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Relationship of the menstrual cycle phase to anterior cruciate ligament injuries in teenaged female athletes

  • Arthroscopy & Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Anterior cruciate ligament (ACL) injuries are more common among female athletes compared to male athletes. Several studies have been reported to explain the gender difference in ACL injury rates and several risk factors underlying gender disparity are believed to exist. Hormonal effects are considered to be one of the etiological factors for female non-contact ACL injuries. The objectives of this study were to determine if ACL injuries occurred randomly or correlated with a specific phase of the female menstrual cycle in teenaged female athletes and then to determine if pre-menstrual and menstrual dysfunctions influenced these ACL injuries.

Materials and methods

Eighteen of 37 consecutive female athletes, with ACL injuries, met the study criteria: teenage, with regular menstrual cycle, and non-contact injury. The menstrual history, athletic activity, and injury history were collected.

Results

Seventy-two percent of the subjects had premenstrual symptoms and 83% had menstrual symptoms. The subjective activity level at the follicular phase was significantly lowest between the phases. A significant statistical association was found between the phase of the menstrual cycle and ACL injuries (P = 0.0002). There were more injuries in the ovulatory phase than expected, and fewer injuries occurred in the other phases.

Conclusion

The results showed a significant increase in non-contact ACL injuries in teenage female athletes during the ovulatory phase of the menstrual cycle and the subjective activity level and the premenstrual and menstrual symptoms might not affect the likelihood of the injuries. These findings suggest that sex hormones might play a role in the incidence of female non-contact ACL injuries.

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Authors and Affiliations

  1. Department of Fundamental Nursing, School of Health Sciences, Faculty of Medicine, Tottori University, Yonago, Japan

    Noriko Adachi & Michio Maeta

  2. Department of Sports Medicine and Orthopaedic Surgery, Sanin Rosai Hospital, 1-8-1 Kaikeshinden, Yonago, 683-8605, Japan

    Koji Nawata

  3. Division of Health Administration and Promotion, Department of Social Medicine, Faculty of Medicine, Tottori University, Yonago, Japan

    Youichi Kurozawa

Authors
  1. Noriko Adachi
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  2. Koji Nawata
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  4. Youichi Kurozawa
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Correspondence to Koji Nawata.

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Adachi, N., Nawata, K., Maeta, M. et al. Relationship of the menstrual cycle phase to anterior cruciate ligament injuries in teenaged female athletes. Arch Orthop Trauma Surg 128, 473–478 (2008). https://doi.org/10.1007/s00402-007-0461-1

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  • DOI: https://doi.org/10.1007/s00402-007-0461-1

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