Upper Body Goniometric Assessment: Technique and Potential Restricting Structures
Goniometry of the upper body, including shoulder flexion, extension, internal rotation, external rotation, and cervical spine goniometry. A list of potential muscles, fascia, and neural structures that may restrict motion at the shoulder and spine.
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Course Description: Goniometry: Upper Body
Why Assessment? All fitness, performance, and rehabilitation programs should start with an assessment. The goal of assessment is to refine technique selection, with the intent of improving client and patient outcomes. This course describes the reliable goniometric assessments used to assess range of motion (ROM) of the upper extremity joints and cervical spine (Note, reliable = shoulder flexion goniometry is included, and shoulder abduction goniometry is not).
- Goniometry - "refers to the measurement of angles, in particular, the measurement of angles created at human joints by the bones of the body (1)"
Why Goniometry? Most often, goniometric assessment highlights osteokinematic hypomobility (loss of joint ROM), aiding in the selection of release, mobilization, and stretching techniques. Less often, goniometry will highlight hypermobility (excessive joint ROM) and imply a need for activation, stabilization, and conditioning techniques. For an introduction to specific terminology, defining "good assessments," defining what goniometry measures, and best use, please check out:
Why Add Goniometry to Movement Assessment? Goniometry adds an assessment with continuous interval measures to movement assessments that only provide binary or discrete values. Assessments that only provide binary values include the Overhead Squat Assessment (OHSA) , the latissimus dorsi muscle length test , the Functional Movement Screen, static postural assessments, the L.E.F.T. Test, and shoulder mobility-dependent special tests such as Apley's Scratch Test or the Supine Shoulder Impingement Test .
- For example, if an Overhead Squat Assessment (OHSA) results in the identification of Arms Fall , and your intervention improves but does not completely resolve Arms Fall , your reassessment with the OHSA will appear the same on paper. With the OHSA you either have Arms Fall or you do not, there is no reliable method for tracking "some improvement" using the OHSA alone. However, if you follow the OHSA with Shoulder Flexion Goniometry you can reliably track improvements in shoulder flexion range of motion (ROM) of just 5 degrees. Note, you could also use Shoulder Internal Rotation Goniometry and Shoulder External Rotation Goniometry to aid in deducing which structures are most likely to be contributing to dysfunction (e.g. if shoulder internal rotation is limited this may imply posterior deltoid over-activity ).
The Brookbush Institute recommends that these assessments are added to the repertoire of all sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.).
Goniometric Assessments Covered in this Course
Each goniometric assessment in this course includes a list of potentially affected structures, and those structures are hyperlinked to courses that cover specific interventions for those structures. Predictive Models of Postural Dysfunction were used to aid in considering all muscular, articular, fascial, and neural structures that may restrict each motion.
- Shoulder Flexion
- Shoulder Extension
- Shoulder Internal Rotation
- Shoulder External Rotation
- Cervical Lateral Flexion
Printable PDF of the Movement Assessment Template:
Pre-approved credits for:
Pre-approved for Continuing Education Credits for:
- Athletic Trainers
- Chiropractors
- Group Exercise Instructors
- Massage Therapists
- Occupational Therapists
- Personal Trainers
- Physical Therapists
- Physical Therapy Assistants
- Yoga Instructors
This Course Includes:
- AI Tutor
- Text and Illustrations
- Audio Voice-over
- Technique Videos
- Practice Exam
- Pre-approved Final Exam
Course Study Guide: Upper Body Goniometric Assessment
Introduction
Shoulder External Rotation
Shoulder Internal Rotation
Shoulder Flexion Goniometry
Shoulder Extension Goniometry
Cervical Lateral Flexion
Bibliography
- Cynthia C. Norkin, D. Joyce White. Measurement of Joint Motion: A Guide to Goniometry 3rd Edition. Copyright (C) 2003 by F.A. Davis Company
- Dr. Mike Clark & Scott Lucette, “NASM Essentials of Corrective Exercise Training” © 2011 Lippincott Williams & Wilkins
- Donald A. Neumann. Kinesiology of the Musculoskeletal System: Foundations of Rehabilitation – 2nd Edition © 2012 Mosby, Inc.
- Cynthia C. Norkin, Pamela K. Levangie, Joint Structure and Function: A Comprehensive Analysis: Fifth Edition © 2011 F.A. Davis Company
- David G. Simons, Janet Travell, Lois S. Simons, Travell & Simmons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition,© 1999 Williams and Wilken
- Tom Myers, Anatomy Trains: Second Edition. © 2009 Elsevier Limited
- David Butler. The Sensitive Nervous System © 2000 NOI Group
- Michael Shacklock. Clinical Neurodynamics: A New System of Musculoskeletal Treatment © 2005 Elsevier Limited
- Moore, Margaret L. "Clinical assessment of joint motion." Therapeutic Exercise, ed 3 (1978): 151-190.
- Miller, P. J. (1985). Assessment of joint motion. Measurement in physical therapy, 103-136.
- Lea, R. D., & Gerhardt, J. J. (1995). Range-of-motion measurements. J Bone Joint Surg Am, 77(5), 784-798.
- Gajdosik, R. L., & Bohannon, R. W. (1987). Clinical measurement of range of motion. Physical Therapy, 67(12), 1867-1872.
- Bovens, A. M., van Baak, M. A., Vrencken, J. G., Wijnen, J. A., & Verstappen, F. T. (1990). Variability and reliability of joint measurements. The American Journal of Sports Medicine, 18(1), 58-63.
- Both Upper and Lower
- Boone, D. C., Azen, S. P., Lin, C. M., Spence, C., Baron, C., & Lee, L. (1978). Reliability of goniometric measurements. Physical Therapy, 58(11), 1355-1360.
- Rothstein, J. M., Miller, P. J., & Roettger, R. F. (1983). Goniometric reliability in a clinical setting. Physical Therapy, 63(10), 1611-1615.
- Upper Body
- Cools AM, De Wilde L, Van Tongel A, et al. (2014). Measuring shoulder external and internal rotation strength and range of motion: comprehensive intra-rater and inter-rater reliability study of several testing protocols. J. Shoulder Elbow Surg. 23: 1454-1461.
- Dougherty J, Walmsley S, and Osmotherly PG. (2014). Passive range of movement of the shoulder: a standardized method for measurement and assessment of intrarater reliability. Journal of Manipulative and Phsyiological Therapeutics. 38(3): 218-224.
- MacDermid JC, Chesworth BM, Patterson S, and Roth JH. Intratester and intertester reliability of goniometric measurement of passive lateral shoulder rotation. Journal of Hand Therapy. 12(3): 187-192.
- Awan R, Smith J, Boon AJ. (2002). Measuring shoulder internal rotation range of motion: a comparison of 3 techniques. Arch. Phys. Med. Rehabil. 83:1229-1234.
- Mullaney MJ, McHugh MP, Johnson CP, Tyler TF. (2010). Reliability of shoulder range of motion comparing goniometer to a digital level. Physiotherapy Theory & Practice. 26(5): 327-333.
- Riddle DL, Rothstein JM, Lamb RL. (1987). Goniometric reliability in a clinical setting. Physical Therapy. 67(5): 668-673.
- Cervical spine
- Youdas JW, Carey JR, Garrett TR. (1991). Reliability of measurements of cervical spine range of motion- comparison of three methods. Phys. Ther. 71: 98-106.
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