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Shoulder Range of Motion Norms

CDC shoulder flexion by age and sex, common reference values and how to measure each motion with a goniometer.

⚠️ 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.

Shoulder 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
Flexion180°[4]180°[5]172.0° / 168.8°168.1° / 164.0°
Extension60°[4]———
Abduction180°[4]180°[5]——
Internal (medial) rotation70°[4]90°[5]——
External (lateral) rotation90°[4]90°[5]——

The CDC study measured shoulder flexion only. It was measured passively, supine with the knees bent to flatten the low back, with the scapula stabilized. For shoulder rotation the VA measures with the arm abducted to 90° and the elbow bent to 90°. [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.

Shoulder flexion

Age (years)Females: mean ± SD (95% CI) [n]Males: mean ± SD (95% CI) [n]
2–8178.6° ± 5.5 (176.9–180.3) [39]177.8° ± 4.0 (176.7–178.9) [55]
9–19171.8° ± 7.6 (169.8–173.8) [56]170.9° ± 6.4 (169.1–172.7) [48]
20–44172.0° ± 6.8 (170.9–173.1) [143]168.8° ± 8.0 (167.3–170.3) [114]
45–69168.1° ± 8.2 (166.7–169.5) [123]164.0° ± 8.3 (162.3–165.7) [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.

Flexion

Patient position
Supine, knees bent so the low back stays flat; arm at the side, palm facing the body.
Stabilize
Hold the scapula and thorax so the shoulder blade doesn’t elevate or tip and the back doesn’t arch.
Axis (fulcrum)
Lateral aspect of the greater tubercle (center of the humeral head).
Stationary arm
Along the mid-axillary line of the trunk.
Moving arm
Lateral midline of the humerus toward the lateral epicondyle.
Watch for
Arching the low back, trunk rotation, the arm drifting into abduction, the scapula elevating.
Typical end-feel
Firm (posterior capsule and muscle tension).

Extension

Patient position
Prone, face turned away, arm at the side, elbow slightly bent so the biceps doesn’t limit motion.
Stabilize
Hold the scapula down against the thorax.
Axis (fulcrum)
Lateral aspect of the greater tubercle.
Stationary arm
Mid-axillary line of the trunk.
Moving arm
Lateral midline of the humerus toward the lateral epicondyle.
Watch for
Scapular elevation or anterior tilt, trunk rotation, lifting the shoulder off the table.
Typical end-feel
Firm.

Abduction

Patient position
Supine, arm at the side, shoulder externally rotated (palm up) so the greater tubercle clears the acromion.
Stabilize
Hold the thorax and watch the scapula; stop when the scapula starts to rotate upward if you want glenohumeral motion only.
Axis (fulcrum)
Anterior aspect of the acromial process.
Stationary arm
Parallel to the midline of the sternum.
Moving arm
Anterior midline of the humerus toward the medial epicondyle.
Watch for
Side-bending the trunk, shrugging the shoulder, the arm drifting into flexion, missing the external rotation.
Typical end-feel
Firm.

Internal rotation

Patient position
Supine, shoulder abducted 90°, elbow bent 90°, forearm pointing at the ceiling; a folded towel under the upper arm keeps it level.
Stabilize
Steady the distal humerus; block the shoulder from rolling forward.
Axis (fulcrum)
Olecranon process.
Stationary arm
Vertical (perpendicular to the floor).
Moving arm
Along the ulna toward the ulnar styloid.
Watch for
Scapular protraction or anterior tilt, elbow angle changing, the arm sliding out of 90° abduction.
Typical end-feel
Firm.

External rotation

Patient position
Same start as internal rotation.
Stabilize
Steady the distal humerus; keep the low back from arching at end range.
Axis (fulcrum)
Olecranon process.
Stationary arm
Vertical (perpendicular to the floor).
Moving arm
Along the ulna toward the ulnar styloid.
Watch for
Arching the back, scapular retraction, the elbow drifting away from 90°.
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 shoulder flexion?

Common reference values list 180 degrees (AAOS, as reported by Norkin and White; the VA rating schedule also uses 180). In the CDC study of healthy people, average passive flexion was lower in adults: about 172 degrees in women and 169 in men aged 20 to 44, and 168 in women and 164 in men aged 45 to 69.

Why does the CDC average fall short of 180 degrees?

The 180-degree figure is a single reference value, not a measured average. The CDC values are means from healthy people measured with a goniometer, and range fell with age in both sexes.

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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