Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2012

01.08.2012 | Sports Medicine

Menstrual cycle and knee joint position sense in healthy female athletes

verfasst von: Rose Fouladi, Reza Rajabi, Nasrin Naseri, Fereshteh Pourkazemi, Mehrnaz Geranmayeh

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 8/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of this study was to investigate the effect of menstrual cycle on knee joint position sense (JPS) in healthy female athletes.

Methods

Sixteen healthy female athletes participated in this study. Serum estrogen and progesterone levels were collected during the three phases of menstrual cycle. The knee JPS was also measured during the same phases using a system comprise of skin markers, digital photography, and AutoCAD software. Absolute angular errors were calculated as well as changes in hormone levels between the three phases.

Results

Serum estrogen concentration was significantly higher during the mid-luteal (179.5 Pg/ml) and mid-follicular (125.6 Pg/ml) phases as compared with the early-follicular (menses) (22.8 Pg/ml) phase (P = 0.0001). Also serum progesterone concentration was significantly higher during the mid-luteal phase (7.35 Ng/ml) as compared with the menses (0.58 Ng/ml) and mid-follicular (0.5 Ng/ml) phases (P = 0.0001). The greatest amount of mean (SD) value of absolute error was at menses (4.2°), and the least amount of it was at mid-luteal (2.5°) phase. Also, a significant difference was observed within three phases of menstrual cycle (P = 0.025).

Conclusion

The result of this study suggests that healthy female athletes have different levels of knee JPS across a menstrual cycle. JPS accuracy decreases in menses, when circulating sex-hormones levels are low. Therefore, female athletes are at higher risk of injury at menses and improving their awareness regarding the knee injury risk factors can be a fundamental step toward preventing injuries.

