Lower limb asymmetry in mechanical muscle function: A comparison between ski racers with and without ACL reconstruction

Due to a high incidence of anterior cruciate ligament (ACL) re-injury in alpine ski racers, this study aims to assess functional asymmetry in the countermovement jump (CMJ), squat jump (SJ), and leg muscle mass in elite ski racers with and without anterior cruciate ligament reconstruction (ACL-R). Elite alpine skiers with ACL-R (n=9; 26.2 +/- 11.8 months post-op) and uninjured skiers (n=9) participated in neuromuscular screening. Vertical ground reaction force during the CMJ and SJ was assessed using dual force plate methodology to obtain phase-specific bilateral asymmetry indices (AIs) for kinetic impulse (CMJ and SJ phase-specific kinetic impulse AI). Dual x-ray absorptiometry scanning was used to assess asymmetry in lower body muscle mass. Compared with controls, ACL-R skiers had increased AI in muscle mass (P<0.001), kinetic impulse AI in the CMJ concentric phase (P<0.05), and the final phase of the SJ (P<0.05). Positive associations were observed between muscle mass and AI in the CMJ concentric phase (r=0.57, P<0.01) as well as in the late SJ phase (r=0.66, P<0.01). Future research is required to assess the role of the CMJ and SJ phase-specific kinetic impulse AI as a part of a multifaceted approach for improving outcome following ACL-R in elite ski racers.