This document provides instructions and range of motion measurements for goniometry of several upper limb joints, including the shoulder, elbow, wrist, fingers, and thumb. It describes starting and ending positions for flexion, extension, abduction, internal and external rotation, pronation, and supination movements at each joint. Range of motion values are provided for all movements measured in degrees.

1. Upper limb
Goniometry
Attiya Aziz​

2. SHOLDER
JOINT
GONIOMETRY
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3. SH0LDER JOINT FLEXSION:
ROM 160°-180°
Patient position: supine, palm inwards towards body.
Starting position:
fulcrum at acromion process
Stationary arm at midline of humerus
Moving arm at lateral epicondyle
Ending position:
Arm moves backside at the level of head
Moving plus stationary arm same as starting.
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4. 11/29/2023 4

5. START 11/29/2023 5
SHOULDER EXTENSION:
STARTING POSITION: ROM: 40°-60°
Prone, arms on side, elbow slightly bend.
F= acromion process
S= mid axillary line
M= lateral epicondyle
ENDING POSITION:
Position Same as above.
Arm moves upward.

6. START 11/29/2023 6
SHOULDER ABDUCTION:
ABDUCTION: ROM= 160°-180°
Instruction:
bring arm out to side close to head, palm
inward.
Starting position:
supine, arms on side, palm interiorly
F= acromion process on front side
S+M= midline of humerus
ENDING POSITION:
arm moves outside till the level of head
F= same
S= parallel to sternum
M= midline of humerus

7. Shoulder external and
internal rotation:
STARTING POSITION:
supine, arm 90° abduction and 90°
flexion
arm not supported
F= olecranon process of elbow
S= ulnar styloid
M= vertically
ENDING POSITION:
goniometer position same as above.
internal forearm moves downward
palmer side while in external its dorsal
side moves upward
ROM OF INTERNAL= 60°-70°
ROM OF EXTRNAL= 40°- 45°
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8. Elbow Joint
Goniometry
START 11/29/2023 8

9. FLEXSION:
PATIENT POSITION: ROM= 150°-160°
supine, patient on edge, hand supination
Starting position:
F= Lateral epicondyle
S= midline of humerus
M= aligned on radius
ENDING POSITION= weight lifting position, elbow bend, forearm
moves towards chest
Extension is 0° because it is an anatomical position.
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10. PRONATION:
PATIENT POSITION: ROM= 70°-75°
Sitting, shaking hand position, elbow flex at 90, palm downward.
STARTING POSITION:
F= lateral to ulnar styloid
S= parallel to humerus
M=dorsum of radius
ENDING POSITION:
M= midline of humerus.
Palm faces downward
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11. SUPINATION:
PATIENT POSITION: ROM= 90°-95°
Sitting, shaking hand position, elbow flex at 90,
palm upward,
STARTING POSITION:
F= medial to ulnar styloid
S= parallel to humerus
M=vertical aspect of radius
ENDING POSITION:
M= midline of humerus.
Palm faces upward
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12. WRIST
JOINT
GONIOMETRY
START 11/29/2023 12

13. WRIST FLEXSION:
ROM=60°-80°
PATIENT POSITION:
Sitting, shoulder abducted to 90
degrees, elbow flexed to 90 degrees
and wrist over the edge of a table,
forearm in pronation.
STARTING POSITION:
F= lateral side
S= ulnar side
M= 5th metacarpal
ENDING POSITION:
patient wrist moves downward.
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14. WRIST EXTENSION:
ROM= 60°-75°
STARTING POSITION:
Sitting, shoulder abducted to 90
degrees, elbow flexed to 90 degrees
and wrist over the edge of a table,
forearm in pronation.
STARTING POSITION:
F= triquetrum
S= aligned with ulna
M= 5th metacarpal
ENDING POSITION:
hand moves upward
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15. RADIAL DEVIATION:
ROM= 20°-25°
PATIENT POSITION:
SITTING, elbow flexed to 90 degrees, wrist over the edge
of a table, forearm in pronation.
STARTING POSITION:
F=capitate, dorsum
S=dorsal midline of forearm
M= 3rd metacarpal
ENDING POSITION:
Hand moves inward
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16. ULNAR DEVIATION:
ROM= 30°-40°
PATIENT POSITION:
SITTING, elbow flexed to 90 degrees, wrist over the
edge of a table, forearm in pronation.
STARTING POSITION:
F=capitate, dorsum
S=dorsal midline of forearm
M= 3rd metacarpal
ENDING POSITION:
Hand moves outward
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17. FINGER
JOINT
GONIOMETRY
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18. METACARPOPHALANGEAL
JOINT:
FLEXSION: ROM= 90°-110°
PATIENT POSITION:
sitting, forearm and hands supported, forearm in
midposition, wrist neutral.
STARTING POSITION:
F=Dorsal aspect of MCP joint
S=Dorsum of the metacarpal
M=Dorsal midline of proximal phalanx
ENDING POSITION:
Pinch position
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19. 11/29/2023 19
EXTENSION:
ROM= 20°-45°
PATIENT POSITION:
sitting, forearm and hands supported, forearm in
midposition, wrist neutral.
STARTING POSITION:
F=Dorsal aspect of MCP joint
S=Dorsum of the metacarpal
M=Dorsal midline of proximal phalanx
ENDING POSITION:
1ST finger facing downward
Hook

