SHORT COMMUNICATION
Inter-Limb Asymmetry: Lessons Learnt
from 10 Years of Data Collection in Performance Sport
1
London Sport Institute, Faculty of Science and Technology, Middlesex University, London, UK.
2
Centre of Research, Education, Innovation, and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal.
Submission date: 2026-05-29
Acceptance date: 2026-06-18
Publication date: 2026-07-19
Journal of Human Kinetics 2026;103:5-14
KEYWORDS
TOPICS
ABSTRACT
For years, inter-limb asymmetry data have been reported in performance science and injury rehabilitation literature, together with routine monitoring in professional practice. Intuitively, many practitioners are almost ‘hard-wired’ to think that if a sizable inter-limb asymmetry presents itself, then something must be done to correct it. However, before any attempt is considered regarding trying to alter the magnitude of asymmetry, practitioners and researchers should first better comprehend the associated challenges and pitfalls of inter-limb asymmetry data. Once these are understood, a series of robust and pragmatic principles are proposed to enhance the utility of asymmetry data, which in turn, should help ensure that appropriate due-diligence is undertaken, serving to guide subsequent decision-making when considering this metric.
REFERENCES (34)
1.
Afonso, J., Renato, A., Eduardo, O., Turner, A., Warneke, K., & Bishop, C. (2026). Asymmetries and Injury Risk: When Titles Spin the Tale. Journal of Strength and Conditioning Research, 40(5), e530–e533. https://doi.org/10.1519/JSC.00....
2.
Afonso, J., Virgile, A., Pena, J., Jordan, M., Garcia-de-Alcaraz, A., Sa, M., & Bishop, C. (2025). On uneven ground: embracing the challenges of inter-limb asymmetries and their assessment. Asymmetry, 1, 1–19. https://doi.org/10.55092/asymm....
3.
Banyard, H., Nosaka, K., & Haff G. (2017). Reliability and Validity of the Load-Velocity Relationship to Predict the 1RM Back Squat. Journal of Strength and Conditioning Research, 31, 1897–1904. https://doi.org/10.1519/JSC.00....
4.
Barber, S., Noyes, F., Mangine, R., McColskey, J., & Hartman, W. (1990). Quantitative assessment of functional limitations in normal and anterior cruciate ligament-deficient knees. Clinical Orthopaedics and Related Research, 255, 204–214.
5.
Becerra-Patino, B., Paucar-Uribe, J., Olivares-Arancibia, J., Ojeda-Aravena, A., Yanez-Sepulveda, R., Gamonales, J., Lopez-Gil, J., & Hernandez-Beltran, V. (2025). Mapping the Knowledge of Research Trends in Sports Performance Asymmetries from 2015 to 2024: A Bibliometric Study and Analysis of the Most-Cited Papers. Sports, 13, 93–116. https://doi.org/10.3390/sports....
6.
Bishop, C. (2025). Using Ratio Data in Strength and Conditioning: Component Parts Hold the Key. Journal of Strength and Conditioning Research, 39, e176–e179. https:// doi.org/10.1519/JSC.0000000000005010.
7.
Bishop, C., Read, P., Bromley, T., Brazier, J., Jarvis, P., Chavda, S., & Turner, A. (2022b). The Association Between Interlimb Asymmetry and Athletic Performance Tasks: A Season-Long Study in Elite Academy Soccer Players. Journal of Strength and Conditioning Research, 36, 787–795. https://doi.org/10.1519/JSC.00....
8.
Bishop, C., Read, P., Chavda, S., & Turner, A. (2016). Asymmetries of the Lower Limb: The Calculation Conundrum in Strength Training and Conditioning. Strength and Conditioning Journal, 38, 27–32. https://doi.org/10.1519/SSC.00....
9.
Bishop, C., Read, P., Lake, J., Chavda, S., & Turner, A. (2018b). Interlimb Asymmetries: Understanding How to Calculate Differences From Bilateral and Unilateral Tests. Strength and Conditioning Journal, 40, 1–6. https:/doi.org/10.1519/SSC.0000000000000371.
10.
Bishop, C., Read, P., McCubbine, J., & Turner, A. (2021). Vertical and Horizontal Asymmetries Are Related to Slower Sprinting and Jump Performance in Elite Youth Female Soccer Players. Journal of Strength and Conditioning Research, 35, 56–63. https://doi.org/10.1519/JSC.00....
11.
Bishop, C., Shrier, I., & Jordan, M. (2023). Ratio Data: Understanding Pitfalls and Knowing When to Standardise. Symmetry, 15(2), 318–323. https://doi.org/10.3390/sym150....
12.
Bishop, C., Turner, A., & Read, P. (2018a). Effects of inter-limb asymmetries on physical and sports performance: A systematic review. Journal of Sports Sciences, 36, 1135–1144. https://doi.org/10.1080/026404....
13.
Bishop, C., Turner, A., Jordan, M., Harry, J., Loturco, I., Lake, J., & Comfort, P. (2022a). A Framework to Guide Practitioners for Selecting Metrics During the Countermovement and Drop Jump Tests. Strength and Conditioning Journal, 44, 95–103. https://doi.org/10.1519/SSC.00....
14.
Davey, K., Read, P., Coyne, J., Jarvis, P., Turner, A., Brazier, J., Sarabon, N., Jordan, M., & Bishop, C. An Assessment of the Hopping Strategy and Inter-Limb Asymmetry during the Triple Hop Test: A Test–Retest Pilot Study. Symmetry, 13, 1890–1901. https://doi.org/10.3390/sym131....
15.
