Using A Goniometer Effectively

Joint Range of Motion Data Using a Goniometer
Introduction
Joint flexibility is defined as the range of motion (ROM) allowed at a joint. A joint's ROM
is usually measured by the number of degrees from the starting position of a segment to
its position at the end of its full range of the movement. The most common way this is
done is by using a double-armed goniometer. A stationary arm holding a protractor is
placed parallel with a stationary body segment and a movable arm moves along a
moveable body segment. The pin (axis of goniometer) is placed over the joint. When
anatomical landmarks are well defined, the accuracy of measurement is greater. If there
is more soft tissue surrounding the joint area, measurement error can be more frequent.
Background Information:
Range of motion (ROM) is a description of how much movement exists at a joint.

Rotation is the typical movement at a joint. This is called “angular” movement. Because
the movement is angular, the unit “degree” is used when measuring ROM rather than
inches or millimeters. ROM can be measured as either active or passive. Active ROM is
created by the person contracting the muscles around that joint. Passive ROM is
created by an external force pushing on the body around the joint (e.g., a partner, an
opponent, a piece of equipment). Passive ROM is always greater than active ROM.
Joint ROM can be assessed through a variety of

methods including using sophisticated devices to
measure ROM which provide greater accuracy with little
increase in the complexity of the equipment and training
required. These devices include goniometers (electro-,
protractor, pendulum), inclinometers, and hygrometers.
The most accurate techniques for measuring ROM
(particularly dynamic ROM) include measurements of
joint angles from arthrographs, radiographic images,
photographs, and video (see figure to the right).
However, these techniques require expensive, complex
equipment and extensive training. In this lab, you will
learn to measure ROM using a protractor goniometer,
which is simply a protractor designed for use on the
human body.
There are 3 typical methods used today for flexibility

training: static, dynamic (ballistic), and proprioceptive
neuromuscular facilitation (PNF) stretching. Because temperature affects the
extensibility of the soft tissues around the joint, completing 5 minutes of warm-up (light
aerobic exercise) is recommended before performing flexibility exercises. Static and
dynamic stretching are both effective means of increasing flexibility, but generally static
stretching is considered safer and results in less soreness of muscles. Dynamic
stretching recruits the muscle spindle to reflexively cause contraction just after the fast
stretch. This may result in small muscle tears in the muscle due to a fast/forceful
transition that may not be timed perfectly. The slow or static stretch also recruits the
muscle spindle, but at a lower response intensity so that tearing is minimized or
eliminated. Holding a stretched position for 10-30 s is usually effective. PNF may be the
most effective method that results in the least amount of post-stretching soreness.
There are several methods of engaging in PNF. Two of these include contract-relax
Goniometers available from www.aokhealth.com

(CR) and contract-relax antagonist contract (CRAC). Use of PNF terminology and
definitions is confusing in the literature, and a full understanding of PNF theory is yet to
be developed. However, it is currently believed that suppression of the stretch reflex
and enhancement of the Golgi tendon reflex work to make this method effective. Thus,
the PNF technique is designed to capitalize on the neurological mechanisms in the
muscle and joint.
What is a Goniometer
A goniometer is a device used to measure joint angles or range-of-motion. In MSI

prevention, a goniometer is used to measure range-of-motion (in degrees) of joints for
either active or passive joint range. This is pertinent to functional reach and workplace
design. Using a goniometer, an ergonomist can quantify posture, including measuring
joint angles during performance of a task.
Knowing the joint angle associated with a task can help ergonomists to make more
specific design recommendations or to compare worker posture before and after
changes have been made.
A goniometer can also measure progress in return of range-of-motion during recovery.
A traditional goniometer is a protractor with extending arms. To use a goniometer:
(1) Align the fulcrum of the device with the fulcrum

or the joint to be measured
(2) Align the stationary arm of the device with the
limb being measured
(3) Hold the arms of the goniometer in place while
the joint is moved through its range of motion
The degree between the endpoints represents the

entire range-of-motion.
Important Tips
Stabilize the stationary portion of the body. This is the part of the body that is proximal
(closer to the midline of the body) to the joint you are testing. It is important that the
patient does not move his body while moving the joint; this step isolates the joint
movement for a more accurate measurement.
Look at the reading on the goniometer before removing it from the patient's body.
Ensure that you take an accurate reading of the degree of motion on the goniometer,
and that you consistently use the same stationary and movable landmarks on the body
when measuring, to ensure consistency. Be sure to record the range of motion for the
joint.

