Inter-limb sensorimotor and functional performance asymmetries in elite wrestlers with unilateral knee injury

Knee injuries are common in wrestling and may result in persistent sensorimotor deficits and inter-limb asymmetries affecting performance. This study compared proprioceptive accuracy, dynamic postural control, and functional performance between injured and uninjured limbs in elite wrestlers with a history of unilateral knee injury.

Twenty elite wrestlers (10 females, 10 males) who had returned to full participation in training participated in this cross-sectional comparative study. Proprioception was assessed using joint position sense (JPS) at 15°, 30°, and 60° of knee flexion. Dynamic balance and functional performance were evaluated using the Y-Balance Test (YBT) and the single-leg hop test. Pain and subjective knee function were measured using the Visual Analog Scale (VAS), International Knee Documentation Committee (IKDC), and Lysholm scores. Paired comparisons and correlation analyses were performed.

The injured limb showed significantly greater JPS error at 15° (p = 0.001, dz = 0.89) and reduced performance in the posteromedial direction of the YBT (p = 0.005, dz = 0.71). Hop test distance was also significantly lower in the injured limb (p = 0.001; dz = 0.92). Moderate correlations were observed between hop performance, IKDC scores, pain intensity, and YBT reach distances.

Elite wrestlers may exhibit persistent sensorimotor and functional performance asymmetries despite returning to sport. These findings suggest that return to sport may not reflect full neuromuscular recovery. Comprehensive assessment of sensorimotor function and inter-limb performance asymmetry may help identify residual impairments and improve return-to-sport decision-making.