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Enhancing Athletic Recovery: A Comprehensive Guide to Lower Extremity Return to Sport Testing

Written By: Jordan Peoples, PT, DPT

Returning to sport after a lower extremity injury is a crucial phase for athletes, requiring careful assessment and rehabilitation. One of the key components in this process is return to sport (RTS) testing, which evaluates an athlete’s readiness to resume competitive activity safely and effectively. In this blog post, we’ll explore the importance of RTS testing for lower extremity injuries and highlight six essential tests used by healthcare professionals: the single leg hop, triple hop, crossover hop, broad jump, single leg squat test, and the y-balance test. These tests require minimal equipment but do provide extremely valuable information in determining programming and readiness for RTS.

Understanding Return to Sport Testing:

RTS testing is a comprehensive process designed to assess an athlete’s physical readiness to return to their pre-injury level of sport. It goes beyond basic measures of strength and range of motion, focusing on functional tasks that mimic the demands of athletic competition. By identifying any residual deficits in strength, stability, and neuromuscular control, RTS testing helps minimize the risk of re-injury and optimize performance upon return to play.

The Single Leg Hop Test:

The single leg hop test is a simple yet effective assessment of lower extremity function and power. During this test, the athlete hops forward as far as possible on the injured leg while maintaining balance upon landing. The distance hopped is measured and compared to the uninjured side, providing valuable information about limb symmetry and functional capacity.

The Triple Hop Test:

Similar to the single leg hop test, the triple hop test evaluates unilateral lower extremity function but incorporates a series of consecutive hops. In this test, the athlete performs three consecutive hops on the injured leg, aiming for maximal distance with each hop. The total distance hopped is recorded and compared between the injured and uninjured limbs, highlighting any deficits in power and coordination.

The Crossover Hop Test:

The crossover hop test assesses lateral stability and proprioception, crucial for sports involving cutting and pivoting movements. During this test, the athlete laterally hops back and forth over a designated line or marker, landing on the injured limb with each hop. The number of successful hops completed within a specified time frame reflects the athlete’s ability to control dynamic movements and absorb forces effectively.

The Broad Jump Test:

The broad jump test measures lower extremity power and explosiveness, essential for sports requiring quick acceleration and jumping ability. In this test, the athlete stands behind a starting line and jumps forward as far as possible, landing with both feet simultaneously. The distance jumped provides valuable insights into lower limb strength and coordination.

The Single Leg Squat Test:

The single leg squat test assesses lower limb strength, balance, and neuromuscular control in a functional movement pattern. During this test, the athlete performs a controlled squat on the injured leg, aiming to achieve a specified depth while maintaining proper alignment and stability. Any deviations from the ideal squatting pattern or difficulty maintaining balance may indicate lingering deficits requiring further rehabilitation. This test can be set to a metronome to not only measure quality of movement, but quantify lower extremity endurance. It can also be performed in different planes of movement depending on specific sports or activity demands.

The Y-Balance Test:

The Y-balance test is a dynamic assessment of lower extremity strength, flexibility, and balance. Using a specialized Y-balance testing kit, the athlete reaches in three directions (anterior, posteromedial, and posterolateral) while standing on one leg. The distance reached in each direction is measured and compared between the injured and uninjured limbs, providing valuable data on asymmetries and functional deficits.

RTS:

Return to sport testing plays a crucial role in the rehabilitation process for lower extremity injuries. By systematically assessing strength, stability, and functional capacity, healthcare professionals can make informed decisions regarding an athlete’s readiness to return to play. Incorporating tests such as the single leg hop, triple hop, crossover hop, broad jump, single leg squat test, and the y-balance test allows for a comprehensive evaluation of athletic recovery. Ultimately, prioritizing thorough assessment and targeted rehabilitation interventions can help athletes return to their sport safely and confidently, minimizing the risk of re-injury and optimizing performance.

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Jessica Jones

Physical Therapist

Jessica recently moved to Seattle from Boston, MA and is excited to join the Therapydia team. Her treatment experience includes orthopedics, sports medicine, pediatrics, and vestibular therapy. Jessica received her Doctorate in Physical Therapy from Northeastern University in Boston, MA in 2016. She has completed the Pediatric Physical Therapy Residency at Boston Children’s Hospital and is in the process of completing a Comprehensive Vestibular Rehabilitation certification. Jessica believes in empowering and inspiring patients to take control of their health through education, movement, and exercise. She enjoys treating patients of all ages and levels while utilizing soft tissue techniques, neuromuscular re-education, balance training as well as therapeutic exercise. In her free time, Jessica enjoys yoga, dancing, kayaking, and hiking with her dog!