Return to play and physical performance tests: evidence-based, rough guess or charade?

It was with great interest that we read the recent BMJ editorial by professors Lohmander and Roos1 that challenged the orthopaedic and sports world to have greater evidence to support interventions. We would place ourselves firmly on their bandwagon as we examine the evidence supporting physical performance tests (PPTs) in athletes. A PPT is aptly named as each requires an athlete to perform a physical task that is believed to be a component of sports activity. PPTs are simple, portable, low-tech assessments and as such, are quite attractive. Representative of PPTs is the single leg hop test2 and its variations (triple, crossover, and timed 6 m hop), which are ubiquitous in sports rehabilitation environments. PPTs are routinely used to predict/determine if: 1. An athlete will be injured at some future time based on substandard performance of the test (injury prediction); 2. The athlete will perform at a higher level than his or her peers for the foreseeable future …