A footballer's peak isokinetic quadriceps torque is 200 Nm and his hamstring torque is 90 Nm at 60 degrees per second. What is the conventional hamstring to quadriceps ratio, and how is it interpreted?

0.45, below the usual 0.6 benchmark: relative hamstring weakness

1.0, the ideal ratio that every player needs

0.45, which lies within the normal athletic range

2.2, which is the normal ratio for a footballer

During a squash match, a man of 30 feels sudden calf pain, as if struck from behind, and now walks with a limp. He has a palpable gap and a positive Thompson test. What is the most appropriate next step?

Immobilise in plantar flexion and refer urgently

Apply deep friction massage over the gap

Encourage running to keep the tendon strong

Start eccentric heel drops straight away

A swimmer has pain with overhead movement and a painful arc between 60 and 120 degrees of abduction. Which initial treatment is most appropriate?

Scapular and rotator cuff strengthening with load modification

A corticosteroid injection as the only treatment

Immobilisation in a sling for 6 weeks, avoiding all shoulder movement

Heavy overhead lifting to strengthen the shoulder quickly

A patient with a suspected large rotator cuff tear cannot hold the arm at the side in 90 degrees of external rotation. Which test is positive?

The apprehension test, used for anterior instability

The Neer test, used for subacromial impingement

The sulcus sign, used for inferior laxity

In an ankle examination, a talar tilt (inversion stress) test mainly stresses which structure?

