A client may hop forward well but lose control when they need to rotate and land.
In sport, this matters because many cutting, pivoting and landing tasks require the lower limb to absorb force while the body rotates.
The 90 Degree Medial Rotation Hop Test provides a structured way to assess single-leg hop capacity in a rotational direction.
Test name: 90 Degree Medial Rotation Hop Test
Purpose: Assess single-leg hop power and rotational landing control
What it assesses: Hop distance, medial rotation control, balance and landing stability
Equipment required: MAT, Hop MAT or marked measuring surface
Key finding: Hop distance and landing quality
Best used with: Anterior Hop, Medial Hop, Lateral Hop, Triple Hop, Crossover Hop, 6 m Timed Hop, strength and balance testing
Key limitation: It is not diagnostic and should not be used alone for return-to-sport decisions
The 90 Degree Medial Rotation Hop Test is a single-leg hop assessment.
The client stands on one leg, hops while rotating medially through approximately 90 degrees, then lands on the same foot.
The test challenges the client to produce force, rotate, land and hold balance.
It is more demanding than a straight-line hop because the client must control both distance and rotation.
The test is used to assess whether a client can control a rotational single-leg landing task.
This can be useful when monitoring clients who need to return to:
Cutting
Pivoting
Landing
Direction change
Field sport tasks
Court sport tasks
Rotational lower-limb loading
Forward hop tests are useful, but they may not show how well a client controls movement in rotational or multidirectional tasks.
The test measures:
Single-leg hop distance
Medial rotation control
Landing balance
Lower-limb power expression
Limb confidence
Ability to hold a rotated landing position
It does not directly measure:
Isolated strength
Ligament integrity
Diagnosis
Reactive agility
Full sport readiness
Injury risk by itself
A good result should include both distance and landing quality.
This test may be useful for:
Field sport athletes
Court sport athletes
Pivoting sport clients
ACL rehabilitation clients
Lower-limb injury rehabilitation clients
Clients returning to cutting, jumping or landing tasks
Active clients who need rotational single-leg control
It should only be used when the client is prepared for single-leg hopping and rotational landing.
MAT, Hop MAT or marked floor
Flat, non-slip surface
Tape measure if not using MAT markings
Measurz or MAT for recording
Optional video for landing review
Ask the client to complete a suitable warm-up.
This may include:
Dynamic mobility
Low-level hops
Progressive single-leg landing drills
Practice rotational hops
The client stands on one foot at the edge of the MAT, Hop MAT or marked surface.
The test leg should be slightly flexed, with the opposite foot off the ground.
Cue the client to hop and rotate medially through approximately 90 degrees.
The client lands on the same foot and holds the landing for 1–2 seconds.
Measure the distance from the start position to the landing heel or agreed foot landmark.
Repeat for multiple trials.
Test the opposite leg using the same protocol.
Record the best distance, average distance or limb symmetry consistently.
Record:
Side tested
Hop distance
Trial number
Best or average score
Rotation accuracy
Landing quality
Pain
Confidence
Balance loss
Compensation notes
Better performance usually includes:
Greater hop distance
Accurate 90 degree rotation
Controlled landing
Quiet foot contact
Stable hip, knee and trunk position
Ability to hold balance for 1–2 seconds
A lower score or poor landing may suggest reduced rotational control, power, confidence or tolerance.
It does not identify a specific diagnosis.
No high-quality universal normative values were found for this exact protocol across all populations.
The best available benchmark approach is to use:
Individual baseline
Side-to-side comparison
Limb symmetry index
Repeat testing over time
Sport-specific demands
Comparison with other hop tests
A commonly used performance benchmark in hop testing is 90% limb symmetry, but this should be interpreted cautiously. Limb symmetry alone can miss movement-quality issues, bilateral deficits or poor confidence.
In one study of forward, medial and rotational hop tests, only 46.9% of ACL-reconstructed participants passed the ≥90% limb symmetry cut-off on the 90 Degree Medial Rotation Hop Test, compared with higher pass rates on forward hop tests. This suggests rotational hop tests may reveal asymmetries that straight-line hop tests miss. ()
The strongest specific evidence for this test comes from Dingenen and colleagues.
They examined forward, medial and rotational single-leg hop tests, including the 90 Degree Medial Rotation Hop for Distance. The study reported excellent test-retest reliability, with ICC values across the hop tests ranging from 0.93 to 0.98. The standard error of measurement ranged from 2.6% to 4.1%, and the smallest detectable difference ranged from 7.2% to 11.3% of mean hop distance. ()
This supports the test as a repeatable performance measure when the protocol is standardised.
