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Range of motion

Elbow and Forearm ROM

The elbow is the joint where functional ROM is most famous: Morrey's study found most daily activities are accomplished within a 100-degree arc, from 30 to 130 degrees of flexion, with about 50 degrees each of pronation and supination. A patient missing the last 20 degrees of extension often has no functional deficit at all, which is worth saying in documentation.

Normal values

Elbow and forearm, normal values (AAOS)verify before clinical use
MotionDegrees
Elbow flexion0-150
Elbow extension0 (full extension)
Forearm pronation0-80
Forearm supination0-80

Degrees from anatomical neutral. Confirm against the AAOS booklet or Norkin & White before clinical use.

Source: AAOS Joint Motion (1965)

Functional elbow arc (Morrey)verify before clinical use
MotionFunctional range
Flexion-extension30-130 (100-degree arc)
PronationAbout 50
SupinationAbout 50

Ranges within which most studied daily activities were accomplished. Confirm against the published study before clinical use.

Source: Morrey et al., 1981

Clinical notes

  • Feeding runs high in the arc (about 130 degrees of flexion to reach the mouth); pushing up from a chair runs low, toward full extension.
  • Forearm rotation is measured with the elbow flexed to 90 and tucked at the side; letting the elbow drift into extension recruits shoulder rotation and inflates the number.
  • Supination carries keys-and-coins tasks and receiving objects in the palm; pronation carries keyboarding and most tabletop work.
  • A fixed flexion contracture under about 30 degrees rarely limits ADLs per the functional arc, but document the task impact, not just the angle.

References

  1. American Academy of Orthopaedic Surgeons. Joint Motion: Method of Measuring and Recording. Chicago: AAOS; 1965. Values as commonly reproduced in goniometry references (e.g., Norkin & White, Measurement of Joint Motion).
  2. Morrey BF, Askew LJ, Chao EY. A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am. 1981;63(6):872-877. PubMed