Execution
- 1Expose both shoulders sufficiently to observe the scapula, clavicle, humerus, and thoracic posture from anterior and posterior views.
- 2Ask the patient to actively perform elevation through abduction, forward flexion, scaption, external rotation, internal rotation, extension, adduction, horizontal adduction/abduction, and circumduction.
- 3Observe scapulohumeral rhythm, clavicular motion, scapular winging, shrugging, painful arc, apprehension, and side-to-side asymmetry.
- 4Compare movement in the patient’s usual posture and, when relevant, in a corrected posture to see whether symptoms or range change.
- 5Add combined, sustained, or repetitive movements when the history suggests symptoms occur with those tasks.
Positive outcome
Abnormal findings: painful arc, loss of range, scapular dysrhythmia, winging, reverse scapulohumeral rhythm, apprehension, or compensatory shoulder hiking.
Expected range- Painful arc 60°–120° suggests subacromial / rotator cuff-related pain
- Pain near 170°–180° may implicate the acromioclavicular joint
- Shrug sign: inability to elevate the arm without excessive scapular elevation
AROM is a screen for movement behavior, not a structure-specific diagnosis. Apparent glenohumeral restriction may reflect scapular, clavicular, thoracic, rib, or motor-control compensation.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Mullaney et al. (2010) | NA | NA | NA | NA | NA |
CommentAROM is a broad screening examination rather than a diagnostic test for one structure. Magee emphasizes that apparent glenohumeral restriction may actually reflect scapular, clavicular, thoracic, rib, or motor-control compensation. Use this test to identify the comparable sign and movement quality before moving into PROM, resisted testing, or special tests.