One Leg Hop Test: Guide for Athletes & Active Folks

The single-leg hop test, a valuable tool in sports medicine, serves as a crucial performance indicator and rehabilitation benchmark for athletes recovering from injuries such as anterior cruciate ligament (ACL) tears. Clinicians and physical therapists frequently employ variations of the one leg hop test, like the single hop for distance and the triple hop for distance, to objectively measure lower extremity function and readiness to return to sport. Standardized protocols for the one leg hop test, often documented and refined by organizations such as the National Strength and Conditioning Association (NSCA), ensure reliable and comparable data across different individuals and testing environments. Furthermore, research conducted at institutions specializing in sports-related injuries, like the Hospital for Special Surgery (HSS), continually contributes to understanding the correlation between one leg hop test performance and long-term athletic outcomes.

The Single Leg Hop for Distance test is a pivotal assessment tool in the arsenal of rehabilitation professionals.

It serves as a practical measure of lower extremity function.

Specifically, it quantifies an individual's ability to generate power and control movement on a single leg.

This foundational understanding is crucial as we delve into its clinical applications.

Defining the Single Leg Hop for Distance

At its core, the Single Leg Hop for Distance test is a performance-based evaluation.

The patient is instructed to hop as far as possible on one leg.

Distance is then measured from the starting point to the point of landing.

This straightforward yet informative assessment provides valuable insight into the individual’s functional capacity.

The Role in Return to Sport (RTS) Assessment

The single leg hop test plays a vital role in determining an athlete’s readiness to return to sport following injury.

It acts as one piece of the larger puzzle for assessing functional symmetry.

It also assesses explosive power, and overall lower extremity control, all critical factors for safe and effective RTS.

A successful hop test demonstrates the athlete's capacity to withstand the demands of their sport.

This helps minimize the risk of re-injury.

Application in ACL Reconstruction (ACLR) Rehabilitation

One of the most common applications of the single leg hop test lies within ACLR rehabilitation protocols.

Following ACL reconstruction, patients often exhibit deficits in strength, power, and neuromuscular control.

The hop test helps identify and quantify these deficits.

This allows clinicians to tailor interventions to address specific weaknesses.

It also allows clinicians to monitor progress throughout the rehabilitation process.

The Imperative of Objective Measures

The single leg hop test offers an objective measure of functional performance.

This objectivity is paramount in guiding rehabilitation protocols.

Subjective reports of pain or perceived function can be unreliable.

However, quantifiable data from the hop test provides clinicians with a more accurate and reliable assessment of progress.

This ensures that return-to-sport decisions are based on evidence rather than solely on patient perception.

Target Audience: Rehabilitation Professionals

This discussion is primarily geared towards a specific audience of rehabilitation professionals.

This includes physical therapists/physiotherapists, athletic trainers/sports medicine physicians, and strength and conditioning coaches.

These are the professionals most likely to administer, interpret, and apply the results of the single leg hop test in their clinical practice.

Therefore, the following sections will provide a comprehensive overview of the test.

The discussion includes procedures, interpretation, and clinical application.

All of these points are from the perspective of these rehabilitation specialists.

Purpose and Clinical Relevance of the Single Leg Hop Test

The Single Leg Hop for Distance test is a pivotal assessment tool in the arsenal of rehabilitation professionals. It serves as a practical measure of lower extremity function. Specifically, it quantifies an individual's ability to generate power and control movement on a single leg. This foundational understanding is crucial as we delve into its clinical purpose and the populations who benefit most from its application.

Objectives of the Single Leg Hop Test

The single leg hop test serves multiple crucial objectives within the rehabilitative process. It's not just about how far someone can hop; it's about what that distance reveals regarding their functional capacity.

Evaluating Functional Symmetry

One of the primary goals of the single leg hop test is to evaluate functional symmetry between limbs. Ideally, both legs should perform similarly, indicating balanced strength, power, and control. Discrepancies between limbs, quantified by the Limb Symmetry Index (LSI), may indicate deficits that need to be addressed through targeted interventions. Significant asymmetries could point to incomplete rehabilitation or compensatory movement patterns.

Assessing Lower Extremity Power and Control

The hop test provides a dynamic assessment of lower extremity power. It requires a coordinated effort of multiple muscle groups to generate the necessary force for propulsion. Further, the ability to maintain balance and control upon landing is equally critical. A successful hop demonstrates not only power but also efficient neuromuscular control and proprioception.

