Normal values for hip flexion, extension, abduction, adduction and rotation, how to line up a goniometer for each one, and how to measure from a camera.
Hip measurements are easy to inflate with the pelvis. A posterior pelvic tilt adds to flexion, an anterior tilt to extension, and a hitched pelvis to abduction. Fix the pelvis first, then read the hip.
Normal hip range of motion
AAOS reference values, with the CDC average for healthy adults aged 20 to 44 where it was measured. Hip flexion is measured with the knee bent, which slackens the hamstrings.
| Motion | AAOS | CDC average women / men |
|---|---|---|
| Flexion | 0–120° | 134° / 130° |
| Extension | 0–30° | 18° / 17° |
| Abduction | 0–45° | – |
| Adduction | 0–30° | – |
| Internal rotation | 0–45° | – |
| External rotation | 0–45° | – |
By age and sex
From the CDC Normal Joint Range of Motion Study: more than 600 healthy people measured by physical therapists with universal goniometers. Women had more range than men in nearly every joint, and range fell with age in both.
| Motion | Women 20–44 | Men 20–44 | Women 45–69 | Men 45–69 |
|---|---|---|---|---|
| Flexion | 133.8° | 130.4° | 130.8° | 127.2° |
| Extension | 18.1° | 17.4° | 16.7° | 13.5° |
How to measure hip range of motion with a goniometer
Standard goniometric alignment. Stabilize the pelvis for every motion and record the patient position you used.
Flexion
- Position
- Supine, knee allowed to bend
- Axis
- Greater trochanter
- Stationary arm
- Lateral midline of the pelvis
- Moving arm
- Lateral midline of the femur, toward the lateral epicondyle
- Watch for
- Posterior pelvic tilt and lumbar flexion
Extension
- Position
- Prone, knee straight
- Axis
- Greater trochanter
- Stationary arm
- Lateral midline of the pelvis
- Moving arm
- Lateral midline of the femur, toward the lateral epicondyle
- Watch for
- Anterior pelvic tilt and lumbar extension
Abduction and adduction
- Position
- Supine, legs straight
- Axis
- Anterior superior iliac spine (ASIS) of the side measured
- Stationary arm
- Along a line between the two ASISs
- Moving arm
- Anterior midline of the femur, toward the middle of the patella
- Watch for
- Hip hiking and the leg rotating
Internal and external rotation
- Position
- Seated, hip and knee at 90°
- Axis
- Anterior aspect of the patella
- Stationary arm
- Perpendicular to the floor
- Moving arm
- Anterior midline of the tibia, toward the midpoint between the malleoli
- Watch for
- Weight shifting onto one buttock. Prone measurement reads higher than seated, so record the position
Measuring hip range of motion with a camera
Hip flexion and extension read best side-on with the camera at hip height. Abduction and adduction read best from in front, with the camera at the level of the pelvis. Rotation is measured seated or prone, so the camera needs to look along the thigh at the lower leg.
- From a photo: the free online goniometer lets you tap the axis and both segments on a picture and read the angle. Nothing is uploaded.
- Live: MotionArc tracks the joints from any phone, tablet or laptop camera and measures the movement as it happens, in the clinic or on a video call.
Why two clinicians get different numbers
A goniometer reading depends on the person holding it. Finding the bony landmarks, lining up the arms and positioning the patient all add variation, and that variation is larger between two clinicians than for one clinician measuring twice.
- Small changes between two clinicians may not be real. At the shoulder, a true change measured by two different therapists needs about 15°, compared with 6° to 11° when the same therapist measures both times. Agreement between testers is weakest for shoulder extension and internal rotation.
- The instrument matters. At the knee, the smallest difference you can trust is about 6° with an inclinometer, 10° with a long-arm goniometer, 12° with a smartphone app and 14° with a short-arm goniometer or a visual estimate.
- Video can work. Shoulder angles measured over a video call with an on-screen protractor came within 0.2° to 5° of goniometer readings on average, and most smartphone apps studied show adequate reliability.
- What helps: a written protocol for patient position and landmarks, the same instrument each time, the same clinician where possible, and a note of how the measurement was taken.
Measuring from a camera takes out the hand-held step. Nobody has to line up the goniometer arms by hand, and the same view can be set up visit after visit.
Early access is limited, and we set up every account personally.
More reference values: normal range of motion chart for every joint. Other joints: Shoulder · Knee · Ankle · Neck · Low back.
Sources
- American Academy of Orthopaedic Surgeons. Joint Motion: Method of Measuring and Recording. Chicago: AAOS; 1965.
- AAOS values as tabulated in a Jones & Bartlett Learning clinical handbook, chapter 1 (sample chapter). Link
- Hendriks et al. Plastic and Reconstructive Surgery Global Open. 2020. Supplement: normal range of motion values according to the AAOS. Link
- Soucie JM, Wang C, Forsyth A, et al. Range of motion measurements: reference values and a database for comparison studies. Haemophilia. 2011;17(3):500-507. Reference values from the CDC Normal Joint Range of Motion Study. Link
- Norkin CC, White DJ. Measurement of Joint Motion: A Guide to Goniometry. 5th ed. Philadelphia: F.A. Davis; 2016.
- University of West Alabama Athletic Training. Goniometry lab: joint measurement procedures. Link
- Simoneau GG, et al. 1998 (hip rotation range of motion, sitting versus prone). Link
- Mullaney MJ, et al. Physiother Theory Pract. 2010;26:327 (reliability of shoulder range of motion measurement). Link
- Riddle DL, Rothstein JM, Lamb RL. Goniometric reliability in a clinical setting: shoulder measurements. Phys Ther. 1987;67:668. Link
- Hancock GE, et al. J Exp Orthop. 2018 (reliability of knee range of motion measurement methods). Link
- Sahu et al. J Shoulder Elbow Surg. 2022;31:201 (shoulder range of motion by video conference versus goniometer). Link
- Keogh JWL, et al. Reliability and validity of clinically accessible smartphone applications to measure joint range of motion: a systematic review. PLOS ONE. 2019;14:e0215806. Link
Measure hip range of motion from any camera.
No goniometer, no wearables. The same movement, measured the same way, every visit.
Straight answers. If yours is not here, request access and ask us anything.
Most AAOS tables list about 120° of flexion, 30° of extension, 45° of abduction, 30° of adduction and 45° each of internal and external rotation. Healthy adults in a CDC study averaged about 130° to 134° of flexion and 17° to 18° of extension.
With the patient supine, center the axis over the greater trochanter, align the stationary arm with the lateral midline of the pelvis and the moving arm along the femur toward the lateral epicondyle. Let the knee bend, and stop when the pelvis starts to tilt.
Yes. External rotation measured prone reads higher than seated, so always record the position and use the same one at every visit.
Yes. MotionArc measures range of motion, form and balance from any phone, tablet or laptop camera, in the clinic or live on a video call. Early access is open to a small group of professionals.
Clinicians sign a business associate agreement (BAA) with us before any real patient data is entered. The free goniometer on this site runs in your browser and never uploads photos.