Level of evidence

Case series, Level IV.
Literatur
1.
Zurück zum Zitat Adachi N, Ochi M, Uchio Y et al (2002) Mechanoreceptors in the anterior cruciate ligament contribute to the joint position sense. Acta Orthop Scand 73:330–334PubMedCrossRef Adachi N, Ochi M, Uchio Y et al (2002) Mechanoreceptors in the anterior cruciate ligament contribute to the joint position sense. Acta Orthop Scand 73:330–334PubMedCrossRef
2.
Zurück zum Zitat Alentorn-Geli E, Myer GD, Silvers HJ et al (2009) Prevention of non-contact anterior cruciate ligament injuries in soccer players. Knee Surg Sports Traumatol Arthrosc 17:705–729PubMedCrossRef Alentorn-Geli E, Myer GD, Silvers HJ et al (2009) Prevention of non-contact anterior cruciate ligament injuries in soccer players. Knee Surg Sports Traumatol Arthrosc 17:705–729PubMedCrossRef
3.
Zurück zum Zitat Arendt E, Dick R (1999) Knee injury patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am J Sports Med 23:694–701CrossRef Arendt E, Dick R (1999) Knee injury patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am J Sports Med 23:694–701CrossRef
4.
Zurück zum Zitat Aydog ST, Hascelik Z, Demirel HA et al (2005) The effects of menstrual cycle on the knee joint position sense:preliminary study. Knee Surg Sports Troumatol Arthrosc 13:649–653CrossRef Aydog ST, Hascelik Z, Demirel HA et al (2005) The effects of menstrual cycle on the knee joint position sense:preliminary study. Knee Surg Sports Troumatol Arthrosc 13:649–653CrossRef
5.
Zurück zum Zitat Baker V, Bannel K, Stillman B et al (2002) Abnormal knee joint position sense in individuals with patello femoral pain syndrome. J Orthop Res 20:208–214PubMedCrossRef Baker V, Bannel K, Stillman B et al (2002) Abnormal knee joint position sense in individuals with patello femoral pain syndrome. J Orthop Res 20:208–214PubMedCrossRef
6.
Zurück zum Zitat Berek JS (2002) Berek and Novak’s gynecology. Lippincott Williams & Wilkins, Philadelphia, pp 159–161 Berek JS (2002) Berek and Novak’s gynecology. Lippincott Williams & Wilkins, Philadelphia, pp 159–161
7.
Zurück zum Zitat Boden B, Dean G, Feagin J et al (2000) Mechanisms of anterior cruciate ligament injury. Orthopedics 23:573–578PubMed Boden B, Dean G, Feagin J et al (2000) Mechanisms of anterior cruciate ligament injury. Orthopedics 23:573–578PubMed
8.
Zurück zum Zitat Bowerman SJ, Smith DR, Carlson M et al (2006) Comparison of factors influencing ACL injury in male and female athletes and non-athletes. Phys Ther Sport 7:144–152CrossRef Bowerman SJ, Smith DR, Carlson M et al (2006) Comparison of factors influencing ACL injury in male and female athletes and non-athletes. Phys Ther Sport 7:144–152CrossRef
9.
Zurück zum Zitat Cesar GM, Pereira VS, Santiago PR et al (2011) Variations in dynamic knee valgus and glotus medius onset timing in non- athletic females related to hormonal changes during the menstrual cycle. Knee 18:224–230PubMedCrossRef Cesar GM, Pereira VS, Santiago PR et al (2011) Variations in dynamic knee valgus and glotus medius onset timing in non- athletic females related to hormonal changes during the menstrual cycle. Knee 18:224–230PubMedCrossRef
10.
Zurück zum Zitat Deie M, Sakamaki Y, Sumen Y et al (2002) Anterior knee laxity in young women varies with their menstrual cycle. Int Orthop 26:154–156PubMedCrossRef Deie M, Sakamaki Y, Sumen Y et al (2002) Anterior knee laxity in young women varies with their menstrual cycle. Int Orthop 26:154–156PubMedCrossRef
11.
Zurück zum Zitat Ekenros L, Hirschberg AL, Backstrom T, Friden C (2011) Postural control in women with premenstrual symptoms during oral contraceptive treatment. Acta Obstet Gynecol Scand 90:97–102PubMedCrossRef Ekenros L, Hirschberg AL, Backstrom T, Friden C (2011) Postural control in women with premenstrual symptoms during oral contraceptive treatment. Acta Obstet Gynecol Scand 90:97–102PubMedCrossRef
12.
Zurück zum Zitat Hamlet WP, Liu SH, Panossian V et al (1997) Primary immuno-localization of androgen target cells in the human ACL ligament. Orthop Res 15:657–663CrossRef Hamlet WP, Liu SH, Panossian V et al (1997) Primary immuno-localization of androgen target cells in the human ACL ligament. Orthop Res 15:657–663CrossRef
13.
Zurück zum Zitat Heitz NA (1999) Hormonal changes throughout the menstrual cycle and increased anterior cruciate ligament laxity in females. J Athl Train 343:144–149 Heitz NA (1999) Hormonal changes throughout the menstrual cycle and increased anterior cruciate ligament laxity in females. J Athl Train 343:144–149
14.
Zurück zum Zitat Herrington L (2005) Knee joint position sense: The relationship between open and closed kinetic chain tests. J Sport Rehabil 14:356–362 Herrington L (2005) Knee joint position sense: The relationship between open and closed kinetic chain tests. J Sport Rehabil 14:356–362
15.
