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Tibial acceleration profiles during the menstrual cycle in female athletes

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

Abstract

Purpose

Fluctuating levels of endogenous estrogen are thought to have an adverse effect on lower limb biomechanics, given the observed higher rate of ACL injury at certain phases of the menstrual cycle. The purpose of this study was to investigate the effects of fluctuating endogenous estrogen levels during the menstrual cycle on acceleration transients at the proximal tibia in young physically active females.

Methods

Eleven females aged 16–18 years participated in this study and were compared to a male control group. Female subjects were tested at each of the four phases of the menstrual cycle: menses, follicular, ovulation and luteal. On each test occasion, acceleration transients at the proximal tibia were measured while subjects performed an abrupt deceleration task (simulated netball landing).

Results

No significant differences were found between the different phases of the menstrual cycle for peak tibial acceleration (PTA; P = 0.57), and time to zero tibial acceleration (TZTA; P = 0.59). However, there was a significant difference for time to peak tibial acceleration (TPTA) between menstruation and follicular (P = 0.04), menstruation and ovulation (P = 0.001), menstruation and luteal phase (P = 0.002), and follicular phase and ovulation (P = 0.007). In the male control group, no significant between-test session differences were observed for PTA (P = 0.48), TZTA (P = 0.08) and TPTA (P = 0.29). While there were no significant between-group differences for PTA (P = 0.21) and TZTA (P = 0.48), significant between-group differences were observed for TPTA (P = 0.001).

Conclusion

The results of this project strongly suggest that serum estrogen fluctuations have an effect on tibial acceleration profiles in young female athletes during different phases of the menstrual cycle.

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References

  1. Abt JP, Sell TC, Laudner KG, McCrory JL, Loucks TL, Berga SL, Lephart SM (2007) Neuromuscular and biomechanical characteristics do not vary across the menstrual cycle. Knee Surg Sports Traumatol Arthrosc 15:901–907

    Article  PubMed  Google Scholar 

  2. Bell DG, Jacobs I (1986) Electromechanical response times and rate of force development in males and females. Med Sci Sports Exerc 18:31–36

    Article  CAS  PubMed  Google Scholar 

  3. Bell DR, Blackburn JT, Hackney AC, Marshall SW, Beutler AI, Padua DA (2014) Jump-landing biomechanics and knee-laxity change across the menstrual cycle in women with anterior cruciate ligament reconstruction. J Athl Train 40(2):154–162

    Article  Google Scholar 

  4. Beynnon BD, Bernstein I, Belisle A (2005) The effect of estradiol and progesterone on knee and ankle laxity. Am J Sports Med 33:1298–1304

    Article  PubMed  Google Scholar 

  5. Brophy RH, Silvers HJ, Mandelbaum BR (2010) Anterior cruciate ligament injuries: etiology and prevention. Sports Med Arthrosc Rev 18:2–11

    Article  Google Scholar 

  6. Bryant AL (2007) Knee function and neuromuscular adaptations following ACL rupture and reconstruction. PhD Thesis, University of Wollongong

  7. Bryant AL, Newton RU, Steele J (2009) Successful feed-forward strategies following ACL injury and reconstruction. J Electromyogr Kinesiol 9:988–997

    Article  Google Scholar 

  8. Carter C, Wilkinson J (1964) Persistent laxity and congenital dislocation of the hip. J Bone Joint Br 62:40–45

    Google Scholar 

  9. Clark RA, Bartold S, Bryant AL (2010) Tibial acceleration variability during consecutive gait cycles is influenced by the menstrual cycle. Clin Biomech 25:557–562

    Article  Google Scholar 

  10. Deie M, Sakamaki Y, Sumen Y, Urabe Y, Ikuta Y (2002) Anterior knee laxity in young women varies with their cycle. Int Orthop 26:154–156

    Article  PubMed Central  PubMed  Google Scholar 

  11. Ebben WP, Fauth ML, Petushek E, Garceau LR, Hsu BE, Lutsch BN, Feldmann CR (2010) Gender-based analysis of hamstring and muscle activation during jump landings and cutting. J Strength Cond Res 24:408–415

    Article  PubMed  Google Scholar 

  12. Eiling E, Bryant AL, Petersen W, Murphy A, Hohmann E (2007) Effects of menstrual cycle hormone fluctuations on muscultendinous stifness and knee joint laxity. Knee Surg Sport Traumatol Arthrosc 15:126–132

    Article  CAS  Google Scholar 

  13. Fagenbaum R, Darling WG (2003) Jump landing strategies in male and female college athletes and the implications of such strategies for anterior cruciate ligament injury. Am J Sports Med 31:233–240

    PubMed  Google Scholar 

  14. Gehring D, Meinyk M, Gollhofer A (2009) Gender and fatigue have influence on knee joint control strategies during landing. Clin Biomech 24:82–87

