Dear Tim

These informations may be useful for you

Range of Motion Explained

Generally speaking, range of motion refers to the distance and direction a joint can move to its full potential. Each specific joint has a normal range of motion that is expressed in degrees after being measured with a goniometer (i.e., an instrument that measures angles from axis of the joint).

Limited Range of Motion

Limited range of motion refers to a joint that has a reduction in its ability to move. The reduced motion may be a mechanical problem with the specific joint or it may be caused by diseases such as osteoarthritis, rheumatoid arthritis, or other types of arthritis. Pain, swelling, and stiffness associated with arthritis can limit the range of motion of a particular joint and impair function and the ability to perform usual daily activities.

Range-of-Motion Exercises

Physical therapy can help to improve joint function by focusing on range-of-motion exercises. The goal of these exercises is to gently increase range of motion while decreasing pain, swelling, and stiffness. There are three types of range-of-motion exercises:

Active range-of-motion - patient exercises without any assistance

Active assistive range-of-motion - patient requires some help from therapist to do the exercises

Passive range-of-motion - therapist or equipment moves patient through range of motion (no effort from patient)

Normal Range of Motion for Each Joint

It's important to know the normal range of motion for each joint. After physical examination, if it is determined that you have limited or abnormal range of motion in one or more joints, you can put together a treatment plan with your doctor. You can be reassessed for range of motion to determine if the treatment is effective. Patients who have joint surgery must also go through extensive rehabilitation to get back to normal range of motion in the affected joint.

Normal Values (in degrees):

Hip flexion (bending) 0-125

Hip extension (straightening) 115-0

Hip hyperextension (straightening beyond normal range) 0-15

Hip abduction (move away from central axis of body) 0-45

Hip adduction (move towards central axis of body) 45-0

Hip lateral rotation (rotation away from center of body) 0-45

Hip medial rotation (rotation towards center of body) 0-45

Knee flexion 0-130

Knee extension 120-0

Ankle plantar flexion (movement downward) 0-50

Ankle dorsiflexion (movement upward) 0-20

Foot inversion (turned inward) 0-35

Foot eversion (turned outward) 0-25

Metatarsophalangeal joints flexion 0-30

Metatarsophalangeal joints extension 0-80

Interphalangeal joints of toe flexion 0-50

Interphalangeal joints of toe extension 50-0

Shoulder flexion 0-90

Shoulder extension 0-50

Shoulder abduction 0-90

Shoulder adduction 90-0

Shoulder lateral rotation 0-90

Shoulder medial rotation 0-90

Elbow flexion 0-160

Elbow extension 145-0

Elbow pronation (rotation inward) 0-90

Elbow supination (rotation outward) 0-90

Wrist flexion 0-90

Wrist extension 0-70

Wrist abduction 0-25

Wrist adduction 0-65

Metacarpophalangeal (MCP) joints abduction 0-25

MCP adduction 20-0

MCP flexion 0-90

MCP extension 0-30

Interphalangeal proximal (PIP) joints of fingers flexion 0-120

PIP extension 120-0

Interphalangeal distal (DIP) joint of fingers flexion 0-80

DIP extension 80-0

Metacarpophalangeal joint of thumb abduction 0-50

MCP of thumb adduction 40-0

MCP of thumb flexion 0-70

MCP of thumb extension 60-0

Interphalangeal joint of thumb flexion 0-90

Interphalangeal joint of thumb extension 90-0

Sources:

1) Physical Therapy. Merck Manual Professional. November 2005.

http://www.merck.com/mmpe/sec22/ch336/ch336b.html

2)Limited Range of Motion. University of Maryland Medical Center. 11/2/2006.

http://www.umm.edu/ency/article/003173.htm

There are different systems of measuring the range of motion. Probably, the most popular is the Neutral-Zero-System, advocated by the American Academy of Orthopaedic Surgeons.

Hi Tim,

The literature on joint "hypermobility" sybdromes tends to describe the normal and abnormal ranges of motion with great care. So this sort of literature mnay be a good place to look for a systematic approach to quantifying joint range of motion (ROM).

Here is a recent paper that looks at ROM and injury risk. It is useful by itself, but the paper's reference list should also give you good guidance to literature on joint ROM and hypermobility.

Pacey, V., Nicholson, L. L., Adams, R. D., Munn, J., & Munns, C. F. (2010). Generalized Joint Hypermobility and Risk of Lower Limb Joint Injury During Sport. Am J Sports Med, 38(7), 1487-1497.

Cheers,

Jeremy

As regards the issue of general ranges of motion and risk of injury, the short answer to your question is no. There are some papers that describe ranges of motion as risk factor for injury at particular body sites and in particular populations (which have tended to be healthy young people such as athletes or military recruits). These papers also tend to look particularly at injuries occuring either in sport-specific or military training.

I think every musculoskeletal exam textbook describes normal range of motion in each joint and as far as I can tell these normal values were made up and have been passed down through time without empirical validation. Moreover, what is "normal" is a different question than what places a person at risk for injury.

I am not sure which body part, and which population you are specifically interested in. However, this a review article that does not directly answer your question, though it has many references that may be nice leads depending on which body part you are particularly interested in.

Thacker, S. B., et al. "The impact of stretching on sports injury risk: a systematic review of the literature." Medicine and Science in Sports & Exercise 36.3 (2004): 371-378.

Thanks a lot for all the answers. I really appreciate the help. At the university we are taught that limited ROM can be a cause of an injury, yet nobody never told us what is a "safe" ROM. That's why I was asking ...

As a kinesiology student, I think I have to know these things :)