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Spring Sports Safety for Success

Are you worried that you or your athlete may be at risk for injury?

Here are five screens, which can help you determine risk of injury and need for a physical therapy prevention program.

  1. Star Excursion Balance Test (SEBT)

Screen for: Ankle Sprain and Lower Leg Injury

According to Plisky et al, the SEBT is a reliable and good predictive test for lower extremity injury in young athletes. The results of the study concluded that athletes with a difference of 4cm in forward reach were more likely to have an injury to the lesser reach side.

Test: Begin with standing in the middle of a star marked with tape on the floor, and reach with the opposite leg in all directions of the tape, marking where the toe is able to reach. Repeat on the other leg and mark where the toe reaches. Check the markings to see if any distances between both legs are greater than 4cm. Should there be a difference of 4cm or more, between the legs in any direction, this may indicate risk of injury.

  1. Hyperextension Test

Screen for: Ligamentous Injury of the Knee and Elbow

In a study by Myer et al, it was found that hyperextension of a joint may indicate increased risk for ligamentous injury for the knee, elbow, and fingers.

Athletes that have hyperextension at the knees or elbows are at risk for stress to the ligaments and injury. Common ligamentous injuries include tearing the Anterior Cruciate Ligament (ACL).

Test: Have the athlete stand straight with their knees straight and see if they have any hyperextension. The same goes with the elbow straighten and see if there is any hyperextension.

  1. Hop Test

Screen for: Knee Stability/Ligamentous Injury of the Knee

Hamilton et al, found that the hop test is a strong tool to predict dynamic knee stability to obtain information about the neuromuscular and strength aspects of the knee to determine risk. Asymmetries between the knees and hips, and excursion of the hips and/or knees are determining factors for risk of injury due to the instability of the landing and knee joint demonstrated by these signs.

Test: Have the athlete hop with both feet leg vertical in the air, then hop with one foot; watch their take off and landing. Should their knee bow in or excessively out they are at risk for knee injury. Below is an example of poor landing mechanics that is stressing the joints.

  1. Upper Quadrant Y Balance Test (UQYBT)

Screen for: Shoulder Injury

Westrick et al, performed a study on the UQYBT as a measure for functional performance and risk of injury on a sample of college students average ages 18-19 in females and males. The study showed that it was a reliable measure to screen for potential injury in the shoulders measuring between the two shoulders as well as core stability.

Test: From a pushup position the athlete reaches with one arm to the side of the extended arm for medial, over top the stabilizing arm for a superior lateral direction, and under the stabilizing arm in a downward direction for inferior lateral. Each of these reaches should be marked as they will be the comparison between each arm as well as taking note of the quality of the reaches whether there is shaking of break of position.

  1. Anatomical Factors for the Ankle

Screen for: Risk of injury to the ankle and knee

In the Clinical Journal of Sports Medicine, Onate et al performed a systematic review on high school athletes for risk of injury and discovered that excessive foot pronation and supination have been found to be risk factors for injury. Pronation occurs when the arch of the foot caves inward, decreasing the normal arch, such ankles have been linked to stress to the shin. Supination occurs when the ankle is rolled out to the side with more weight bearing on the outside of the foot, many of these injuries are caused from overuse.

Test:  Standing barefoot, assess whether or not the ankle is turned outward to the outside of the foot for supination or in the inside arches are caving in for pronation. The more exaggerated the position of the ankle may indicate the likely risk of injury.

Should you see any indication for potential risk of injury for the tester, physical therapy is a way to address the dysfunctions and decrease the risk of injury through movement science, neuromotor control, as well as many manual therapy techniques. Here at Lilly Physical Therapy we address all issues of the musckuloskeletal system and take a whole body approach to look up and down the kinetic chain for dysfunction and reason for dysfunction to reduce risk of injury. Call us today! (425)-224-2476


  1. Plisky PJ, Gorman PP, Butler RJ, Kiesel KB, Underwood FB, Elkins B. The Reliability of an Instrument Device for Measuring Components of the Star Excursion Balance Test. North American Journal of Sports Physical Therapy. 2009 Volume:4 Issue:2 Pages:92-99.
  1. Meyer DM, Ford KR, Paterno MV, Nick TG, Hewett TE. The Effects of Generalized Joint Laxity on Risk of Anterior Cruciate Ligamet Injury in Young Female Athletes. The American Journal of Sports Medicine. 2008 Volume:36 Issue:6 Pages:1073-1080.
  1. Fitzgerald GK, Lephart SM, Hwang JH, Wainner MR. Hop Test as Predictors of Dynamic Knee Stability. The Journal of Orthopaedic and Sports Physical Therapy. 2001 Volume: 31. Issue: 10 Pages: 588-597.
  1. Westrick RB, Miller JM, Carow SD, Gerber JP. Exploration of the Y-Balance Test for Assessment of Upper Quadrant Closed Kinetic Chain Performance. International Journal of Sports Physical Therapy. 2012 Volume: 7, Issue 2. Pages: 139-147.
  1. Onate JA, Everhart JS, Best TM, Borchers JR, Chaudhari AMW. Physical Exam Risk Factors for Lower Extremity Injury in High School Athletes: A Systematic Review. Clinical Journal of Sports Medicine. 2016 Volume: 26 Issue: 6 Pages: 435-444.