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Home› Physical Therapy› Free Self-Checks› ROM Norms› Elbow & Forearm

Elbow & Forearm ROM Norms

CDC elbow flexion, extension, pronation and supination by age and sex, plus how to measure each one.

Reviewed by Dr. Richard Holsman, PT, DPT, NCS · Last reviewed November 13, 2026 · For clinician education

⚠️ For clinicians

This page is a measurement reference for physical therapists, occupational therapists, students and other clinicians. Patients with joint pain or stiffness should be examined by a licensed clinician.

Elbow & Forearm range of motion values from the CDC Normal Joint Range of Motion Study (where it measured this joint), the most-quoted reference values, and our clinicians’ goniometry steps for each motion. All values are in degrees.

On this page

Reference values at a glance

MotionAAOS reference valueVA rating scheduleCDC mean, women / men, 20–44CDC mean, women / men, 45–69
Elbow flexion150°[4]145°[5]150.0° / 144.6°148.3° / 143.5°
Elbow extension0°[4]—4.7° / 0.8°3.6° / −0.7°
Pronation80°[4]80°[5]82.0° / 76.9°80.8° / 77.7°
Supination80°[4]85°[5]90.6° / 85.0°87.2° / 82.4°

In the CDC tables, a positive elbow extension value means the elbow straightened past 0° (hyperextension) and a negative value means it stopped short of straight. Women had more elbow hyperextension than men in every age group. Pronation and supination were measured sitting, elbow at 90°, from a thumb-up start. [3]

AAOS and VA numbers are single reference values, not averages. A dash means we could not verify a value from a source we could check, so we left it out.

CDC norms by age and sex

Healthy volunteers aged 2 to 69 (674 people) were measured passively by trained physical therapists with a universal goniometer to the nearest degree. Values are mean ± standard deviation, the 95% confidence interval of the mean, and group size.

Elbow flexion

Age (years)Females: mean ± SD (95% CI) [n]Males: mean ± SD (95% CI) [n]
2–8152.9° ± 4.4 (151.5–154.3) [39]151.4° ± 2.4 (150.8–152.0) [55]
9–19149.7° ± 4.7 (148.5–150.9) [56]148.3° ± 5.2 (146.8–149.8) [48]
20–44150.0° ± 5.5 (149.1–150.9) [143]144.6° ± 5.5 (143.6–145.6) [114]
45–69148.3° ± 5.6 (147.3–149.3) [123]143.5° ± 6.0 (142.3–144.7) [96]

Passive ROM, universal goniometer, both sides averaged. Source: CDC[1]; SD and group size from Soucie et al.[2]

Elbow extension

Age (years)Females: mean ± SD (95% CI) [n]Males: mean ± SD (95% CI) [n]
2–86.8° ± 5.2 (5.2–8.4) [39]2.2° ± 5.0 (0.9–3.5) [55]
9–196.4° ± 6.3 (4.7–8.1) [56]5.3° ± 6.0 (3.6–7.0) [48]
20–444.7° ± 4.8 (3.9–5.5) [143]0.8° ± 3.8 (0.1–1.5) [114]
45–693.6° ± 5.5 (2.6–4.6) [123]−0.7° ± 3.9 (−1.5–0.1) [96]

Passive ROM, universal goniometer, both sides averaged. Source: CDC[1]; SD and group size from Soucie et al.[2]

Forearm pronation

Age (years)Females: mean ± SD (95% CI) [n]Males: mean ± SD (95% CI) [n]
2–884.6° ± 5.8 (82.8–86.4) [39]79.6° ± 3.0 (78.8–80.4) [55]
9–1981.2° ± 6.0 (79.6–82.8) [56]79.8° ± 7.2 (77.8–81.8) [48]
20–4482.0° ± 5.8 (81.0–83.0) [143]76.9° ± 7.0 (75.6–78.2) [114]
45–6980.8° ± 6.3 (79.7–81.9) [123]77.7° ± 6.0 (76.5–78.9) [96]

Passive ROM, universal goniometer, both sides averaged. Source: CDC[1]; SD and group size from Soucie et al.[2]

