Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes

Edward M. Wojtys, Laura J. Huston, Thomas N. Lindenfeld, Timothy Hewett, Mary Lou V H Greenfield

Research output: Contribution to journalArticle

236 Citations (Scopus)

Abstract

Anterior cruciate ligament injury rates are four to eight times higher in women than in men. Because of estrogen's direct effect on collagen metabolism and behavior and because neuromuscular performance varies during the menstrual cycle, it is logical to question the menstrual cycle's effect on knee injury rates. Of 40 consecutive female athletes with acute anterior cruciate ligament injuries (less than 3 months), 28 (average age, 23 ± 11 years) met the study criteria of regular menstrual periods and noncontact injury. Details concerning mechanism of injury, menstrual cycle, contraceptive use, and previous injury history were collected. A chi-square test was used to compute observed and expected frequencies of anterior cruciate ligament injury based on three different phases of the menstrual cycle: follicular (days 1 to 9), ovulatory (days 10 to 14), and luteal (day 15 to end of cycle). A significant statistical association was found between the stage of the menstrual cycle and the likelihood for an anterior cruciate ligament injury (P = 0.03). In particular, there were more injuries than expected in the ovulatory phase of the cycle. In contrast, significantly fewer injuries occurred in the follicular phase. These hormones may be a factor in the knee ligament injury dilemma in women.

Original languageEnglish (US)
Pages (from-to)614-619
Number of pages6
JournalAmerican Journal of Sports Medicine
Volume26
Issue number5
StatePublished - Sep 1998
Externally publishedYes

Fingerprint

Menstrual Cycle
Athletes
Wounds and Injuries
Knee Injuries
Follicular Phase
Corpus Luteum
Chi-Square Distribution
Contraceptive Agents
Ligaments
Estrogens
Collagen
Anterior Cruciate Ligament Injuries
Hormones

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Wojtys, E. M., Huston, L. J., Lindenfeld, T. N., Hewett, T., & Greenfield, M. L. V. H. (1998). Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes. American Journal of Sports Medicine, 26(5), 614-619.

Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes. / Wojtys, Edward M.; Huston, Laura J.; Lindenfeld, Thomas N.; Hewett, Timothy; Greenfield, Mary Lou V H.

In: American Journal of Sports Medicine, Vol. 26, No. 5, 09.1998, p. 614-619.

Research output: Contribution to journalArticle

Wojtys, EM, Huston, LJ, Lindenfeld, TN, Hewett, T & Greenfield, MLVH 1998, 'Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes', American Journal of Sports Medicine, vol. 26, no. 5, pp. 614-619.
Wojtys, Edward M. ; Huston, Laura J. ; Lindenfeld, Thomas N. ; Hewett, Timothy ; Greenfield, Mary Lou V H. / Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes. In: American Journal of Sports Medicine. 1998 ; Vol. 26, No. 5. pp. 614-619.
@article{70c81d5441ff442cad74f12e4d34b95f,
title = "Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes",
abstract = "Anterior cruciate ligament injury rates are four to eight times higher in women than in men. Because of estrogen's direct effect on collagen metabolism and behavior and because neuromuscular performance varies during the menstrual cycle, it is logical to question the menstrual cycle's effect on knee injury rates. Of 40 consecutive female athletes with acute anterior cruciate ligament injuries (less than 3 months), 28 (average age, 23 ± 11 years) met the study criteria of regular menstrual periods and noncontact injury. Details concerning mechanism of injury, menstrual cycle, contraceptive use, and previous injury history were collected. A chi-square test was used to compute observed and expected frequencies of anterior cruciate ligament injury based on three different phases of the menstrual cycle: follicular (days 1 to 9), ovulatory (days 10 to 14), and luteal (day 15 to end of cycle). A significant statistical association was found between the stage of the menstrual cycle and the likelihood for an anterior cruciate ligament injury (P = 0.03). In particular, there were more injuries than expected in the ovulatory phase of the cycle. In contrast, significantly fewer injuries occurred in the follicular phase. These hormones may be a factor in the knee ligament injury dilemma in women.",
author = "Wojtys, {Edward M.} and Huston, {Laura J.} and Lindenfeld, {Thomas N.} and Timothy Hewett and Greenfield, {Mary Lou V H}",
year = "1998",
month = "9",
language = "English (US)",
volume = "26",
pages = "614--619",
journal = "American Journal of Sports Medicine",
issn = "0363-5465",
publisher = "SAGE Publications Inc.",
number = "5",

}

TY - JOUR

T1 - Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes

AU - Wojtys, Edward M.

AU - Huston, Laura J.

AU - Lindenfeld, Thomas N.

AU - Hewett, Timothy

AU - Greenfield, Mary Lou V H

PY - 1998/9

Y1 - 1998/9

N2 - Anterior cruciate ligament injury rates are four to eight times higher in women than in men. Because of estrogen's direct effect on collagen metabolism and behavior and because neuromuscular performance varies during the menstrual cycle, it is logical to question the menstrual cycle's effect on knee injury rates. Of 40 consecutive female athletes with acute anterior cruciate ligament injuries (less than 3 months), 28 (average age, 23 ± 11 years) met the study criteria of regular menstrual periods and noncontact injury. Details concerning mechanism of injury, menstrual cycle, contraceptive use, and previous injury history were collected. A chi-square test was used to compute observed and expected frequencies of anterior cruciate ligament injury based on three different phases of the menstrual cycle: follicular (days 1 to 9), ovulatory (days 10 to 14), and luteal (day 15 to end of cycle). A significant statistical association was found between the stage of the menstrual cycle and the likelihood for an anterior cruciate ligament injury (P = 0.03). In particular, there were more injuries than expected in the ovulatory phase of the cycle. In contrast, significantly fewer injuries occurred in the follicular phase. These hormones may be a factor in the knee ligament injury dilemma in women.

AB - Anterior cruciate ligament injury rates are four to eight times higher in women than in men. Because of estrogen's direct effect on collagen metabolism and behavior and because neuromuscular performance varies during the menstrual cycle, it is logical to question the menstrual cycle's effect on knee injury rates. Of 40 consecutive female athletes with acute anterior cruciate ligament injuries (less than 3 months), 28 (average age, 23 ± 11 years) met the study criteria of regular menstrual periods and noncontact injury. Details concerning mechanism of injury, menstrual cycle, contraceptive use, and previous injury history were collected. A chi-square test was used to compute observed and expected frequencies of anterior cruciate ligament injury based on three different phases of the menstrual cycle: follicular (days 1 to 9), ovulatory (days 10 to 14), and luteal (day 15 to end of cycle). A significant statistical association was found between the stage of the menstrual cycle and the likelihood for an anterior cruciate ligament injury (P = 0.03). In particular, there were more injuries than expected in the ovulatory phase of the cycle. In contrast, significantly fewer injuries occurred in the follicular phase. These hormones may be a factor in the knee ligament injury dilemma in women.

UR - http://www.scopus.com/inward/record.url?scp=0031685986&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031685986&partnerID=8YFLogxK

M3 - Article

VL - 26

SP - 614

EP - 619

JO - American Journal of Sports Medicine

JF - American Journal of Sports Medicine

SN - 0363-5465

IS - 5

ER -