Shoulder Girdle Movements & ROM
Stand behind a subject who has removed clothing from the waist up. Palpate the inferior
angle and the vertebral border of the scapula (Figure 1).
FIGURE 1. Scapula Movements

(Adapted from Luttgens & Hamilton, 1997)
FIGURE 2. Lateral Motion of the Scapula

Shoulder Joint ROM

Figure 3. Medial & Lateral Rotation of the Shoulder
Elbow Joint ROM
FIGURE 4. Elbow Joint Motions

Wrist Joint ROM
FIGURE 5. Wrist Joint Motions
Hip Joint ROM
FIGURE 6. Hip Joint Motions

Hip flexion
Starting position:
Subject lies supine upon a firm, flat surface with the opposite
hip held in anatomical position. Knee should flexed maximally
while performing the movement. Do not allow the pelvis to
lift during the movement.
Goniometer placement:
Proximal point of proximal segment – lateral pelvis midline (pointing toward GH joint)
Approximate joint axis – greater trochanter of femur
Distal point of distal segment – lateral condyle of femur
Measurements to perform (record in Table 1):
Active hip flexion
Passive hip flexion
Trial 1 Trial 2 Trial 3 Average of 2
Closest
Active flexion
Passive flexion
Hip extension
Starting position:
Subject lies prone in anatomical position on a firm, flat
surface. Subject should maintain contact of both
iliac crests with the surface during measurement.
Goniometer placement:
Proximal point of proximal segment – lateral pelvis
midline (pointing toward GH joint)
Approximate joint axis – greater trochanter of femur
Distal point of distal segment – lateral condyle of femur
Measurements to perform (record in Table 1):
Active hip hyperextension
Passive hip hyperextension
Trial 1 Trial 2 Trial 3 Average of 2

Closest
Active hyperextension
Passive hyperextension

Knee Joint ROM
FIGURE 7. Knee Joint Motions
Ankle Joint ROM
FIGURE 8. Ankle Joint Motions
Summary
Improving joint flexibility is essential for injury prevention. On may increase joint
flexibility (range of motion) by regular stretching. What are the factors affecting flexibility
of a joint? Table 1 summarizes the average ROMs published. Compare your
measurements with these values. Are they in similar ranges or not? If not, why?
References
Luttgens, K. & Hamilton, N. (1997). Kinesiology: Scientific Basis of Human Motion, 9th
Ed., Madison, WI: Brown & Benchmark.

TABLE. 1 Average ROMs (Adapted from Luttgens & Hamilton, 1997)
Source Source Source Source

Joint/Segment Movement
1* 2* 3* 4*
Flexion 140 145 145 145
Elbow
Hyperextension 0 0 0 0-10
Pronation 80 90 90 80
Forearm
Supination 80 85 90 90
Extension (Dorsiflexion) 60 70 70 50
Flexion (Palmar flexion) 60 90 - 60
Wrist
Radial Deviation 20 20 20 20
Ulnar Deviation 30 30 35 30
Flexion 180 170 130 180
Hyperextension 50 30 80 60
Shoulder
Abduction 180 170 180 180
Adduction 50 - - -
Internal Rotation 90 90 70 60-90
Shoulder External Rotation 90 90 70 90
w/ Abducted Arm Horizontal Adduction - - - 135
Horizontal Adduction - - - 45
Flexion 100 120 125 120
Hyperextension 30 10 10 30
Hip
Abduction 40 45 45 45
Adduction 20 - 10 0-25
Internal Rotation 40 35 45 40-45
Extended Hip
External Rotation 50 45 45 45
Knee Flexion 150 120 140 130
Plantar flexion 20 45 45 50
Ankle
Dorsiflexion 30 15 20 20
Flexion 60 - - 40
Hyperextension 75 - - 40
Cervical Spine
Lateral Flexion 45 - - 45
Rotation 80 - - 50
Flexion 45-50 - - 45
Lumbar-thoracic Hyperextension 25 - - 20-35
Spine Lateral Flexion 25 - - 30
Rotation 30 - - 45

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Joint Range of Motion Data Using a Goniometer

Range of motion (ROM) is a description of how much movement exists at a joint.

Joint ROM can be assessed through a variety of

There are 3 typical methods used today for flexibility

Goniometers available from www.aokhealth.com

A goniometer is a device used to measure joint angles or range-of-motion. In MSI

A goniometer can also measure progress in return of range-of-motion during recovery.

A traditional goniometer is a protractor with extending arms. To use a goniometer:

(1) Align the fulcrum of the device with the fulcrum

The degree between the endpoints represents the

Goniometers available from www.aokhealth.com

Shoulder Girdle Movements & ROM

FIGURE 1. Scapula Movements

FIGURE 2. Lateral Motion of the Scapula

Shoulder Joint ROM

Goniometers available from www.aokhealth.com

Figure 3. Medial & Lateral Rotation of the Shoulder

(Adapted from Luttgens & Hamilton, 1997)

Elbow Joint ROM

FIGURE 4. Elbow Joint Motions

(Adapted from Luttgens & Hamilton, 1997)

Goniometers available from www.aokhealth.com

Wrist Joint ROM

FIGURE 5. Wrist Joint Motions

(Adapted from Luttgens & Hamilton, 1997)

Hip Joint ROM

FIGURE 6. Hip Joint Motions

(Adapted from Luttgens & Hamilton, 1997)

Goniometers available from www.aokhealth.com

Trial 1 Trial 2 Trial 3 Average of 2

Goniometers available from www.aokhealth.com

Knee Joint ROM

FIGURE 7. Knee Joint Motions

(Adapted from Luttgens & Hamilton, 1997)

Ankle Joint ROM

FIGURE 8. Ankle Joint Motions

(Adapted from Luttgens & Hamilton, 1997)

Goniometers available from www.aokhealth.com

TABLE. 1 Average ROMs (Adapted from Luttgens & Hamilton, 1997)

Source Source Source Source

Goniometers available from www.aokhealth.com

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