Summary Ranges of Joint Motion shoulder flexion 0o – 180



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Summary Ranges of Joint Motion
SHOULDER

  • Flexion 0o – 180o (150o – 180o)

  • Extension 0o – 45o (40o – 60o)

  • Abduction 0o – 180o (150o – 180o)

  • Internal rotation 0o – 90o (70o – 90o)

  • External rotation 0o – 90o (80o – 90o)



ELBOW


  • Flexion 0o – 145o (120o – 160o)

  • Extension 0o



FOREARM


  • Supination from midposition 0o – 80o (70o – 80o)

  • Pronation from midposition 0o – 80o (70o – 80o)



WRIST


  • Neutral when the midline between flexion and extension is 0o and when forearm and third metacarpal are in line

  • Flexion 0o – 90 o (75 o - 90o )

  • Extension 0 0 – 70o (65o – 70o)

  • Radial abduction 0o – 20o (15o – 25o)

  • Ulnar abduction 0o – 30o (25o – 40o)



FINGERS


  • MCP flexion 0o – 90o (85o – 100o)

  • MCP hyperextension 00 – 20o (0o – 45o)

  • MCP abduction 0o – 20o

  • MCP abduction 0o

  • PIP flexion 0o – 120o (90o – 120o)

  • DIP flexion 0o – 90o (80o – 90o)

  • IP extension 0o



THUMB


  • MCP flexion 0o – 45o (40o – 90o)

  • MCP abduction and adduction (NEGLIGIBLE)

  • IP extension 0o – 90o (80o – 90o)

HIP


  • Flexion 0o – 120o (110o – 135o)

  • Extension 0o – 10o

  • Abduction 0o – 45o (40o – 55o)

  • Adduction 20o – 30o across midline

  • External rotation 0o – 45o (40o – 50o)

  • Internal rotation 0o – 35o (30o – 45o)



KNEE


  • Flexion 0o – 135o (120o – 160o)

  • Extension 0o



ANKLE


  • Neutral with foot at a right angle to the leg and knee flexed.

  • Plantar flexion 0o – 45o (40o – 50o)

  • Dorsiflexion 0o – 15o (10o – 20o)

  • Inversion 0o - 35o / Eversion 0o - 15o

TOES


      • MTP flexion 0o – 40o (30o – 45o)

      • MTP extension 0o – 80o (50o – 90o)

      • MTP abduction (present)

      • IP flexion 0o – 60o (50o - 80o)

      • IP extension 0o

____________________________________________________________________________________
The values in bold type are round numbers that are convenient to remember in estimating the amount of normal motion present. The values in parentheses are the ranges of average normal motion reported in several sources.
SOURCES: American Academy of Orthopedic Surgeons, 1965; Departments of the Army and Air Force, 1968; Kendall, Kendall, and Wadsworth, 1971; Daniels and Worthingham, 1972; Gerhardt and Russe, 1975; and Kapandjl, 1982 and 1987. Ortho Notes 2005.

Flexibility Tests



Straight Leg Raise Test (hamstrings) – 70o-90o

Thomas Test – 0o (bottom leg)

Gastroc stretch test – 0o (subtalor neutral)


Trunk and Neck ROM norms


Cervical:

  • Flexion 0-60

  • Extension 0-75

  • Sidebend 0-45

  • Rotation 0-80


Thoracic/Lumbar:

  • Flexion 40-60 (inclimometer)

