The effect of limb dominance on change of direction biomechanics: A systematic review of its importance for injury risk

Abstract

Objective: To critically evaluate the effect of limb dominance on change of direction (COD) biomechanics associated with increased ACL injury-risk.

Methods: A systematic review of the literature was conducted using Medline and Sport DISCUS databases. Studies that compared COD biomechanics (lower-limb/whole-body kinetics/kinematics) between limbs, contained an approach run, and included physically active participants were included.

Results: Of the 456 articles identified, six were included. All studies investigated a cutting action, while the majority defined limb dominance as the preferred kicking limb, whereas one study defined limb dominance as preferred push-off cutting limb. Conflicting observations were found, with one study indicating the non-dominant and one study indicating the dominant limb displayed biomechanical deficits associated with increased non-contact ACL injury-risk during COD. Conversely, the remaining studies demonstrated no significant or substantial differences in COD biomechanics between limbs.

Conclusions: Female soccer players, male rugby players, and female handball players exhibit subtle side-to-side differences when performing cutting manoeuvres. However, the limb displaying high-risk mechanics is inconsistent within and between studies and populations. Thus, it remains inconclusive for COD that limb dominance is an ACL injury-risk factor and whether a particular limb is of heightened injury-risk.

Level of evidence: Level 2, Systematic review.

Keywords: Anterior cruciate ligament; Asymmetries; Cutting; Limb preference.