Then the patient’s arm is brought behind the back and lifted off the thorax. So your thigh fixates the shoulder girdle anteriorly against the clavicle and your arm rests against the scapula. The fixation of the shoulder girdle is then going to be opposite to the one we’ve seen for external rotation.
#Passive range of motion shoulder professional#
Then use your other hand to induce external rotation by grabbing onto the wrist of the patient’s arm and moving it outwards approximately 60°įor internal rotation, the patient can sit on the end of the bench. Fifty patients with a clinical diagnosis of adhesive shoulder capsulitis were examined by two independent testers. We (1) assessed the glenohumeral joint passive range of motion (PROM) characteristics in professional baseball pitchers and (2) applied these findings clinically in a treatment program to restore normal PROM and assist in injury prevention. The hand of that same arm cups the elbow of the patient to stabilize it in the anatomic position. To fixate the shoulder girdle and thus isolate movement in the glenohumeral joint, place your thigh on the scapula and the contralateral arm over the patient’s chest. A normal range of movement for shoulder adduction is 30 to 50.
If you hug yourself, your shoulders are adducting. For external rotation, have the patient in upright sitting position. Shoulder adduction occurs when you move your arms towards the middle of the body. You can fixate the clavicle and scapula with your body and hand and then move into horizontal extension.Īt last, let’s examine the rotations in the glenohumeral joint. Horizontal abduction is minimal at around 15°. Letting go of the scapula will allow you to move further across. With proper scapula fixation, you should reach end-range at around 110°. Fixate the scapula at the lateral border and bring the arm towards the midline of the body. We then refer to horizontal abduction and adduction.įor horizontal adduction, start with the arm in 90° abduction. If we let go of the fixation we should be able to move the arm further but will eventually have to externally rotate it slightly to reach end-range.Ībduction and adduction can not only happen in the frontal plane but also in the transversal plane. For abduction, the patient is again in sitting position and we will apply the same proximal fixation as with flexion. Let’s now look at abduction and adduction. Shoulder flexion can be accomplished in one of two ways, through glenohumeral joint flexion, or through glenohumeral joint, scapular, and clavicular motion.
If we let go of the fixation and thus allow the clavicle and scapula to move, we should be able to raise the arm above the head to round about 180 degrees.įor extension, the same principles apply but the arm is moved backward to around 60° as a norm. Then grasp the patient’s humerus as distal as possible and move it into forward flexion, which should be limited at around 80-90° for pure glenohumeral flexion. With the patient sitting on the bench, place one hand on the scapula and clavicle to fixate both. Let’s first look at forward flexion in the glenohumeral joint.
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