Effect of the Oral Contraceptive Pill on Ligamentous Laxity

Martineau, Paul A.; Al-Jassir, Fawzi F.; Lenczner, Eric; Burman, Mark

doi:10.1097/00042752-200409000-00006

Cited by 44 publications

(45 citation statements)

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“…It has been suggested that hormonal fluctuations may have an indirect effect on neuromuscular control and consequently injury [129]. Furthermore, OCP use combined with neuromuscular training may be advantageous for increasing the dynamic stability of the knee and thus reducing injury risk [130][131][132]. Indirect support also exists for a link between the use of OCP and reduced soft tissue [133] and traumatic injuries [134].…”

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confidence: 99%

Applied Physiology of Female Soccer: An Update

et al. 2014

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The popularity and professionalism of female soccer has increased markedly in recent years, with elite players now employed on either a professional or semi-professional basis. The previous review of the physiological demands of female soccer was undertaken two decades ago when the sport was in its relative infancy. Increased research coupled with greater training and competition demands warrants an updated review to consider the effect on physical performance and injury patterns.The physical demands of match-play along with the influence of factors such as the standard of competition, playing position and fatigue have been explored. Total distance covered for elite female players is approximately 10 km, with 1.7 km completed at high-speed (>18 km.h -1 ). Elite players complete 28% more high-speed running and 24% more sprinting than moderate level players. Decrements in high-speed running distance have been reported between and within halves, which may indicate an inability to maintain highintensity activity. Although physical capacity of female players is the most thoroughly researched area comparisons are difficult due to differing protocols. Elite players exhibit maximal oxygen uptake (VO2max) values of 49.4 -57.6 ml.kg -1 .min -1 , Yo Yo Intermittent Endurance test level 2 (YYIE2) scores of 1774 ± 532 m (mean ± SD) and 20 m sprint times of 3.17 ± 0.03 s (mean ± SD). Reasons for the increased prevalence of anterior cruciate ligament injuries in females (2-6 times greater than males) are discussed with anatomical, biomechanical loading and neuromuscular activation differences being cited in the literature. This review presents an in-depth contemporary examination of the applied physiology of the female soccer player.Applied Physiology of Female Soccer 2 1) Introduction The last review of the physiological demands of female soccer was undertaken two decades ago [1] . At the time of that review, women's soccer was in its relative infancy with the inaugural Women's World Cup having taken place in 1991. The popularity of women's soccer has increased markedly in recent years with 29 million participants recorded in 2011, an increase of 34% from 2000 [2]. The 2015 Women's World Cup will have 24 participating nations, an increase of eight from the previous tournament.Since the previous review, increasing attention in the scientific literature has focused on women's soccer with over two thousand scientific articles published. There has been a drive towards professionalism in the sport with players at the highest level now employed on a professional or semi-professional basis. Current elite players are exposed to greater training volumes and competition demands than ever before, consequently these increased physical demands may have implications for both physical performance levels and injury patterns. Inline with these changes, advances in technology available for monitoring athletes has led to greater opportunities to scientifically support players and thus information regarding the modern elite female player...

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confidence: 99%

Applied Physiology of Female Soccer: An Update

et al. 2014

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“…To fully characterize the potential time-dependent properties of this relationship, daily measurements of stiffness and hormonal environment may be necessary (Zazulak et al, 2006). As the use of hormonal contraceptives has been suggested to reduce menstrual cycleinduced knee laxity variations and potentially reduce the risk of ACL injury in female athletes (Martineau et al, 2004), elucidation of this relationship may help to further our understanding of joint stability and injury risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…Pokorny et al (2000) found no significant differences between the two groups, but with low post-hoc statistical power. On the other hand, Martineau et al (2004) found that HC users exhibit significantly decreased knee joint laxity compared to non-users. However, results from these studies may be confounded by the experimenters' lack of control for menstrual cycle phase at the time of testing.…”

Section: Introductionmentioning

confidence: 90%

“…However, results from these studies may be confounded by the experimenters' lack of control for menstrual cycle phase at the time of testing. As such, the difference observed by Martineau et al (2004) could be the result of instantaneous hormone concentrations and/or an accumulative effect of prior HC usage and hormonal fluctuations (Strauss et al, 2004). The differential contributions of instantaneous and prior hormonal concentrations to joint stiffness remain unknown.…”

Section: Introductionmentioning

confidence: 99%

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The differential effects of gender, anthropometry, and prior hormonal state on frontal plane knee joint stiffness

Cammarata

Dhaher

2008

Clinical Biomechanics

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Background-Gender differences in passive frontal plane knee stiffness may contribute to the increased anterior cruciate ligament injury rate in females. Gender-based stiffness differences have been attributed to anthropometric variations, but little data exist describing this relationship. Furthermore, sex hormone levels appear to influence joint stiffness, but the differential effects of instantaneous and prior hormonal concentrations remain unknown. This study sought to explore the effect of gender, prior hormonal status, and anthropometry on passive frontal plane knee joint stiffness.

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“…The combined OCP contains estrogen and progesterone as synthetic steroids that prevent ovulation by inhibiting the release of follicle-stimulating hormone and luteinizing hormone from the pituitary gland in the brain (Kenny et al 2008;Krishnan and Kiley 2010). The 17-β estradiol receptors on the ACL are well established and therefore, it is of no surprise that OCP users have less ACL laxity than non-OCP users due to consistently lower levels of estradiol (Martineau et al 2004;Lee et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Do Oral Contraceptives Alter Knee Ligament Damage with Heavy Exercise?

Lee

Petrofsky

Yim

2015

Tohoku J. Exp. Med.

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Hormones such as estradiol have an effect on human connective tissue, making women more susceptible to knee injuries. Indeed, women have a greater risk for non-contact injuries of anterior cruciate ligament (ACL) compared to men when participating in the same sports. The purpose of the present study was to examine the difference in ACL laxity after an eccentric exercise in the lower limbs in young healthy women between oral contraceptive pill (OCP) users and non-OCP users to see the effect of OCP on ACL laxity. Forty young healthy women participated in the experiments (25 with normal menstrual cycle and 15 with taking OCP). ACL laxity and a visual analog pain scale were measured before and after a bout of squat. OCP users had more pain than non-OCP users after heavy exercise (p < 0.001). Both groups showed a significant reduction in ACL laxity on the 2nd day after exercise (p < 0.05). While ACL laxity was always less in the OCP group, when expressed as a percent change from baseline, the ACL laxity change was similar in both groups (p > 0.05). We found that there was no statistically significant difference in ACL laxity recovery over time in response to the delayed onset muscle soreness after a bout of squat between two groups. However, health professionals working with young female adults should recognize that OCP users with less ACL laxity are at higher risk for having knee injuries because of ACL stiffness when doing exercise.

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Effect of the Oral Contraceptive Pill on Ligamentous Laxity

Cited by 44 publications

References 31 publications

Applied Physiology of Female Soccer: An Update

Applied Physiology of Female Soccer: An Update

The differential effects of gender, anthropometry, and prior hormonal state on frontal plane knee joint stiffness

Do Oral Contraceptives Alter Knee Ligament Damage with Heavy Exercise?

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