Isokinetic Testing

It is absolutely amazing to me that people still make extensive of isokinetic testing both for injury screening, rehabilitation, and research. This was considered cutting edge in the 1970’s when we did not know any better. At best isokinetic testing serves as a random number generator. It tells us what an individual muscle or group of muscles is capable of in a very controlled (but very unnatural) sterile environment. In the late 70’s and early 80’s at various USOC camps, in track & Field, we did extensive isokinetic testing, because we felt we needed to assess strength. I remember puzzling over the results of my athletes test results. The numbers never made sense to me, sure there were right to left differences, but when I began to understand that the body is fundamentally asymmetrical that concern was alleviated. Then there was the infamous hamstring to quadriceps ratio. As the speed of testing went up to 300 degrees/sec the hamstring to quadriceps ratio became 1:1, what was that telling us? Well it was telling what we now know from biomechanical analysis about hamstring function and what the work of Lieber has told about muscle architecture. How about in rehab as an indicator that strength is sufficient to return to play? Totally bogus, I have seen athletes with great isokinetic scores limp out of the therapy office. They were not ready to play! In summary an isolated single joint, single plane test done at speeds no where near performance speeds, in a proprioceptively unchallenging environment tells us virtually nothing about the ability to perform beyond that isolated test.