Constant and Murley describe a 100-point shoulder functional scoring system developed and refined over four years. It combines patient-reported pain and activity limitations with clinician-measured active range of motion and abduction strength. The paper validates reproducibility across three observers and calibrates the subjective-to-objective scoring ratio against patient self-assessment.
Before this score, no standardized method existed for comparing shoulder function across diagnoses, surgeons, or institutions — different groups used incompatible single-parameter or questionnaire-based systems that could not be aggregated.
The Constant-Murley Score solved this by providing a single universal scale applicable to any shoulder pathology. When you document a patient's shoulder function before and after intervention, this is the tool you reach for: record both shoulders, score all four domains, and track changes over time.
ROM and strength together account for 65% of the score, so a patient with severe stiffness or weakness will score poorly even if pain is controlled. This framing helps communicate realistic outcome expectations to patients before surgery.
The score's one important blind spot: it was not designed for instability patients and does not discriminate referred pain from intrinsic shoulder pathology, so apply it with caution in those populations.
Constant and Murley describe a 100-point shoulder functional scoring system developed and refined over four years. It combines patient-reported pain and activity limitations with clinician-measured active range of motion and abduction strength. The paper validates reproducibility across three observers and calibrates the subjective-to-objective scoring ratio against patient self-assessment.
Before this score, no standardized method existed for comparing shoulder function across diagnoses, surgeons, or institutions — different groups used incompatible single-parameter or questionnaire-based systems that could not be aggregated.
The Constant-Murley Score solved this by providing a single universal scale applicable to any shoulder pathology. When you document a patient's shoulder function before and after intervention, this is the tool you reach for: record both shoulders, score all four domains, and track changes over time.
ROM and strength together account for 65% of the score, so a patient with severe stiffness or weakness will score poorly even if pain is controlled. This framing helps communicate realistic outcome expectations to patients before surgery.
The score's one important blind spot: it was not designed for instability patients and does not discriminate referred pain from intrinsic shoulder pathology, so apply it with caution in those populations.