SKILLS LAB: SHOULDER ROM
NAME:
Range of motion is defined as the amount of movement a joint can perform. For the shoulder, this occurs at the glenohumeral and
scapulothoracic joints. Movement takes place at the glenohumeral joint in FLEXion, EXTension, ABDuction, ADDuction, Interal
Rotation, External Rotation, Horizontal ABDuction, and Horizontal ADDuction. At the scapulothoracic joint, movement takes place in
PROTRACTION, RETRACTION, ELEVation, and DEPression. During an evaluation, range of motion is evaluated in three ways: actively,
passively, and resistively. Active and passive range of motion are graded as either within normal limits (WNL) or abnormal, with a
description of the abnormality. Resistive range of motion is graded on a 0-5 scale, as it is muscle strength that is being assessed. For
the rotator cuff, manual muscle tests (MMTs) are used to isolate each muscle. These are also graded on a 0-5 scale. Documenting
range of motion must include all ranges of motion tested, a description of those ranges of motion, and a grading of the ranges of
motion. For example:
AROM: R:
L:
PROM: R:
L:
RROM: R:
ALL ROM WNL
ER LIMITED DUE TO PN; ALL OTHER ROM WNL
ALL ROM WNL
ALL ROM WNL FOR SHOULDER; PN WITH IR
5/5 FLEX, 5/5 EXT, 5/5 ABD, 5/5 ADD, 5/5 ER, 5/5 IR; 5/5 ELEV; MMT 5/5 SUPRA, 5/5 INFRA, 5/5 TM,
5/5 SUBSCAP
L:
5/5 FLEX, 5/5 EXT, 4/5 ABD, 5/5 ADD, 3+/5 ER, 5/5 IR; 5/5 ELEV; MMT 5/5 SUPRA, 3/5 INFRA, 3/5 TM,
5/5 SUBSCAP
Shoulder Movements
To evaluate…
Flexion
Extension
Abduction
Adduction
Internal Rotation
External Rotation
Horiz. ABD
Horiz. ADD
Protraction
Retraction
Elevation
Depression
The patient will…
Raise their hand
Push their arm back
Arm out to the side
Arm next to the side
Back of palms on small of back
Make a W shape
Make a T shape
Arm across front of body
Separate shoulder blades
Squeeze shoulder blades
Shrug shoulders
Drop shoulders towards waist
Supraspinatus MMT
 Shoulder flexion in the plane of the scapula
 Hold position against resistance for 5-6 sec.
 “Don’t let me push your arms down”
Infraspinatus MMT
 External rotation at 0-90 position
 Hold position against resistance for 5-6 sec.
 “Push out against my hand”
Teres minor MMT
 External rotation at 90-90 position
 Hold position against resistance for 5-6 sec.
 “Push back against my hand”
Subscapularis MMT
 Internal rotation behind the back
 Hold position against resistance for 5-6 sec.
 “Push back into my hand.”
In this lab, students will pair up with a classmate and assess, grade, and document the range of motion for the
shoulder. Students will have the instructor observe and sign-off on their ability.
Examiner:
Patient:
AROM: R:
L:
PROM: R:
L:
RROM: R:
L:
MMT: R:
L:
Instructor sign-off:
Review Questions
1. When assessing AROM, which movements can be assessed bilaterally at the same time? Which must be
performed one side at a time?
2. List the muscles responsible for:
a. Shoulder flexion
b. Abduction
c. Internal rotation
3. What grade would you score a MMT for the Subscapularis if the patient wasn’t able to hold the position against
full resistance?