From Rehabilitation to Sport Performance: A Criterion-Based, Functional Return to Sport Testing Algorithm—Part I Early to Mid-Stage Criteria

The determination of return to sport (RTS) following knee injury and surgical interventions is a complex, multifactorial process that remains controversial in sports medicine. However, current research and clinical practice patterns endorse a compilation of subjective outcome measures, physical examination, as well as physical performance and function to determine an athlete’s readiness for RTS, the specific tests, and the respective criteria areas of ongoing debate. Given the inconsistency of RTS tests and criteria, the less than satisfactory return to prior levels of competition, and increased risks of reinjury rates, a comprehensive and objective testing sequence is needed. The purpose of this chapter is to propose a comprehensive, criterion-based return to sport testing sequence for early to mid-stages of rehabilitation that synthesizes the current literature with practice-based evidence of industry-leading experts. The chapter is part one of a two-part chapter series that outlines early and mid-stage components of The Function Testing Algorithm (FTA) and provides “evidence-informed” recommendations and guidance to rehabilitation and sports medicine professionals. The rationale for considering each physical construct (i.e., range of motion, neuromuscular function, Postural Control, etc.) and the justifications for selecting each assessment are discussed. The criterion-based FTA will provide experienced clinicians with a theoretical and tangible framework for an effective and efficient research-based testing approach while providing more novice clinicians in this specialty area with a specific, comprehensive, and replicable test sequence to follow.