Inter-limb muscle mass asymmetry is a meaningful difference in muscle mass between the right and left limbs that may disturb movement biomechanics and increase the risk of musculoskeletal injury. We report a 30-year-old woman with grade I obesity (body fat 40.2%) who had trained at the gym independently without supervision for more than six months. Body composition assessment revealed lower-extremity muscle mass asymmetry (segmental bioelectrical impedance analysis: right limb 7.3 kg vs left 6.9 kg; 5.5% difference) accompanied by a 15.1% handgrip strength asymmetry. The clinical question was whether the detected lower-extremity muscle mass asymmetry constitutes a risk factor for musculoskeletal injury in physically active young adults. A systematic search following the PRISMA flow across three databases yielded four prognostic studies, critically appraised using the CEBM Oxford Prognosis Worksheet. The evidence indicates that inter-limb asymmetry is associated with an increased risk of non-contact lower-extremity injury, amplified by obesity and low aerobic capacity. Unilateral resistance training with volume bias toward the weaker limb effectively reduced the asymmetry. Early detection and correction are preventive against injury.
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