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Tremback-Ball A1, Kneller A1, Gibbons M1, Fulton K1, Giampietro N1, Zelinka H1
1Misericordia University, Physical Therapy, Dallas, United States
Background: Studies have shown that women participating in the same sports activities as men are two to ten times more prone to ligamentous injury. Some studies contribute these findings to varying anatomical structure between men and women, female athletes taking oral contraceptives and hormonal differences related to the menstrual cycle. The phase of the menstrual cycle influences levels of many hormones including relaxin. Relaxin is commonly recognized as a hormone that is related to pregnancy. Its plays a role in increasing joint laxity to accommodate changes in anatomy as the body prepares for childbirth. During a normal menstrual cycle, relaxin relaxes the wall of the uterus and prepares the lining of the uterus for pregnancy. The levels are highest during the mid-luteal phase until menstruation begins. Therefore there are certain points in the menstrual cycle that women are at higher risk for injury due to the effect relaxin has on connective tissue. Given the research that hormonal changes throughout the menstrual cycle can impact women's vulnerability to injury, it is important to also explore the effect the menstrual cycle has on athletic performance.
Purpose: The purpose of this systematic review was to examine the effect of phases of the menstrual cycle on strength and athletic performance. We also aimed to discuss potential injury prevention strategies for female athletes based on the findings.
Methods: Two searches of the literature were performed. The first search was completed between in March 2018 and the second in August 2018 using EBSCO host, Academic Search Complete, CINAHL Complete, Health Source: Nursing/Academic Edition, and MEDLINE. All articles included in the review were analyzed for quality on the PEDro scale and a hierarchy of evidence scale.
Results: Eight articles were included in the results. The experimental articles had an average score of 5/10 on the PEDro scale and were all level 2b on the hierarchy of evidence scale. Dependent variables included measures of athletic performance such as vertical jump height, balance, sprint times, and rowing performance.
Conclusion(s): The effect of menstrual cycle on injury and sport performance is becoming a more popular topic in current literature. The studies examined by the current researchers had varying conclusions. Studies looking at endurance generally found that phase of menstrual cycle had an impact on sport performance. However studies looking a power and sports that require high intensity short term activity such as sprinting and jumping did not find a relationship.
Implications: A female athlete may be just as fit than her male counterpart, yet there appears to be different vulnerabilities among men and women that predispose women to higher rates of injury and decreased athletic performance. Physical therapists can and should apply this knowledge in their practice of treating female athletes. Incorporating tracking of the menstrual cycle into a plan of care can help therapists to determine best exercises based on phase of cycle, its affect on ligament laxity and known increased risk for injury. It can also help to educate patients on risk of injury and expectations on performance.
Keywords: Women's Health, Athletic Performance, Injury Prevention
Funding acknowledgements: None
Purpose: The purpose of this systematic review was to examine the effect of phases of the menstrual cycle on strength and athletic performance. We also aimed to discuss potential injury prevention strategies for female athletes based on the findings.
Methods: Two searches of the literature were performed. The first search was completed between in March 2018 and the second in August 2018 using EBSCO host, Academic Search Complete, CINAHL Complete, Health Source: Nursing/Academic Edition, and MEDLINE. All articles included in the review were analyzed for quality on the PEDro scale and a hierarchy of evidence scale.
Results: Eight articles were included in the results. The experimental articles had an average score of 5/10 on the PEDro scale and were all level 2b on the hierarchy of evidence scale. Dependent variables included measures of athletic performance such as vertical jump height, balance, sprint times, and rowing performance.
Conclusion(s): The effect of menstrual cycle on injury and sport performance is becoming a more popular topic in current literature. The studies examined by the current researchers had varying conclusions. Studies looking at endurance generally found that phase of menstrual cycle had an impact on sport performance. However studies looking a power and sports that require high intensity short term activity such as sprinting and jumping did not find a relationship.
Implications: A female athlete may be just as fit than her male counterpart, yet there appears to be different vulnerabilities among men and women that predispose women to higher rates of injury and decreased athletic performance. Physical therapists can and should apply this knowledge in their practice of treating female athletes. Incorporating tracking of the menstrual cycle into a plan of care can help therapists to determine best exercises based on phase of cycle, its affect on ligament laxity and known increased risk for injury. It can also help to educate patients on risk of injury and expectations on performance.
Keywords: Women's Health, Athletic Performance, Injury Prevention
Funding acknowledgements: None
Topic: Sport & sports injuries; Health promotion & wellbeing/healthy ageing; Women's & men's pelvic health
Ethics approval required: No
Institution: Misericordia University
Ethics committee: Internal Review Board
Reason not required: No data collected on humans or animals. Systematic review.
All authors, affiliations and abstracts have been published as submitted.