Forearm supination

Age (years)Females: mean ± SD (95% CI) [n]Males: mean ± SD (95% CI) [n]
2–893.7° ± 7.3 (91.4–96.0) [39]86.4° ± 4.2 (85.3–87.5) [55]
9–1990.0° ± 7.5 (88.0–92.0) [56]87.8° ± 7.3 (85.7–89.9) [48]
20–4490.6° ± 8.5 (89.2–92.0) [143]85.0° ± 6.6 (83.8–86.2) [114]
45–6987.2° ± 6.9 (86.0–88.4) [123]82.4° ± 7.5 (80.9–83.9) [96]

Passive ROM, universal goniometer, both sides averaged. Source: CDC[1]; SD and group size from Soucie et al.[2]

CDC norm lookup

Pick a motion, age group and sex to see the CDC group’s average passive range. Add your patient’s measurement to see where it falls. Nothing is saved or sent.

The CDC sample was 2 to 69 years old. For patients 70 and older, the 45–69 values are the closest available but were not measured in that age group.

Goniometry guide[6]

Our clinicians’ step-by-step method for each motion. Use the same position, landmarks and instrument every time you retest.

Elbow flexion

Patient position
Supine, arm at the side, a small pad under the distal humerus, forearm supinated (palm up).
Stabilize
Hold the distal humerus so the shoulder doesn’t flex.
Axis (fulcrum)
Lateral epicondyle of the humerus.
Stationary arm
Lateral midline of the humerus toward the acromion.
Moving arm
Lateral midline of the radius toward the radial styloid.
Watch for
Shoulder flexion lifting the humerus, forearm drifting out of supination.
Typical end-feel
Usually soft (forearm meets upper arm); hard or firm in a lean patient.

Elbow extension / hyperextension

Patient position
Same as flexion; the pad under the distal humerus leaves room for any hyperextension.
Stabilize
Hold the distal humerus.
Axis (fulcrum)
Lateral epicondyle.
Stationary arm
Lateral midline of the humerus toward the acromion.
Moving arm
Lateral midline of the radius toward the radial styloid.
Watch for
Recording a stop short of 0° as a positive number. Write it clearly: a loss of extension and hyperextension are different findings.
Typical end-feel
Hard (olecranon in the olecranon fossa).

Pronation

Patient position
Sitting, arm at the side, elbow bent 90°, forearm thumb-up.
Stabilize
Keep the elbow tucked against the trunk so the shoulder can’t abduct or rotate.
Axis (fulcrum)
Just proximal to the ulnar styloid, on the ulnar side.
Stationary arm
Vertical, parallel to the anterior midline of the humerus.
Moving arm
Across the back of the distal forearm just above the styloids.
Watch for
Shoulder abduction and internal rotation, measuring at the hand instead of the distal forearm, wrist motion.
Typical end-feel
Hard or firm.

Supination

Patient position
Same start as pronation.
Stabilize
Keep the elbow tucked against the trunk.
Axis (fulcrum)
Just proximal to the ulnar styloid, on the ulnar side.
Stationary arm
Vertical, parallel to the anterior midline of the humerus.
Moving arm
Across the palm side of the distal forearm just above the styloids.
Watch for
Shoulder adduction and external rotation, wrist extension, measuring at the hand.
Typical end-feel
Firm.

Measurement notes

  • Reliability in the CDC study: after a one-day training, the nine study therapists measured the same 10 people and differed by 5° or less[2].
  • Left versus right: in the CDC data, average left–right differences were under 1°, which supports using the uninvolved side for comparison[2].
  • Active or passive: say which you measured. The CDC values are passive.
  • Record the method: position, instrument and anything that changed (pain, guarding, a different start position) so the next measurement is comparable.

Other joints

Sources, review and disclosures

Graded citations

How we grade sources. A = population study of healthy people with published methods (CDC). B = widely used consensus reference values, as reported in a textbook or peer-reviewed paper; these are single “normal” numbers, not measured averages. C = U.S. government rating standard written for disability evaluation, not as clinical norms. D = expert clinical opinion.

