Why Passing Sports Performance Testing is Key to Your Safe Return After ACL Rehab

As sports physical therapists, our priority is not just to follow a timeline but to ensure that athletes are truly ready—both physically and psychologically—to return to their sport after ACL reconstruction. While surgeons may clear patients based on the healing of their graft, our role is to determine if they are functionally prepared to handle the demands of competition and reduce the risk of reinjury.

Objective and Subjective Testing: A Holistic Approach

Our return-to-sport testing is based on a rigorous and comprehensive battery of assessments. We evaluate both the physical and psychological readiness of our patients, ensuring that they meet the necessary criteria before resuming their sport. This approach helps to mitigate the high risk of reinjury associated with premature return.

Strength Testing

We conduct objective strength assessments of the quadriceps, hamstrings, and hip musculature. A key requirement for clearance is achieving at least 90% strength symmetry compared to the non-injured leg, as well as ensuring absolute strength values are within an appropriate range for the athlete’s age and gender.

Hop Testing

Hop testing is crucial for assessing explosive power, control, and limb symmetry. Our battery includes:

Horizontal Hop Testing: Single hop, triple hop, crossover hop, and lateral hop tests. Evaluating not just their distance but the quality of their movement and landing mechanics.
Vertical Hop Testing: Evaluating vertical power and symmetry in landing mechanics.

Balance and Agility Testing

We assess dynamic stability and control with:

Balance Testing: Measuring postural control and neuromuscular coordination.
Lateral Tap Down Testing: Assessing eccentric control, stability, and the endurance required to maintain a consistent metronome pace for one minute.
Agility Testing: Ensuring the athlete can change direction quickly and efficiently under game-like conditions.

Psychological Readiness

Physical readiness alone is not enough; psychological readiness plays a crucial role in an athlete’s confidence and overall success upon return. We utilize the ACL Return to Sport After Injury (ACL-RSI) Questionnaire to gauge psychological readiness, addressing concerns like fear of reinjury and confidence in knee function.

Why This Matters

Too often, athletes are cleared based on surgical timelines alone, without fully considering functional and psychological readiness. However, research consistently shows that premature return to sport significantly increases the risk of reinjury. Our goal is to bridge that gap, ensuring our patients not only return to play but do so safely and with confidence.

By implementing this thorough return-to-sport testing process, we provide our athletes with the best possible care, reducing the likelihood of reinjury and helping them achieve long-term success in their sport. If you or someone you know is recovering from ACL reconstruction, make sure they undergo a comprehensive return-to-sport assessment—because getting back to the game should mean staying in the game.