Let me paint you a picture… You have been out injured with a strained hamstring that happened 6 weeks ago playing footy. You have been consistent with your physiotherapy exercises, following all the correct pacing techniques, meaning your hamstring has been feeling good. Your footy team has made the finals and you’re desperate to play but are you ready…?

This is where your physiotherapist will play a critical role in determining your readiness to play and if you are at a point of being able to return to sport. If you return to your sport too soon from an injury there is a risk that you can aggravate the injury or make the situation worse than previous. As to what tests will be completed to determine readiness to play, there are key principles that can be utilised for most injuries and sporting codes.

Before evening considering if you can return to sport, the physio will first consider the type of injury you have and the typical expectations that would be seen for its’ progressions and prognosis. For example, a grade 1 hamstring strain typically takes 1-3 weeks to recover, whereas a grade 2 hamstring increases the time to 4-6 weeks and a grade 3 will be 8-12 weeks minimum. Depending on the type of injury you have will firstly indicate when return to sport may be an option. Additionally, if it is a recurrent injury then the physiotherapist may increase the recovery time to try and reduce the risk of re-injury.

Testing the strength of the muscles around the injury area provides an objective and valid measurement of strength which is compared to the non-injured side. Your physiotherapist will use a device called a dynamometer to gain an accurate measure of strength. With a hamstring, a maximal hamstring curl will be done on your left and right leg, looking for measures that are less than 10% different from each side and cause no pain. The objective measure also allows your physio to see if the prescribed exercises are achieving the goal of increasing strength.

When testing the endurance aspect, this can mean different things depending on your injury and the type of sport you’re returning to. For example, a footy player requires to run. Therefore, your physio may look at completing a running test for endurance. However, a basketball player who’s a shooter may take up to 40 shots in a game. Therefore, your physio may instead consider a test or exercise that looks at upper limb repetitive movements as an endurance test.

Functional tests are look at key aspects of your sport and determine what movements are essential to do at an optimal level. For example, a soccer play will need to be to run at different paces and either in straight lines or different directions. Therefore, your physio may look at your different running speed and the ability to run in different directions or ability to accelerate/decelerate. A test like the T test would be a good example of a valid and functional test.

The last and most important return to sport testing aspect is the ability to complete sport-specific skills. This can be done more so within the training session as this most closely correlates with game readiness such as pacing skills, tackling, and attack/defence plays.

Below is an example of testing measures progression that can be used for the footy player mentioned at the start with the injury hamstring:

• Pain scale
• Knee range of motion
• Dynamometry strength of hamstring
• Running/Jogging endurance
• Broad jump
• T test
• Single leg hopping
• Sport-specific skills testing (pacing, tackling)
• Return to sport

Once all tests have been performed and they have come back cleared, sport-specific practice has been completed with no concerns, then you are ready to return to sport! Ensure to complete suitable warm ups and follow the physio’s advice for preventative management to be able to continue playing your sport without injuring yourself!