Functional Tests for the Injured Athlete

Returning to Sports after Injury

Photo of an athlete doing a box jump.
Plyometric training may be a part of your ankle fracture rehab. John Fredele/Getty Images

If you are an athlete who has suffered an injury to your hip, knee, or ankle, then you may benefit from physical therapy to help improve your mobility, decrease your pain, and get you back to your normal activity.

Your physical therapist will perform various tests to help determine the cause of your injury and to prescribe the correct treatment. Tests may include measuring range of motion, strength, or flexibility. Your physical therapist may also utilize video technology to assess motions specific to your sport. He or she can then slow down the video to assess nuances on how you are moving.

Lower extremity functional tests help your physical therapist assess how your range of motion, strength, balance, or flexibility deficits all work together.  These impairments may be mild, but when combined, they may lead to significant deficits that prevent you from performing your best on the athletic field.

After injury, how do you know when it is time to return to sports? How does your PT test your ability to jump and land properly, squat, or start and stop suddenly when running?

Here is a step-by-step progression your PT may use to assess your injury and to determine how your total body movements are affecting your ability to participate in sports. These functional tests can also be used to determine your ability to safely to return to your sport.

Be sure to check in with your doctor or physical therapist before starting any specific tests for your injury.

Functional Squat Test

Photo of a young woman squatting at the gym.
Your PT can assess you condition with the squat test. Kevin Kozicki / Getty Images

To perform the squat functional test, stand with your knees about shoulder width apart and your arms straight out in front of you. Keep your back straight and slowly squat down until your knees are bent about 90 degrees.

What to Watch

While squatting, watch your knees and hips. Your knees should move directly over your first and second toes. If your knees turn in and touch when you squat, this may indicate weakness in your hip gluteus medius muscle and poor neuromuscular balance and control.

If your back bends forward while you squat, you may have thightness in your middle and lower back. Lack of mobility in your spine may make performing a squat difficult and may lead to injury.

Feet and ankles that collapse in during a squat may indicate a pronated foot position and this could cause increased strain in your legs and lead to lower extremity injury or foot pain.

Single Leg Squat

Image of balance exercises on therapy foam.
Use a piece of foam or a pillow to add difficulty to your balance exercises. Brett Sears, PT, 2015

The single leg squat can be done to assess your lower extremity kinematics and overall proprioception and balance. To do this, stand on one foot with your other leg straight out in front of you up in the air. Slowly bend your stance knee to squat down.

What to Watch

When performing the single leg squat, does your knee move inward through adduction and internally rotate? Look to see if your knee is right above you second toe; if it has moved inwards over your foot and ankle, this may indicate weak hips or poor proprioception in your leg. This may lead to injury such as an ACL sprain or knee pain from patellofemoral stress syndrome.

Turning in of your knee during the single leg squat is called a "collapsing kinetic chain." This has been shown to to potentially lead to hip, knee, and ankle pain.

The Drop Jump Test

Woman box jumping.
Jump and land properly with the Drop Jump Test. Hero Images/Getty Images

The drop jump test is a great way to assess your ability to safely jump up and and down, important skills to have in sports like basketball, volleyball, and soccer. To do the test, stand on a stool that is 18 inches high. Jump down - landing on both feet - and then immediately jump back up in the air. Stick the landing, and you're done.

What to Watch

Since the drop jump test happens so quickly, you may need to use video technology to slow the action down. When assessing the test, watch for that dreaded "collapsing kinetic chain." Your knees should remain squarely over your feet when landing and jumping; knees that turn inwards or that touch upon landing may indicate weak hip muscles, poor balance, and impaired proprioception. This may lead to knee pain or injuries.

Single Leg Stance in a T Formation

Photo of woman practicing yoga on the beach.
The T-Stance is a great exercise to build better balance. Zero Creatives/Getty Images

To do the T-stance, stand on one foot, then slowly lean forward at your hips and bring your leg up behind you. Keep your back straight, and spread your arms out to either side, as if you were the letter "T."

What to Watch

During the T-stance, watch your lower extremity for shaking or turning inwards, indicating lack a stability and poor balance. Turning in of your knee may also indicate your gluteus medius is weak.

In your upper body, your back should be straight as you are in the T-stance. Rotation or flexing of your spine may indicate weak abdominals or tightness in your lower and middle spine.

Single Leg Hop Testing

Photo of woman hopping while running.
The single leg hop test can be used to assess your readiness to return to sports. Adrianna Williams / Getty Images

Single leg hop testing is often used after ACL rehabilitation to assess your readiness to return to high level athletics. To perform the test, stand on one foot, and then hop forward as far as possible. You can also repeat the the test over three hops. Measure the distance you travel in centimeters.

What to Watch

During single leg hop testing, you should not experience any pain or falling over. Your distance covered tells your PT your overall readiness to return to sports; your scores will be compared to expected norms for men and women.

If you have an injury that prevents you from engaging in your normal sports activity, you may benefit from physical therapy to help you fully recover. Your PT may use lower extremity functional tests to assess your condition and to provide the best exercise prescription for you. He or she may also use lower extremity functional tests to determine your readiness to return to your respective sport or activity.

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