When you’re a student athlete one of the most common thoughts on your mind is the fear of injury. A significant number of the 25 varsity sports teams offered by Dickinson are “contact sports,” meaning this risk of injury is even more heightened.
Anterior Cruciate Ligament (ACL) injuries, which are graded in terms of their severity, are a relatively common and extremely painful injury athletes of all levels and genders can experience. While anyone is at risk for an ACL rupture, strain, or tear, scientific and sports medicine literature have been reporting that there is a correlation between the phase of a woman’s menstrual cycle and an increased risk of tearing her ACL.
An early study from 2002, found that out of the 27 female athletes evaluated (out of a total of 38), 10 reported their cycle day at time of injury sustained an ACL injury immediately before or 1 to 2 days after the onset of menses. Thus, the null hypothesis that such high frequency was due to random chance was rejected. This study was the first to confirm self-reported menstrual histories with salivary sex-hormone profiles at the time of ACL injury.
Another study discussed the fact that periodic hormonal (estradiol, progesterone, and relaxin) fluctuations in the menstrual cycle have been postulated to cause ligament laxity, increasing the risk for ACL injuries. This study cited a smaller study that found that female athletes playing NCAA Division 1 sports with relaxin levels greater than 6.0 pg/mL were four times more likely to sustain an ACL tear. While the instance of an ACL tear is certainly a multifaceted issue, there is a more recent study that posits a connection between the phases of the menstrual cycle and occurrence of an ACL injury.
That the increased risk of injury may be the result of an unfettered increase in estradiol that happens during the pre-ovulatory phase of the menstrual cycle (ie. an increased concentration of estradiol and a decreased concentration of progesterone).
It is also reported that the risk of an ACL disruption is greater during the preovulatory phase of the menstrual cycle than the postovulatory phase. This research should not dissuade aspiring athletes and make them fear the fields, courses, and courts that bring them happiness or peace.
In fact, this research is an invitation for further research, as there is still much to be uncovered about this topic, along with how factors such as age, skill level, athleticism, psychologic characteristics, and prior knee injury act as risk factors in ACL injury. This research is vital as encouraging women and girls to participating in sports honors the hard work that went into policies such as Title IX, in addition to this research destigmatizing discussion surrounding menstruation.