The greatest predictor of re-injury is a previous injury. This statement gives Physical Therapists here at PTOSI motivation to make sure each patient is ready to return to their activity as quickly and safely as possible. Whether someone wants to get back to sports, performing arts, work, or everyday life, we want to be sure they can return with as low a risk of re-injury as possible.
How do we know if someone is ready? Basic range of motion and strength testing are important, however research has shown that a year after a total knee replacement many still have an abnormal sit to stand movement pattern. For athletes, functional or hop testing is used to help determine readiness for return to play but those who have had an anterior cruciate ligament reconstruction (and have normal range of motion, and strength) have only a 50% chance of returning to their previous level of play and a 20-30% chance of re-injuring their operated or non-operated knee. This data suggests that we need to also be looking at fundamental motor or muscle control tests which can help predict risk of re-injury. Some of these tests include the Functional Movement Screen (FMS), Y Balance Test, and the Dynamic Movement Assessment (DMA).
The FMS, Y Balance test, and the DMA are all types of body weight tests using movements such as squatting, single leg squats, jumps, and hops focusing on quality as much as distance or height. Video can be used for feedback and analysis as well The goal is to identify abnormal movement patterns that increase risk of re-injury but that can be modified or improved through manual therapy and corrective exercise/neuromuscular reeducation. Once the risk factors have been corrected then greater than body weight testing (i.e. Hop tests) can be used to determine return to sport specific training and competition.
If you would like further information, PTOSI’s Eric Polson, PT, DPT, ATC – Roseville location (651) 635-0578 incorporates Functional Movement Screens (FMS) with his patients to help them achieve their highest potential when returning to activities.