Range of motion exercises

Range of motion, or ROM for short, is defined as the normal movement potential of a joint to the extent that is not causing any pain!

The range of motion is measured in degrees and it’s determined by the type of joint, its articular surfaces, regional muscles, ligaments, and tendons.

Now, during everyday activities, people typically use all of their joints through their complete range of motion. But this is not the case with some individuals.

Some of them have restricted movement due to pain, while others might have conditions that cause muscle weakness or paralysis that prevent them from completing the full motion.

Either way, if not treated, decreased range of motion can lead to muscle atrophy, which is the wasting away of muscles due to disuse and contractures, a condition where muscles and tendons are permanently shortened.

To prevent this, range-of-motion exercises, or ROM exercises, are prescribed for these individuals.

Now, range of motion exercises are typically done to preserve a person’s joint and muscle function, but they can also be used to either increase or prevent further loss in the range of motion.

They are usually done at least two times a day, and based on the client’s involvement, they can be subdivided into three groups.

The first group includes active range-of-motion exercises. These exercises are done by your client independently but with your verbal guidance and encouragement.

The second group covers active-assistive range-of-motion exercises. Here, clients require your help to complete the full motion. These exercises are commonly prescribed to individuals that have some form of muscle weakness.

The last group includes passive range-of-motion exercises, which are done by a nursing assistant without the active participation of the client. These exercises are commonly done for comatose and paralyzed individuals.

Now, let’s switch our focus to joint movements. But, before we start, think of a joint as the connection between two adjacent segments of the body.

Now flexion, or bending, represents a decrease in the angle between the bones that make up the joint; while extension, or straightening, represents an increase in the angle between the bones that make up the joint.

There’s also hyperextension, which can be described as extending the joining beyond the normal straight position.

Next, we have abduction, which is a movement of a body part away from the body’s midline; and adduction, which is a movement of a body part toward the body’s midline.

Next up are internal rotation, or turning the body part inwards toward the center of the body. For example the femur in the leg can internally rotate when you turn your foot towards the center of your body.

External rotation is turning a body part outwards away from the center of the body. So, if you turn your feet to point away from the midline of the body, the femur will externally rotate.

Now, let’s move on to more specific joint movements. Supination describes the rotation of the forearm so that the palm is facing upward, while pronation describes the rotation of the forearm so that the palm is facing downward. These two movements are specific for elbow joints!

Next, we have dorsiflexion, which refers to the movement of raising the foot and toes upwards toward your chin.

On the other hand, plantar flexion refers to the action in which your foot and toes point away from your chin. These two are specific for your ankles!

Opposition is a specific movement in which the thumb touches each finger of the same hand. The last joint movement is circumduction, which refers to a circular movement of a limb.

In other words, the proximal part of the limb is fixed, while the distal part is moving by describing a circle. Now, let’s demonstrate these movements, starting with the neck.

Flexion of the neck refers to the motion of bringing the chin down to your chest; while extension refers to the action of returning the head to its normal position.

Hyperextension describes the bending of the head toward the back. The next one is lateral flexion, or bending of the head laterally and bringing the ear to your shoulder.

Finally, we have lateral rotation, which is the movement of the chin toward the shoulder. Remember that passive range of motion exercises of the neck is usually done by a physical therapist, but a nursing assistant might be able to assist depending on facility policy.

Moving on to the upper limbs. In the shoulders, flexion refers to the action of raising the arm above the head; while extension refers to the motion of bringing the arm back to its starting position.

Hyperextension is the opposite of flexion, meaning the arm is moved backward. Next, we have abduction, or moving the arm away from the body like lifting it to the side and then above the head; and adduction, or bringing the arms down and across the body.

Now, to perform rotation, lift your arm to the same level as your shoulder and bend the elbow. To do internal rotation, turn the forearm so the fingers are pointing down. On the other hand, to do external rotation, turn the forearm so the fingers are pointing up.