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Article

Difference Asymmetry between Preferred Dominant and Non-Dominant Legs in Muscular Power and Balance among Sub-Elite Soccer Players in Qatar

by
Monoem Haddad
1,*,
Zied Abbes
1,*,
Nidhal Zarrouk
2,
Zlatan Aganovic
1,
Albraa Hulweh
1,
Imen Moussa-Chamari
1 and
David G. Behm
3
1
Physical Education Department, College of Education, Qatar University, Doha P.O. Box 2713, Qatar
2
Research Laboratory, Education, Motricité, Sport et Santé (EM2S), LR 19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3029, Tunisia
3
School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
*
Authors to whom correspondence should be addressed.
Symmetry 2023, 15(3), 625; https://doi.org/10.3390/sym15030625
Submission received: 6 October 2022 / Revised: 10 November 2022 / Accepted: 2 December 2022 / Published: 2 March 2023
(This article belongs to the Section Life Sciences)
Browse Figure
Versions Notes

Abstract

:
The objective of this study was to determine and compare leg asymmetry between preferred dominant and non-dominant legs in muscular power and balance among sub-elite soccer (football) players in Qatar. Thirty-two professional local soccer players from the Qatar Stars League (Second Division) participated in the study (23.1 ± 6.1 years). They were classified according to their preferred dominant leg (preferred leg to kick the ball). Twenty-two players had a right dominant leg, and the remaining ten had a left dominant leg. Countermovement jump (CMJ) was used to measure unilateral and bilateral vertical jump performances. The Y-balance test (YBT) was used to assess dynamic balance. No significant differences were found between the dominant and non-dominant leg for CMJ flight height (p > 0.05; asymmetry index (AI) = 1.83 ± 11.46) or the relative and absolute reach distance derived from the YBT (p > 0.05; AI (relative) = −0.45 ± 9.68, AI (absolute) = −0.60 ± 12.3). Bilateral asymmetry in dynamic balance was not significant for any of the anterior, posteromedial, or the posterolateral reaching directions (p > 0.05). The selected football players demonstrated an acceptable level of leg symmetry for power and dynamic balance. These findings may prove helpful for the assessment and evaluation of talents and should help to develop and optimize training regimes.
Keywords:
asymmetry; soccer; balance; jumps