  1. Grade A Centers for Disease Control and Prevention. Normal Joint Range of Motion Study: reference values for normal joint range of motion (mean and 95% confidence interval by sex and age). Archived CDC page, last reviewed April 28, 2023. archive.cdc.gov (Normal Joint ROM Study)
  2. Grade A Soucie JM, Wang C, Forsyth A, Funk S, Denny M, Roach KE, Boone D; Hemophilia Treatment Center Network. Range of motion measurements: reference values and a database for comparison studies. Haemophilia. 2011;17(3):500-507. doi:10.1111/j.1365-2516.2010.02399.x (Table 3 and Appendix Tables 1–11: group size, mean, SD and percentiles). onlinelibrary.wiley.com
  3. Grade A Centers for Disease Control and Prevention. Public Use Dataset for Normal Joint Range of Motion: Data Description and Sample Data Tables (measurement positions and recording conventions). 2010. CDC Stacks, marked Public Domain. stacks.cdc.gov/view/cdc/153156
  4. Grade B Norkin CC, White DJ. Measurement of Joint Motion: A Guide to Goniometry. 5th ed. F.A. Davis; 2016. Appendix A, Tables A.1 and A.3 (American Academy of Orthopaedic Surgeons [AAOS] column). Individual values cited; the table is not reproduced. fadavispt.mhmedical.com
  5. Grade C U.S. Department of Veterans Affairs. Schedule for Rating Disabilities, 38 CFR §4.71, Measurement of ankylosis and joint motion, Plates I and II. ecfr.gov (38 CFR 4.71)
  6. Grade D Holsman Physical Therapy clinical guidance. Goniometry steps, common errors and end-feels written in our own words by Holsman physical therapists and reviewed by Dr. Richard Holsman, PT, DPT, NCS. Expert opinion, not a research source.

Reviewer

Reviewed by Dr. Richard Holsman, PT, DPT, NCS (Board-Certified Clinical Specialist in Neurologic Physical Therapy), founder of Holsman Physical Therapy. Last reviewed: November 13, 2026.

Change log

  • November 13, 2026: Page published. All CDC values checked against the CDC page and Soucie et al. (2011); reference values checked against the cited sources.

Review policy

We re-check every number on this page against its source at least once a year, and sooner if a source is updated or a reader reports a problem. Changes are listed in the change log with the date. To report an error, contact us.

Licensing

Source: CDC. The CDC normative values are a U.S. government work in the public domain (CDC Stacks marks the study’s data documents “Public Domain”), used under CDC’s Use of Agency Materials terms. The values are shown as published, and the original material is available on CDC’s website at no charge. Our use of CDC material and links to CDC do not imply endorsement by CDC, HHS or the U.S. Government. The VA values come from a federal regulation (38 CFR), also public domain. AAOS values are cited as individual numbers with credit to the publication that reports them; no table layout or text is copied. The goniometry guide is original text by Holsman Physical Therapy.

Conflict of interest and advertising

This page is published by Holsman Physical Therapy and Wellness, P.C., which runs outpatient and in-home therapy practices; that is our only commercial interest. The page carries no advertising, no sponsorship and no affiliate links, and we received no payment from any source for it. We do not sell goniometers or apps. Holsman Physical Therapy is not affiliated with the CDC, the VA, the AAOS, or the authors and publishers cited, and they do not endorse this website.

For clinician education. Norms vary; interpret with clinical judgment. Range of motion differs with age, sex, body type, activity, measurement position, instrument, and whether motion is active or passive. A value outside a reference range is not a diagnosis. Compare with the uninvolved side, retest with the same method, and read the number alongside the patient’s symptoms and function.

Common Questions

What is normal elbow flexion?

Reference values list 150 degrees (AAOS, as reported by Norkin and White) or 145 degrees (VA rating schedule). In the CDC study, healthy adults aged 20 to 44 averaged 150 degrees (women) and about 145 degrees (men) of passive flexion.

Is elbow hyperextension normal?

A few degrees often is, especially in women and children. In the CDC study, women aged 20 to 44 averaged about 5 degrees past straight, while men of the same age averaged about 1 degree. Compare with the other arm.

Referring a Patient?

Holsman physical therapists see patients at clinics across North Jersey, the Bronx and Brooklyn, plus in-home visits.

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