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
Wrist Range of Motion
FREE SAMPLELearn when and why to use active, passive and resisted range of motion during a practical wrist 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.
WRIST MOVEMENTS
Wrist movements to assess
Flexion
ACTIVE:
Ask the client to bend the wrist forward, bringing the palm toward the forearm.
PASSIVE:
Support the forearm and gently move the wrist into flexion.
RESISTED:
Client attempts wrist flexion while resistance is applied against the palm.
Extension
ACTIVE:
Ask the client to bend the wrist backward, bringing the back of the hand toward the forearm.
PASSIVE:
Support the forearm and gently move the wrist into extension.
RESISTED:
Client attempts wrist extension while resistance is applied against the back of the hand.
Radial Deviation
ACTIVE:
Ask the client to move the hand toward the thumb side.
PASSIVE:
Support the forearm and gently move the wrist into radial deviation.
RESISTED:
Client attempts radial deviation while resistance is applied against the thumb side of the hand.
Ulnar Deviation
ACTIVE:
Ask the client to move the hand toward the little-finger side.
PASSIVE:
Support the forearm and gently move the wrist into ulnar deviation.
RESISTED:
Client attempts ulnar deviation while resistance is applied against the little-finger side of the 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.
Phalen’s Test
Carpal Tunnel
Tinel’s Sign
Median Nerve / Carpal Tunnel
Finkelstein Test
De Quervain’s
Ulnar Fovea Sign
Ulnar-sided Wrist / TFCC Region
QUICK REVIEW
Quick Review
History→Observation→Active ROM→Passive ROM→Resisted ROM→Special Tests→Treatment Planning
CHECK YOUR UNDERSTANDING
Test Yourself
1. Which wrist movement brings the palm toward the forearm?
2. Which wrist movement moves the hand toward the thumb side?
3. Which test is commonly used for De Quervain’s-related symptoms?
4. Which test is commonly used as part of carpal tunnel assessment?
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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