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

To critically evaluate the effect of limb dominance on change of direction (COD) biomechanics associated with increased ACL injury-risk. 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. 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. 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 2, Systematic review •Athletes exhibit subtle side-to-side differences when performing cutting actions.•The limb displaying “high-risk” mechanics during cutting is inconsistent within and between studies and populations.•It is inconclusive whether the dominant or non-dominant limb is of heightened injury-risk during cutting.•Practitioners should screen cutting biomechanics in both limbs to identify aberrant mechanics.