How Do Chiropractors Measure Range of Motion?

Limited range of motion is usually caused by an injury in a specific joint or by a chronic condition such as osteoarthritis, and is often accompanied by stiffness, pain, and swelling. At some point, limited range of motion can interfere with a patient’s ability to perform day-to-day activities. When this happens, range of motion testing becomes a very important diagnostic and treatment tool for chiropractic physicians.

From a clinical point of view, chiropractors must measure a patient’s range of motion to set a baseline, design an appropriate treatment plan and monitor progress over time. Range of motion testing is also commonly used during a broad-based physical therapy evaluation, along with tests to evaluate a patient’s balance, coordination, flexibility, strength and stamina. Range of motion testing also has other administrative uses, including for insurance reimbursement purposes (that is, proof that the patient requires treatment because it is “medically necessary”) and as a way to document improvement.

Range of motion—the movement of a joint from full flexion (flexed) to full extension, usually measured in degrees—is a very important concept in diagnosing and treating musculoskeletal problems that affect joint function, and chiropractors can measure it in several different ways depending on the part of the body in question. Each joint has a different range of motion, and the parameters of a “normal” range of motion are arrived at by observation and general consensus within the chiropractic community.

Chiropractors often use a device such as a goniometer or an inclinometer to measure an axis and range of motion of a patient’s joints. They will also look for signs of discomfort, resistance and compensation as the patients’ joints are moved. Range of motion testing is painless for the most part—sometimes, post-operation and post-injury range of motion testing may be painful, but the pain lasts only as long as the testing does.

The tests themselves are actually very simple movements, many of which resemble basic stretches or exercises. They may measure so-called “passive” range of motion, “active assistance” range of motion, or “active” range of motion, depending on the patient’s needs. The passive range of motion exercises involve no effort at all from the patient—the movement is controlled by either a therapist or some type of equipment. Active assistance range of motion exercises require some outside help, but the patient is also responsible for moving the muscles around the affected joint. Active range of motion exercise is performed by the patient alone, moving the joint without any outside assistance.

The specific process a chiropractor uses to test a joint’s range of motion may vary a bit from physician to physician, but there are a few general principles that most will follow:

• The chiropractor will test the unaffected or uninjured side first for a frame of reference.
• The chiropractor will warn the patient before testing the injured or affected joint, mentioning that there may be some discomfort or pain.
• The chiropractor will use active tests before passive tests, giving instructions and explanations along the way.
• The chiropractor will thoroughly assess painful movements last in order to minimize discomfort and will never stress the joint beyond the point of pain.

Range of motion testing allows your chiropractor to gauge your flexibility and make ongoing treatment decisions. Whether you’re receiving spinal adjustments, extremity adjustments, massage therapy or some other form of in-office manual therapy, or you’ve been prescribed at-home exercise or stretching programs, your chiropractor will work closely with you to relieve your pain and to improve your joint function. But range of motion testing also gives you—the patient—an easy way to see the difference your treatment is making.