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Risk
of Knee Ligament
Injury Tied To Ovulation
NEW
YORK (Reuters Health) - Women are known to face a greater risk
of knee ligament injury compared with men. Now new study findings
suggest that ovulation, and possibly oral contraceptive use, may
play important roles in women's odds of injuring their anterior
cruciate ligaments (ACL).
The investigators
found that women were nearly three times more likely to sustain
an ACL injury while they were ovulating than during other points
of the menstrual cycle. But because this pattern emerged only
among women not on birth control pills, the findings also suggest
oral contraception may provide some measure of protection from
the injury, the researchers note.
However, lead
study author Dr. Edward M. Wojtys stressed that the findings do
not suggest birth control pills offer a way to prevent ACL injuries.
``This research
does not justify pulling young ladies out of sports or putting
young women on oral contraceptives in order to prevent ligament
injuries,'' Wojtys, the director of sports medicine at the University
of Michigan in Ann Arbor, said in a statement.
``There is
some evidence that ACL injuries are tied to the menstrual cycle
and probably to hormones,'' he added, ``but we don't have enough
information yet to justify the use of oral contraceptives in order
to prevent ligament injuries.''
Wojtys and
his colleagues studied 65 women with ACL injuries, collecting
urine samples within a day of each woman's injury to establish
the phase of her menstrual cycle. They found that more than 2.5
times the expected number of injuries occurred during mid-cycle,
or ovulation.
Wojtys presented
the findings at a recent meeting of the American Orthopaedic Society
for Sports Medicine in Keystone, Colorado.
Studies indicate
that female athletes rupture their ACLs up to eight times more
often than male athletes do. The ACL is a tough band of tissue
that helps stabilize the knee, and ACL tears occur most commonly
in sports that require quick pivoting and jumps, such as basketball
and soccer.
A number of
factors--from differences in musculature and training methods
to women's wider hips--are believed to account for the higher
rate of ACL injuries among females. Previous research has also
pointed to the role of the menstrual cycle, showing that ACL injuries
are more common during ovulation. Estrogen levels are increased
during ovulation, and since ligaments have estrogen receptors,
some researchers have speculated that hormone fluctuations factor
into women's ACL injury risk.
But Wojtys
said this relationship remains unproven. ``Even if it is the menstrual
cycle that is having some effect on the susceptibility of soft
tissue...the susceptibility is not clear,'' he said in the statement.
``People are
jumping to the conclusion that it is estrogen and it is acting
at the anterior cruciate ligament, when in fact, there are multiple
places where any hormone could act, including muscles, the central
nervous system and the peripheral nervous system,'' Wojtys added.
He called
for further research into how hormones affect ligaments and other
soft tissue, as well as how they might alter the function of muscles
and nerves.
Reference
Source 89
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