1. Introduction

The sport of football (soccer) has evolved as a result of increased physical performance and technical competence in recent decades [1]. It is well known that soccer players are commonly exposed to injuries, with a substantial prevalence of muscle injuries [2,3,4]. Svensson, Eckerman [5] analyzed possible muscle injury differences with respect to type, localization, and the extent of injury between the dominant and non-dominant leg in male soccer players. They found that more severe structural hamstring injuries occurred in the dominant leg (preferred leg to kick the ball) than in the non-dominant leg. Furthermore, in a recent systematic review with meta-analysis, DeLang, Salamh [6] showed that soccer players are more likely to sustain injuries to the dominant limb, regardless of playing level or sex; this was mostly attributable to training kicking performance and frequency, as kicking comprises only a small part of in-game competition. Research showed that soccer players with untreated strength asymmetries are four to five times more likely to sustain a muscle injury that may affect performance (e.g., hamstrings strain) than players with no significant asymmetries [7]. In general, symmetry can be classified as one of three types, as outlined by Van Valen [8]. Directional asymmetry describes a characteristic that consistently develops toward a given side. Antisymmetry describes a characteristic that typically develops toward a certain side; however, the side on which it occurs is variable. Fluctuating asymmetry (FA) describes a characteristic that is expected to develop symmetrically but deviates from this path.
Manual asymmetry is task-specific, with variation of the asymmetry profile as a function of the distinct sensorimotor requirements of each task [9]. Hemispheric asymmetry is related to neuronal processes and is a fundamental feature of the human brain, driving symptom lateralization in Parkinson’s disease (PD), but its molecular determinants are unknown [10]. Functional asymmetry is a major characteristic of human brain organization and cognition. This phenomenon is also termed cerebral dominance, functional or brain lateralization, and hemispheric specialization [11].
Despite the substantial literature related to soccer, strength asymmetries and lateral dominance remain controversial. Many studies have demonstrated the significant strength and power superiority of the dominant limb compared to the non-dominant leg [12], whereas others have claimed the absence of any significant difference between the two legs in soccer [13]. Considering the positive relationship between CMJs and soccer [14,15,16] and that most soccer players are forced to use one particular leg for ball kicking and cutting skills [17], it is important to ascertain whether soccer players show a normal or exaggerated asymmetry between the legs.
The CMJ has been widely used to test and train soccer players [14,18]. However, because many jumps and most propulsive forces are generated in a unilateral fashion, unilateral jump assessments appear to have the advantage in terms of reproducing specific movement patterns [19]. Unilateral jumps can also be used to identify lower-limb asymmetries [19]. Some studies have shown a significant strength and power superiority of the dominant extremity compared to the non-dominant limb [20], whereas others have claimed the absence of any significant difference between the two legs in football [20].
Dynamic balance is the ability to stabilize the body and maintain a stable center of mass during dynamic actions. The latter is relevant for the successful performance of fundamental movement skills [21], many of which are important for success during a soccer game. According to Plisky [22], in a sample of basketball players, individuals with anterior left/right asymmetries greater than 4 cm on the Y-balance test (YBT) were 2.5 times more likely to sustain a lower-extremity injury. Paillard, Noé [23] also reported that an increased level of soccer competition was associated with increased dynamic balance. Furthermore, Stiffler, Sanfilippo [24], suggested that YBT values vary by team, with a difference between sexes observed for soccer. The aforementioned studies reported conflicting results with respect to a standard cutoff to define athletes at high risk of injury, although they agreed that YBT could be useful to identify athletes who are vulnerable to injuries [25].
Athletes recovering from prior leg injuries should generally seek less than a 15% difference between the injured and uninjured leg before fully returning to training and competition [26]. Therefore, the objective of this study was to determine and compare leg asymmetry between preferred dominant and non-dominant legs in muscular power and balance among sub-elite soccer players from Qatar.

2. Materials and Methods

2.1. Subjects

Thirty-two professional local soccer players (n = 32) from the Second Division of the Qatar Stars League participated in this study. Characteristics of the players are described in Table 1. Players were free of injury at the time of testing, and they were required to abstain from taking any stimulants or any other substances, including caffeine, for at least 6 h prior to testing, in addition to refraining from sports and hard exercise training for one day prior to testing. Prior to the study, all players were informed of the potential risks and benefits associated with participation, and they signed a written informed consent form, agreeing to the protocol procedures and the publication of the data. Data were collected during the COVID-19 restrictions, and players and officials were part of a strict medical bubble system designed to protect their health and wellbeing, including regular COVID-19 testing, safe transportation methods, and regular disinfection of the testing venue. The study was conducted according to the Declaration of Helsinki, and the protocol was fully approved by the University Institutional Review Board (QU-IRB 1017-EA/19). All players were fully accustomed to the procedures used in this research and were informed that they could withdraw from the study in any time without penalty.

