Range of motion refers to the amount of movement that a particular joint or body part can move. Range of motion is a common assessment procedure in orthopedic injury. Injuries to muscle, ligaments or bone can impair range of motion.
According to the text "Orthopedic Physical Assessment," during an examination there are two types of range of motion that are commonly performed. These are active range of motion and passive range of motion. Active range of motion refers to movements done by the patient, such as tucking their chin to chest. Passive range of motion refers to motions that are carried out by the doctor or therapist, such as the doctor moving the patient's head without help from the patient.
There are specific ranges of motion for all areas of the body. Range of motion is measured in degrees.
Cervical Ranges of Motion
The cervical spine is made up of the seven bones in the neck. When checking cervical range of motion, the examiner is testing the movement of the head, or skull, and neck. This is performed in flexion, extension, lateral bending, and rotation. Reduced range of motion can occur if there is damage to the soft tissues of the neck from something like a whiplash injury, or if the curve of the cervical spine is decreased.
Normal range of motion for the cervical spine includes flexion, 50 degrees; extension, 60 degrees; lateral, or side bending, 45 degrees; and rotation, 80 degrees.
Thoracic Spine or Upper/Mid Back Ranges of Motion
The thoracic spine consists of the 12 thoracic vertebra and the ribs located on each side. Thoracic range of motion is also tested from time to time during an examination.
The ranges of motion for the thoracic spine includes 30 degrees of rotation and 50 degrees of kyphosis. Kyphosis is the name given to the outward curve of the mid back from the first thoracic vertebra to the 12th thoracic vertebra.
Lumbar, or Low Back Ranges of Motion
The lumbar spine, commonly known as the low back, is also tested during range of motion exams. The lumbar spine has five vertebra and connects the spine to the pelvis. Decreased lumbar range of motion can result from problems with the lumbar discs, weak or tight muscles, pain, and injury to the spinal joints.
Normal lumbar ranges of motion include 60 degrees of flexion, 25 degrees of extension, and 25 degrees of lateral, or side, bending.
Upper Extremity Ranges of Motion
The upper extremities consist of the shoulder complex, humerus, elbow joint, forearm, wrist joint, and the bones of the hand. These joints are tested, commonly in sports medicine, when injury is suspected to this area. The upper extremity has multiple joints and the total range of motion is a combination of all of these joints working together. The text "Examination of Orthopedic and Athletic Injuries", notes that a deficit in one joint affects the motion in the others.
Common upper extremity ranges of motions for the shoulder include 170 to 180 degrees of flexion, 50 to 60 degrees of extension, 170 to 180 degrees of abduction, for moving the arm away from the body, 80 to 90 degrees of internal rotation, and 90 to 100 degrees of external rotation.
Range of motion in the elbow and forearm include 145 to 155 degrees of elbow flexion and 0 degrees of extension due to the bony anatomy of the joint; hyper-extension can occur from injury. Also, 90 degrees of supination and pronation, or rotating the forearm.
Wrist range of motion includes 80 to 90 degrees of flexion and 75 to 85 degrees of extension.
Lower Extremity Ranges of Motion
The lower extremity is a combination of many joints, including the hip joint, femur, knee joint, lower leg, ankle joint and the bones of the foot. Injury can affect ranges of motion in the lower extremity and limit the ability to walk comfortably, which can affect the joints of the pelvis and spine above.
Lower extremity ranges of motion for the hip include 120 to 130 degrees of flexion, 10 to 20 degrees of extension, 45 degrees of abduction away from the body, 30 degrees of adduction toward body, 45 degrees of internal rotation, and 50 degrees of external rotation.
Knee range of motion consists of the flexion and extension arc of motion which totals 1350145 degrees.
Ankle range of motion is measured as 50 degrees of plantar-flexion, or toes pointing toward the ground; 20 degrees of dorsi-flexion, with the toes pointing toward head, 20 degrees of inversion, and 5 degrees of eversion.
Prevention of Loss of Range of Motion
The human body requires all joints to be able to move through a full range of motion to function correctly. To prevent loss of range of motion you should follow a few easy steps. They include exercise, walking, stretching and avoiding injury.
References
- "Orthopedic Physical Assessment Fifth Edition"; Magee DJ; 2008.
- "Examination of Orthopedic and Athletic Injuries Edition 3"; Starkey C, Brown SD, Ryan J. 2010.