Zurück zum Zitat Hertel J, Williams NI, Olmsted-Kramer LC, Leidy HJ, Putukian M (2006) Neuromuscular performance and knee laxity do not change across the menstrual cycle in female athletes. Knee Surge Sports Traumatol Arthrosc 14:817–822CrossRef Hertel J, Williams NI, Olmsted-Kramer LC, Leidy HJ, Putukian M (2006) Neuromuscular performance and knee laxity do not change across the menstrual cycle in female athletes. Knee Surge Sports Traumatol Arthrosc 14:817–822CrossRef
16.
Zurück zum Zitat Hopper DM, Creagh MJ, Formby PA et al (2003) Functional measurement of knee joint position sense after anterior cruciate ligament reconstruction. Arch Phys Med Rehabil 84:868–872PubMedCrossRef Hopper DM, Creagh MJ, Formby PA et al (2003) Functional measurement of knee joint position sense after anterior cruciate ligament reconstruction. Arch Phys Med Rehabil 84:868–872PubMedCrossRef
17.
Zurück zum Zitat Lebrun CM (1994) The effect of the phase of the menstrual cycle and the birth control pill in athletic performance. Clin Sports Med 13:419–441PubMed Lebrun CM (1994) The effect of the phase of the menstrual cycle and the birth control pill in athletic performance. Clin Sports Med 13:419–441PubMed
18.
Zurück zum Zitat Lephart SM, Pincivero DM, Giraldo Jl et al (1997) The role of proprioception in the management and rehabilitation of athletic injuries. Am J Sports Med 25:130–137PubMedCrossRef Lephart SM, Pincivero DM, Giraldo Jl et al (1997) The role of proprioception in the management and rehabilitation of athletic injuries. Am J Sports Med 25:130–137PubMedCrossRef
19.
Zurück zum Zitat Liu SH, Al-Shaikh RA, Panossian V et al (1996) Primary immunolocalization of estrogen and progesterone target cells in the human anterior cruciate ligament. Orthop Res Soc 14:526–533CrossRef Liu SH, Al-Shaikh RA, Panossian V et al (1996) Primary immunolocalization of estrogen and progesterone target cells in the human anterior cruciate ligament. Orthop Res Soc 14:526–533CrossRef
20.
Zurück zum Zitat Marks R (1994) The reliability of knee position sense measurements in healthy women. Physiother Can 46:37–41 Marks R (1994) The reliability of knee position sense measurements in healthy women. Physiother Can 46:37–41
21.
Zurück zum Zitat Marks R, Quinney HA, Wessel J (1993) Proprioceptive sensibility in women with normal and osteoarthritic knee joints. Clin Rheumatol 12:170–175PubMedCrossRef Marks R, Quinney HA, Wessel J (1993) Proprioceptive sensibility in women with normal and osteoarthritic knee joints. Clin Rheumatol 12:170–175PubMedCrossRef
22.
Zurück zum Zitat Moller-Neilsen J, Hammar M (1989) Women’s soccer injury in relation to the menstrual cycle and oral contraceptive use. Med Sci Sports Exerc 21:126–129 Moller-Neilsen J, Hammar M (1989) Women’s soccer injury in relation to the menstrual cycle and oral contraceptive use. Med Sci Sports Exerc 21:126–129
23.
Zurück zum Zitat Nasseri N, Hadian MR, Bagheri H et al (2007) Reliability and accuracy of joint position sense measurement in the laboratory and clinic; utilizes a new system. Acta Med Ir 45:395–404 Nasseri N, Hadian MR, Bagheri H et al (2007) Reliability and accuracy of joint position sense measurement in the laboratory and clinic; utilizes a new system. Acta Med Ir 45:395–404
24.
Zurück zum Zitat Naylor JM, Ko V, Adie S et al (2011) Validity and reliability of using photography for measuring knee range of motion:a methodological study. BMC Musculoskelet Disord 12:77–87PubMedCrossRef Naylor JM, Ko V, Adie S et al (2011) Validity and reliability of using photography for measuring knee range of motion:a methodological study. BMC Musculoskelet Disord 12:77–87PubMedCrossRef
25.
Zurück zum Zitat Park SK, Stefanyshyn DJ, Loitz-Ramage B et al (2009) Changing hormone levels during the menstrual cycle affect knee laxity and stiffness in healthy female subjects. Am J Sports Med 37:588–598PubMedCrossRef Park SK, Stefanyshyn DJ, Loitz-Ramage B et al (2009) Changing hormone levels during the menstrual cycle affect knee laxity and stiffness in healthy female subjects. Am J Sports Med 37:588–598PubMedCrossRef
26.
Zurück zum Zitat Park SK, Stefanyshyn DJ, Ramage B (2009) Relationship between knee joint laxity and knee joint mechanics during the menstrual cycle. Br J Sports Med 43:174–179PubMedCrossRef Park SK, Stefanyshyn DJ, Ramage B (2009) Relationship between knee joint laxity and knee joint mechanics during the menstrual cycle. Br J Sports Med 43:174–179PubMedCrossRef
27.
Zurück zum Zitat Park SK, Stefanyshyn DJ, Ramage B et al (2009) Alterations in knee joint laxity during the menstrual cycle in healthy women leads to increases in joint loads during selected athletic movements. Am J Sports Med 37:1169–1177PubMedCrossRef Park SK, Stefanyshyn DJ, Ramage B et al (2009) Alterations in knee joint laxity during the menstrual cycle in healthy women leads to increases in joint loads during selected athletic movements. Am J Sports Med 37:1169–1177PubMedCrossRef
28.