2.2. Procedures

The experiments were conducted at the Soccer Club Clinic. Participants were classified into two groups according to their preferred dominant leg. Dominant limb was defined as the leg mainly used for kicking, shooting, and passing the ball [20]. Twenty-two players reported right leg dominance (PDR; n = 22) and the remaining players left leg dominance (PDL; n = 10). Each player performed two sessions on different days at a similar time (between 16:00 and 20:00 h) [27]. The first session was dedicated to anthropometric measurements and test familiarization, whereas the second session (main testing) was allocated for the study tests. During the main testing session, players performed/underwent the following:
  • Body mass index (BMI) was calculated using a body composition analyzer (ACCUNIC BC380). Body height was measured in meters (m). Body mass was measured in kilograms (kg). BMI was computed as weight in kilograms divided by the square of height in meters (kg/m2). Yang et al. [28] examined the validity and reproducibility of the impedance body fat measurement devices of three bioelectrical impedance analyzers (BIA). They found a higher correlation when employing the algorithm associated with the multifrequency BIA method in ACCUNIQ BC products.
  • The Y-balance test (YBT) was used to assess dynamic balance [29,30] and has shown good to excellent reliability with standardized equipment and methods [22,31]. The apparatus comprises a centralized platform connected to three cylindrical plastic bars (Figure 1). Each plastic bar is attached to a sliding measurement box to be pushed by the participant’s foot. The participants performed the Y-balance test during a station-based testing session using the Functional Movement Systems Y-Balance Test Kit [22]. In addition, each subject’s lower extremity limb length was measured in supine position with a cloth tape measure from the inferior aspect of the anterior superior iliac spine to the inferior aspect of the medial malleolus only on the right leg. Limb length measurement allowed for the normalization of the reach distance to control for inherent anthropometric differences between groups. To express reach distance as a percentage of limb length, the normalized value was calculated as reach distance divided by limb length and multiplied by 100 [22]. Detail please refer to Figure 1.
  • Countermovement Jump (CMJ) was measured across three trials on each leg, with 3 min rest between trials (starting with the left leg), followed by both legs together (best performance was included in the analysis in each case). Participants were instructed to place their hands on their hips when performing each trial. If the hands did not stay on the hips during the jumping procedure, the test was cancelled and repeated [32]. The jump height was measured using a photoelectric cell (Outjump, Microgate, BZ, Italy).

2.3. Statistical Analysis

Quantile–quantile plots and Shapiro–Wilk tests were used to verify normality of the data. All data were normally distributed. Means ± standard deviations (SDs) were used to describe variables. Independent Student’s t-test was used. Statistical analyses were performed using IBM SPSS software statistical package (SPSS Inc., Chicago, IL, USA, version. 28.0), and statistical significance was set at p < 0.05. Post hoc power analysis was conducted using the PS Power and Sample Size Calculations program, version 3.0 [33]. The asymmetry index (AI) was calculated to define the interlimb asymmetry between the preferred dominant (PDL) and non-dominant (ND) leg in the unilateral vertical jump (CMJ) and dynamic balance (YBT) using the following formula: (PDL − ND/PDL) × 100 Newton, Gerber [34]. The data for the PDL and ND groups relative to the baseline characteristics and balance control abilities obtained from the study tests were assessed using independent t-tests.

3. Results

No significant differences (Table 2) were found between the dominant and non-dominant leg for CMJ height or relative and absolute reach distances derived from the YBT.
Bilateral asymmetry in dynamic balance (Table 3) was not significant for any of the maximum reach directions.

