floor

  • Moving arm: Lying against the dorsal aspect of distal radius/ulna

Pronation

  • Range of Motion: 0-80°

  • Axis: Adjacent to distal dorsal ulna.

  • Landmark Used: Ulnar styloid.

  • Stationary: perpendicular to the floor

  • Moving arm: lying against the dorsal aspect of distal radius/ ulna

Wrist Movement Mechanics

Wrist Flexion

  • Range of Motion: 0°-80°

  • Bony landmark: Capitate

  • Stationary Arm: directly against the midline of dorsal forearm

  • Moving Arm: lying against the volar aspect of the distal radius/ulna.

Extension

  • Range of Motion: 0°-70°

  • Axis: Adjacent to the volar wrist.

  • Landmark Used: capitate

  • Stationary arm: Directly against the midline of the dorsal forearm

  • Moving arm: directly against the 3rd metacarpal

Ulnar Deviation

  • Range: 0- 30°

  • Axis: Capitate bone.

  • Landmark Used: Capitate bone.

  • Stationary: Directly against midline of volar forearm

  • Moving: adjacent to volar 3rd metacarpal through web space between ring and middle finger

Radial Deviation

  • Range of Motion: 0°-20°

  • Axis: Capitate bone (base of the 3rd metacarpal).

  • Landmark Used: Metacarpal directly against the midline.

  • Stationary: directly against midline of volar forearm

  • Moving: 3rd metacarpal

Thumb Movement Mechanics

Carpometacarpal (CM) Joint

CM Flexion

  • Range of Motion: 0°-15°

  • Axis and landmarks: Adjacent to the CMC joint midway.

  • Stationary: parallel to midline of radius

  • Moving: 1st metacarpal

CM Extension

  • Range of Motion: 0°-20°

  • Axis and landmarks : Adjacent to the CMC joint midway.

  • Stationary: parallel to midline of radius

  • Moving: against midline of dorsal aspect of proximal phalanx

MP Flexion

  • Range of Motion: 0-50

  • Axis and landmarks : Adjacent to dorsal IP joint ( Goni upright)

  • Stationary: Against midline of dorsal aspect of 1st metacarpal

  • Moving: Against midline of dorsal aspect of the proximal phalanx

MP Extension

  • Range of Motion: 0-50

  • Axis and landmarks : Adjacent to dorsal IP joint ( Goni upright)

  • Stationary: Against midline of dorsal aspect of 1st metacarpal.

  • Moving:

IP Flexion

  • Range of Motion: 0-50

  • Axis and landmarks : adjacent to dorsal IP joint

  • Stationary: against midline of dorsal aspect

  • Moving: dorsal aspect of proximal phalanx

IP Extension:

  • Range of Motion: 0-50

  • Axis and landmarks :

  • Stationary: against midline of dorsal aspect

  • Moving: dorsal aspect of distal phalanx

Palmar Abduction

  • Range of Motion: 0-70

  • Axis and landmarks : adjacent to lateral cmc joint

  • Stationary: midline of posterior aspect of 2nd metacarpal

  • Moving: 1st metacarpal

Radial Abduction:

  • Range of Motion: 0-80

  • Axis and landmarks : adjacent to dorsal cmc joint

  • Stationary: midline of posterior aspect of 2nd metacarpal

  • Moving: 1st metacarpal

Digit Movements

Digital MCP (Metacarpophalangeal) Movements

  • MCP Flexion: 0°-90°

    • Axis: Adjacent to the dorsal MCP joint, goniometer upright.

    • Stationary: against midline of dorsal metacarapal

    • Moving: against midline of dorsal middle phalanx

  • PIP (Proximal Interphalangeal) Flexion: 0°-100°

    • Axis: Adjacent to the dorsal PIP joint.

    • Stationary: against midline of dorsal proximal phalanx

    • Moving: against midline of dorsal middle phalanx

PIP Extensor and Flexor Movements

  • PIP Extension: 0°-100°

    • Axis: Adjacent to the dorsal PIP joint.

  • DIP (Distal Interphalangeal) Flexion: 0°-90°.

    • Axis: Adjacent to dorsal DIP joint, upright position.

DIP Extension

  • Flexion and Extension Ranges: Both at 0°-90°.

    • Axis: Adjacent to the dorsal DIP joint.

Shoulder Movement Mechanics

Shoulder Flexion

  • Range of Motion: 0-180°

  • Axis and landmark: Lateral aspect of the humeral head.

  • Stationary Arm: Lateral midline of the trunk.

  • Moving Arm: Midline of the lateral humerus.

Shoulder Extension

  • Range of Motion: 0°-60°

  • Axis and Landmark: Lateral aspect of the humeral head.

  • Stationary Arm: lateral midline of trunk.

  • Moving Arm: midline of lateral humerus.

Shoulder Abduction

  • Range of Motion: 0-180°

  • Axis and landmark: Posterior aspect of the humeral head.

  • Stationary Arm: Perpendicular to the floor and parallel to the trunk.

  • Moving Arm: Posterior midline of the humerus.

Shoulder Internal Rotation

  • Range of motion : 0°-70°, with client laying supine (on the back)

  • Axis: Olecranon

  • Stationary Arm: perpendicular to the floor

  • Moving arm: Midline of the ulna

Shoulder External Rotation

  • Range of motion: 0°, 90°, client laying prone ( on stomach)

  • Axis and landmark : Olecranon.

  • Stationary arm: Perpendicular to ceiling

  • Moving arm: midline of ulnar