Range of motion is generally defined as the amount of movement that a joint or body part can move. Anatomy and bio-mechanic textbooks have listed range of motion normals and procedures have been developed to test whether a person's range of motion is within normal limits. These exams look for areas of limited range of motion. Medline Plus states that limited range of motion is a term meaning that a specific joint or body part cannot move through its normal range of motion, this motion can be decreased due to mechanical problems, swelling, muscle tightness, or pain. Range of motion testing is performed by visual estimation and by the use of tools or computerized equipment.
Movements of the Head and Neck
The head and neck consist of the skull and cervical spine. This area has primary movements of 50 degrees of flexion, 60 degrees of extension, 45 degrees of lateral bending, and 80 degrees of rotation in both right and left directions. Dysfunction in the spine, muscles, and individual joints can limit head and neck range of motion. When testing range of motion in this area, the examiner is looking for decreased movement and any pain that may be associated with the movements.
Movements of the Mid Back and Lower Back
The mid back and lower back include the thoracic spine and lumbo-sacral spine. These two areas have a total of 17 vertebrae and various attachments including the rib cage, stabilizing muscles, and strong ligaments. The normal range of motion for the thoracic spine includes 30 degrees of rotation and 50 degrees of kyphosis, which is a measurement of the outward facing curve of the mid back. The lower back has a range of motion of 60 degrees of flexion, 25 degrees of extension, and 25 degrees of lateral bending according to "Anatomy of Human Movement Structure and Function".
The Upper Extremity Ranges of Motion
The upper extremity includes the shoulder complex, arm, and hand. The upper extremity is important in many of our daily activities. Range of motion in the shoulder is stated as 180 degrees of forward flexion, 50 degrees of extension, 50 degrees of adduction, 180 degrees of abduction, and 90 degrees of internal and external rotation, according to the textbook "Mosby's Guide to Physical Examination." The elbow is the middle joint of the upper extremity and it has a range of motion of 160 degrees of flexion. The elbow only extends to bring the arm back to neutral from flexion. This is due to the bony anatomy of the elbow. The wrist is able to move with 70 degrees of extension and 90 degrees of flexion.
Lower Extremity Range of Motion
The lower extremity range of motion is a combination of movements of the hip, knee, and ankle. 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 135 to 145 degrees. Ankle range of motion includes 50 degrees of plantar-flexion, or toes pointing toward the ground, and 20 degrees of dorsi-flexion with the toes pointing toward head. It also includes 20 degrees of inversion and 5 degrees of eversion.
Exercises for Improving Range of Motion
Simple exercises can be performed that will help keep your joints limber and flexible. They do not require any equipment and they can be performed any time of day. According to University of Washington, you should try to move your joints through their full range of motion every day. They state that daily activities, such as housework, climbing stairs, dressing, bathing, cooking, lifting, or bending do not provide enough movement and do not move the joints through their full range of motion.
References
- Medline Plus: Limited Range of Motion
- "Anatomy and Human Movement Structure and Function"; Palastanga N, Field D, Soames R: 2006
- "Mosby's Guide to Physical Examination Fifth Edition"; Seidel HM, Ball JW, Dains JE, Benedict GW: 2003
- University of Washington Department of Ortheopedics