4. Discussion

The results of this study indicate no significant differences between dominant and non-dominant legs (asymmetry) in terms of CMJ height or relative and absolute reach distance derived from the YBT in soccer players from the Second Division of the Qatar Stars League. As suggested by several studies, lower body bilateral asymmetries are suspected to increase the risk of injury and impact player performance [35,36]; therefore, the lack of asymmetry in soccer players in this study should be interpreted as beneficial in terms of injury prevention.
The asymmetry index (AI) value between both limbs was 2% within the 10% threshold suggested as normal muscle imbalances/asymmetries in CMJ [37]. Recently, Bishop, Brashill [38] confirmed that a 5% asymmetry between legs may affect jumping performance among soccer players. Similarly, Menzel, Chagas [39] reported a 7% difference between the right and left leg in vertical jump values in CMJs among Brazilian professional soccer players.
However, other studies have shown different results; a nearly 10% asymmetry in athletes in the vertical jump test had no effect on other physical performances [40]. Additionally, Hoffman, Ratamess [41] reported a 10% asymmetry between limbs assessed during a single-leg countermovement jump. Based on the aforementioned studies, the interlimb asymmetry was measured for various tasks with mixed and inconsistent results. Therefore, there is a need for further research in this area.
Soccer, as any other sport, is characterized by a high volume of repetition and movement patterns [42], including many asymmetrical movements [43]. Theoretically, these patterns can result in muscle imbalance and alter tissue stress, which could result in injury [42]. Dynamic balance performance has previously been associated with increased injury risk in multiple populations [44,45]. Moreover, athletes across sports with significant reach asymmetries on the YBT are more likely to sustain non-contact injuries [46]. The results of the current research show no significant differences in terms of relative reach distance AI between PDL and ND legs, similar to previous research studies showing no difference in the dynamic balance performance between the dominant and non-dominant legs [47,48,49]. However, the latter studies included only female athletes. In this regard, the literature is lacking information on asymmetry of male players. To the best of our knowledge, it remains unknown whether elite male football players display any extent of asymmetry. In other words, we do not know whether a certain degree of asymmetry is “the norm”, and whether it is associated with an extremely high level of performance. However, the lack of asymmetry in soccer players in this and other studies may emphasize the greater influence of the predominant bilateral activities of sprinting and running versus the periodic unilateral activity of kicking and passing. As sprinting, change of direction (agility), and even passing emphasize symmetrical contributions, the tendency to kick the ball with the dominant leg is counterbalanced by bilateral soccer activities.
Additionally, the amount of interlimb differences observed in this study seems to be lower than that observed in other studies [46,50]. According to Plisky [22], individuals with left/right asymmetry greater than 4 cm on the Y-balance test (YBT) were 2.5 times more likely to sustain a lower-extremity injury. These results suggest that interlimb comparison could be a useful and rapid screening tool for lower-extremity injury risk [22]. In our study, one-third (10 of 33) of the participants expressed anterior PD/ND asymmetries greater than 4 cm, which could increase the risk of injury. However, our study design did not allow for verification of this phenomenon in the long term. Further large-scale studies could investigate this further [22]. Further studies are needed to establish reference values for the same outcome measures in different age groups or sex to enhance the usefulness of these measures for the assessment and training prescription of soccer players.

5. Conclusions

In conclusion, our results show no significant difference between PD and ND limbs among sub-elite soccer players when assessed by vertical jumping and dynamic balance testing. Whereas the results for Qatari soccer players reported herein cannot be fully applied to all other soccer groups, this representative group of players demonstrates that the bilateral movements inherent to soccer (e.g., running, sprinting, agility, and passing) were sufficient to promote a symmetry in leg performance (i.e., jumping and balance). The above results can prove useful for coaches and trainers in developing training concepts, as they are based on tests that reflect the specific characteristics of individual playing categories assessed by vertical jumping and dynamic balance testing. These findings contribute to the international literature and the enrichment of data on the functional characteristics of football players.

Author Contributions

Conceptualization, M.H.; methodology, M.H. and Z.A. (Zied Abbes); software, M.H. and Z.A. (Zied Abbes); validation, M.H.; formal analysis, Z.A. (Zied Abbes); investigation, M.H., N.Z., Z.A. (Zlatan Aganovic), A.H. and Z.A. (Zied Abbes); writing—original draft preparation, M.H., D.G.B., and Z.A. (Zied Abbes); writing—review and editing, M.H., N.Z., Z.A. (Zlatan Aganovic), A.H., D.G.B., I.M.-C. and Z.A. (Zied Abbes); visualization, M.H., N.Z., Z.A. (Zied Abbes) and Z.A. (Zlatan Aganovic); supervision, M.H. and D.G.B.; project administration, M.H., Z.A. (Zied Abbes) and Z.A. (Zlatan Aganovic); funding acquisition, M.H. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by Qatar National Research Funds (QNRF UREP24-150-3-044), and Qatar University (QUST-1-CED-2023-869).

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the University Institutional Review Board (QU-IRB 1017-EA/19; date of approval: 16 January 2019).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Acknowledgments

The authors thank the coaches and soccer players who participated in this study, as well as students Mohammed Abdo Mohamed Alnasser and Mohammad Prince for their assistance and contribution in the Undergraduate Research Experience Program (UREP)-QNRF.

