How to Measure Medial Rotation of the Shoulder

Use a goniometer to measure the medial rotation of the shoulder.

Medial rotation of the shoulder is needed to throw a ball, swim freestyle and to push something behind you. If there is an injury to the shoulder complex, it could result in a loss of range of motion during this movement. Some patients may exhibit pain when performing this motion if something is wrong with their shoulder rotators, while others will simply be lacking in a full range of motion. To check range of motion, you will need to properly measure the medial rotation with a goniometer.

Difficulty:

Moderate

Instructions

Things You'll Need

• Small towel
• Goniometer

1. Ask the patient to lay down on his back on the exam table. His injured arm should be facing you. Place his arm at a 90-degree angle at the elbow with his palm facing forward and his pinky finger toward you. Place a rolled towel underneath his elbow.

2. Have the patient medially rotate his arm (bring the front of his hand toward the table). Ensure the patient is able to move his shoulder in this direction without experiencing any pain. If pain is felt, have the patient only move the shoulder to the extent before pain is felt. Watch for the elbow to move away from the 90-degree angle. It is a natural reaction for the patient to try to pull the elbow down as he medially rotates his arm. You may need to stabilize the elbow during this motion.

3. Use the goniometer to measure the range of motion of medial rotation of the shoulder. Place the fulcrum of the goniometer on the tip of the elbow, with the stationary arm perpendicular to the floor and the movable arm along the midline of the forearm. Using the moveable arm, follow the patient's motion as he reaches forward toward the table. Note the reading at the end of the patient's range of motion.

4. Compare the patient's range of motion to the accepted value of 90 degrees of medial shoulder rotation. If the patient has more than 90 degrees of medial rotation, he is considered to be normal. If he has less than 90 degrees of medial shoulder rotation, then further investigation is needed to figure out what is causing the lack of rotation.

Tips & Warnings

• Be sure you know the accepted value of medial rotation of the shoulder so you can easily compare your readings to normal readings.

• Do not force the arm to medially rotate more than the patient allows it to. This could cause further damage to an existing injury.

Resources

• How to Measure Shoulder Flexion Range of Motion