  • Extension 20-25

  • Sidebend 15-35

  • Rotation 5-45



HIP


Origin

Insertion

Action

Innervation

Psoas Major

Anterior and lateral surfaces of T12 through L5

Lesser trochanter

Hip flexion

L2 and L3

Iliacus

Iliac fossa

Lesser trochanter

Hip flexion

Femoral nerve

Piriformis

Ant. surface of sacrum

Greater trochanter

ER hip, ABD thigh with hip flexed

Sacral nerve

Adductor Brevis

Pubis

Pectineal line and proximal linea aspera

Hip adduction

Obturator nerve

Semimembranosus

Ischial tuberosity

Posterior surface of medial condyle of tibia

Extend hip and flex knee

Sciatic nerve

Rectus Femoris

Anterior inferior iliac spine

Tibial tuberosity

Hip flexion, knee extension

Femoral nerve

Adductor magnus

Ischium and pubis

Entire linea aspera and adductor tubercle

Hip adduction

Obturator nerve

Semitendinosus

Ischial tuberosity

Anteromedial surface of proximal tibia

Extend hip and flex knee

Sciatic nerve

Sartorius

Anterior superior iliac spine

Proximal medial aspect of tibia

Combination of hip flexion, abduction, lateral rotation

Femoral nerve

Gracilis

Pubis

Anterior medial surface of proximal end of tibia

Hip adduction

Obturator nerve

Biceps femoris

Long head: Ischial tuberosity. Short head: Lateral lip of linea aspera

Fibular head

Long head: Extend hip and flex knee. Short head: Flex knee

Long head: Sciatic nerve, Short head, Common peroneal nerve

Pectineus

Superior ramus of pubis

Pectineal line of femur

Hip flexion and adduction

Femoral nerve

Gluteus maximus

Posterior sacrum and ilium

Posterior femur distal to greater trochanter

Hip extension, hyperextension, lateral rotation

Inferior gluteal nerve

Gluteus medius

Lateral ilium

Greater trochanter

Hip abduction

Superior gluteal nerve

Adductor longus

Pubis

Middle on-third of the linea aspera

Hip adduction

Obturator nerve

Gluteus minimus

Lateral ilium

Anterior surface of the greater trochanter

Hip abduction, medial rotation

Superior gluteal nerve

Tensor fascia latae

Anterior superior iliac spine

Lateral condyle of tibia

Combined hip flexion and abduction

Superior gluteal nerve


KNEE


Origin

Insertion

Action

Innervation

Rectus femoris

Anterior inferior iliac spine

Tibial tuberosity

Hip flexion, knee extension

Femoral nerve

Vastus intermedialis

Anterior femur

Tibial tuberosity via patellar tendon

Knee extension

Femoral nerve

Biceps femoris

Long head: Ischial tuberosity. Short head: Lateral lip of linea aspera

Fibular head

Long head: Extend hip and flex knee.

Short head: Flex knee



Long head: Sciatic nerve.

Short head, Common peroneal nerve



Vastus lateralis

Linea aspera

Tibial tuberosity via patellar tendon

Knee extension

Femoral nerve

Semimembranosus

Ischial tuberosity

Posterior surface of medial condyle of tibia

Extend hip and flex knee

Sciatic nerve

Popliteus

Lateral condyle of femur

Posteriorly on medial condyle of tibia

Initiates knee flexion

Tibial nerve

Vastus medialis

Linea aspera

Tibial tuberosity via patellar tendon

Knee extension

Femoral nerve

Semitendinosus

Ischial tuberosity

Anteromedial surface of proximal tibia

Extend hip and flex knee

Sciatic nerve

Gastrocnemius

Medial and lateral condyles of femur

Posterior calcaneus

Knee flexion, ankle plantar flexion

Tibial nerve




ANKLE & FOOT

Origin

Insertion

Action

Innervation

Gastrocnemius

Medial and lateral condyles of femur

Posterior calcaneus

Knee flexion, ankle plantar flexion

Tibial nerve

Entensor digitorum longus

Fibula, interosseous membrane, tibia

Distal phalanx of four lesser toes

Extends four lesser toes, assists in ankle dorsiflexion

Deep peroneal nerve

Soleus

Posterior tibia and fibula

Posterior calcaneus

Ankle plantar flexion

Tibial nerve

Extensor hallucis longus

Fibula and interosseous membrane

Distal phalanx of great toe

Extends first toe; assists in ankle inversion and dorsiflexion

Deep peroneal nerve

Plantaris

Posterior lateral condyle of femur

Posterior calcaneus

Very weak assist in knee flexion; ankle plantar flexion

Tibial nerve

Tibialis anterior

Lateral tibia and interosseous membrane

First cuneiform and metatarsal

Ankle inversion and dorsiflexion

Deep peroneal nerve

Tibialis posterior

Interosseous membrane, adjacent tibia and fibula

Navicular and most tarsals and metatarsals

Ankle inversion; assists in plantar flexion

Tibial nerve

Peroneus longus

Lateral proximal fibula and interosseous membrane

Plantar surface of first cuneiform and metatarsal

Ankle eversion; assists in ankle plantar flexion

Superficial peroneal nerve

Flexor hallucis longus

Posterior fibula and interosseous membrane

Distal phalanx of the great toe

Flexes great toe; assists in inversion and plantar flexion of the ankle

Tibial nerve

Peroneus brevis

Lateral distal fibula

Base of fifth metatarsal

Ankle eversion; assists in plantar flexion

Superficial peroneal

Flexor digitorum longus

Posterior tibia

Distal phalanx of four lesser toes

Flexes the four lesser toes; assists in ankle inversion and plantar flexion of the ankle