Conflicts of Interest

The authors declare no conflict of interest.

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Symmetry 15 00625 g001 550
Figure 1. Y-balance test apparatus.
Figure 1. Y-balance test apparatus.
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Table
Table 1. Descriptive characteristics of the football players. PDL = preferred dominant left leg; PDR = preferred dominant right leg.
Table 1. Descriptive characteristics of the football players. PDL = preferred dominant left leg; PDR = preferred dominant right leg.
Main OutcomesMeans ± SD
(Overall)
N = 32		Means ± SD
(PDL)
N = 10		Means ± SD
(PDR)
N = 22
Age (Years)23.10 ± 6.1025.70 ± 7.5921.91 ± 5.01
Body mass (kg)68.90 ± 10.8065.56 ± 9.1270.38 ± 11.30
Lean mass (kg)52.50 ± 7.2050.05 ± 5.7353.64 ± 7.610
Fat mass (%)56.60 ± 7.8053.98 ± 6.1457.85 ± 8.25
Body Height (cm)171.80 ± 8.40168.73 ± 7.61173.15 ± 8.58
BMI (kg/m2)23.20 ± 2.3022.95 ± 2.1223.37 ± 2.45
Table
Table 2. Descriptive characteristics of the asymmetry metrics between PDL (preferred dominant leg) and ND (non-dominant leg); AI: asymmetry index between the PDL and ND; CMJ: countermovement jump; YBT: Y-balance test; P = statistical power.
Table 2. Descriptive characteristics of the asymmetry metrics between PDL (preferred dominant leg) and ND (non-dominant leg); AI: asymmetry index between the PDL and ND; CMJ: countermovement jump; YBT: Y-balance test; P = statistical power.
Main outcomesPDLNDAI (%)P
CMJ—Jump Height (cm)17.9 ± 3.2517.6 ± 3.711.83 ± 11.460.861
YBT—Relative reach distance (%)99.5 ± 13.6099.3 ± 12.21−0.45 ± 9.680.806
YBT—Absolute reach distance (cm)94.3 ± 14.6294.1 ± 13.83−0.60 ± 12.300.806
Table
Table 3. Descriptive characteristics of Y-balance test outcomes between PDL (preferred dominant leg) and ND (non-dominant leg); P = statistical power.
Table 3. Descriptive characteristics of Y-balance test outcomes between PDL (preferred dominant leg) and ND (non-dominant leg); P = statistical power.
Y-Balance TestPDLNDP
Anterior100 ± 12.3100 ± 14.60.805
Posteromedial91.2 ± 17.989.9 ± 13.90.956
Posterolateral91.6 ± 18.292.4 ± 17.00.999
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Haddad, M.; Abbes, Z.; Zarrouk, N.; Aganovic, Z.; Hulweh, A.; Moussa-Chamari, I.; Behm, D.G. Difference Asymmetry between Preferred Dominant and Non-Dominant Legs in Muscular Power and Balance among Sub-Elite Soccer Players in Qatar. Symmetry 2023, 15, 625. https://doi.org/10.3390/sym15030625

AMA Style

Haddad M, Abbes Z, Zarrouk N, Aganovic Z, Hulweh A, Moussa-Chamari I, Behm DG. Difference Asymmetry between Preferred Dominant and Non-Dominant Legs in Muscular Power and Balance among Sub-Elite Soccer Players in Qatar. Symmetry. 2023; 15(3):625. https://doi.org/10.3390/sym15030625

Chicago/Turabian Style

Haddad, Monoem, Zied Abbes, Nidhal Zarrouk, Zlatan Aganovic, Albraa Hulweh, Imen Moussa-Chamari, and David G. Behm. 2023. "Difference Asymmetry between Preferred Dominant and Non-Dominant Legs in Muscular Power and Balance among Sub-Elite Soccer Players in Qatar" Symmetry 15, no. 3: 625. https://doi.org/10.3390/sym15030625

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