Deltoid ligament, which resists eversion

Posterior talofibular ligament, which is rarely torn

Anterior talofibular ligament, which the anterior drawer tests

Sports injuries and return to sport

50 Gulf Prometric Physiotherapist (DHA, DOH, MOH, SCFHS, QCHP) practice questions on Sports injuries and return to sport, part of Sports Physiotherapy. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Hard
A footballer's peak isokinetic quadriceps torque is 200 Nm and his hamstring torque is 90 Nm at 60 degrees per second. What is the conventional hamstring to quadriceps ratio, and how is it interpreted?
1. A1.0, the ideal ratio that every player needs
2. B0.45, which lies within the normal athletic range
3. C2.2, which is the normal ratio for a footballer
4. D0.45, below the usual 0.6 benchmark: relative hamstring weakness
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Answer: D · 0.45, below the usual 0.6 benchmark: relative hamstring weakness
The ratio is 90 / 200 = 0.45. A conventional ratio of about 0.6 at slow speeds is the commonly cited benchmark, and even the lowest values quoted as normal are about 0.5, so 0.45 shows relatively weak hamstrings, which may raise the risk of hamstring strain and ACL injury.
- A: The ratio here is not 1.0, and 1.0 is not a required target.
- B: 0.45 is below even the lowest commonly quoted normal value.
- C: 2.2 inverts the ratio.
Remember this
Hamstring to quadriceps ratio = hamstring torque / quadriceps torque; well below 0.6 suggests relative hamstring weakness.
Question 2 · Hard
During a squash match, a man of 30 feels sudden calf pain, as if struck from behind, and now walks with a limp. He has a palpable gap and a positive Thompson test. What is the most appropriate next step?
1. AApply deep friction massage over the gap
2. BEncourage running to keep the tendon strong
3. CImmobilise in plantar flexion and refer urgently
4. DStart eccentric heel drops straight away
Show answerHide answer
Answer: C · Immobilise in plantar flexion and refer urgently
These findings indicate a complete Achilles rupture. The foot is placed in equinus to approximate the ends and the patient is referred for specialist decision-making between surgical and functional non-operative care. Loading or massage can worsen the gap.
- A: Friction massage can increase damage.
- B: Running is contraindicated.
- D: Eccentric loading is for tendinopathy, not rupture.
Remember this
A palpable gap with a positive Thompson test means complete Achilles rupture: immobilise and refer.
Question 3 · Medium
A swimmer has pain with overhead movement and a painful arc between 60 and 120 degrees of abduction. Which initial treatment is most appropriate?
1. AA corticosteroid injection as the only treatment
2. BImmobilisation in a sling for 6 weeks, avoiding all shoulder movement
3. CScapular and rotator cuff strengthening with load modification
4. DHeavy overhead lifting to strengthen the shoulder quickly
Show answerHide answer
Answer: C · Scapular and rotator cuff strengthening with load modification
Subacromial pain syndrome responds to exercise that restores scapular control and cuff strength, combined with relative load reduction. Prolonged immobilisation causes stiffness, and heavy overhead lifting aggravates the problem.
- A: An injection alone does not address the cause.
- B: A sling for 6 weeks leads to stiffness.
- D: Heavy overhead lifting irritates the tissue.
Remember this
Subacromial pain responds to scapular and cuff strengthening with load modification.
Question 4 · Medium
A patient with a suspected large rotator cuff tear cannot hold the arm at the side in 90 degrees of external rotation. Which test is positive?
1. AThe apprehension test, used for anterior instability
2. BExternal rotation lag sign
3. CThe Neer test, used for subacromial impingement
4. DThe sulcus sign, used for inferior laxity
Show answerHide answer
Answer: B · External rotation lag sign
The external rotation lag sign is positive when the arm drifts back into internal rotation after being placed passively in full external rotation. It indicates a tear of the supraspinatus and infraspinatus. It is more specific than pain-based tests.
- A: The apprehension test is for anterior instability.
- C: Neer's test indicates impingement and does not test a lag.
- D: The sulcus sign tests inferior laxity.
Remember this
A positive external rotation lag sign suggests a large supraspinatus and infraspinatus tear.
Question 5 · Medium
In an ankle examination, a talar tilt (inversion stress) test mainly stresses which structure?
1. ACalcaneofibular ligament
2. BDeltoid ligament, which resists eversion
3. CPosterior talofibular ligament, which is rarely torn
4. DAnterior talofibular ligament, which the anterior drawer tests
Show answerHide answer
Answer: A · Calcaneofibular ligament
The talar tilt places the ankle in inversion with the foot near neutral, which stresses the calcaneofibular ligament. Excess tilt compared with the other side suggests a calcaneofibular tear, usually together with an anterior talofibular injury. The anterior drawer test examines the anterior talofibular ligament.
- B: The deltoid ligament is stressed by eversion.
- C: The posterior talofibular ligament is rarely injured.
- D: The anterior drawer test examines the anterior talofibular ligament.
Remember this
Talar tilt tests the calcaneofibular ligament; anterior drawer tests the anterior talofibular ligament.
Question 6 · Easy
Cozen's test, which reproduces pain with resisted wrist extension, is used to confirm which condition?
1. AMedial epicondylalgia (golfer's elbow)
2. BCubital tunnel syndrome
3. CLateral epicondylalgia (tennis elbow)
4. DOlecranon bursitis
Answer and explanation in LearnFree account
Question 7 · Hard
A runner has insertional Achilles tendinopathy at the calcaneus. How should an eccentric heel-drop programme be modified?
1. AAdd a stretch into full dorsiflexion after every set
2. BLower the heel as far as possible below the edge of a step
3. CReplace loading with three months of complete rest
4. DDo the drops on flat ground, without dorsiflexing past neutral
Answer and explanation in LearnFree account
Question 8 · Easy
Which of these muscles is torn most often in rotator cuff disease?
1. ATeres major
2. BSupraspinatus
3. CSubscapularis
4. DInfraspinatus
Answer and explanation in LearnFree account
Question 9 · Easy
Which mechanism is the most common cause of a non-contact ACL rupture?
1. ASudden deceleration with a pivot and the knee collapsing into valgus
2. BA direct blow to the front of the shin from a tackle