Tibial nerve

Peroneus tertius

Distal medial fibula

Base of fifth metatarsal

Assists somewhat in ankle eversion and dorsiflexion

Deep peroneal nerve




SHOULDER GIRDLE

Origin

Insertion

Action

Innervation

Upper trapezius

Occipital bone, nuchal ligament

Outer third of clavicle, acromion process

Scapular elevation and upward rotation

cranial nerve XI

Middle trapezius

Spinous processes of C7 through T3

Scapular spine

Scapular retraction

cranial nerve XI

Lower trapezius

Spinous processes of middle and lower thoracic vertebrae

Base of the scapular spine

Scapular depression and upward rotation

cranial nerve XI

Levator scapulae

Transverse process of first four cervical vertevrae

Vertebral border of scapula between the superior angle and spine

Scapular elevation and downward rotation

C 3,4

Pectoralis minor

Anterior surface, third through fifth ribs

Coracoid process of the scapula

Scapular depression, protraction, and downward rotation

Medial pectoral nerve

Serratus anterior

Lateral surface of the upper eight ribs

Vertebral border of the scapula, anterior surface

Scapular protraction and upward rotation

Long thoracic nerve

Rhomboids

Spinous processes of C7 through T5

Vertebral border of scapula between the spine and inferior angle

Scapular retraction and downward rotation

Dorsal scapular nerve




GH JOINT

Origin

Insertion

Action

Innervation

Anterior deltoid

Lateral third of the clavicle

Deltoid tuberosity

Shoulder flexion, medial rotation, horizontal adduction

Axillary nerve

Middle deltoid

Acromion process

Deltoid tuberosity

Shoulder abduction

Axillary nerve

Posterior deltoid

Spine of scapula

Deltoid tuberosity

Shoulder extension, hyperextension, lateral rotation, horizontal abduction

Axillary nerve

Pectoralis major, clavicular and sternal portions

Medial third of clavicle, sternum, costal cartilage of first six ribs

Lateral lip of bicipital groove of humerus

Shoulder adduction, medial rotation, horizontal adduction

Lateral and medial pectoral nerve

Latissimus dorsi

Spinous processes of T7 through L5 (via dorsolumbar fascia), posterior surface of sacrum, iliac crest, and lower three ribs

Medial lip of bicipital groove of humerus

Shoulder extension, adduction, medial rotation, hyperextension

Thoracodorsal nerve

Teres major

Axillary border of scapula near the inferior angle

Crest below lesser tubercle next to the latissimus dorsi muscle attachment

Shoulder extension, adduction, medial rotation

Subscapular nerve

Teres minor

Axillary border of scapula

Greater tubercle of humerus

Shoulder lateral rotation, horizontal abduction

Axillary nerve

Supraspinatus

Supraspinous fossa of the scapula

Greater tubercle of the humerus

Shoulder abduction

Suprascapular nerve

Infraspinatus

Infraspinous fossa of scapula

Greater tubercle of humerus

Shoulder lateral rotation, horizontal abduction

Suprascapular nerve

Subscapularis

Subscapular fossa of the scapula

Lesser tubercle of the humerus

Shoulder medial rotation

Subscapular nerve

Coracobrachialis

Coracoid process of scapula

Medial surface of mid-humeral shaft

Adducts & Flexes the shoulder (late flexor)

musculocutaneous

Long head of Triceps & Biceps

See elbow













ELBOW AND FOREARM

Origin

Insertion

Action

Innervation

Biceps

Scapula: Long head, supraglenoid tubercle, Short head, coracoid process

Radial tuberosity of radius

Elbow flexion, forearm supination

Musculocutaneous nerve

Triceps

Long head: infraglenoid tubercle of scapula, Lateral head: Inferior to greater tubercle on posterior humerus, Medial head: Posterior surface of humerus

