RANGE OF MOTION EXERCISES

Passive range of motion exercises are done to preserve flexibility and mobility of the joints on which they are performed. It is important to perform these exercises to prevent deformities. All the exercises should be done several times a day. A good time to do them is after the baby's bath or at each diaper change. Your physical therapist will tell you how many times to do each one. These exercises should be done slowly and steadily. Never force a joint. Damage to the joint space can occur if too much force is applied. Joint range of motion is done on one joint at a time. Stabilize with one hand just above the joint and place your other hand below the joint to move the part through its full range of motion.

***These exercises can be administered by an Occupational or
Physical Therapist or under the direction of a therapist.***

Shoulder
Elbow
Wrist
Fingers
Thumb

Shoulder

SHOULDER FLEXION
Starting Position
Place child lying on back.

Hand Placement
Stabilize with one hand at the shoulder so that it doesn't come up. Hold wrist with the other hand.

Motion
Bend the arm up so hand is over the head, thumb leading. Keep the elbow straight.

shoulder flexion exercises   shoulder flexion exercises
Figure 1.

SHOULDER ADDUCTION
Starting Position
Lay child on back, arm away from body.

Hand Placement
Stabilize with one hand at the shoulder. Hold the wrist with the other hand.

Movement
Bend the arm across the body toward the other arm.

shoulder adduction exercises
Figure 2.

SHOULDER ROTATION
Starting Position
Lay child on back, elbow bent and arm straight out to the side.

Hand Placement
Hold arm straight out to the side. Hold the forearm with the other hand.

Movement
Roll the forearm up, then roll the forearm down.

shoulder rotation exercises
Figure 3.

SHOULDER ABDUCTION
Starting Position
Place child lying on back.

Head Placement
Stabilize with one hand at the shoulder so it doesn't come up. Hold forearm with the other hand.

Motion
Bend the arm sideways away from the body; bring the arm straight out to the side.

shoulder abduction exercises
Figure 4.

Elbow

ELBOW FLEXION AND EXTENSION
Starting Position
Lay child on back, elbow straight, arm away from body.

Hand Placement
Stabilize the elbow, hold wrist with other hand.

Motion
Bend the elbow gently, then straighten the elbow.

elbow flexion and extension exercises
Figure 5.

FOREARM SUPINATION AND PRONATION
Starting Position
Lay child on back, elbow bent, arm close to body.

Hand Placement
Stabilize the upper arm with one hand, hold the wrist with the other hand.

Movement
Roll the forearm and hand up, then roll the forarm and hand down.

forearm supination and pronation exercises
Figure 6.

Wrist

WRIST FLEXION AND EXTENSION
Starting Position
Place child laying on back.

Hand Placement
Stabilize the forearm with one hand. Hold child's hand with your other hand.

Movement
Bend the wrist forward and back.

wrist flexion and extension exercises
Figure 7.

WRIST ABDUCTION AND ADDUCTION (radial and ulnar deviation)
Starting Position
Place child lying on back.

Hand Placement
Stabilize the forearm with one hand. Hold the child's hand with your other hand.

Movement
Bend the wrist from side to side.

wrist flexion and extension exercises
Figure 8.

Fingers

FINGER FLEXION AND EXTENSION
Starting Position
Optional

Hand Placement
Stabilize the forearm and wrist with one hand. Hold the child's fingers with your other hand.

Movement
Bend the fingers, then straighten the fingers.

wrist flexion and extension exercises
Figure 9.

FINGER ABDUCTION AND ADDUCTION
Starting Position
Hold the child's hand and wrist open and straight.

Hand Placement
Hold the fingers straight.

Movement
Spread the fingers apart gently, bring them back together.

finger abduction and adduction exercises   shoulder flexion exercises
Figure 10.

KNUCKLE FLEXION AND EXTENSION (knuckle bent, fingers straight)
Starting Position
Optional.

Hand Placement
Stabilize the child's wrist with one hand. Hold the fingers with your other hand.

Motion
Bend the knuckle while keeping the fingers straight.

finger abduction and adduction exercises
Figure 11.

Thumb

THUMB OPPOSITION
Starting Position
Hold the child's hand open with palm up.

Hand Placement
Stabilize with one hand at the base of the little finger. Hold the end of the thumb with your other hand.

Movement
Bend the thumb up and over toward the base of the little finger.

thumb opposition exercises
Figure 12.

THUMB FLEXION AND EXTENSION
Starting Position
Hold hand open with palm up.

Hand Placement
Stabilize with one hand in the palm of the child's hand. Hold the end of the thumb with your other hand.

Movement
Straighten the thumb upward, away from the palm.

thumb abduction-adduction exercises
Figure 13.

THUMB ABDUCTION-ADDUCTION
Starting Position
Hold hand open with palm up.

Hand Placement
Stabilize with one hand in the palm of the child's hand. Hold the end of the thumb with the other hand.

Movement
Bend the thumb away from the side of the hand.

thumb abduction-adduction exercises
Figure 14.

The Brachial Plexus Palsy Foundation is not affiliated with any of the organizations or individuals mentioned herein. We are solely an information provider and are not medical professionals. We are providing this information as a resource and are not in anyway trying to influence the reader's decision to call these contacts that we have provided.
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