How is active range of motion tested in the physical exam of supraspinatus tendonitis?

Updated: Dec 04, 2017
  • Author: Thomas M DeBerardino, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Active range of motion:

  • Test this if possible; if not, then test passive range of motion.

  • Test forward flexion. The average range is 150-180°.

  • Test abduction. The average range is 150-180°.

  • Test external rotation. The average range with the arm in adduction is 30-60°, and the average range with the arm in abduction is 70-90°.

  • Test internal rotation. The average range is measured by how high the patient can reach up his or her back with the ipsilateral thumb (ie, ipsilateral hip, T12, L5). The average range is above T8.

  • Test adduction. The average range is 45°.

  • Test extension. The average range is 45°.

  • Note that stiffness with external/internal rotation is best tested with the arm in 90° of abduction. Also, for an optimal evaluation, test external and internal rotation in the supine position with the scapulothoracic articulation stabilized. Moreover, most high-level pitchers have increased external rotation and decreased internal rotation in the pitching arm compared with the nonpitching arm. However, the overall absolute arc of motion when measured in degrees is usually equal. This may not be pathologic in the high-level athletic population. Finally, a painful arc of motion may be experienced with elevation above the shoulder level in patients with impingement (typically 80-150°).

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