Determining Readiness for Return to Sport Activities

Ultimately, the single leg hop test helps determine an individual's readiness to return to sport. It serves as an objective measure to gauge whether an athlete has regained sufficient function to safely participate in their chosen activity. In conjunction with other clinical assessments, the hop test provides valuable data to inform return-to-sport decisions. Premature return to sport, without adequate functional capacity, significantly increases the risk of re-injury.

Clinical Relevance Across Various Conditions

The single leg hop test finds broad application across various musculoskeletal conditions. Its versatility makes it a valuable tool for assessing function and guiding rehabilitation.

Knee Injuries

The hop test is frequently used in the management of knee injuries, particularly following ligamentous injuries such as ACL tears. It provides objective data to assess the success of rehabilitation protocols and to determine when an individual is ready to progress to more demanding activities. In addition to ACL injuries, the hop test can also be used to assess patients following meniscus repairs or other knee surgeries.

Ankle Sprains

While often associated with knee rehabilitation, the single leg hop test is also valuable in the management of ankle sprains. Chronic ankle instability can lead to impaired balance and proprioception, which can be effectively assessed using the hop test. Improvements in hop distance and landing stability indicate improved ankle function and reduced risk of recurrent sprains.

Post-Surgical Rehabilitation (e.g., ACLR)

Following ACL reconstruction, the single leg hop test is a cornerstone of the rehabilitation process. It helps track progress, identify deficits, and guide treatment decisions. Serial hop tests provide valuable feedback on the effectiveness of the rehabilitation program and help ensure that the individual meets objective criteria before returning to sport. The hop test is not simply a measure of distance; it's a comprehensive assessment of the coordinated neuromuscular control required for dynamic single-leg activities.

Step-by-Step Test Procedures and Protocols

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Proper administration of the Single Leg Hop for Distance test is critical to ensure reliable and valid results. This section provides a detailed guide on the execution of the test, standardized instructions, warm-up procedures, and required equipment. We will also briefly introduce related hop tests for context.

Single Leg Hop Test: Execution

The Single Leg Hop for Distance test requires the patient to hop as far as possible on a single leg. It is crucial to standardize the procedure to minimize variability and ensure accurate comparisons over time or between individuals.

1. Starting Position: The patient stands on the tested leg behind a designated starting line. They should be instructed to maintain balance and avoid any preliminary hopping or bouncing.

2. The Hop: The patient initiates the hop by flexing the knee and hip, swinging their arms forward for momentum, and then forcefully extending the leg to propel themselves forward. Emphasis should be placed on maximizing horizontal distance while maintaining a controlled landing.

3. Landing: The patient must land on the same leg used for the hop and maintain balance for at least two seconds without hopping or touching the other leg to the ground. Any loss of balance or use of the other leg constitutes a failed attempt.

4. Measurement: The distance is measured from the starting line to the heel of the landing foot. This measurement should be taken in centimeters or inches, depending on the preferred unit of measurement.

5. Trials: Typically, three trials are performed on each leg, with adequate rest between trials to prevent fatigue. The best of the three distances is recorded.

Standardized Patient Instructions

Consistent instructions are essential for test reliability. The patient should be informed about the purpose of the test and the expected movements.

Here are some standardized instructions:

• "You will be hopping as far as you can on one leg."

• "Try to use your arms to help you generate momentum."

• "When you land, try to stick the landing, holding your balance for two seconds."

• "If you lose your balance or hop again after landing, that trial will not count."

• "We will perform a few practice trials, and then we will record three official trials."

The Importance of Warm-Up

A proper warm-up is crucial to prepare the muscles and joints for the test and reduce the risk of injury. The warm-up should include both general and specific exercises.

1. General Warm-Up: 5-10 minutes of light aerobic activity such as jogging or cycling, to increase blood flow and muscle temperature.

2. Specific Warm-Up: Dynamic stretches and exercises that mimic the movements involved in the hop test, such as:

   • Leg swings (forward, backward, and sideways)
   • Calf raises
   • Squats
   • Mini-hops on both legs.

3. Practice Hops: Several practice hops on each leg, gradually increasing the distance.

Related Hop Tests

The Single Leg Hop for Distance is often used in conjunction with other hop tests to provide a more comprehensive assessment of lower extremity function.

