Is a professional soccer player’s dominant lower limb at higher risk of injury than their non-dominant lower limb? A systematic review

Abstract

Background: Understanding incidences of soccer injuries is important to improving injury prevention and rehabilitation.

Objective: To investigate whether a professional soccer player’s dominant lower limb (LL) is at higher risk of injury than their non-dominant LL.

Methods: A systematic search was conducted using PubMed, SportsDiscus, CINHAL, SCOPUS and OpenGrey (09/01/2018–22/02/2018). Search terms included Sport*, injur* risk factor*, lower limb, limb dominance (LD), dominan*, functional laterality, handedness, limb preference, kicking leg, football, professional*. Observational studies reporting association between LD and LL injury in adult, professional soccer were eligible. Risk of bias was assessed with the ROBINS-I tool, articles with serious/critical risk of bias were excluded. Methodological quality was assessed using the Joanna Briggs Institute Tool.

Results: 14 articles were eligible following risk of bias assessment (8 high quality, 6 low quality; 12 males, 2 females). Males: Results, based on seven high quality articles, found that quadriceps, knee joint/ligament, adductor and ankle injuries occurred more frequently on the dominant LL, whilst LD had no association with hamstring, calf and patella tendinopathy injuries. Females: one high quality study found anterior cruciate ligament injuries occurred more frequently on the non-dominant LL.

Conclusions: For males, kicking may be influential in quadriceps and adductor injury mechanisms and player-to-player contact influential in knee joint/ligament and ankle injury mechanisms. For females, anterior cruciate ligament injury may occur more frequently during unilateral non-dominant LL loading. Further investigation is needed into the impact of contact on dominant-side injuries in males and the influence of LD on injury in females.

Keywords:

• football
• epidemiology
• risk factor
• limb dominance

Acknowledgments

Thanks go to Professor Tim Watson and Dr Christian Worsfold for their guidance throughout this project.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Richard Thompson

Richard Thompson, MSc Advanced Physiotherapy, BSc Physiotherapy: Richard trained as a physiotherapist at St. George’s, University of London, UK, qualifying in 2008. He is a registered physiotherapist in the UK and Sweden. Richard completed his MSc in Advanced Physiotherapy at the University of Hertfordshire, UK, 2019. He has clinical experience within the NHS, sports physiotherapy and as a director of Uxbridge Physiotherapy at Brunel University’s Indoor Athletics Centre. Richard is also a researcher with the Athletics Research Centre, Linköping’s University, Sweden, which primarily conducts research within track and field athletics. Richard is the corresponding author for this paper: [email protected]. This research was conducted through the University of Hertfordshire.

Tim Watson

Professor Tim Watson, PhD BSc FCSP DipTP: Tim trained as a physiotherapist in London, UK, qualifying in 1979. After spending some years in the Health Service, with various sports clubs and National Teams, he began lecturing at West Middlesex Hospital, then Brunel University and now at the University of Hertfordshire. He undertook a degree in Biomedical Sciences followed by a PhD in Bioelectronics from the University of Surrey in 1994. He researches in several fields associated primarily with electro physical agents/electrotherapy and tissue repair and is currently Professor of Physiotherapy at the University of Hertfordshire and a freelance consultant. He has published over 50 journal papers, is editor of a core text on electrotherapy and has contributed numerous chapters in other edited texts and is on the Editorial Board of two physical therapy journals. He was awarded a Fellowship of the Chartered Society of Physiotherapy in the UK in 2013 and is on the Executive for the Electro Physical Agents and Diagnostic Ultrasound (EPADU) group in the UK and President of the International Society for Electro Physical Agents in Physical Therapy (ISEAPT) group of the WCPT.