Background Limb dominance has often been associated with injury, but there is very little evidence for this in the literature for elite runners.

Objective To test for differences in strength, flexibility and function between dominant and non-dominant sides of elite orienteers, to determine a relationship with injury history, and establish a correlation between test results.

Design A standardized PPE of 45 tests customized to the specifics of middle distance runners was used to assess all variables.

Setting Edinburgh University, Fitness Assessment Sports Injury Clinic.

Participants All 17 National Level Orienteers participating in a High Performance program at Edinburgh University during 2011–12 were selected. All were well matched for age, training and competitive level.

Interventions Testing took place pre-season. Subjects were assessed by their regular physiotherapist for limb dominance and injury history. The main researcher was blinded to this information and undertook the PPE testing.

Main outcome measurements Muscle power was tested with HHD, flexibility using a goniometer, knee valgus angles using video analysis, core strength using pressure biofeedback.

Results Non-dominant legs had significantly (P<.01) greater knee valgus angle measured during single knee bend. Subjects had significantly increased thoracic spine rotation on the side they held their map whilst running. There was no relationship between retrospective injury history and limb dominance. In both dominant and non-dominant sides there were equally strong correlations (P<.01) with functional tests, lower limb, hip, abdominal, and glut strength, and quadriceps and hip flexor flexibility.

Conclusions Few tests showed a relationship with dominant or non-dominant legs. Data collected on specific tests showed associations that were similar on both sides indicating the bilateral nature of running but also the relationship between trunk muscles and the lower limb. Future study in this area should focus on whether interventions addressing these areas show improvement in function and reduction of injuries.