Della Villa, F., Buckthorpe, M., Grassi, A., Nabiuzzi, A., Tosarelli, F., Zaffagnini, S., & Della Villa, S. (2020). Systematic video analysis of ACL injuries in professional male football (soccer): injury mechanisms, situational patterns and biomechanics study on 134 consecutive cases. British Journal of Sports Medicine, 54, 1423–1432. https:doi.org/ 10.1136/bjsports-2019-101247.
16.
Exell, T., Irwin G., Gittoes, M., & Kerwin, D. (2011). Implications of intra-limb variability on asymmetry analyses. Journal of Sports Sciences, 30, 403–409. https://doi.org/ 10.1080/02640414.2011.647047.
17.
Fox, K., Pearson, L., & Hicks, K. (2023). The effect of lower inter-limb asymmetries on athletic performance: A systematic review and meta-analysis. PLoS One, 18, e0286942. https:doi.org/10.1371/journal.pone.0286942.
18.
Gathercole, R., Sporer, B., Stellingwerff, T., & Sleivert, G. (2015). Alternative countermovement jump analysis to quantify acute neuromuscular fatigue. International Journal of Sports Physiology and Performance, 10, 84–92. https:doi.org/ 10.1123/ijspp.2013-0413.
19.
Helme, M., Tee, J., Emmonds, S., & Low, C. (2021). Does lower-limb asymmetry increase injury risk in sport? A systematic review. Physical Therapy in Sport, 49, 204–213. https://doi.org/10.1016/j.ptsp....
20.
King, E., Richter, C., Franklyn-Miller. A., Wadey, R., Moran, R., & Strike, S. (2019). Back to normal symmetry? biomechanical variables remain more asymmetrical than normal during jump and change-of-direction testing 9 months after anterior cruciate ligament reconstruction. American Journal of Sports Medicine, 47, 1175–1185. https://doi.org/ 10.1177/0363546519830656.
21.
Kotsifaki, A., Korakakis, V., Whiteley, R., Van Rossom, S., & Jonkers, I. (2020). Measuring only hop distance during single leg hop testing is insufficient to detect deficits in knee function after ACL reconstruction: a systematic review and meta-analysis. British Journal of Sports Medicine, 54, 139–153. https://doi.org/10.1136/bjspor....
22.
Kotsifaki, A., Sideris, V., King, E., Bahr, R., & Whiteley, R. (2023). Performance and symmetry measures during vertical jump testing at return to sport after ACL reconstruction. British Journal of Sports Medicine, 57(20), 1304–1310. https://doi.org/ 10.1136/bjsports-2022-106588.
23.
Kotsifaki, A., Whiteley, R., Van Rossom, S., Korakakis, V., Bahr, R., Sideris, V., Graham-Smith, P., & Jonkers, I. (2022). Single leg hop for distance symmetry masks lower limb biomechanics: time to discuss hop distance as decision criterion for return to sport after ACL reconstruction? British Journal of Sports Medicine, 56, 249–256. https://doi.org/ 10.1136/bjsports-2020-103677.
24.
Kyritsis, P., Bahr, R., Landreau, P., Miladi, R., & Witvrouw, E. (2016). Likelihood of ACL graft rupture: Not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture. British Journal of Sports Medicine, 50, 946–951.https://doi.org/10.1136/bjspor....
25.
Lauersen, J., Andersen, T., & Andersen, L. (2018). Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis. British Journal of Sports Medicine, 52, 1557–1563. https://doi.org/10.1136/bjspor....
26.
Lauersen, J., Bertelsen, D., & Andersen, L. (2014). The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 48, 871–877. https://doi.org/ 10.1136/bjsports-2013-092538.
27.
Loturco, I., Pereira, L. A., Kobal, R., Abad, C. C., Rosseti, M., Carpes, F. P., & Bishop, C. (2019). Do asymmetry scores influence speed and power performance in elite female soccer players?. Biology of Sport, 36, 209–216. https://doi.org/ 10.5114/biolsport.2019.85454.
28.
Maloney, S. (2019). The Relationship Between Asymmetry and Athletic Performance: A Critical Review. Journal of Strength and Conditioning Research, 33, 2579–2593. https://doi.org/10.1519/JSC.00....
29.
Montgomery, C., Blackburn, J., Withers, D., Tierney, G., Moran, C., & Simms, C. (2018). Mechanisms of ACL injury in professional rugby union: a systematic video analysis of 36 cases. British Journal of Sports Medicine, 52, 994–1001. https://doi.org/ 10.1136/bjsports-2016-096425.
30.
Noyes, F., Barber, S., & Mangine, R. (1991). Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture. American Journal of Sports Medicine, 19, 513–518.
31.
Parkinson, A., Apps, C., Morris, J., Barnett, C., & Lewis, M. (2021). The Calculation, Thresholds and Reporting of Inter-Limb Strength Asymmetry: A Systematic Review. Journal of Sports Science and Medicine, 20, 594–617. https://doi.org/ 10.52082/jssm.2021.594.
32.
Rohman, E., Steubs, J. T., & Tompkins, M. (2015). Changes in involved and uninvolved limb function during rehabilitation after anterior cruciate ligament reconstruction: Implications for limb symmetry index measures. American Journal of Sports Medicine, 43, 1391–1398. https://doi.org/10.1177/036354....
33.
Turner, A. (2024). What Is Evidence-Based Practice in Strength and Conditioning? Strength and Conditioning Journal, 46, 725–728. https://doi.org/10.1519/SSC.00....
34.
Wellsandt, E., Failla, M., & Snyder-Mackler, L. (2017). Limb Symmetry Indexes can Overestimate Knee Function after Anterior Cruciate Ligament Injury. Journal of Orthopaedic and Sports Physical Therapy, 47, 334–338. https://doi.org/ 10.2519/jospt.2017.7285.
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| eISSN: | 1899-7562 |
| ISSN: | 1640-5544 |
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