Shoulder Range of Motion Lab
The shoulder is one of the most frequently injured joints. Due to its lack of structural congruency and dependence on
passive restraints, it is susceptible to traumatic injuries and general “wear and tear” injuries that accumulate over one’s life
span. As a result shoulder ROM is frequently evaluated by therapists to assist in diagnosis, determine treatment, and set
goals.
Overall ROM of the shoulder is the result of the combined motion of the glenohumeral (GH), scapulothoracic (ST),
sternoclavicular, acromioclavicular, and supraacromial joints. Therefore, when evaluating ROM of the shoulder, the
therapist must be sensitive to the amount and quality of motion of each of these contributing joints.
The purpose of this lab is to raise the awareness of the therapist to the contribution of the glenohumeral and scapulothoracic
joints to gross shoulder ROM. The ability to discriminate between lost glenohumeral or scapulothoracic ROM is an
important skill in accurately diagnosing shoulder pathology and establishing a treatment plan
Procedures
By carefully monitoring the movement of the scapula when measuring shoulder PROM, the therapist can determine when
passive GH motion ends and when passive ST motion begins. Measure the PROM of the shoulder as outlined in the tables
below.
1.
In groups of three students, designate a subject, therapist, and recorder.
2.
Using the chart below, position the patient as stated and have the therapist measure "glenohumeral PROM" with a
blinded goniometer. To minimize bias of subsequent measurements, the therapist should NOT read the goniometer.
3.
The therapist should give the goniometer to the recorder, and the recorder will read and document the PROM measure
in the appropriate cell in the table below.
4.
The therapist and recorder should repeat steps 2 and 3 for "total shoulder PROM". The recorder can then determine
"Scapulothoracic PROM" by subtracting "glenohumeral PROM" from "total shoulder PROM".
5.
Alternate the subject, therapist, and recorder so each student has the opportunity to perform each role.
Shoulder
Motion
Body
Position
Glenohumeral PROM
T1
Flexion
Abduction
IR
ER
IR
ER
T2
T3
avg
Total Shoulder
PROM
T1 T2 T3 avg
Scapulothoracic
PROM
T1 T3 T2 avg
supine
supine
supine
supine
prone
prone
Make sure you can answer these questions:
1.
For shoulder flexion and abduction, how did your subject’s PROM measures compare to the generally accepted
theoretical measures for GH, ST, and overall shoulder ROM?
2.
When assessing a patient’s passive shoulder flexion and abduction you discover limited GH motion, what are the
possible causes? If ST motion is restricted, what are the possible causes?
3. Compare supine and prone measures of shoulder IR for the GH and ST joints. Were there any differences? Why or
why not? Do the same for shoulder ER.
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