Triple Hop for Distance

The patient performs three consecutive hops on the same leg, attempting to cover as much distance as possible. The total distance is measured from the starting line to the final landing point.

Crossover Hop for Distance

The patient hops forward while crossing over a marked line with each hop. This test challenges balance and coordination.

6-Meter Timed Hop Test

The patient hops on one leg as quickly as possible over a 6-meter distance. The time taken to complete the distance is recorded.

Required Equipment

Having the right equipment ensures accurate test administration and measurement.

• Measuring Tape/Meter Stick: To accurately measure the hop distance.

• Stopwatch: For the 6-Meter Timed Hop Test, ensuring precise timing.

• Tape/Cones/Markers: To designate the starting line, mark distances, and create a clear testing area.

Accurate Measurement and Limb Symmetry Index (LSI) Calculation

The Single Leg Hop for Distance test is a pivotal assessment tool in the arsenal of rehabilitation professionals. It serves as a practical measure of lower extremity function. Specifically, it quantifies an individual's ability to generate power and maintain control during a dynamic, single-leg activity. After performing the hop test, the data collected is meaningless until properly measured and compared. Accurate measurements and calculations are essential to extract meaningful insights.

This section outlines the procedures for precise hop distance measurement and the calculation of the Limb Symmetry Index (LSI), a crucial metric for determining functional symmetry and guiding return-to-sport decisions. Understanding these aspects is paramount for clinicians seeking to objectively assess patient progress and optimize rehabilitation strategies.

Measuring Hop Distance Accurately

Accurate measurement is the bedrock of reliable hop test data. Inconsistent or imprecise techniques can lead to erroneous conclusions about a patient's functional status. Therefore, it’s important to carefully adhere to a standardized protocol.

The starting point is clearly marking the toe-line from which the patient will initiate the hop. This line serves as the reference point for all subsequent measurements. Use a non-stretchable measuring tape, such as a fiberglass tape measure, or a laser distance measurer, to minimize measurement error.

After the hop, the measurement is taken from the toe-line to the heel of the landing foot. The point closest to the origin should be used. The patient should hold their landing position until the measurement is recorded. This prevents any further shifting which can impact the data.

Record the distance in centimeters or inches, depending on your clinic's standard practice. However, be consistent throughout all measurements for a given patient. Document the distance for each trial, as well as any observations about the quality of the hop (e.g., excessive trunk sway, loss of balance upon landing).

Calculating the Limb Symmetry Index (LSI)

The Limb Symmetry Index (LSI) is a ratio that compares the performance of the injured limb to the uninjured limb. It provides a quantifiable measure of functional symmetry, a key indicator of rehabilitation progress and readiness for return to sport.

LSI Formula

The LSI is calculated using the following formula:

LSI = (Involved Limb Distance / Uninvolved Limb Distance) x 100

For example, if a patient hops 150 cm on the involved limb and 170 cm on the uninvolved limb, the LSI would be: (150/170) x 100 = 88.2%.

Interpreting LSI Scores

The LSI score is typically expressed as a percentage. A score of 100% indicates perfect symmetry between the limbs, while a score less than 100% suggests a deficit in the involved limb.

Most sources consider an LSI of 90% or greater as a benchmark for return to sport. However, it's important to interpret LSI scores in conjunction with other clinical findings. This includes range of motion, strength, pain levels, and functional assessments. A high LSI score alone does not guarantee that a patient is ready for unrestricted activity.

Clinicians should also consider the patient's pre-injury functional level and the demands of their sport. Some athletes may require a higher level of symmetry than others, depending on the specific activities involved.

Furthermore, it’s important to recognize the LSI’s limitations. A high LSI can sometimes mask subtle deficits in neuromuscular control or movement quality. Therefore, a comprehensive assessment that includes both quantitative and qualitative measures is essential for making informed return-to-sport decisions.

Key Factors Influencing Hop Test Performance

The Single Leg Hop for Distance test is a pivotal assessment tool in the arsenal of rehabilitation professionals. It serves as a practical measure of lower extremity function. Specifically, it quantifies an individual's ability to generate power and maintain control during a dynamic, single-legged task. However, interpreting the results of this test requires a nuanced understanding of the various factors that can influence performance. Let's consider the technical aspects of hop technique, landing mechanics, neuromuscular control, and balance.

