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Med Sci Sports Exerc. 2016 Jul;48(7):1379-87. doi: 10.1249/MSS.0000000000000897.

Musculoskeletal Asymmetry in Football Athletes: A Product of Limb Function over Time.

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1Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, AUSTRALIA; 2Fremantle Dockers Football Club, Perth, WA, AUSTRALIA; 3Centre for Exercise and Sport Science Research, Edith Cowan University, Perth, WA, AUSTRALIA; 4School of Health Science, University of Notre Dame, Perth, WA, AUSTRALIA; and 5School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, AUSTRALIA.



Asymmetrical loading patterns are commonplace in football sports. Our aim was to examine the influence of training age and limb function on lower-body musculoskeletal morphology.


Fifty-five elite football athletes were stratified into less experienced (≤3 yr; n = 27) and more experienced (>3 yr; n = 28) groups by training age. All athletes underwent whole-body dual-energy x-ray absorptiometry scans and lower-body peripheral quantitative computed tomography tibial scans on the kicking and support limbs.


Significant interactions between training age and limb function were evident across all skeletal parameters (F16, 91 = 0.182, P = 0.031, Wilks Λ = 0.969). Asymmetries between limbs were significantly larger in the more experienced players than the less experienced players for tibial mass (P ≤ 0.044, d ≥ 0.50), total cross-sectional area (P ≤ 0.039, d ≥ 0.53), and stress-strain indices (P ≤ 0.050, d ≥ 0.42). No significant asymmetry was evident for total volumetric density. More experienced players also exhibited greater lower-body tibial mass (P ≤ 0.001, d ≥ 1.22), volumetric density (P ≤ 0.009, d ≥ 0.79), cross-sectional area (P ≤ 0.387, d ≥ 0.21), stress-strain indices (P ≤ 0.012, d ≥ 0.69), fracture loads (P ≤ 0.018, d ≥ 0.57), and muscle mass and cross-sectional area (P ≤ 0.016, d ≥ 0.68) than less experienced players.


Asymmetries were evident in athletes as a product of limb function over time. Chronic exposure to routine high-impact gravitational loads afforded to the support limb preferentially improved bone mass and structure (cross-sectional area and cortex thickness) as potent contributors to bone strength relative to the high-magnitude muscular loads predominantly afforded to the kicking limb.

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