20. ABDUCTION:
ROM= 25°
PATIENT POSITION:
sitting, forearm and hands
supported, forearm in midposition,
wrist neutral.
STARTING POSITION:
F=Dorsal aspect of MCP joint
S=Dorsum of the metacarpal
M=Dorsal midline of proximal
phalanx
ENDING POSITION:
1ST finger being abducted from 2nd
*ADDUCTION is not possible.
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21. Interphalangeal Joint:
PROXIMAL: FLEXSION ROM= 70°-90°
EXTENSION ROM= 0°
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EXTENSION doesn’t occur in this joint
FLEXSION:
PATIENT POSITION:
Sitting, neutral
STARTING POSITION:
F= dorsum of PIP
S=DORSUM OF PROXIMAL PHALANX
M= dorsum of middle phalanx
ENDING POSITION:
Middle and distal phalanx facing
downward
DISTAL : FLEXSION ROM= 70°-90°
EXTENSION ROM= 0°

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23. THUMB
GONIOMETRY
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24. 11/29/2023 24
CARPOMETACARPEL JOINT:
FLEXSION:
ROM= 0°
PATIENT POSITION:
Sitting, forearm resting on table, carpel stabilize
STARTING POSITION:
F= carpometacarpal joint
S=aligned with radius
M= metacarpal of thumb
ENDING POSITION:
same

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CARPOMETACARPEL JOINT:
EXTENSION:
ROM= 15°-25°
PATIENT POSITION:
Sitting, forearm resting on table, carpel stabilize
STARTING POSITION:
F= carpometacarpal joint palmar side
S=aligned with radius
M= metacarpal of thumb
ENDING POSITION:
Thumb moves outward

26. ABDUCTION:
START 11/29/2023 26
ROM= 40°-50°
PATIENT POSITION:
Sitting, forearm resting on table, hand stabilize
STARTING POSITION:
F= radial styloid
S= metacarpal of index finger
M= metacarpal of thumb
ENDING POSITION:
Thumb moves away

27. ADDUCTION:
ROM= 0°
PATIENT POSITION:
Sitting, forearm resting on table, hand stabilize
STARTING POSITION:
F= radial styloid
S= metacarpal of index finger
M= metacarpal of thumb
ENDING POSITION:
same
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28. METACARPOPHALANGEAL JOINT:
FLEXSION:
ROM= 50°-60°
STARTING POSITION:
Sitting, arm on a table and elbow flexed.
The forearm is positioned in the mid-position
the wrist is slightly positioned in extension.
F= dorsum of MCP joint
S= shaft of the metacarpal
M= longitudinal axis of the proximal phalanx
ENDING POSITION:
The thumb MCP joint is flexed to the limit of motion.
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29. METACARPOPHALANGEAL JOINT:
EXTENSION:
ROM= 0°
STARTING POSITION:
Sitting, arm on a table and elbow flexed.
The forearm is positioned in the mid-position
wrist is slightly positioned in Flexion.
F= dorsum of MCP joint
S= shaft of the metacarpal
M= longitudinal axis of the proximal phalanx
ENDING POSITION:
The thumb MCP joint is flexed to the limit of motion.
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30. THANK
YOU
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