The 90° Medial Rotation Hop Test assesses single-leg hop performance with a rotational landing demand. It is useful for assessing side-to-side control, landing quality, confidence and lower-limb power in a more sport-relevant direction than straight-line hopping alone. The result should be interpreted as part of a broader lower-limb test battery, not as a stand-alone clearance or diagnostic test.
A client may perform well on straight-line hop tests but still struggle to control turning, pivoting or rotational landings. The 90° Medial Rotation Hop Test adds a 90-degree medial rotation demand to a single-leg hop, requiring the client to produce force, rotate, land and stabilise on the same limb.
This test can be useful when straight-line hopping is no longer challenging enough or when rotational control is relevant to the client’s sport or training goals. Hop tests are commonly used in lower-limb assessment and return-to-sport batteries, but current evidence supports using them alongside strength, movement-quality, symptom and sport-specific information rather than in isolation.
Test name: 90° Medial Rotation Hop Test
Purpose: Assess single-leg rotational hop performance
What it assesses: Hop control, rotational landing ability, lower-limb power, balance, confidence and side-to-side comparison
Equipment: Flat non-slip surface, tape or floor marker, measuring tape or digital measurement option, Measurz for recording
Key finding: Successful controlled landing, distance if measured, quality notes and side-to-side comparison
Best used with: Anterior Hop, Medial Hop, Lateral Hop, Triple Hop, Crossover Hop, 6m Timed Hop, strength testing and balance testing
Key limitation: Exact-test normative data is limited, so baseline comparison and movement quality are important
The 90° Medial Rotation Hop Test is a single-leg hop assessment where the client hops from one leg, rotates approximately 90 degrees medially and lands on the same leg.
The test challenges the client’s ability to control the limb during take-off, rotation and landing. It is more demanding than a straight anterior hop because the landing includes rotational alignment, trunk control and foot placement requirements.
This test is used to assess single-leg control in a rotational task. It may be useful when the client needs to tolerate turning, pivoting, cutting, landing or direction-change demands.
It can help professionals observe whether the client can maintain alignment, stick the landing, avoid excessive corrective hops and perform the task confidently on both sides.
The test may reflect lower-limb power, rotational control, dynamic balance, trunk control, hip control, knee alignment, foot and ankle stability, confidence and landing strategy.
It does not directly measure isolated muscle strength, ligament healing, injury risk, sport readiness or the cause of pain.
This test may be useful for field sport athletes, court sport athletes, running athletes, pivoting sport clients, jump-sport athletes and gym clients progressing beyond straight-line hop testing.
It may not be suitable for clients who cannot safely perform a controlled single-leg landing, have pain with basic hopping, cannot complete straight-line hop tests or are not ready for rotational loading.
Flat non-slip surface
Tape or floor marker
Measuring tape or digital distance measurement option
Measurz for recording side, trial, distance, quality and symptoms
Optional video review
Optional metronome if rhythm is standardised
Mark a clear starting point and a 90-degree medial rotation landing direction. Ensure the surface is flat, dry and non-slip.
Ask the client to stand on the test leg at the start point. The opposite foot should be off the ground.
The client hops from the test leg, rotates approximately 90 degrees medially and lands on the same leg.
A valid landing requires control without extra hops, hand support, foot repositioning or loss of balance.
Allow practice trials so the client understands the movement and landing direction.
Perform the agreed number of trials per side with adequate rest between attempts.
Record whether the trial was valid, the distance if measured, landing quality, pain, symptoms and confidence.
Scoring may include pass/fail landing control, hop distance, number of valid trials, limb symmetry, rotation accuracy, pain response and landing-quality notes.
A better result includes a controlled 90-degree landing, stable trunk, controlled knee alignment, quiet foot contact and no additional corrective hop. A longer hop is not automatically better if landing quality is poor.
Limb Symmetry Index may be useful when distance is measured, but it should not override movement quality or symptoms. Recent work has highlighted the importance of adding movement-quality assessment to hop testing rather than relying only on distance or symmetry.
Exact normative data for this rotational hop variation is limited.
Practical interpretation should prioritise:
Side-to-side comparison
Baseline and retest change
Valid trial count
Landing quality
Rotation accuracy
Pain and confidence
Related straight-line hop performance
A 90% Limb Symmetry Index may be useful as one benchmark when distance is measured, but it should not be used as a stand-alone clearance rule. Evidence suggests hop-test symmetry can provide useful information after ACL injury, but certainty is low and outcomes are multifactorial.
Direct reliability evidence for this exact rotational hop variation is limited. Related hop tests, including single-forward and repeated-forward hop tests, are widely used in lower-limb assessment and ACL rehabilitation contexts. However, hop performance should be interpreted alongside movement quality, strength, symptoms and sport demands.
Reliability is likely improved when the same surface, footwear, arm-use instructions, landing criteria, number of trials and scoring method are repeated.
Common errors include under-rotating, over-rotating, landing with knee collapse, taking extra hops, using the arms inconsistently, failing to standardise footwear, recording distance without movement quality and progressing to rotation before straight-line hop control is adequate.
The main limitation is that exact-test norms are limited, so the result is best used for side comparison, progress tracking and qualitative movement assessment.
Use this test to assess rotational hop control, compare sides and monitor progress from straight-line hopping toward more sport-specific landing tasks.
It is most useful when paired with anterior hop, medial hop, lateral hop, triple hop, crossover hop, strength testing, balance testing and symptom monitoring.
Record side tested, trial number, valid or invalid attempt, distance if measured, rotation direction, landing control, pain score, symptom location, confidence, footwear, surface, arm-use instruction and retest date.
Useful notes include extra hop, unstable landing, knee valgus, trunk lean, reduced rotation, over-rotation, foot repositioning, apprehension or pain-limited effort.
Anterior Hop Test
Medial Hop Test
Lateral Hop Test
Triple Hop Test
Crossover Hop Test
6m Timed Hop Test
Side Hop Test
Single-Leg Balance Test
Y-Balance Test
Lower-Limb Strength Testing
It measures single-leg hop performance with a rotational landing demand.
No. It adds a 90-degree medial rotation, which changes the control and landing demands.
Yes. Side-to-side comparison is one of the most useful parts of the test.
No. Landing control, symptoms and confidence should also be recorded.
No. It can support decision-making as part of a broader assessment battery, but it should not be used alone.
The 90° Medial Rotation Hop Test adds a rotational demand to single-leg hop testing.
Exact-test norms are limited, so baseline and side comparison matter.
Landing quality is essential.
Distance should not override symptoms or control.
Record side, validity, distance, pain and movement quality in Measurz.
Welling, W., Benjaminse, A., Lemmink, K., Dingenen, B., & Gokeler, A. (2024). Evaluation of hop test movement quality to enhance return to sport testing after ACL reconstruction. Frontiers in Sports and Active Living.
West, T. J., Bruder, A. M., Crossley, K. M., & Culvenor, A. G. (2023). Unilateral tests of lower-limb function as prognostic indicators of future knee-related outcomes following anterior cruciate ligament injury: A systematic review and meta-analysis. British Journal of Sports Medicine, 57(13), 855–864.
Girdwood, M. A., Crossley, K. M., Rio, E. K., Patterson, B. E., Haberfield, M. J., Couch, J. L., Mentiplay, B. F., Hedger, M., & Culvenor, A. G. (2024). Hop to it! A systematic review and longitudinal meta-analysis of hop performance after anterior cruciate ligament reconstruction. Sports Medicine. Advance online publication.