3. CRepetitive running on a flat and even surface
4. DSlow, controlled hyperextension while lying on a couch
Answer and explanation in LearnFree account
Question 10 · Medium
In a patient with shoulder pain, which test checks the supraspinatus by resisted abduction at 90 degrees in the scapular plane with the thumbs pointing down?
1. AThe lift-off test, used for the subscapularis
2. BEmpty can (Jobe) test
3. CThe belly press test, also used for the subscapularis
4. DSpeed's test, used for the long head of biceps
Answer and explanation in LearnFree account
Question 11 · Medium
Which description of second impact syndrome is correct?
1. ADelayed healing of a muscle tear after a second strain to the same hamstring muscle
2. BA re-tear of the ACL graft after surgery
3. CRapid brain swelling after a second blow before the first concussion has resolved
4. DAn adverse reaction to the anaesthetic given for surgery
Answer and explanation in LearnFree account
Question 12 · Medium
A climber has pain at the front of the shoulder when he resists forward flexion with the elbow straight and the forearm supinated. Which structure is most likely affected?
1. ASupraspinatus tendon
2. BSubscapularis tendon
3. CLong head of the biceps tendon
4. DAcromioclavicular joint
Answer and explanation in LearnFree account
Question 13 · Easy
Which exercise approach is a well-established first-line loading programme for mid-portion Achilles tendinopathy?
1. ACold packs applied several times a day and nothing else
2. BComplete rest from all activity for 12 weeks
3. CEccentric heel drops, 3 sets of 15, twice a day
4. DCalf stretching alone, held for 30 seconds at a time
Answer and explanation in LearnFree account
Question 14 · Medium
A runner has a tendon pain level of 3/10 during loading exercise that settles by the next morning. How should the therapist interpret this?
1. AIt is acceptable, and the load can be continued and progressed gradually
2. BThe exercise must stop for 6 weeks
3. CThe pain must reach 8/10 for the exercise to be effective
4. DIt means the tendon has ruptured and needs surgery
Answer and explanation in LearnFree account
Question 15 · Medium
A weekend runner has Achilles pain on starting a run that eases after warm-up. What is the best rationale for avoiding corticosteroid injection in or near the tendon?
1. AIt cures the condition permanently after a single dose
2. BIt stimulates the tendon to repair itself faster
3. CIt weakens collagen and increases the risk of rupture
4. DIt lowers the temperature of the tendon and calms it
Answer and explanation in LearnFree account
Question 16 · Easy
Which test is used to detect rotatory instability, with a subluxation and reduction clunk, in a knee with an ACL tear?
1. AApley compression test
2. BLachman test
3. CPivot-shift test
4. DValgus stress test
Answer and explanation in LearnFree account
Question 17 · Medium
Which sign after a head injury in a sports player is a red flag needing urgent transfer to the emergency department?
1. ASlight dizziness that resolved within a minute
2. BRepeated vomiting with worsening headache and increasing drowsiness
3. CTiredness after the match, with normal conversation
4. DA mild headache that is steadily improving
Answer and explanation in LearnFree account
Question 18 · Medium
Which exercise puts the highest strain on a healing ACL graft and is therefore limited in the early phase?
1. AStanding weight-shifting between the two legs
2. BA leg press with a small range of movement and light load
3. CMini squats performed within a limited range of knee flexion
4. DOpen-chain knee extension against resistance from about 45 to 0 degrees
Answer and explanation in LearnFree account
Question 19 · Medium
According to the tendon continuum model (Cook and Purdam), which stage responds best to load reduction and isometric exercise rather than aggressive loading?
1. AA normal tendon, which needs no specific treatment
2. BDegenerative tendinopathy, which needs progressive loading
3. CA complete tendon rupture, which needs specialist review
4. DReactive tendinopathy
Answer and explanation in LearnFree account
Question 20 · Hard
A tennis player has shoulder pain, and the drop-arm test is positive, with weak abduction and a positive external rotation lag sign. MRI shows a full-thickness supraspinatus and infraspinatus tear. He is 28 and active. What is the most appropriate management consideration?
1. AEarly referral for a surgical opinion, as such a tear is unlikely to heal with exercise alone
2. BReassurance and no treatment, as the tear will heal
3. CA cervical collar for 3 months to unload the shoulder
4. DStrength training with heavy overhead presses at once to rebuild the cuff quickly and completely
Answer and explanation in LearnFree account
Question 21 · Medium
A football team physiotherapist wants to screen hamstring injury risk. Which exercise has strong evidence for reducing hamstring injury rates when performed regularly?
1. AA static quadriceps stretch held before training
2. BA seated leg curl at light load on a machine
3. CNordic hamstring exercise
4. DHip abduction in side-lying with an ankle weight
Answer and explanation in LearnFree account
Question 22 · Easy
According to the Ottawa ankle rules, a radiograph of the ankle is requested for which finding?
1. ABone tenderness at the posterior edge or tip of the lateral malleolus
2. BPain on active dorsiflexion of the ankle alone
3. CSoft-tissue swelling over the ligament alone
4. DBruising over the heel alone with a normal gait
Answer and explanation in LearnFree account
Question 23 · Medium
After ACL reconstruction, which functional test is commonly used to assess readiness for return to sport?
1. ASingle-leg hop for distance with a limb symmetry index
2. BPassive knee flexion, measured by the goniometer
3. CThe Schober test, used to measure lumbar flexion
4. DThe straight leg raise, a basic test of hip flexion
Answer and explanation in LearnFree account
Question 24 · Easy
Which hamstring muscle is most commonly strained in sprinting athletes?
1. AGracilis, a medial thigh adductor muscle
2. BSemitendinosus, the superficial medial hamstring
3. CSemimembranosus, the deepest medial hamstring
4. DBiceps femoris, long head
Answer and explanation in LearnFree account
Question 25 · Easy
Which ligament is injured most often in a lateral ankle sprain?
1. AAnterior talofibular ligament
2. BBifurcate ligament
3. CPosterior talofibular ligament
4. DCalcaneofibular ligament
Answer and explanation in LearnFree account

