The Elbow & Forearm: ROM

Question 0

Elbow EXTENSION

Answer 0

Patient Position:
Supine 
Shoulder 0* flex, ABD, ext
Arm held close to body
Forearm supinated 
*Towel placed under humerus to all full ext

Goniometer:
Axis: lateral epicondyle
Proximal Arm: lateral midline of humerus
Distal Arm: lateral midline of radius (radial styloid process and radial head for reference)

Stabilization:
Distal end of humerus to prevent flex of shoulder

End Feel:

• hard: bc of contact btw Olecranon process and Olecranon fossa
• firm: bc tension in anterior capsule, collateral ligaments, biceps, and Brachialis.

Question 1

Elbow FLEXION

Answer 1

Patient Position:
Supine 
Shoulder 0* flex, ABD, ext
Arm held close to body
Forearm supinated 
*Towel placed under humerus to all full ext

Goniometer:
Axis: lateral epicondyle
Proximal Arm: lateral midline of humerus
Distal Arm: lateral midline of radius (radial styloid process and radial head for reference)

Stabilization:
Distal end of humerus to prevent flex of shoulder

End Feel:

• soft: bc compression of soft tissue
• hard: bc of muscle atrophied
• firm: bc tension in posterior capsule of triceps

Question 2

Forearm PRONATION

Answer 2

Patient Position: 
Seated
Shoulder in neutral
Elbow flexed to 90*
Humerus against trunk
Forearm supported in midline position

Goniometer:
Axis: lateral and proximal to the ulna styloid process
Proximal Arm: parallel to midline of humerus
Distal Arm: across dorsal surface of forearm (parallel to styloid processes)

Stabilization:
At distal humerus to prevent medial rotation and ABD of shoulder

End Feel:

• hard: bc contact btw ulna and radius
• firm: bc tension in dorsal Radioulnar ligament, interosseous membrane and supinator

Question 3

Forearm SUPINATION

Answer 3

Patient Position: 
Seated
Shoulder in neutral
Elbow flexed to 90*
Humerus against trunk
Forearm supported in midline position

Goniometer:
Axis: medial and proximal to ulna styloid process
Proximal Arm: parallel to midline of humerus
Distal Arm: across the ventral surface of forearm, proximal and parallel to styloid processes

Stabilization:
At distal humerus to prevent medial rotation and ABD of shoulder

End Feel:
-firm: bc of tension in palmar Radioulnar ligament, interosseous membrane, Pronator Teres and Pronator quadrantus muscle