Hop Technique and Form

The manner in which an individual executes the hop significantly affects the distance achieved. Optimal technique involves a coordinated sequence of movements that maximize propulsive force while minimizing energy expenditure. Deviations from this ideal can lead to reduced hop distance and potentially mask underlying deficits.

Consider these crucial elements of hop technique:

• Takeoff Angle: A slightly forward lean with an appropriate knee angle at takeoff will optimize the trajectory of the hop.
• Arm Swing: The coordinated use of arm swing generates momentum, contributing to the overall distance covered. Restricted or asymmetrical arm movements often impair hop performance.
• Leg Drive: Effective hip extension and knee extension are essential for generating the necessary power during the hop.

Landing Mechanics

Equally important is how the individual lands after the hop. The landing phase is a critical transition that highlights the body's ability to absorb impact and maintain stability. Deficiencies in landing mechanics not only reduce hop distance, but also increase the risk of re-injury.

Visual Assessment of Landing Stability and Control

Visual assessment of landing should focus on:

• Knee Valgus: Observe for excessive inward movement of the knee, indicative of poor hip and knee control.
• Trunk Stability: Look for excessive trunk sway or rotation, which can compromise balance and increase stress on the lower extremity.
• Ground Contact Time: A prolonged ground contact time suggests impaired power absorption and diminished eccentric control.

The Importance of a Controlled and Balanced Landing

A controlled and balanced landing is paramount. The patient should demonstrate the ability to maintain a stable single-leg stance upon landing, with minimal postural sway. They should also land softly without excessive knee flexion or hip adduction.

Neuromuscular Control and Proprioception

Neuromuscular control refers to the coordinated activation of muscles to produce controlled movements. Effective neuromuscular control depends on adequate proprioception, the body's ability to sense its position and movement in space. Impaired proprioception compromises stability.

After injury, neuromuscular control and proprioception are often diminished. This can manifest as:

• Delayed Muscle Activation: Muscles may not activate quickly enough to stabilize the joint upon landing.
• Poor Coordination: The timing and sequencing of muscle activation may be disrupted, leading to inefficient movement patterns.

Balance and Stability

Balance, or the ability to maintain equilibrium, is fundamental to the single leg hop. Both static and dynamic balance are crucial. Deficits in either of these aspects can significantly limit hop performance.

Specifically, consider the following aspects of balance:

• Static Balance: Assessed through measures such as the single leg stance test.
• Dynamic Balance: Evident in the ability to maintain stability during the hop and upon landing.
• Contribution to Hop Distance: A compromised balance increases the energy expended on stabilization, which decreases the power available for propulsion.

Understanding Validity, Reliability, and Normative Data

The Single Leg Hop for Distance test is a pivotal assessment tool in the arsenal of rehabilitation professionals. It serves as a practical measure of lower extremity function. Specifically, it quantifies an individual's ability to generate power and maintain control during a dynamic, single-legged task. However, the true value of this test lies not just in its execution, but in the rigorous understanding of its validity, reliability, and how these factors shape the interpretation of the obtained data.

Validity and Reliability of the Single Leg Hop Test

Validity refers to the degree to which the test measures what it is intended to measure. In the context of the single leg hop test, this means how accurately it reflects lower extremity function, strength, and power. Reliability, on the other hand, assesses the consistency and reproducibility of the test results. A reliable test will yield similar results when performed repeatedly by the same individual under similar conditions.

The single leg hop test has demonstrated acceptable to good validity in assessing functional performance, particularly in individuals recovering from lower extremity injuries. Its ability to differentiate between injured and uninjured limbs, as well as its correlation with other measures of strength and function, support its validity.

In terms of reliability, studies have reported moderate to high intra-rater and inter-rater reliability for the single leg hop test. This implies that the test results are generally consistent when administered by the same tester or by different testers, respectively. However, it's crucial to acknowledge the factors that can compromise these measures.

