Please list your: 

1. First Name

2. Sport

Approximate number of years participating in your sport/activity? 

Current level of competition?

Do you have any past injuries or physical concerns that we should know about?

Below, please provide any other relevant information you would like us to know. Then proceed to the final 7 screen questions. 

1. SINGLE LEG HEEL RAISE

Can you perform 25 consecutive heel raises on one leg?

Instructions:

• Stand on one foot, keeping your balance with your other leg slightly lifted off the ground.
• Slowly rise onto the ball of your foot, lifting your heel as high as possible.
• Lower your heel back down in a controlled manner.

2. SINGLE LEG SQUAT

When completing 10 single leg squats on each side, does your knee wiggle a little or a lot, and are you able to keep your hips level? 

Instructions:

• Stand on one foot, with your other leg extended slightly in front of you.
• Slowly lower your body by bending your knee and pushing your hips back, keeping your chest upright.
• Go as low as you can comfortably while maintaining balance and control.
• Push through your heel to return to the starting position.

3. SINGLE LEG BALANCE WITH EYES CLOSED 

Can you balance on one leg for at least 30 seconds with your eyes closed?

Instructions:

• Stand on one foot, keeping your other leg slightly lifted off the ground.
• Find your balance with your eyes open first.
• Close your eyes and try to maintain your balance for 30 seconds.

4. CENTER PLANK WITH SLOW ALTERNATING SHOULDER TAPS (10 each side)

When performing shoulder taps, does your body tip or drop as you alternate?

Instructions: 

• Start in a plank position, with your body in a straight line from head to heels and your hands directly under your shoulders.
• Keep your core tight and avoid shifting your hips as you lift one hand to tap the opposite shoulder.
• Slowly alternate sides, tapping your shoulder with control.
• Complete 10 taps on each side, focusing on maintaining stability throughout the movement

5. SIDE PLANK

Can you hold a side plank for 90 seconds while keeping your spine and hips in a straight line?

Instructions:

• Lie on your side, with your elbow directly under your shoulder and your legs stacked on top of each other.
• Lift your hips off the ground, creating a straight line from your head to your feet.
• Keep your core engaged and your body stable, avoiding any sagging or rotation.

6. SINGLE LEG BRIDGE (30 seconds each side)

While holding the single leg bridge, where do you primarily feel the effort?

Instructions:

• Lie on your back with one knee bent and the other leg extended straight out.
• Press through your heel of the bent leg to lift your hips off the ground, creating a straight line from your shoulders to your knee.
• Keep your extended leg in line with your torso as you lift.
• Lower your hips back down with control and repeat for 30 seconds, then switch legs.

In number 6 (Single leg bridge), are you able to keep your hips level?

In number 6 (Single leg bridge), do you experience any cramping in your hamstrings?

7. 10 SLOW PUSH-UPS (on knees or toes)

Are your movements controlled both on the way up and down for all 10 push-ups?

Instructions: 

• Start in a push-up position with your hands slightly wider than shoulder-width apart. You can be on your toes or knees, depending on your level.
• Slowly lower your chest toward the ground, keeping your body in a straight line from head to knees/toes.
• Pause briefly at the bottom, maintaining control and tension in your core.
• Push back up slowly to the starting position, fully extending your arms.
• Repeat 10 times