Range of Motion.
Range of Motion is the movement of a joint within a 3-dimensional space.
Before performing Remedial Massage or a Thai massage and or MLD session, we check for a Range of Motion, know also as ROM.
Checking for ROM is to establish the functionality of the joint and the muscles that surround it.
For example, when a client walks in complaining of cervical pain, the first thing we look in too after the postural assessment, are the ROM.
A postural assessment is an evaluation of the skeletal structure.
After that, we ask the client to do certain movements with their head.
Like, Rotation side to side, flexion, extension, and lateral flexion.
Indeed, these are the basic range of motion for the cervical area.
What this range of motion can tell us?
Well, depending on the basic mobility of the person, we expect a minimum and maximum range.
Let’s say that the client has average mobility, we expect the range of motion of their cervical to be:
- Flexion (able to flex the head forward, and leave a gap of 3cm from between the chin and the sternum)
- Extension, we look in too 70° of movement
- Lateral Rotation we look in too 80° of rotation (the chin is nearly in line with the shoulder)
- Lateral Flexion we look in too 45°.
Said so, not everyone is expected to have such a range.
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A person who has a hypermobile joint range may have a 10° about less ROM than this.
Indeed, a person that has a hypermobile joint range can reach 10° furthermore.
That’s why every person needs his own evaluation.
Moving forward, if the range of motion is limited, it could be a muscle tight or a joint mobilization issue.
With Remedial Massage and or Thai Massage we tend to address the muscle more than the joint itself.
Is with the Myotherapy studies (I am by now going through my first semester of Myotherapy) that we start to look in too joint mobilization.
Back to the ROM, what a Remedial Massage and or Thai Massage can do is address the tension of the muscle, by releasing the trigger point or strengthening the muscle itself.
In fact, the release of tension from the muscle would improve the ROM.
On the other hand, when we ask a client to do a ROM we don’t look only for the length of movement.
We look in too also the quality of movement.
For the quality of movement, we refer to how smooth the movement is.
Is the client trying to compensate for the cervical rotation by flexing the head?
Is the client compensating for the flexion by shrugging the shoulder?
Indeed, the Range of Motion of a joint is the key to understanding what muscle in the body is responsible for the pain, discomfort or limited ROM.
Once we individualism the key muscle/s we can address the issue.
In conclusion, the ROM can be active, passive and resisted.
- Active ROM is done from the client itself.
- Passive are ROM done by the therapist with no assistance in controlling the movement by the client.
- Reisted is ROM active done by the client, with a resistance force applied from the therapist again the client movement.
Each of this ROM can tell us something different about the joint.
Active is about muscle lengthening.
Passive is about the joint mobility (ligament and tendon)
Resisted is about the strength of the muscle.
We can’t use the Passive or Resisted if either Active or Passive reproduce pain.
In regards to the Resisted ROM, the resistance is applied in 3 different levels.
When the pain gets reproduced, we stop the test.
Occasionally, an orthopaedic test can be performed too. Orthopaedic tests are specific tests to evaluate in specific the muscle involved in the limited ROM.