Olecranon process of ulna

Elbow extension

Radial nerve

Brachialis

Distal half of humerus, anterior surface

Coronoid process and ulnar tuberosity of the ulna

Elbow flexion

Musculocutaneous nerve

Brachioradialis

Lateral supracondylar ridge on the humerus

Styloid process of the radius

Elbow flexion

Radial nerve

Supinator

Lateral epicondyle of humerus and adjacent ulna

Anterior surface of the proximal radius

Forearm supination

Radial nerve

Pronator teres

Medial epicondyle of humerus and coranoid process of ulna

Lateral aspect of radius at its midpoint

Forearm pronation, assistive in elbow flexion

Median nerve

Pronator quadratus

Distal fourth of ulna

Distal fourth of radius

Forearm pronation

Median nerve




WRIST AND HAND

Origin

Insertion

Action

Innervation

Flexor carpi radialis

Medial epicondyle of the humerus

Base of second and third metacarpals

Wrist flexion, radial deviation

Median nerve

Flexor carpi ulnaris

Medial epicondyle of humerus

Pisiform, and base of fifth metacarpal

Wrist flexion, ulnar deviation

Ulnar nerve

Extensor carpi radialis longus

Supracondylar ridge of humerus

Base of second metacarpal

Wrist extension, radial deviation

Radial nerve

Extensor carpi radialis brevis

Lateral epicondyle of humerus

Base of third metacarpal

Wrist extension

Radial nerve

Extensor carpi ulnaris

Lateral epicondyle of humerus

Base of 5th metacarpal

Wrist extension, ulnar deviation

Radial nerve

Extensor digitorum

Lateral epicondyle of the humerus

Base of distal phalanx of the second – fifth fingers

Extends all three joints of the fingers

Radial nerve

Flexor digitorum superficialis

Common flexor tendon, coronoid process, and radius

Sides of the middle phalanx of the four fingers

Flexes MP and PIP joints of the fingers

Median nerve

Flexor digitorum profundus

Upper three-fourths of ulna

Distal phalanx of the four fingers

Flexes all three joints of the fingers

Median and ulnar nerves

Flexor pollicis longus

Radius, anterior surface

Distal phalanx of thumb

Flexes all joints of the thumb

Median nerve

Abductor pollicis longus

Posterior radius, interosseous membrane, middle ulna

Base of the first metacarpal

Abducts thumb

Radial nerve

Extensor digiti minimi

Lateral epicondyle of humerus

Base of distal phalanx of fifth finger

Extends all joints of fifth finger

Radial nerve

Extensor pollicis brevis

Posterior distal radius

Base of the proximal phalanx of thumb

Extends MP joint of thumb

Radial nerve

Extensor pollicis longus

Middle posterior ulna and interosseous membrane

Base of distal phalanx of thumb

Extends MP and IP joints of the thumb

Radial nerve

Palmaris longus

Medial epicondyle of humerus

Palmar fascia

Assistive in wrist flexion

Median nerve




TRUNK AND NECK

Origin

Insertion

Action

Innervation

Quadratus lumborum

Iliac crest

Twelfth rib, transverse processes of L2-L5

Trunk lateral bending

Twelfth thoracic and first lumbar nerves

Sternocleidomastoid

Sternum and clavicle

Mastoid process

Bilateral: Flexes neck Unilateral: Laterally bends the neck; rotates head to the opposite side

Accessory nerve (cranialXI); second and third cervical nerves

Scalenes

Transverse processes of the cervical vertebrae

First and second rib

Bilateral: Assists in neck flexion, Unilateral: Neck lateral bending

Lower cervical nerve

Splenius capitis

Lower half of nuchal ligament; spinous processes of C7 through T3

Lateral occipital bone; mastoid process

Bilateral: Extend head, Unilateral: Rotate head to same side

Middle and lower cervical nerves

Splenius cervicis

Spinous processes of T3 through T6

Transverse processes of C1 through C3

Bilateral: Extend head and neck, Unilateral: Rotate neck to same side

Middle and lower cervical nerves

Rectus abdominis

Pubis

Costal cartilages of fifth, sixth, and seventh ribs

Trunk flexion; compression of abdomen

Seventh through twelfth intercostals nerves

External oblique

Lower eight ribs laterally

Iliac crest and linea alba

Bilateral: Trunk flexion; compression of abdomen, Unilateral: Lateral bending; rotation to opposite side

Eighth through twelfth intercostals, iliohypogastric, and ilioinguinal nerves

Internal oblique

Inguinal ligament, iliac crest, thoracolumbar fascia

Tenth, eleventh, and twelfth ribs; abdominal aponeurosis

Bilateral: Trunk flexion; compression of abdomen, Unilateral: Lateral bending; rotation to same side

Eighth through twelfth intercostals, iliohypogastric, and ilioinguinal nerves




Transverse abdominis

Inguinal ligament, iliac crest, thoracolumbar fascia, and last six ribs

Abdominal aponeurosis and linea alba

Compression of abdomen

Seventh through twelfth intercostals, iliohypogastric, and ilioinguinal nerves

Erector spinae

Spinous processes, transverse processes, and posterior ribs from the occiput to the sacrum and ilium

Spinous processes, transverse processed, and posterior rubs from the occiput to the sacrum and ilium

Bilateral: Extend, Unilateral: Lateral bend

Spinal nerves

Diaphragm

Xiphoid process, ribs, lumbar vertebra

Central tendon

Inspiration

Phrenic nerve


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