    Article  Google Scholar 

  15. Griffin LY, Albohm MJ, Arendt EA, Bahr R, Beynnon BD et al (2006) Understanding and preventing noncontact anterior cruciate ligament injuries. A review of the Hunt Valley II Meeting, January 2005. Am J Sports Med 34:1512–1532

    Article  PubMed  Google Scholar 

  16. Gwinn DE, Wilckens JH, McDevitt ER, Ross G, Kao TC (2000) The relative incidence of anterior cruciate ligament injury in men and women in the United States Naval Academy. Am J Sports Med 27:98–102

    Google Scholar 

  17. Hakkinen K (1991) Force production characteristics of leg extensor, trunk flexor, and extensor muscles in male and female basketball players. J Sports Med Phys Fitness 31:325–331

    CAS  PubMed  Google Scholar 

  18. Hennig EM, LaFortune MA (1991) Relationships between ground reaction force and tibial bone acceleration parameters. Int J Sports Biomech 7:303–309

    Google Scholar 

  19. Heitz NA, Eisenman PA, Beck CL, Walker JA (1999) Hormonal changes throughout the menstrual cycle and increased anterior cruciate ligament laxity in females. J Athl Training 343:144–149

    Google Scholar 

  20. Hertel J, Williams NI, Olmsted-Kramer LC, Leidy HJ, Putkian M (2006) Neuromsucular performance and knee laxity do not change across the menstrual cylcle in female athletes. Knee Surg Sports Traumatol Arthrosc 14:817–822

    Article  PubMed  Google Scholar 

  21. Hewett TE, Myer GD, Ford KR, Heidt RS Jr, Colosimo AJ, McLean SG, van den Bogert AJ, Paterno MV, Succop P (2005) Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med 33:492–501

    Article  PubMed  Google Scholar 

  22. Hicks-Little CA, Thatcher JR, Hauth J, Goldfuss AJ, Cordova ML (2007) Menstrual cycle stage and oral contraceptive effects on anterior tibial displacement in collegiate female athletes. J Sports Med Phys Fitness 45:255–260

    Google Scholar 

  23. Hume PA, Steele JR (2000) A preliminary investigation of injury prevention strategies in netball: are players heeding the advice? J Sci Med Sport 3:406–413

    Article  CAS  PubMed  Google Scholar 

  24. Ireland ML (2002) The female ACL: why is it more prone to injury? Orth Clin North Am 33:637–651

    Article  Google Scholar 

  25. Irmischer BS, Harris C, Pfeiffer RP, DeBeliso MA, Adams KJ, Shea KG (2004) Effects of a knee ligament injury prevention exercise program on impact forces in women. J Strength Cond Res 18:703–707

    PubMed  Google Scholar 

  26. Krishnan C, Huston K, Amendola A, Williams GN (2008) Quadriceps and hamstring muscle control in athletic males and females. J Orthop Res 26:800–808

    Article  PubMed  Google Scholar 

  27. LaFortune MA, Hennig EM (1991) Contribution of angular motion and gravity to tibial accerelation. Med Sci Sports Exerc 23:360–363

    Article  CAS  PubMed  Google Scholar 

  28. LaFortune MA, Hennig EM, Valiant GA (1995) Tibial shock measured with bone and skin mounted transducers. J Biomech 28:989–993

    Article  CAS  PubMed  Google Scholar 

  29. Lephart SM, Ferris CM, Riemann BL, Myers JB, Fu FH (2002) Gender differences in strength and lower extremity kinematics during landing. Clin Orthop Rel Res 401:162–169

    Article  Google Scholar 

  30. Malinzak RA, Colby SM, Kirkendall DT, Yu B, Garrett WE (2001) A comparison of knee joint motion patterns between men and women in selected athletic tasks. Clin Biomech (Bristol, Avon) 16:438–445

    Article  CAS  Google Scholar 

  31. Manal K, McClay Davis I, Galinat B, Stanhope S (2003) The accuracy of estimating proximal tibial translation during natural cadence walking: bone vs skin mounted targets. Clin Biomech 18:126–131

    Article  CAS  Google Scholar 

  32. McLean SG, Oh YK, Palmer ML, Lucey SM, Lucarelli DG, Ashton-Miller JA, Wojtys EM (2011) The relationship between tibial acceleration, tibial slope, and ACL strain during a simulated jump landing task. J Bone Joint Surg Am 93(14):1310–1317

    Article  PubMed  Google Scholar 

  33. Mc Nair PJ, Marshall RN (1994) Landing characteristics in subjects with normal and anterior cruciate ligament deficient knee joints. Arch Phys Med Rehabil 75:584–589

    CAS  Google Scholar 

  34. Melnyk M, Gollhofer A (2007) Submaximal fatigue of the hamstrings impairs specific reflex components and knee stability. Knee Surg Sports Traumatol Arthrosc 15:525–532