However, reliability depends on:
Clear instructions
Consistent start position
Consistent measurement landmark
Accurate 90 degree rotation
Same footwear and surface
Same scoring method
Adequate familiarisation
Consistent trial number
Sensitivity and specificity are not applicable for routine use.
This is a performance test, not a diagnostic test.
It can support functional assessment and progress tracking, but it does not diagnose ACL injury, lower-limb injury or return-to-sport readiness.
Common errors include:
Under-rotating
Over-rotating
Landing with the opposite foot down
Failing to hold balance
Measuring from inconsistent landmarks
Allowing uncontrolled trunk rotation
Ignoring pain or confidence
Testing before the client is ready for rotational hopping
Using distance only and ignoring landing quality
Key limitations include:
No universal norms are available
Landing quality is partly observational
Limb symmetry can hide bilateral deficits
It is not a stand-alone return-to-sport test
Results are influenced by confidence, fatigue, surface and footwear
Use this test to:
Monitor rotational hop control
Compare left and right limbs
Track progress over time
Support return-to-pivot progressions
Identify whether further strength, power, balance or landing control work is needed
Add rotational demand to a hop test battery
It is most useful when combined with other tests, not used in isolation.
In Measurz, record:
Side tested
Hop distance
Trial number
Best or average score
Limb symmetry index, if used
Pain score
Confidence rating
Landing quality
Rotation accuracy
Balance loss
Footwear and surface
Compensation notes
Related strength or hop results
Example note:
“90 Degree Medial Rotation Hop Test completed on Hop MAT. Three trials each side. Best right: 82 cm. Best left: 74 cm. Left landing showed mild trunk rotation and balance correction. No pain. Confidence lower on left.”
Anterior Hop Test
Medial Hop Test
Lateral Hop Test
Triple Hop Test
Crossover Hop Test
6 m Timed Hop Test
Single Leg Balance
Knee strength testing
Lower-limb power testing
It measures single-leg hop distance and rotational landing control.
No. It can support functional assessment, but it does not diagnose ACL injury or confirm readiness.
Yes, when safe and relevant. Side-to-side comparison is a key part of interpretation.
A trial may be invalid if the client loses balance, touches the opposite foot down, under-rotates, over-rotates, lands unsafely or cannot hold the landing.
The test assesses rotational single-leg hop control.
Record both distance and landing quality.
No universal norms are available for all populations.
The 90% limb symmetry benchmark can be useful, but should not be used alone.
Measurz should capture distance, side, landing quality, confidence and compensation notes.
Dingenen, B., Truijen, J., Bellemans, J., & Gokeler, A. (2019). Test-retest reliability and discriminative ability of forward, medial and rotational single-leg hop tests. The Knee, 26(5), 978–987. https://doi.org/10.1016/j.knee.2019.06.010
Gustavsson, A., Neeter, C., Thomeé, P., Silbernagel, K. G., Augustsson, J., Thomeé, R., & Karlsson, J. (2006). A test battery for evaluating hop performance in patients with an ACL injury and patients who have undergone ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy, 14(8), 778–788. https://doi.org/10.1007/s00167-006-0045-6
Mengis, N., Höher, J., Ellermann, A., Eberle, C., Hartner, C., Keller, M., Rippke, J.-N., Sprenger, N., Stein, T., Stoffels, T., Egloff, C., & Niederer, D. (2025). A guideline for validated return-to-sport testing in everyday clinical practice: A focused review on the validity, reliability, and feasibility of tests estimating the risk of reinjury after ACL reconstruction. Orthopaedic Journal of Sports Medicine, 13(5), 23259671251317208. https://doi.org/10.1177/23259671251317208
Van Melick, N., van Cingel, R. E. H., Brooijmans, F., Neeter, C., van Tienen, T., Hullegie, W., & Nijhuis-van der Sanden, M. W. G. (2016). Evidence-based clinical practice update: Practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus. British Journal of Sports Medicine, 50(24), 1506–1515. https://doi.org/10.1136/bjsports-2015-095898
Weber, M., Müller, M., Mathieu-Kälin, M., Caminada, S., Häberli, M., & Baur, H. (2024). Evaluation of hop test movement quality to enhance return to sport testing: A cross-sectional study. Frontiers in Sports and Active Living, 6, 1305817. https://doi.org/10.3389/fspor.2024.1305817
