Lefties vs Righties: Is Your Lateral Bias Increasing Your Risk of Dance Injury?

Lateral bias in dance assessment at Performance Medicine

We have all been in a dance class and heard that familiar groan when a particularly challenging turn sequence has to be repeated on the left. Many dancers experience niggles, tightness, or injury after overworking a specific limb. Dancers often develop specific limb preferences. These preferences can contribute to injury, particularly during the early years of training. But do these preferences set us up for higher risk of potential injury on either the dominant or non-dominant leg?

To understand this, we first need to explore what a “dominant” or “preferred” leg actually is. Is it the leg that feels easier to throw into a high kick, or is it the one that feels better to turn on? And is this even the same leg? As a sports physiotherapist who primarily works with dancers and performers at Performance Medicine, we undertook a study on Relationships between lateral limb bias, turnout, and lower limb injury in a pre-professional dancer population to answer these questions.

So… What Is a Lateral Bias?

Lateral bias refers to the tendency to favour one side of the body over the other. Much like how you usually write with your dominant hand, your body can favour a leg that you prefer to turn towards, balance on, or land on. A study by McMahon, titled Lateral Bias in Dance Teaching, termed this phenomenon “lateral bias” or “preference”. The study suggested that it may increase injury risk because different stresses and strains are placed on each leg.

To make defining the dominant leg easier, there are two key definitions we use at Performance Medicine:

Working Leg: This is the leg that performs the action: whether kicking, pointing, or moving through space. The working leg is typically the one you feel most comfortable gesturing with, and it may also be your more flexible leg, as the working leg often has to move into higher degrees of range.

Supporting Leg: This is the leg that provides balance and stability during dance movements. It is usually the leg that remains grounded while the other performs movements and actions. If you favour your right leg for support, your right side may naturally become stronger and more stable, while your left side might be less accustomed to bearing the load. Overuse injuries may therefore be more common on the right.

What Do the Stats Say?

Researchers consistently show that most people have a dominant side for both arms and legs.

  • 90% of people are right-handed. 75% are right-legged (Lábas et al. 2016). 67% of dancers have a right-side dominance, with 87% preferring the right leg as their supporting leg and 65% as their working leg (McMahon et al. 2021).
  • 53% of dancers from the same study reported at least one injury in the last 12 months, and injuries were significantly related to leg dominance -if they were “right-dominant,” the injury was likely to be on the right side.
  • Of these injuries, the vast majority were overuse in nature and more likely to occur at higher training loads.
Dance physiotherapy assessment at Performance Medicine

Are You at Risk?

A dancer’s lateral bias may not seem like a major concern at first. However, favouring one side of the body over time can create physical imbalances. When one side of the body consistently bears more weight, muscle imbalances can develop. This may increase stress on certain joints, reduce coordination on the non-dominant side, and raise the risk of injury.

Certain ballet or choreography styles can also exacerbate lateral bias. For instance, if you know you’re performing a right-side dominant show (such as classical ballets like La Bayadère, Minkus, or Giselle), where multiple arabesques are performed on the same side, this places significantly more strain on the overused side. Similarly, strengthening the less-used side helps to create better overall balance and reduce the risk of injury.

Common Lateral Bias Injuries

At Performance Medicine, our dance physiotherapists regularly treat injuries that develop from strong lateral biases:

Knee Pain: Imbalances in leg strength can place extra load through the knee, especially when turning or jumping. This can lead to patellofemoral pain syndrome (PFPS), where the kneecap doesn’t track properly in its groove, causing irritation and pain.

Hip Issues: Uneven distribution of weight can affect hip alignment and mobility. Over time, this imbalance may contribute to conditions such as hip impingement or instability.

Lower Back Overload: A strong lateral bias, especially when it relates to imbalances of the muscles around the pelvis, can place more strain on the lower back. This can result in chronic lower back pain, muscle spasms, or bone stress injuries.

Achilles Tendinopathy: If one side of the body is consistently favoured – especially during rehearsal footwork and repetitive jumps – this can overload the Achilles tendon and surrounding structures, causing pain and swelling. This condition, known as tendinopathy, is common in dancers who consistently place more weight on their dominant leg.

What Can You Do?

The positive news is that there are several ways to address lateral biases in dance, helping to reduce the risk of injury and enhance overall performance. At Performance Medicine, our dance physiotherapy team in Sydney and Melbourne works with dancers at every level to build stronger, more balanced bodies.

Cross-Training: Incorporating exercises that work both sides of the body equally is important. Cross-training activities outside of dance – such as Pilates, yoga, or strength training – can challenge the muscles on both sides of the body at the same time.

Symmetrical Training: Training to feel strong through both legs is very important to reduce imbalances. If you need to perform pirouettes on your stronger side, practise these movements on your weaker side until they feel as natural. It doesn’t feel as unnatural on your non-dominant side – incorporating mirror drills and exercises that force you to execute movements equally on both sides can also help with this.

Strength Program: A targeted strength program is essential to address muscle imbalances. Focus on exercises that specifically strengthen the weaker side, such as single-leg squats, lunges, or resistance band exercises. Using light weights or bands, gradually increase the load and repetitions on the weaker side to build both strength and endurance.

Professional Support

Talk to Your Dance Physiotherapist

If you suspect you have a significant lateral bias or are experiencing discomfort, consult a dance physiotherapist at Performance Medicine. Our physio team can assess your movement patterns and design a personalised program to address any imbalances. We also help with injury management and offer targeted treatment to reduce the risk of long-term dysfunction or injury.

Mental Performance and Motor Learning

Mental Rehearsal

Lateral bias isn’t just physical; it also involves the brain. Research has found that choreography on your non-dominant side can improve through mental imagery and visualisation. Visualising and mentally rehearsing movements on your non-dominant side can improve coordination and muscle memory, making it easier to transfer learned movements into practice. Some studies have shown that mental imagery and visualisation can improve skill development on the weaker side before even entering the studio (Pavlik & Nordin-Bates, 2016).

Final Thoughts

At the end of the day, it is very normal to have a preferred leg for specific tasks, and no individual is perfectly symmetrical. What matters most is identifying and training strong brain-to-body connections so that this asymmetry isn’t as predominant and doesn’t predispose you to injury. In the long run, it will help you to become a more complete dancer who can mirror or complete exercises and choreography well on both sides.

If you are a dancer experiencing pain, tightness, or an overuse injury related to lateral bias, our expert dance physiotherapy team at Performance Medicine is here to help. Book a dance physiotherapy appointment today and take the first step towards a stronger, more balanced performance career.

Elissa Petesic