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Sports injuries and return to sport

A footballer's peak isokinetic quadriceps torque is 200 Nm and his hamstring torque is 90 Nm at 60 degrees per second. What is the conventional hamstring to quadriceps ratio, and how is it interpreted?

During a squash match, a man of 30 feels sudden calf pain, as if struck from behind, and now walks with a limp. He has a palpable gap and a positive Thompson test. What is the most appropriate next step?

A swimmer has pain with overhead movement and a painful arc between 60 and 120 degrees of abduction. Which initial treatment is most appropriate?

A patient with a suspected large rotator cuff tear cannot hold the arm at the side in 90 degrees of external rotation. Which test is positive?

In an ankle examination, a talar tilt (inversion stress) test mainly stresses which structure?

Cozen's test, which reproduces pain with resisted wrist extension, is used to confirm which condition?

A runner has insertional Achilles tendinopathy at the calcaneus. How should an eccentric heel-drop programme be modified?

Which of these muscles is torn most often in rotator cuff disease?

Which mechanism is the most common cause of a non-contact ACL rupture?

In a patient with shoulder pain, which test checks the supraspinatus by resisted abduction at 90 degrees in the scapular plane with the thumbs pointing down?

Which description of second impact syndrome is correct?

A climber has pain at the front of the shoulder when he resists forward flexion with the elbow straight and the forearm supinated. Which structure is most likely affected?

Which exercise approach is a well-established first-line loading programme for mid-portion Achilles tendinopathy?

A runner has a tendon pain level of 3/10 during loading exercise that settles by the next morning. How should the therapist interpret this?

A weekend runner has Achilles pain on starting a run that eases after warm-up. What is the best rationale for avoiding corticosteroid injection in or near the tendon?

Which test is used to detect rotatory instability, with a subluxation and reduction clunk, in a knee with an ACL tear?

Which sign after a head injury in a sports player is a red flag needing urgent transfer to the emergency department?

Which exercise puts the highest strain on a healing ACL graft and is therefore limited in the early phase?

According to the tendon continuum model (Cook and Purdam), which stage responds best to load reduction and isometric exercise rather than aggressive loading?

A tennis player has shoulder pain, and the drop-arm test is positive, with weak abduction and a positive external rotation lag sign. MRI shows a full-thickness supraspinatus and infraspinatus tear. He is 28 and active. What is the most appropriate management consideration?

A football team physiotherapist wants to screen hamstring injury risk. Which exercise has strong evidence for reducing hamstring injury rates when performed regularly?

According to the Ottawa ankle rules, a radiograph of the ankle is requested for which finding?

After ACL reconstruction, which functional test is commonly used to assess readiness for return to sport?

Which hamstring muscle is most commonly strained in sprinting athletes?

Which ligament is injured most often in a lateral ankle sprain?