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Range of Motion (ROM) Exercises for the Shoulder

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Range of Motion (ROM) Exercises for the Shoulder

Key Points

  • Shoulder ROM includes flexion/extension and abduction/adduction movements.
  • Joint support at elbow and wrist is required throughout movement.
  • Stop immediately if pain or resistance occurs.
  • Begin ROM as early as possible when ordered because immobility-related joint change can begin within days.

Clinical Use Notes

  • ROM types include passive (caregiver/machine moves relaxed joint), active (patient moves independently), and active-assist (partial external assistance).
  • When prescribed, perform stretches slowly and gently, holding each position for about a 15-count and repeating about 10-15 times per session.
  • In neuromuscular conditions, passive stretching may be scheduled into regular morning and evening routines to limit contracture progression.

Equipment

Procedure Steps

  1. Perform routine pre-procedure actions: knock, identify resident, explain procedure, provide privacy, and perform hand hygiene.
  2. Raise bed height if needed and position resident supine with bed flat.
  3. Support shoulder movement with one hand under elbow and one hand under wrist.
  4. Observe for objective pain cues before and during movement.
  5. Move arm gently; stop if resistance is encountered.
  6. Perform shoulder flexion by raising straight arm up and over head.
  7. Ask resident about pain during movement; stop if pain is reported.
  8. Return arm to side for extension.
  9. Repeat flexion/extension as ordered in restorative plan (commonly 10-15 repetitions with slow, gentle motion and hold duration per order).
  10. Keeping arm straight, move arm out from body for abduction, then return to side for adduction.
  11. Repeat abduction/adduction as ordered, maintaining elbow and wrist support (commonly 10-15 repetitions with hold duration per order).
  12. Complete post-procedure safety and comfort checks (bed low/locked and call light within reach), perform hand hygiene, and document ROM completed with any pain, skin issues, or status changes.

Common Errors

  • Moving through resistance → increased risk of joint or soft-tissue injury.
  • Inadequate distal/proximal support → shoulder strain and discomfort.
  • Continuing after pain report → avoidable resident harm and poor tolerance.
  • Skipping documentation of tolerance → weak restorative tracking.

Graph View