Range of Motion (ROM) and Flexibility

What Is Range Of Motion And Flexibility?

  • Range of Motion (ROM)
    The measurable degree of movement a joint can achieve in various directions (e.g., flexion, extension, abduction).
    Includes:
    • Active ROM (AROM) – Movement performed by the child independently.
    • Passive ROM (PROM) – Movement facilitated entirely by an external force (e.g., therapist or caregiver).
  • Flexibility
    The ability of a muscle or muscle group to lengthen and allow a joint to move through its full ROM. Influenced by muscle length, joint capsule mobility, and neurological tone.

What Does Difficulty In This Area Look Like?

  • Joint or Muscle Stiffness
    Limited mobility in a joint or muscle group, such as tight hamstrings or restricted shoulder rotation.
  • Abnormal Movement Patterns
    Compensatory motions due to lack of flexibility, such as trunk leaning or altered gait mechanics.
  • Delayed Motor Milestones
    Difficulty with developmental skills like crawling, sitting, or walking due to restricted ROM.
  • Postural Abnormalities
    Conditions such as scoliosis, torticollis, or crouched posture in cerebral palsy may be linked to ROM/flexibility limitations.
  • Contractures or Fixed Deformities
    Chronic shortening of muscles or tendons resulting in decreased joint mobility, often seen in neuromuscular conditions.

How Can PT Help Build These Skills?

  • Manual Stretching Techniques
    Passive or active-assisted stretches to improve soft tissue extensibility and joint mobility.
  • Therapeutic Exercise
    Active movement and functional stretching incorporated into play-based activities to promote flexibility.
  • Positioning and Orthotic Use
    Use of night splints, serial casting, or dynamic orthoses to maintain or increase ROM over time.
  • Myofascial Release and Soft Tissue Mobilization
    Hands-on techniques to reduce fascial restrictions and muscle tightness.
  • Neuromuscular Inhibition Techniques
    Proprioceptive Neuromuscular Facilitation (PNF) stretching or sustained holds to enhance muscle relaxation and lengthening.
  • Education for Home Program Implementation
    Caregiver instruction on daily stretching routines and proper body positioning to support long-term flexibility.
  • Adaptive Equipment Recommendations
    Use of standers or prone wedges to provide prolonged stretch in a functional, supported position.