man with limited range of motion in his shoulderRange of motion (ROM) means how far and in what direction you can move a joint or muscle. Although joint and muscle flexibility varies for each person, researchers have determined numerical values for the “normal” range of motion. For example, according to experts at the Centers for Disease Control and Prevention (CDC), a normal knee joint can flex between 133 and 153 degrees, depending on age and gender.

The CDC study examined over 600 people of various ages and genders with no known joint mobility problems to establish reference values for the normal range of motion of the body’s five main joints. If your range of motion is below the established norm, you have some degree of limited ROM.

Although aging can cause a natural decline in ROM, there are many other reasons joint mobility may be compromised.

Range of Motion May Be Limited or Decline for Many Reasons

Sports or other injuries, surgery, joint dislocation, infection in the joint, pain, and swelling around the joint often restrict the range of motion in the affected area. Other conditions that may affect the range of motion include but are not limited to the following.

  • Arthritis, including osteoarthritis, adult or juvenile rheumatoid arthritis, and ankylosing spondylitis
  • Cerebral palsy
  • Muscular dystrophy
  • Volkmann contracture (injury to muscles of the forearm, causing muscles to shorten)
  • Dupuytren’s contracture (thickening of the tissue layer under the skin of the hands and wrist)
  • Congenital torticollis (tight, short neck muscle)
  • Stroke or brain injury

Range of Motion Measurements

Physical therapists (PT) routinely measure your range of motion when you begin a physical therapy program and take new measurements throughout the program to chart improvements. Using a goniometer, your physical therapist measures three types of range of motion: active, passive, and active-assistive.

Active Range of Motion (AROM)

You perform an active range of motion without assistance by using your muscles to move the desired body part. During AROM, you actively engage your muscles to contract and relax as they move around a joint. Performing strengthening exercises is an example of AROM.

Passive Range of Motion (PROM)

During passive range of motion, an outside force, like your physical therapist, moves your joint through its maximum capacity with no assistance from you. Your PT may perform PROM manually or use a continuous passive motion (CPM) machine.

PTs often use PROM during the early stages of recovery from an injury or surgery. PROM also helps prevent contractures, pressure sores, or spasticity if you cannot move your limbs on your own for any reason.

Active-Assistive Range of Motion (AAROM)

If you can move a recovering body part but need assistance to protect it from injury as it heals, your physical therapist may use active-assistive range of motion. AAROM may be performed hands-on by your physical therapist or by a machine. Active-assistive ROM helps you build flexibility and strength as you heal.

Your physical therapist decides which range of motion exercise or combination of approaches is most appropriate for your condition. For example, suppose you are recovering from an injury, healing from a surgical procedure, or struggling with a chronic pain condition like arthritis. In that case, your PT may begin with PROM, then to AAROM, and, as you gain strength, flexibility, and your pain decreases, to AROM.

Why Does Your Range of Motion Matter?

Range of motion and flexibility are essential to your body’s functional mobility. Bones, ligaments, muscles, and tendons support each joint in your body, enabling it to move within a specific range. With a good range of motion, your joints move easily and comfortably, your torso and limbs function efficiently, your risk of injury decreases, and you enjoy a higher quality of life.

If you have limited ROM in one or more joints, your body may compensate by placing stress on other joints or muscles, resulting in muscle imbalance and improper body alignment. Poor alignment and muscle imbalance present a greater risk of injury and pain and reduce functional mobility. Limited range of motion can also contribute to mental health issues, including depression.

Your physical therapist can design a ROM exercise and stretching program to help you recover from or avoid a frozen joint.

Multiple studies have concluded that correctly executed range of motion exercises can help:

  • Improve strength and flexibility
  • Reduce pain and discomfort
  • Improve circulation
  • Lessen stiffness
  • Reduce the risk of reinjury
  • Improve mood

A study of stroke survivors in long-term care found range of motion exercises significantly improved “joint angles, activity function, perception of pain and depressive symptoms.”

In another study, stroke patients participated in a four-week range of motion exercise program. Results at the end of the study noted significant improvements in the exercise group when compared to the control group, including:

  • Decreased edema of upper extremities
  • Increase in range of motion
  • Improved function of upper extremities
  • Increased ability to perform activities of daily living

A systemic review of controlled trials studying the benefits of exercise after knee arthroplasty concluded that outpatient physical therapy after surgery should include “strengthening and intensive functional exercises” supervised by a licensed physical therapist.

Contractures, Contracture Deformities, and Frozen Shoulder

Several conditions can lead to severe limitations in range of motion, including adhesive capsulitis and contractures.

Adhesive capsulitis, better known as frozen joint syndrome or frozen shoulder, may result when scar tissue or inflammation around a joint restricts movement. Adhesive capsulitis most often affects the shoulder but may affect the knee or hip joint.

Experts believe a frozen shoulder may result from a long period of immobilization of the joint because of surgery, rotator cuff injury, fractured arm, or stroke. Researchers at the Mayo Clinic also warn some diseases increase the risk of frozen shoulder, including:

  • Diabetes
  • Hyperthyroidism
  • Hypothyroidism
  • Cardiovascular disease
  • Tuberculosis
  • Parkinson’s disease

Contractures develop when skin, muscles, ligaments, tendons, and other tissues around a joint lose elasticity, causing pain and preventing normal movement. A contracture deformity happens when the joint locks permanently into one position.

According to MedlinePlus, contracture can be caused by:

  • Brain and nervous system disorders, such as cerebral palsy or stroke
  • Inherited diseases (such as muscular dystrophy)
  • Nerve damage
  • Reduced use of the joint
  • Severe muscle and bone injuries
  • Scarring after traumatic injury or burns

Range of motion exercises is critical to improve and maintain function in the joint and prevent contracture deformity. Studies find physical therapy and occupational therapy, casting or splinting to stretch tissues, use of a continuous passive motion machine, and medication, if appropriate, are effective approaches to relieving constriction of a joint.

How Physical Therapy Helps Improve Your Range of Motion

A healthy range of motion enables you to move through your life comfortably, independently, and productively. Restricted movement in any part of your body impacts your quality of life and increases your risk of pain, injury, and limited mobility.

At MOTION, we work every day with patients to increase their range of motion and every facet of their health. Your MOTION physical therapist will design a program tailored to your needs, which may include exercises, stretching, neuro-muscular reeducation, hands-on techniques, and other modalities to help:

  • Improve mobility and strength of a specific joint
  • Promote healing of soft tissue and joint lesions
  • Reduce the risk of contracture formation
  • Decrease pain
  • Improve overall fitness and mobility
  • Increase independence

Exercise and stretching also trigger the body to produce more synovial fluid, which helps strengthen muscles, maintain tendon flexibility, and keep cartilage healthy.

Our mission at MOTION is to get you back to what moves you as quickly as possible. Our dedicated physical therapy team is uncompromising in their pledge to improve your mobility and help you overcome pain and any other limitations preventing you from living the life you deserve.

Contact us today to learn how we can help improve your range of motion and your overall well-being.