Passive Range of Motion (PROM) of the Elbow

PROM is usually done when you can observe limited ROM during AROM. The goal of PROM is to obtain the end-feel of the joint to determine what is limiting full range of motion. The following table shows an overview of „normal“ and „abnormal“ kinds of end-feels:

End Feel	Example
NORMAL
Hard (Ligamentous) Soft tissue approximation Tissue stretch	Elbow extension Knee flexion Ankle dorsiflexion, shoulder lateral rotation, finger extension
ABNORMAL
Early muscle spasm Late muscle spasm ‘Mushy’ tissue stretch Spasticity Hard capsular Soft capsular Bone to bone Empty (due to pain) Springy block	Protective spasm following injury Spasm resulting from instability or pain Tight muscle Upper motor neuron lesion Frozen shoulder Synovitis, soft tissue edema Ostephyte formation Acute subacromial bursitis Meniscus tear

 

The normal end-feel for different movements in the elbow is as follows:

Extension: Bone to bone

Flexion: Tissue approximation

Pronation: Tissue stretch

Supination: Tissue stretch

Flexion: Tissue stretch

 

Study	Reliability	Sn	Sp	LR+	LR-
Magee et al. (2014)	NA	NA	NA	NA	NA