Submissions from Readers

ROM limits

Question: Why should it be avoided to range a shoulder over 90 degrees on a flaccid extremity?

Answer: It doesn't have to be totally avoided, but it has to be done correctly and without pain. When passively raising the flaccid arm above 90 degrees the shoulder blade or scapula has to rotate upward to allow for movement of the humerus (upper arm bone). If the scapula does not rotate, then structures can be impinged, damage can occur, and pt. may also experience pain. Some patients may not be aware of the pain because they have lost sensation, so you cannot rely on patient report. The humerus also needs to be externally rotated rather than internally rotated. A therapist can instruct a caregiver on how to help the scapula and humerus rotate and perform ROM in a correct manner.

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