Joint range of motion refers to both the distance a joint can move and the direction in which it can move. There are established ranges that are considered normal for various joints in the body. For example, according to The Merck Manual for Health Care Professionals, the knee should ideally be able to flex (bend) to an angle of 130 degrees. It should be able to be extended so that it is completely straight (Merck & Co., Inc., 2009).
A reduction in normal range of motion in any of the joints is known as limited range of motion. Joint range of motion naturally declines as you age, but it can also occur along with a number of conditions. Certain exercises may be helpful in improving and maintaining flexibility in the joints.
Medical conditions associated with limited range of motion in the joints include:
- ankylosing spondylitis, a type of arthritis that primarily affects the spine
- osteoarthritis, the most common form of arthritis related to older age and wear-and-tear to the joints
- rheumatoid arthritis, an autoimmune form of arthritis caused by your immune system attacking your joints
- juvenile rheumatoid arthritis, an autoimmune form of arthritis that occurs in children under the age of 16 years
- cerebral palsy, a group of neurological disorders that causes muscle paralysis and loss of body control
- the congenital form of torticollis, a stiff neck associated with muscle spasms
- Legg-Calve-Perthes disease, a disorder that causes the thighbone to die because of lack of blood flow to the joint
- septic hip (and other septic joints), a bacterial infection of the joints
- syphilis, a sexually transmitted infection (STI)
It is not only medical conditions that can restrict range of motion. The following may also lead to reduced flexibility in one or more joints:
When to Make an Appointment
See your doctor about any reductions in the normal range of motion of your joints. Make an appointment if you cannot fully straighten or bend one or more joints, or find you are experiencing difficulty moving certain joint(s).
Something to note is that people aren’t always aware of their own limited range of motion. According to the National Institutes of Health (NIH), it may be identified during a visit for another condition or symptom (NIH, 2010).
The Appointment: What Will Likely Happen?
Your initial appointment will likely consist of a physical examination. This will include an assessment of the affected joints. Your doctor may ask questions about your limited range of motion, such as:
- When did the problem first start?
- Are you experiencing discomfort?
- Where is it occurring?
- Are you having any other symptoms?
Your doctor may also assess the function of your bones, muscles, and/or nervous system.
As a follow-up, tests may also be scheduled. Two commonly ordered tests are X-rays of the spine and joints.
Your doctor may recommend a course of physical therapy designed to enhance range of motion.
In some cases, the position of the joint may become permanently fixed. This means you will no longer be able to move the joint past a given point. These are known as contracture deformities. According to the NIH, conditions associated with this complication include:
- cerebral palsy
- muscular dystrophy, an inherited disease involving muscle weakness
- Dupuytren’s contracture, a thickening of the tissue layer beneath the skin in the hands and wrist
- Volkmann’s contracture, a lack of blood flow to the forearm causes the muscles in the arm to shorten
Range of motion exercises are designed specifically to enhance joint flexibility. Range of motion exercises may be done as part of formal sessions with a physical therapist. However, your doctor or physical therapist may also tell you about exercises that you can easily do at home. These can help you maintain or improve joint flexibility, which is associated with overall freedom and ease of movement.
They can be divided into three general categories: active, active assistive, and passive.
These exercises are done without the assistance of another person.
These exercises rely on the combined effort of the individual and another person (often a physical therapist). They are often used when it is painful for the individual to flex or extend the joint.
These rely completely on the effort of the physical therapist or another individual. The person with limited range of motion does not need to do anything. These are typically used because the person being treated is not physically able to perform the movements that are part of the range of motion exercise(s).