March 2016

Test for lower extremity asymmetry identifies risk in recreational runners

In the moment: Running

By P.K. Daniel

Asymmetrical lower extremity neuromuscular control is predictive of repetitive stress injury in recreational runners, according to findings presented at the Combined Sections Meeting of the American Physical Therapy Association in February in Anaheim.

Researchers from Nova Southeastern University in Ft. Lauderdale, FL, assessed anthropometric variables, proximal and distal isometric lower extremity muscle performance, isometric core muscle endurance, lower extremity flexibility, and neuromuscular control in 72 recreational runners and followed them over an 18-week period before a graded marathon training program. During that time, the athletes experienced 33 repetitive stress injuries.

Between-limb asymmetry, based on composite Y Balance Test scores, was significantly greater in injured runners than in their uninjured counterparts, said Steven Jackson, PT, PhD, OCS, a faculty member for the University of Chicago Physical Therapy Orthopedic Residency Program, who presented the findings. An asymmetry of 3.6% or greater predicted 69.2% of the injuries.

Ankle dorsiflexion with the knee extended also differed significantly between the injured and uninjured runners, but the statistical analysis revealed that variable was not predictive of injury risk.


Jackson S, Cheng MS, Kolber M, Smith AR. An investigation of relationships between physical characteristics of recreational runners and lower extremity injuries. J Orthop Sports Phys Ther 2016;46(1):A41.

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