What is the Hop and Stop Test?

The Hop and Stop Test is a functional movement assessment commonly used in physical therapy and sports rehabilitation settings to evaluate lower extremity function. This test specifically assesses an athlete's ability to hop forward on one leg and then come to a complete, controlled stop, demonstrating both strength and stability. It is particularly valuable for athletes recovering from lower limb injuries such as ACL reconstruction, ankle sprains, or knee injuries.

The Hop and Stop Test provides valuable information about an individual's ability to perform functional movements on the affected limb, helping to guide rehabilitation efforts and optimize recovery from lower extremity injuries. Unlike simple strength tests, this functional assessment evaluates the integrated performance of muscles, ligaments, and the neuromuscular system during a sport-relevant movement.

Why Calculate Limb Symmetry Index?

The Limb Symmetry Index (LSI) provides an objective measure of how your injured limb compares to your healthy limb. Research shows that athletes who return to sport with LSI values below 90% have significantly higher rates of re-injury. According to research by Dr. Phil Plisky and others in sports rehabilitation, achieving >95% LSI on hop tests is associated with the lowest re-injury risk.

How to Perform the Hop and Stop Test

Equipment Required: Flat, non-slip surface; tape measure (10 meters); marking tape; stopwatch (optional for timed variations)

Pre-Test Preparation: Explain the test procedures to the subject. Perform screening of health risks and obtain informed consent. Prepare forms and record basic information such as age, height, body weight, gender, and test conditions. Complete an appropriate warm-up including at least 10 minutes of lower extremity stretching and light activity. See more details of pre-test procedures.

Test Procedure

  1. Starting Position: The athlete stands on one leg behind the starting line, with the other limb lifted off the ground and held in the air. Toes should not extend past the line.
  2. Execution: The athlete hops forward as far as possible, landing on the same leg. Arms may be used freely to assist with momentum and balance. No running start is permitted.
  3. Landing Requirement: After completing the hop, the athlete must come to a complete stop and maintain balance for at least 2 seconds. This "stick the landing" requirement is essential for valid results.
  4. Measurement: Record the distance from the starting line to the back of the heel on landing, measured to the nearest 0.5 cm.
  5. Repetitions: Allow 1-2 practice trials, then perform 2-3 measured trials on each limb. Use the average or best score for LSI calculation.

Scoring the Hop and Stop Test

The test is scored by recording hop distance and calculating the Limb Symmetry Index. The number of successful hops and stops, as well as any deviations from proper form or balance, are recorded. The test results are evaluated by a physical therapist or healthcare professional to assess the individual's lower limb function, strength, balance, and proprioception.

What constitutes an invalid trial?

  • Losing balance or failing to hold the landing for 2 seconds
  • Touching down with the non-test leg
  • Using an extra hop or stutter step to stabilize
  • Stepping backward after landing
  • Starting with toes over the line

Understanding Your Limb Symmetry Index (LSI)

The Limb Symmetry Index is calculated using the following formula:

LSI = (Involved Limb Distance ÷ Uninvolved Limb Distance) × 100

LSI Interpretation Guidelines

LSI Range Classification Return to Sport Status
≥95% Excellent Ready for full sport participation
90-94% Good May begin sport-specific training
85-89% Moderate Continue rehabilitation; limited activity
<85% Poor Not ready; focus on strength and function

⚠️ Important: LSI is just one component of return-to-sport testing. Research shows that meeting LSI criteria alone is insufficient—athletes should also meet quadriceps strength criteria and pass psychological readiness assessments before returning to sport. Consult with a sports medicine professional for comprehensive evaluation.

Normative Data for Athletes

Research provides reference values for single leg hop test distances in healthy athletes. These values help contextualize your results and set appropriate rehabilitation goals.

Single Leg Hop Distance by Sex and Competition Level

Population Single Hop Distance (cm) Standard Deviation
Collegiate Male Athletes 163-178 ±20-25
Collegiate Female Athletes 125-142 ±18-22
High School Male Athletes 145-165 ±22-28
High School Female Athletes 115-130 ±18-24
Recreational Adults (Male) 130-155 ±25-30
Recreational Adults (Female) 100-120 ±20-25

Data compiled from Myers et al. (2014), Plisky et al. (2021), and NORMATIVE DATA FOR HOP TESTS IN HIGH SCHOOL AND COLLEGIATE BASKETBALL AND SOCCER PLAYERS (2014).

Sport-Specific Applications

The Hop and Stop Test is particularly relevant for athletes in sports requiring single-leg power, landing control, and rapid deceleration.

Basketball and Volleyball

These sports involve frequent jumping, cutting, and landing on single limbs. Athletes should aim for LSI >95% before returning to full practice, as the demands of repeated jumping and pivoting place significant stress on the lower extremities.

Soccer and Football

Cutting, planting, and rapid direction changes are fundamental to these sports. The hop and stop test specifically mimics the deceleration patterns required during gameplay. Research shows basketball players tend to hop slightly farther than soccer players, likely due to sport-specific training adaptations.

Track and Field

Sprinters, jumpers, and throwers all require excellent single-leg power and stability. For these athletes, the hop test provides insight into push-off power and landing mechanics essential for performance.

