Constant-Murley Score Calculator
Validated Shoulder Function Instrument (CS)
Pain Score
Subjective pain assessment (0-15)
No Pain15Severe Pain
Function Score
Daily shoulder function (0-35)
Full Function35No Function
Active Motion Score
Range of shoulder motion (0-20)
Full ROM20No ROM
Score Overview
Pain (max 15)15
Function (max 35)35
Active Motion (max 20)20
Total Possible70
Current Sum70
Guidelines & Evidence
Verified
Last Review: 2026-07-17
When to Use
When to Use
Pre-operative and post-operative assessment of rotator cuff repair
Functional outcome measurement following shoulder arthroplasty
Evaluation of shoulder pathology: impingement, instability, adhesive capsulitis
Clinical trials comparing shoulder surgery techniques and rehabilitation protocols
Serial monitoring of shoulder function during conservative treatment
Occupational and sports medicine shoulder assessment
Patient Population
Designed for adults with various shoulder conditions including rotator cuff disease, glenohumeral arthritis, proximal humerus fractures, and shoulder instability. Validated across multiple shoulder pathologies.
How it Works
Formula
Total Score = Pain (15) + Function (35) + Active Motion (20) = 70
Pain (0-15): Subjective pain scale — 0 (severe pain) to 15 (no pain)
Function (0-35): Composite of daily activities and work/sport participation
Active Motion (0-20): Sum of active range of motion in forward flexion, abduction, external rotation, and internal rotation
Higher scores indicate better shoulder function
Scoring Components
| Component | Max Points | Description |
|---|---|---|
| Pain | 15 | Patient-reported pain level during daily activities |
| Function: ADL | 20 | Sleep, work/sport, positioning (hand to waist/neck/head/back) |
| Function: Mobility | 15 | Ability to elevate arm to specific levels |
| Active Motion: Flexion | 10 | Active forward elevation (0-10 points based on degrees) |
| Active Motion: Abduction | 10 | Active lateral elevation (0-10 points based on degrees) |
Clinical Pearls
Interpretation Guide
| Score Range | Classification | Clinical Implication |
|---|---|---|
| 80 – 100 | Excellent | Near-normal shoulder function (age-adjusted) |
| 60 – 79 | Good | Mild functional limitations |
| 40 – 59 | Fair | Moderate impairment affecting daily activities |
| < 40 | Poor | Severe disability; consider surgical intervention |
Key Considerations
Age- and sex-adjusted normative values should be used for interpretation
The Constant Score is the most widely used shoulder outcome measure in Europe
Active motion component requires physical examination — not purely patient-reported
A change of 10-15 points represents the minimal clinically important difference
The score correlates moderately with other shoulder-specific instruments
Ceiling effects are noted in young, active patients with high baseline function
Common Pitfalls
Ensure standardized goniometric measurement for active motion components
Do not substitute the patient-reported portion with clinician assessment
Age-adjusted norms must be used: a score of 70 may be "fair" in a 30-year-old but "excellent" in an 80-year-old
Next Steps
Clinical Actions
01
Compare to age- and sex-adjusted normative values for interpretation
02
If score < 40: investigate for structural pathology (imaging, examination under anesthesia)
03
If score 40-59: optimize non-operative management; consider corticosteroid injection
04
Track serial scores to assess response to treatment or rehabilitation
05
For post-operative patients: use score to guide return-to-activity decisions
06
Document score in clinical notes for outcome tracking and research purposes
The Evidence
Primary Reference
A clinical method of functional assessment of the shoulder
Constant CR et al. • Clinical Orthopaedics and Related Research. 1987;214:160-164 — Original description of the Constant-Murley Shoulder Score
Validation Evidence
Inter-observer reliability: ICC 0.80-0.90
Test-retest reliability: ICC 0.85-0.95
MCID: 10-15 points depending on pathology and intervention
Responsiveness: Large effect size for rotator cuff repair (Cohen's d > 1.0)
Significant ceiling effects in young, high-demand patients
Origins & History
Historical Background
The Constant-Murley Score was developed by Dr. Christopher Constant and Mr. Alan Murley at Addenbrooke's Hospital, Cambridge, UK. Published in 1987, it was designed as a standardized functional assessment tool specific to the shoulder, combining both subjective and objective components.
Last Comprehensive Review: 2026-07-17