    Article  PubMed  Google Scholar 

  35. Myer GD, Ford KR, Hewett TE (2005) The effects of gender on quadriceps muscle activation strategies during a maneuver that mimics a high ACL injury risk position. J Electromyogr Kinesiol 5:181–189

    Article  Google Scholar 

  36. Nakamura RM, Stanczyk FZ (1991) Immunoassays. In: Mishell DR Jr, Davajan V, Lobo RA (eds) Infertility, contraception and reproductive endocrinology, 3rd edn. Cambridge press, Cambridge

    Google Scholar 

  37. Prodromos CC, Han Y, Rogowski J, Joyce B, Shi K (2007) A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury-reduction regimen. Arthroscopy 23:1320–1325

    Article  PubMed  Google Scholar 

  38. Romani W, Patrie J, Curl LA, Flaws JA (2003) The correlations between estradiol, estrone, estriol, progesterone and sex hormone-binding globulin and anterior cruciate ligament stiffness in healthy, active females. J Womens Health 2:287–298

    Article  Google Scholar 

  39. Rozzi SL, Lephart SM, Fu FH (1999) Effects of muscle fatigue on knee joint laxity and neuromuscular characteristics of male and female athletes. J Athlet Train 34:106–114

    CAS  Google Scholar 

  40. Salci Y, Kentel BB, Heycan C, Akin S, Korkusuz F (2004) Comparison of landing maneuvers between male and female college volleyball players. Clin Biomech (Bristol, Avon) 19:622–628

    Article  Google Scholar 

  41. Shultz SJ, Sander TC, Kirk SE, Perrin DH (2005) Sex differences in knee joint laxity change across the female menstrual cycle. J Sports Med Phys Fitness 45:594–603

    PubMed Central  CAS  PubMed  Google Scholar 

  42. Shultz SJ, Schmitz RJ, Kong Y, Dudley WN, Beynnon BD, Nguyen AD, Kim H, Montgomery MM (2012) Cyclic variations in multiplanar knee laxity influence landing biomechanics. Med Sci Sports Exerc 44(5):900–909

    Article  PubMed  Google Scholar 

  43. Steele JR (1999) Biomechanical factors affecting performance in Netball. Implications for improving performance and injury reduction. Sports Med 10:88–102

    Article  Google Scholar 

  44. Steele JR, Brown JM (1999) Effects of chronic anterior cruciate ligament deficiency on muscle activation patterns during and abrupt deceleration task. Clin Biomech (Bristol, Avon) 14:247–257

    Article  CAS  Google Scholar 

  45. Sung PS, Lee DC (2009) Gender differences in onset timing and activation of the muscles of the dominant knee during stair climbing. Knee 16:375–380

    Article  PubMed  Google Scholar 

  46. Swanik CB, Lephart SM, Giraldo JL, DeMont RG, Fu FH (1999) Reactive muscle firing of anterior cruciate ligament-injured females during functional activities. J Athl Training 34:121–129

    CAS  Google Scholar 

  47. Turcot K, Aissaoui R, Boivin K, Hagenmeister N, Pelletier M, de Guise JA (2008) Test-retest reliability and minimal change determination for 3-dimensional tibial and femoral accelerations during treadmill walking in knee osteoarthritis patients. Arch Phys Med Rehabil 89:732–737

    Article  PubMed  Google Scholar 

  48. Viola RW, Steadman JR, Mair SD, Briggs KK, Sterett WI (1999) Anterior cruciate ligament injury incidence among male and female professional alpine skiers. Am J Sports Med 27:792–795

    CAS  PubMed  Google Scholar 

  49. Voight ML, Wieder DL (1991) Comparative reflex response times of vastus medialis oblique and vastus lateralis in normal subjects with extensor mechanism dysfunction. Am J Sports Med 19:131–137

    Article  CAS  PubMed  Google Scholar 

  50. Witvrouw E, Sneyers C, Lysens R, Victor J, Bellemans J (1996) Reflex response times of vastus medialis oblique and vastus lateralis in normal subjects and in subjects with patellofemoral pain syndrome. J Orthop Sports Phys Ther 24(3):160–165

    Article  CAS  PubMed  Google Scholar 

  51. Wojtys EM, Huston LJ, Boynton MD, Spindler KP, Lindenfeld TN (2002) The effect of the menstrual cycle on anterior cruciate ligament injuries in women as determined by hormone levels. Am J Sports Med 30:182–188

    PubMed  Google Scholar 

  52. Wojtys EM, Huston LJ, Schock HJ, Boylan JP, Ashton-Miller JA (2003) Gender differences in muscular protection of the knee in size matched athletes. J Bone Joint Surg Am 85A:782–789

    Google Scholar 

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Correspondence to Erik Hohmann.

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Hohmann, E., Bryant, A.L., Livingstone, E. et al. Tibial acceleration profiles during the menstrual cycle in female athletes. Arch Orthop Trauma Surg 135, 1419–1427 (2015). https://doi.org/10.1007/s00402-015-2283-x

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