How to Self Assess for Range of Motion Issues
As mentioned previously, the best way to determine if you lack range of motion in your shoulder is to have an assessment done by a physiotherapist. When I assess someone with shoulder pain, my initial focus is on screening these three specific movements:
- Shoulder Flexion (the movement of your arm overhead)
- Shoulder External rotation (the rotation of your arm away from your body)
- Shoulder internal rotation (the rotation of your arm towards your body)
To physiotherapist, these three movements represent the basic “vital signs” of your shoulder range of motion. In the clinic, I measure these movements with a tool called a goniometer, which allows me to be more accurate than the eyeball test you will be using. Obviously this is not something you can do on yourself, so you will be relying on answering two simple questions:
- Is there a gross/noticeable difference in the amount of movement as compared to your other shoulder
- Does the movement feel stiff/painful/tight.
If you answer yes to one or both of these questions, then you will need to focus on restoring the range of motion into that direction.
Assessing Shoulder Flexion
- insert video for shoulder flexion assessment
- Lie on your back on the floor
- Bend your knees and place your feet flat on the floor
- Raise both arms up overhead as far as you can
- If you have no pain in this position, apply some gentle overpressure with the other hand to push your shoulder further in this direction
- Look at how far the crease of your elbow is from the ground (you may need to use a mirror or shoot a video to see this more clearly
If you elbow is noticeably higher from the floor as compared to the other side and/or you notice pain/stiffness/tightness, then you need to work on improving your shoulder flexion range of motion.
Assessing Shoulder Internal Rotation
- insert video for shoulder internal rotation assessment
- Stand up straight
- Reach your hand to midline, then move up your back as far as you can
- Repeat on the other side
- Look at how far up your back your hand can reach (you may need to use a mirror or shoot a video to see this more clearly)
If your hand does not reach as high up your back as compared to the other side and/or you notice pain/stiffness/tightness, then you need to work on improving your shoulder internal rotation range of motion
Assessing Shoulder External Rotation in Neutral
- insert video for shoulder ER in neutral
- Lie on your back with knees bent, feet flat on the floor
- Tuck your elbows up against your sides
- Bend your elbows to 90 degrees
- Slowly rotate your hands outwards while keeping your upper arms touching your sides (if you have difficulty with this, have someone gently hold your arms against your sides for you)
- Look at how far your wrists are from the ground (you may need to use a mirror or shoot a video to see this clearly)
If your wrist is noticeably higher from the floor as compared to the other side and/or you notice pain/stiffness/tightness, then you need to work on improving your shoulder external rotation range of motion.
If you passed the external rotation test in neutral, then you’ll want to also check your external rotation in 90 degrees of abduction (upper arm at 90 degrees to your side)
Assessing Shoulder External Rotation at 90 Degrees Abduction
- insert video for shoulder ER in 90/90
- Lie on your back with knees bent, feet flat on the floor
- Move your arms away from your sides so that your elbows are in line with your shoulders
- Bend your elbows to 90 degrees with palms facing down towards your feet
- Slowly rotate your hand backwards towards the floor
- Look for how far your hand/wrist is from the floor ( you may need to use a mirror or shoot a video to see this more clearly)
If your hand/wrist is noticeably higher from the floor as compared to the other side and/or you notice pain/stiffness/tightness, then you need to work on improving your shoulder external rotation at 90 degrees of abduction.
What’s Next?
If you passed all these tests (no pain or movement loss), your shoulder pain fix will come from working on strengthening your rotator cuff and scapular stabilizers. If you have noticed some movement loss and/or pain/stiffness with some or all of these tests, then you will need to focus on improving your shoulder range of motion. Please refer to my post on improving shoulder range of motion for some simple exercises to address shoulder range of motion deficits.
– insert link for shoulder ROM treatment