Physical Exam

Shoulder Active Range of Motion

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Video coming September 2026

How to Perform

Ask the patient to move the shoulder actively through its ranges while you observe and compare sides: forward flexion and extension, abduction and adduction, and internal and external rotation (for example, reaching behind the back and behind the head). Note the range achieved in each direction, the smoothness of movement, and any pain, hesitation, or abnormal scapular rhythm.

How to Interpret

Rotator Cuff Disease

Painful arc — pain through the middle of the range (about 60–120°) as the patient actively raises the arm out to the side, easing above and below that arc

Rule in

Somewhat helpful

Rule out

Somewhat helpful

Evidence:Limited

References

Hermans J, Luime JJ, Meuffels DE, Reijman M, Simel DL, Bierma-Zeinstra SMA. Does this patient with shoulder pain have rotator cuff disease? The Rational Clinical Examination systematic review. JAMA. 2013;310(8):837-847. doi:10.1001/jama.2013.276187. PMID 23982370.
Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.