Active ROM
Client moves the joint independently.
Use it to observe:
- available movement
- pain during movement
- movement quality
- willingness to move
Clinical clue: Pain during Active ROM may involve contractile or non-contractile structures.
FREE ROM GUIDE
Elbow Range of Motion
FREE SAMPLELearn when and why to use active, passive and resisted range of motion during a practical elbow assessment.
ROM TESTING OVERVIEW
Active, Passive & Resisted ROM
Passive ROM
Therapist moves the relaxed joint.
Use it to assess:
- available range
- end feel
- pain with passive movement
- joint or non-contractile restriction
Clinical clue: Pain during Passive ROM may suggest involvement of joint, capsule, ligament or other non-contractile structures.
Resisted ROM
Client contracts against resistance without needing large joint movement.
Use it to assess:
- muscle or tendon pain
- strength
- contractile tissue involvement
Clinical clue: Painful resisted contraction may indicate involvement of the muscle-tendon unit being tested.
ELBOW MOVEMENTS
Elbow movements to assess
Flexion
ACTIVE:
Ask the client to bend the elbow, bringing the hand toward the shoulder.
PASSIVE:
Support the arm and gently move the elbow into flexion.
RESISTED:
Client attempts elbow flexion while resistance is applied against the forearm.
Extension
ACTIVE:
Ask the client to straighten the elbow.
PASSIVE:
Support the arm and gently move the elbow into extension.
RESISTED:
Client attempts elbow extension while resistance is applied against the forearm.
Pronation
ACTIVE:
Ask the client to rotate the forearm so the palm turns downward.
PASSIVE:
Support the forearm and gently move it into pronation.
RESISTED:
Client attempts pronation while resistance is applied against the forearm or hand.
Supination
ACTIVE:
Ask the client to rotate the forearm so the palm turns upward.
PASSIVE:
Support the forearm and gently move it into supination.
RESISTED:
Client attempts supination while resistance is applied against the forearm or hand.
ASSESSMENT FLOW
A simple assessment sequence
Observe→Active ROM→Passive ROM→Resisted ROM→Compare sides→Special Tests
Use findings from the history, observation and ROM testing together rather than relying on a single test.
Special Tests
Special Tests
Use orthopaedic tests when the history and ROM findings suggest that a more specific structure or movement needs to be assessed.
Cozen’s Test
Lateral Epicondyle
Resisted Wrist Flexion / Pronation Test
Medial Epicondyle
Hook Test
Distal Biceps Tendon
Valgus Stress Test
Medial Elbow Stability
QUICK REVIEW
Quick Review
History→Observation→Active ROM→Passive ROM→Resisted ROM→Special Tests→Treatment Planning
CHECK YOUR UNDERSTANDING
Test Yourself
1. Which elbow movement brings the hand toward the shoulder?
2. Which forearm movement turns the palm upward?
3. Which orthopaedic test is commonly used for lateral epicondyle symptoms?
4. Which test is commonly used to assess the distal biceps tendon?
ROM findings should be interpreted together with the client's history, symptoms and other assessment findings. This guide is for educational revision and is not a substitute for diagnosis or professional clinical judgement.
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