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I spy with my little eye … a knee about to go ‘pop’? Can coaches and sports medicine professionals predict who is at greater risk of ACL rupture?
  1. Anne Inger Mørtvedt1,
  2. Tron Krosshaug2,
  3. Roald Bahr2,
  4. Erich Petushek3,4
  1. 1 Department of Sports Medicine, Norwergian School of Sport Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
  2. 2 Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
  3. 3 College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
  4. 4 Department of Cognitive and Learning Sciences, Michigan Technological University, Houghton, Michigan, USA
  1. Correspondence to Dr Tron Krosshaug, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Center, 0863 Oslo, Norway; tron.krosshaug{at}


Background The vertical drop jump (VDJ) test is widely used for clinical assessment of ACL injury risk, but it is not clear whether such assessments are valid.

Aim To examine if sports medicine professionals and coaches are able to identify players at risk of sustaining an ACL injury by visually assessing player performance during a VDJ test.

Methods 102 video clips of elite female handball and football players performing a baseline VDJ test were randomly extracted from a 738-person prospective cohort study that tracked ACL injuries. Of the sample, 20 of 102 went on to suffer an ACL injury. These 102 videos were uploaded to an online survey. Sports medicine professionals and coaches were invited to assess athlete performance and rate each clip with a number between 1 and 10 (1 representing low risk of sustaining an ACL injury and 10 representing high risk). Receiver operating characteristic analyses were used to assess classification accuracy and between-group differences were analysed using one-way analysis of variance.

Results 237 assessors completed the survey. Area under the curve values ranged from 0.36 to 0.60, with a mean score of 0.47, which is similar to random guessing. There were no significant differences in classification accuracy between groups (physicians, coaches, certified athletic trainers, researchers or physical therapists).

Conclusion Assessors have poor predictive ability (no better than chance), indicating that visual assessment of a VDJ test is a poor test for assessing ACL injury risk in elite female handball and football players.

  • ACL
  • injury risk
  • visual assessment
  • VDJ test
  • female
  • elite
  • handball
  • football

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  • Contributors All the authors have contributed to the reporting of the work described in the article.

  • Funding The Oslo Sports Trauma Research Center has been established at the Norwegian School of Sport Sciences through generous grants from the Royal Norwegian Ministry of Culture, the South-Eastern Norway Regional Health Authority, the International Olympic Committee, the Norwegian Olympic Committee and Confederation of Sport, and Norsk Tipping AS.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Approved by the Regional Commitees For Medical And Health Research Ethics - 2010/3153.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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