Factors Affecting Reliability and Validity

Several factors can significantly influence the reliability and validity of the single leg hop test, and rehabilitation specialists must be aware of them:

• Standardization of Protocol: Inconsistent instructions, variations in warm-up procedures, or differences in measurement techniques can introduce error and reduce reliability. Standardizing these elements is paramount.
• Patient Motivation and Effort: The test requires maximal effort. Suboptimal motivation or fear of re-injury can lead to underperformance, impacting the validity of the results.
• Pain and Swelling: The presence of pain or swelling in the affected limb can inhibit performance and affect both the reliability and validity of the test.
• Experience of the Tester: An experienced clinician is more likely to administer the test correctly, minimizing measurement error and enhancing reliability.
• Environmental Factors: The surface on which the test is performed, and distractions in the environment, can also affect the patient's performance.
• Equipment Calibration: If the measuring tape is not calibrated this will affect the test.

Interpreting Hop Test Results in Light of Validity and Reliability

Interpreting hop test results requires a nuanced understanding of the test's psychometric properties. While a Limb Symmetry Index (LSI) of 90% or greater is often used as a benchmark for return to sport, this threshold should not be applied rigidly. It's imperative to consider the following:

• Confidence Intervals: Recognize that each test result is subject to measurement error. Reporting results with confidence intervals can provide a more realistic representation of the individual's performance.
• Individual Variability: Recognize that there is normative variation within individuals and groups of people.
• Comparison to Pre-Injury Baseline: Whenever possible, compare the patient's current performance to their pre-injury baseline. This provides a more individualized and meaningful assessment of progress.
• Multiple Assessments: Relying on a single hop test result can be misleading. Conducting multiple assessments over time and observing trends in performance can provide a more comprehensive picture of the patient's functional recovery.
• Holistic Assessment: The hop test is just one component of a comprehensive assessment. Integrate hop test results with other clinical findings, such as strength measurements, range of motion, and patient-reported outcomes, to inform clinical decision-making.
• Statistical Significance: Establish statistical significance between pre and post test results.

In conclusion, understanding the validity and reliability of the single leg hop test is crucial for accurate interpretation and effective clinical decision-making. By acknowledging the factors that can influence these measures and considering the test results in the context of a holistic assessment, rehabilitation professionals can maximize the utility of the hop test in guiding patient care and return-to-sport decisions.

Clinical Interpretation and Practical Application

Understanding Validity, Reliability, and Normative Data The Single Leg Hop for Distance test is a pivotal assessment tool in the arsenal of rehabilitation professionals. It serves as a practical measure of lower extremity function. Specifically, it quantifies an individual's ability to generate power and maintain control during a dynamic, single-limb task. Now, let's transition into understanding how this data translates into actionable clinical decisions and how it fits into the broader picture of patient care and return-to-sport strategies.

Utilizing Hop Test Data to Inform Treatment Decisions

The data obtained from the Single Leg Hop for Distance test is more than just a number. It serves as a vital indicator that guides the progression of rehabilitation programs.

A significant deficit in hop distance, often reflected in a low Limb Symmetry Index (LSI), signals the need for targeted interventions. These interventions should primarily focus on improving strength, power, and neuromuscular control in the affected limb.

For instance, if a patient consistently demonstrates an LSI below the generally accepted threshold of 90%, the treatment plan may necessitate a greater emphasis on exercises that enhance quadriceps and hamstring strength, as well as plyometric drills to improve explosive power.

Conversely, improving hop distance and LSI scores over time provide tangible evidence of progress. This provides valuable feedback to both the clinician and the patient, boosting motivation and reinforcing adherence to the rehabilitation program.

Integrating Hop Test Results with Other Clinical Findings

The Single Leg Hop for Distance test should never be interpreted in isolation. It should be considered as part of a comprehensive clinical evaluation, alongside other objective measures and subjective reports.

Integrating hop test results with findings from range of motion assessments, strength testing, and patient-reported outcome measures (PROMs) provides a more holistic understanding of the patient's functional status.

For example, a patient may demonstrate a good LSI on the hop test but still report significant pain or instability during functional activities. This discrepancy may indicate underlying issues, such as poor landing mechanics or psychological readiness to return to sport.

In such cases, addressing these contributing factors through patient education, neuromuscular retraining, and psychological interventions may be necessary to optimize outcomes.

The clinician can then tailor the rehabilitation program to address any deficits identified through the comprehensive assessment.

Hop Tests as Part of a Comprehensive Assessment

The Single Leg Hop for Distance test is a powerful tool. However, it only provides one piece of the puzzle.

