How can functional testing help make return to play decisions?

Rod Whiteley, PhD

Physiotherapist, Aspetar Sports Medicine Hospital

Successful return to play

• Is what? • For who?

RTS success is defined as…

Defining Return to Sport… when?

Rehab Team

Continuum of Return to Sport

Reh

abTeam

Return to participation

Return to sport

Nothing ruins your outcomes like follow-up

Excellent or good: 92%

Returned to previous professional level > 1 year: 12%

Return to sport continuum

Fishing expeditions

• Biomechanics of jumping, landing, hopping, running

• Muscle Activity

• Forces

• 3-D analysis – Cameras and markers, IMU’s, Markerless

• EMG

• Force Plates, In-shoe measures

22

• Biomech Add on

$100,000 v $2,000

• 34 athletes

• 31 markers (Aspetar protocol)

• 3 tests (3 times each)

Plantar loading

@AtholThomson

-30

-10

10

30

50

70

90

0 2 4 6 8 10 12Month

Un

load

ing

AC

L→

Swing Stance

Lateral hamstring

Medial hamstring

(Hansen, Einarsson, Thomson & Whiteley 2017)

ACL Case & RTS

• 7 months post ACLR, national team player

• Completed rehabilitation & criteria for RTS

• “Doesn’t look right, can you check him?”

0

500

1000

1500

2000

2500

3000

3500

4000

CMJ SLCMJ Hop&Stick

vGRF (N)

AC

LR

AC

LR

AC

LR

@paulread1010

(Some) Problems still to address

• Reactive Agility versus Change of Direction

• Planned versus unplanned

• “Non-contact” injury

• “Sports Specific” on field