MS System: Motion and Expected Range

Jarvis, C. (2019). Physical examination & health assessment (3rd Canadian ed.). A.J. Browne, J.
MacDonald-Jenkins, & M. Luctkar-Flude, (Eds.). Toronto, ON: Elsevier Canada.

1. Cervical spine

 Flexion – 45 degrees.
 Hyperextension- 55 degrees.
 Lateral bending - 40 degrees
 Rotation - 70 degrees
 Muscle testing: Ask the client to repeat
these actions while applying opposing
force. This also tests cranial nerve XI
(spinal).

2. Spine (standing)

 Flexion (touch toes) – 75-90 degrees

and smoothness and symmetry

 Lateral bending - 35 degrees

 Hyperextension - 30 degrees.

 Rotation - 30 degrees, bilaterally

3. Shoulders

 Forward flexion (arms up) - 180 deg

 Hyperextension - up to 50 degrees
  Internal and external rotation - 90 degrees
 Abduction - 180 degrees. Adduction - 50 degrees
 Muscle testing - ask the client to shrug the shoulders, flex them forward and up, and abduct them
against your resistance.

4. Elbows

 Flexion - 150 to 160 degrees; extension 0 deg.

Some healthy people may be missing 5 to 10
degrees of full extension. Hyperextension of 5 to
10 degrees may occur as well.

 Pronation and supination - 90 degrees– touch

palmar and dorsal aspects of hands to the table

 Muscle testing: Have the client flex the elbow

against your resistance applied just proximal to the
wrist. Ask the client to extend the elbow against your resistance.

5. Wrists and hands

 Hyperextension (wrist) - 70 degrees.

 Palmar flexion (wrist) - 90 degrees.

 Flexion at knuckles (metacarpophalangeal or MCP joints) of 90 degrees.

Hyperextension - 30 degrees.

 Ulnar deviation of 50-60 degrees, and radial deviation of 20 degrees

(“waving”)
  Abduction of fingers - 20 degrees (spread fingers); fist tight.

 Touch the thumb to each finger and to the base of the little finger (opposition)

 Muscle testing: Position the person's forearm supinated (palm up) and resting on a table.
Stabilize by holding your hand at the person's mid-forearm. Ask client to flex the wrist against
your resistance at the palm.

6. Hips (lie on back)

 Hip flexion - 90 degrees

 Hip flexion - 120 degrees with leg

bent. The opposite thigh should
remain on the table

 Internal rotation - 40 degrees.

External rotation - 45 degrees
(bent knee, foot on table)

 Abduction - 40 to 45 degrees.
Adduction - 20 to 30 degrees.

 Muscle testing – repeat flexion and

extension with each test

7. Knee (standing)

 Flexion - 130 to 150 degrees.

 Extension: 0 degrees (straight line); up to 15

hyperextension normal in some

 (Seated)

 Muscle strength – ask the client to keep knee

flexion while you oppose strength by trying to pull
the leg forward.

 Muscle extension - demonstrated by client

successfully standing from sitting in a low chair, or rising from a squat without using the
hands for support.

8. Ankles and feet

 Plantar flexion - 45 degrees (point). Dorsiflexion - 20 degrees (flex)

 Eversion - 20 degrees (roll ankle – bottom of foot facing out). Inversion - 30 degrees (roll ankle
– bottom of foot facing in)

 Muscle testing – Ask client to maintain dorsiflexion and plantar flexion against your resistance.