A comprehensive assessment should also include a thorough history, physical examination, and evaluation of other relevant factors. These may include psychological readiness and sport-specific demands.

The hop test's real value lies in its ability to quantify functional deficits and track progress over time. It allows clinicians to monitor the effectiveness of interventions and make informed decisions about when to progress patients to more advanced activities.

Regularly reassessing the patient's hop performance and comparing it to baseline values helps ensure that they are making adequate progress.

Application in Rehabilitation Programs and Return to Sport Protocols

The Single Leg Hop for Distance test plays a crucial role in guiding rehabilitation programs and informing return-to-sport decisions.

It helps determine when a patient is ready to transition from controlled exercises to more dynamic and sport-specific activities.

As the patient progresses through the rehabilitation program, the Single Leg Hop for Distance test can be used to assess their ability to tolerate increasing loads and demands.

Meeting pre-defined criteria on the hop test, in conjunction with other functional assessments, can provide confidence to both the patient and clinician. That means the patient is physically and functionally prepared to return to their desired level of activity.

Furthermore, hop testing serves as a valuable tool for identifying athletes who may be at risk of re-injury. By comparing their performance to normative data and established return-to-sport criteria, clinicians can identify individuals who may require additional rehabilitation or modification of their training program.

Advanced Considerations: Minimizing Error and Maximizing Utility

The Single Leg Hop for Distance test is a pivotal assessment tool in the arsenal of rehabilitation professionals. It serves as a practical measure of lower extremity function. Specifically, it quantifies an individual's ability to generate power, maintain balance, and exhibit controlled movement. However, the true value of this test lies not only in its administration but also in the nuanced interpretation of its results. This involves understanding the roles of different healthcare providers, addressing potential sources of error, and utilizing the data to guide rehabilitation strategies effectively.

Roles of Healthcare Professionals

The administration and interpretation of the single leg hop test often involve a collaborative effort from various healthcare professionals. Physical Therapists/Physiotherapists are typically at the forefront. They use the test to assess functional deficits and track progress throughout rehabilitation programs. Their expertise in movement analysis allows for detailed observation of hop technique and landing mechanics.

Athletic Trainers/Sports Medicine Physicians play a critical role in determining an athlete's readiness to return to sport. They use the hop test to compare an athlete's performance to normative data and to assess functional symmetry between limbs.

Strength and Conditioning Coaches utilize hop test data to design targeted training programs that address specific strength and power deficits. They also use the test to monitor an athlete's progress during training and to adjust training parameters as needed.

Effective communication and collaboration among these professionals are essential for ensuring a comprehensive and individualized approach to patient care.

Minimizing Error and Bias

Several factors can influence the accuracy and reliability of hop test results. Standardization of testing procedures is paramount. This includes using consistent instructions, warm-up protocols, and measurement techniques. Variations in these factors can introduce error and compromise the validity of the test.

Patient motivation and effort can also affect performance. It is essential to encourage patients to give their best effort while also monitoring for signs of fatigue or pain. Observer bias is another potential source of error. Clinicians should be aware of their own expectations and avoid unconsciously influencing the test results.

The patient's fear of re-injury can also affect performance.

Using video recording can provide an objective record of the test, allowing for more detailed analysis and reducing the potential for observer bias.

Utilizing Hop Tests for Progress Tracking and Intervention Modification

The single leg hop test is not simply a one-time assessment but rather a tool for continuous monitoring and adjustment of treatment strategies. Serial hop tests can be used to track a patient's progress over time and to identify plateaus or regressions in performance.

Declines in hop distance may indicate the need for a reassessment of the rehabilitation program. This could involve modifying exercises, increasing the intensity of training, or addressing underlying impairments.

Furthermore, the hop test can be used to guide the progression of rehabilitation exercises. For example, patients who demonstrate good performance on the single leg hop may be progressed to more challenging plyometric exercises.

Conversely, patients who struggle with the hop test may need to focus on improving strength, balance, and neuromuscular control before progressing to more advanced activities. The objective data provided by the hop test allows for more informed and data-driven clinical decision-making.

So, there you have it! The one leg hop test is a fantastic tool for gauging your leg strength and stability. Whether you're recovering from an injury or just trying to level up your athletic performance, give it a try. Remember to listen to your body and maybe grab a friend to spot you at first. Happy hopping!