Rehabilitation After ACL Reconstruction

The hop and stop test is one of four commonly used hop tests in ACL rehabilitation protocols. Research from the Delaware-Oslo ACL Cohort Study demonstrates that athletes achieving >90% LSI on a battery of hop tests have significantly lower re-injury rates. The hop and stop variation specifically assesses the neuromuscular control needed for safe return to sport.

Improving Your Hop and Stop Test Performance

Based on your test results, appropriate rehabilitation exercises and interventions can be prescribed to address any identified deficits and improve lower limb function and stability over time.

If Your LSI is Below 90%

  • Progressive strengthening: Focus on single-leg exercises including Bulgarian split squats, single-leg leg press, and step-ups
  • Plyometric training: Begin with low-intensity hops and progress to depth jumps as tolerated
  • Balance training: Single-leg stance progressions on stable and unstable surfaces
  • Neuromuscular control: Perturbation training and reactive agility drills

If Your Landing Quality is Poor

  • Landing mechanics drills: Practice soft, controlled landings from progressively higher drops
  • Knee control exercises: Focus on preventing valgus collapse during dynamic movements
  • Core stability: Trunk control exercises to maintain upright posture during landing

The Hop and Stop Test may be repeated periodically (every 4-6 weeks during rehabilitation) to track progress and adjust treatment plans as needed.

Test Variations

Several variations of the hop test battery are commonly used in clinical and research settings:

  • Single Hop for Distance: The basic hop and stop test described above
  • Triple Hop for Distance: Three consecutive hops, measuring total distance
  • Crossover Hop for Distance: Three hops while crossing over a center line, adding lateral component
  • 6-Meter Timed Hop: Hop 6 meters as fast as possible, recording time rather than distance
  • Hop for Maximum Height: Vertical component assessing explosive power

Using multiple hop tests as a battery provides a more comprehensive assessment than any single test alone. Research indicates that athletes should achieve >90% LSI on all four hop tests before return to sport.

Frequently Asked Questions

What is a good Limb Symmetry Index (LSI) score?

An LSI of 90% or higher is generally considered the minimum threshold for return to sport after injury. Research indicates healthy athletes typically achieve LSI values between 94-100%. For optimal safety and lowest re-injury risk, achieving >95% LSI is recommended before returning to full sport participation.

How accurate is the Hop and Stop Test?

Single leg hop tests have demonstrated excellent test-retest reliability with ICC values ranging from 0.92-0.97. The standard error of measurement is approximately 4.5-7.9 cm for single hop distance. For most reliable results, ensure consistent warm-up protocols and testing conditions across sessions.

When can I return to sport after ACL surgery?

Most return-to-sport guidelines recommend achieving >90% LSI on all four hop tests, in addition to meeting quadriceps strength criteria (>90% LSI), passing psychological readiness assessments, and receiving clearance from your surgeon. This typically occurs no earlier than 9 months post-surgery, with many experts recommending waiting until 12 months.

Why might my healthy leg score decrease during rehabilitation?

The uninvolved limb often experiences detraining during rehabilitation due to reduced activity levels. This can artificially inflate LSI values since the comparison limb has weakened. This is why some clinicians recommend comparing post-surgery values to pre-injury baseline data when available, rather than relying solely on the uninvolved limb.

Can I perform this test at home?

Yes, the hop and stop test requires minimal equipment (tape measure and flat surface) and can be performed at home. However, for clinical decision-making regarding return to sport, testing should be supervised by a qualified healthcare professional who can assess movement quality and provide comprehensive interpretation of results.

How often should I test my LSI during rehabilitation?

Testing every 4-6 weeks provides useful data for tracking progress without over-testing. More frequent testing may be affected by learning effects and daily variation. Ensure consistent conditions (time of day, warm-up protocol, rest intervals) between testing sessions for valid comparisons.

References

  1. Grindem, H., Snyder-Mackler, L., Moksnes, H., et al. (2016). Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. British Journal of Sports Medicine, 50(13):804-808.
  2. Myers, H., Christopherson, Z., Lynch, S., et al. (2014). Normative data for hop tests in high school and collegiate basketball and soccer players. International Journal of Sports Physical Therapy, 9(5):596-603.
  3. Logerstedt, D., Grindem, H., Lynch, A., et al. (2012). Single-legged hop tests as predictors of self-reported knee function after anterior cruciate ligament reconstruction. American Journal of Sports Medicine, 40(10):2348-2356.
  4. Noyes, F.R., Barber, S.D., & Mangine, R.E. (1991). Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture. American Journal of Sports Medicine, 19(5):513-518.
  5. Munro, A., & Herrington, L. (2011). Between-session reliability of four hop tests and the agility T-test. Journal of Strength and Conditioning Research, 25(5):1470-1477.
  6. Patterson, B.E., Crossley, K.M., Perraton, L.G., et al. (2020). Limb symmetry index on a functional test battery improves between one and five years after anterior cruciate ligament reconstruction. Physical Therapy in Sport, 44:67-74.
  7. Kyritsis, P., Bahr, R., Landreau, P., Miladi, R., & Witvrouw, E. (2016). Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture. British Journal of Sports Medicine, 50:946-951.

Similar Tests

  • One Leg Stand — the US sobriety test, stand with one foot off the ground for 30 seconds
  • 2-Hop Jump Test — perform two consecutive horizontal jumps off both feet
  • Stork Balance Test — stand on the toes of one leg for as long as possible

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