Zurück zum Zitat Posthuma BW, Bass MJ, Bull SB et al (1987) Detecting changes in functional ability in women with premenstrual syndrome. Am J Obstet Gynecol 159:275–278 Posthuma BW, Bass MJ, Bull SB et al (1987) Detecting changes in functional ability in women with premenstrual syndrome. Am J Obstet Gynecol 159:275–278
29.
Zurück zum Zitat Riemann BL, Lephart SM (2002) The sensory system. Part II: the role of proprioception in motor control and functional joint stability. J Athl Train 37:80–84PubMed Riemann BL, Lephart SM (2002) The sensory system. Part II: the role of proprioception in motor control and functional joint stability. J Athl Train 37:80–84PubMed
30.
Zurück zum Zitat Rozzi SL, Lephart SM, Gear WS (1999) Knee joint laxity and neuromuscular characteristics of male and female soccer and basketball players. Am J Sports Med 27:312–319PubMed Rozzi SL, Lephart SM, Gear WS (1999) Knee joint laxity and neuromuscular characteristics of male and female soccer and basketball players. Am J Sports Med 27:312–319PubMed
31.
Zurück zum Zitat Sarwer R, Beltran NB, Rutherford OM (1996) Changes in muscle strength, relaxation rate and fatiguability during the human menstrual cycle. J Physiol 493:267–272 Sarwer R, Beltran NB, Rutherford OM (1996) Changes in muscle strength, relaxation rate and fatiguability during the human menstrual cycle. J Physiol 493:267–272
32.
Zurück zum Zitat Sciore P, Smith S, Frank CB (1997) Detection of receptors for estrogen and progesterone in human ligaments and rabbit ligaments and tendons by RT-PCR. Trans Orthop Res Soc 22:51–56 Sciore P, Smith S, Frank CB (1997) Detection of receptors for estrogen and progesterone in human ligaments and rabbit ligaments and tendons by RT-PCR. Trans Orthop Res Soc 22:51–56
33.
Zurück zum Zitat Slauterbeck JR, Fuzie SF, Smith MP et al (2002) The menstrual cycle, sex hormones and anterior cruciate ligament injury. J Athl Train 37:275–280PubMed Slauterbeck JR, Fuzie SF, Smith MP et al (2002) The menstrual cycle, sex hormones and anterior cruciate ligament injury. J Athl Train 37:275–280PubMed
34.
Zurück zum Zitat Shultz SJ, Carcia CR, Perrin DH (2004) Knee joint laxity affects muscle activation patterns in the healthy knee. J Electromyogr Kines 14:475–483CrossRef Shultz SJ, Carcia CR, Perrin DH (2004) Knee joint laxity affects muscle activation patterns in the healthy knee. J Electromyogr Kines 14:475–483CrossRef
35.
Zurück zum Zitat Shultz SJ, Sander TC, Kirk SE et al (2005) Sex differences in knee joint laxity change across the female menstrual cycle. J Sports Med Phys Fitness 45:594–603PubMed Shultz SJ, Sander TC, Kirk SE et al (2005) Sex differences in knee joint laxity change across the female menstrual cycle. J Sports Med Phys Fitness 45:594–603PubMed
36.
Zurück zum Zitat Shultz SJ, Sander TC, Johnson KM et al (2004) Relationship between sex hormones and anterior knee laxity across the menstrual cycle. Med Sci Sports Exerc 36:1165–1174PubMedCrossRef Shultz SJ, Sander TC, Johnson KM et al (2004) Relationship between sex hormones and anterior knee laxity across the menstrual cycle. Med Sci Sports Exerc 36:1165–1174PubMedCrossRef
37.
Zurück zum Zitat Speroff L, Fritz MA (2005) Clinical gynecologic endocrinology and infertility. Lippincott Williams E Wilkins. 7th ed., A Wolters Kluwer company, pp 187–225 Speroff L, Fritz MA (2005) Clinical gynecologic endocrinology and infertility. Lippincott Williams E Wilkins. 7th ed., A Wolters Kluwer company, pp 187–225
38.
Zurück zum Zitat Stillman BC, McMeeken JM (2001) The role of weight bearing in the clinical assessment of knee joint position sense. Aust J Physiother 47:247–253PubMed Stillman BC, McMeeken JM (2001) The role of weight bearing in the clinical assessment of knee joint position sense. Aust J Physiother 47:247–253PubMed
39.
Zurück zum Zitat Wojtys EM, Huston LJ, Lindenfeld TN et al (1998) Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes. Am J Sports Med 26:614–619PubMed Wojtys EM, Huston LJ, Lindenfeld TN et al (1998) Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes. Am J Sports Med 26:614–619PubMed
40.
Zurück zum Zitat Yu WD, Hatch JD, Panossian V et al (1999) Effect of estrogen on cellular growth and collagen synthesis of human ACL. Clin Orthop Relat Res 366:229–238PubMedCrossRef Yu WD, Hatch JD, Panossian V et al (1999) Effect of estrogen on cellular growth and collagen synthesis of human ACL. Clin Orthop Relat Res 366:229–238PubMedCrossRef
Metadaten
Titel
Menstrual cycle and knee joint position sense in healthy female athletes
verfasst von
Rose Fouladi
Reza Rajabi
Nasrin Naseri
Fereshteh Pourkazemi
Mehrnaz Geranmayeh
Publikationsdatum
01.08.2012
Verlag
Springer-Verlag
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 8/2012
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1811-7

Weitere Artikel der Ausgabe 8/2012

Knee Surgery, Sports Traumatology, Arthroscopy 8/2012 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.