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
Shoulder Range of Motion
FREE SAMPLELearn when and why to use active, passive and resisted range of motion during a practical shoulder 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.
SHOULDER MOVEMENTS
Shoulder movements to assess
Flexion
ACTIVE:
Ask the client to raise the arm forward and overhead.
PASSIVE:
Support the arm and gently move the shoulder into flexion.
RESISTED:
Client attempts shoulder flexion while resistance is applied against the arm.
Extension
ACTIVE:
Ask the client to move the arm backward.
PASSIVE:
Support the arm and gently move the shoulder into extension.
RESISTED:
Client attempts shoulder extension while resistance is applied against the posterior arm.
Abduction
ACTIVE:
Ask the client to raise the arm out to the side.
PASSIVE:
Support the arm and gently move the shoulder into abduction.
RESISTED:
Client attempts shoulder abduction while resistance is applied against the lateral arm.
Adduction
ACTIVE:
Ask the client to move the arm toward or across the body.
PASSIVE:
Support the arm and gently move the shoulder into adduction.
RESISTED:
Client attempts shoulder adduction while resistance is applied against the medial arm.
Internal Rotation
ACTIVE:
Ask the client to rotate the arm inward.
PASSIVE:
Support the arm and gently move the shoulder into internal rotation.
RESISTED:
Client attempts internal rotation while resistance is applied against the forearm.
External Rotation
ACTIVE:
Ask the client to rotate the arm outward.
PASSIVE:
Support the arm and gently move the shoulder into external rotation.
RESISTED:
Client attempts external rotation while resistance is applied against the forearm.
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.
Empty Can / Jobe Test
Rotator cuff
Painful Arc Test
Subacromial pain
Scarf / Cross-Body Adduction Test
AC joint
Apley's Scratch Test
General shoulder mobility
QUICK REVIEW
Quick Review
History→Observation→Active ROM→Passive ROM→Resisted ROM→Special Tests→Treatment Planning
CHECK YOUR UNDERSTANDING
Test Yourself
1. Which shoulder movement raises the arm out to the side?
2. Which shoulder movement rotates the arm outward?
3. Which orthopaedic test is commonly used to assess the supraspinatus?
4. Which test is commonly used to assess painful shoulder abduction through the mid-range?
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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