Gait asymmetry in spatiotemporal and kinetic variables does not increase running-related injury risk in lower limbs: a secondary analysis of a randomised trial including 800+ recreational runners.

Objective: To investigate asymmetry in spatiotemporal and kinetic variables in 800+ recreational runners, identify determinants of asymmetry, investigate if asymmetry is related to greater running injury risk and compare spatiotemporal and kinetic variables between the involved and uninvolved limb at baseline in runners having sustained an injury during follow-up.

Methods: 836 healthy recreational runners (38.6% women) were tested on an instrumented treadmill at their preferred running speed at baseline and followed up for 6 months. From ground reaction force recordings, spatiotemporal and kinetic variables were derived for each lower limb. The Symmetry Index was computed for each variable. Correlations and multiple regression analyses were performed to identify potential determinants of asymmetry. Cox regression analyses investigated the association between asymmetry and injury risk. Analysis of variance for repeated measures was used to compare the involved and uninvolved limbs in runners who had sustained injuries during follow-up.

Results: 107 participants reported at least one running-related injury. Leg length discrepancy and fat mass were the most common determinants of asymmetry, but all correlation coefficients were negligible (0.01-0.13) and explained variance was very low (multivariable-adjusted R<0.01-0.03). Greater asymmetry for flight time and peak breaking force was associated with lower injury risk (HR (95% CI): 0.80 (0.64 to 0.99) and 0.96 (0.93 to 0.98), respectively). No between-limb differences were observed in runners having sustained an injury.

Conclusion: Gait asymmetry was not associated with higher injury risk for investigated spatiotemporal and kinetic variables.

Trial Registration Number: NCT03115437.