When an athlete is cleared to Return to Sport (RTS) after a major injury like an ACL reconstruction, the decision often hinges on a familiar set of benchmarks – strength testing, hop tests, and time since surgery. And on paper, these metrics can look reassuring.
But strength alone doesn’t tell the whole story.
Using our sport science testing with Plantiga insoles, we’re seeing a much more nuanced (and important) picture of readiness to return to high-risk sports like skiing.
A Case Study: Ski Athlete, 6 Months Post ACL + Meniscus Root Repair
In this athlete’s case, traditional dynamometry testing (pictured below) showed strong limb symmetry. Hop testing (not pictured) also suggested acceptable performance.
Based on these measures alone, many RTS decisions – including ones we’ve confidently made in the past – would lean toward clearance.
In a sport like skiing – where repetitive high-velocity loading, unpredictable terrain, and rapid transitions are unavoidable – these asymmetries matter. They represent unfinished neuromuscular recovery, and more importantly, ongoing re-injury risk.
Why This Matters: Re-injury Rates Are Still Alarmingly High
This gap between “passed testing” and true readiness helps explain a sobering reality in ACL rehab. Research consistently shows that second ACL injuries are common, affecting both the
surgical knee and the opposite side:
● ~6% of athletes sustain a second ACL injury within 2 years of return to sport
● Long-term follow-up shows reinjury rates ranging from 12% to over 30%
● Contralateral (opposite knee) injuries often occur more frequently than graft failures
These findings highlight a critical issue: passing strength and hop tests does not guarantee safe movement strategies.
Rethinking Return to Sport Testing
Traditional dynamometry and jump testing still have value – but they shouldn’t be the finish
line. By integrating sport science tools like Plantiga, we can:
● Detect hidden asymmetries in landing and take-off
● Identify compensation strategies before they become injuries
● Make RTS decisions based on how an athlete moves, not just how strong they are
The goal isn’t just returning to sport – it’s returning with confidence, durability, and stoke. For athletes (especially when your sport requires running, cutting and jumping, change of direction and high load) successful RTS means ensuring the body is truly ready for the demands of the sport – not just the clinic.
Below we’ve shared our Sport Science Reports showing asymmetries – highlighting different movement strategies and compensations between the left and right leg
⬆️Large asymmetries in landing & force absorption
⬆️Uneven propulsion during takeoff
⬆️More in-depth testing found compensations that strength tests didn’t catch. The athlete has strong legs, but uneven movement patterns.
Book your Sport Science Assessment now with Chad and return to your sport confidently. Have questions about treatment? Book the Free 15min phone call.
Source: Paterno MV. Incidence and Predictors of Second Anterior Cruciate Ligament Injury After Primary Reconstruction and Return to Sport. Journal of Athletic Training, 2015