Power Testing: 90deg Medial Rotation Hop Test

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.

Quick Summary

• 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

What Is the 90 Degree Medial Rotation Hop Test?

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.

Why It Is Used

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.

What It Measures

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.

Who It Is Useful For

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.

Equipment Required

• 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

Step-by-Step Protocol

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.

Scoring and Interpretation

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.

Normative Data, Benchmarks or Reference Values

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. ()

Reliability and Validity

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

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 and Testing Limitations

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

Practical Applications

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.

How to Record This in Measurz

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.”

Related Tests or Internal Linking Suggestions

• 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

FAQs

What does the 90 Degree Medial Rotation Hop Test measure?

It measures single-leg hop distance and rotational landing control.

Is it an ACL diagnostic test?

No. It can support functional assessment, but it does not diagnose ACL injury or confirm readiness.

Should both legs be tested?

Yes, when safe and relevant. Side-to-side comparison is a key part of interpretation.

What makes a trial invalid?

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.

Key Takeaways

• 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.

References

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