by Mitch Hauschildt, MA, ATC, CSCS
In my 15+ year career, I have worked with thousands of athletes, I have likely trained more female athletes than male athletes. I love training both for different reasons, but there is no doubt that male and female athletes should be trained differently. There are great differences in the sports they play, style of play, body composition, strength, power, stability, personality, and mental approach to their sport. I’m sure there are a number of other areas where they differ as well, but I don’t want to take up your entire day with this post.
As the injury prevention specialist for a NCAA Division I university athletic department, I have spent a lot of time and resources researching injury risk and outcomes. One area that has been pretty widely researched over the past couple of decades is the role of the menstrual cycle for female athletes and how it can change an athlete’s risk for being injured each month.
Much of the research has been done on the ACL, and I honestly think that it is interesting and intriguing to consider. There have also been studies done on other parts of the body, including the foot that show changes in injury rates during the menstrual cycle. The research is pretty conclusive overall. It indicates that female athletes seem to be at greatest risk for joint injuries in the preovulatory phase of their menstrual cycle.
It is theorized that this is due to the changes in joint laxity that occur within the female body as it considers the notion of carrying the load and stress of a small human being. It is fascinating to me that the body will actually change the length and tone of connective tissue based on the hormones that it releases internally as part of the natural child bearing process. It also fascinates me that regardless of the other stressors that high level athletes have placed on them that their body continues with this practice and doesn’t accomodate like it does with so many other things in their world. This tells me that when the female body was designed, our creator placed a very heavy emphasis on procreating and ensuring the survival of the next generation.
As I do with all research that I read, I do have to ask myself one very important question…what does it mean for my practice and my athletes. In this case, I have to admit that as cool as the research is and as intriguing as the I find the science, I don’t think it amounts to much on a practical, day-to-day, coaching level.
In an ideal world, we would avoid risky behavior in the times of month where the athlete(s) is most at risk for injury (preovulatory). Unfortunately, most of us live and work in a world that is less than ideal. I don’t have the luxury of sitting my female athletes down to protect them for 1 week out of the month. Some of them would prefer that we pull them from activity during that phase of their cycle for a host of reasons, but I have never seen any of our competitors even consider it, so we keep pushing hard and doing our thing.
I do think that these changes throughout the month help us to understand why women tear their ACL at a higher rate than their male counterparts (and possibly other injuries). This knowledge has some value. But to me, that value is in emphasizing that I must control all of the other factors as much as I can and maximize things like high quality movement skills, fitness levels, strength, power, etc in hopes that those will overshadow internal risk factors like this that I can’t control.
Overall, I have to say that research with Menstrual Cycles and injury risk falls into the category of “that’s great, but it doesn’t change my daily job.” I can’t wrap by girls in bubble wrap. They need to practice, play and get after it. We need to control everything else that we can control and then let the cards fall where they may. Science is cool, but we have to look at the big picture as well.
J Athl Train. 2008 Sep-Oct; 43(5): 541–542.
Haneul Lee and Jerrold Petrofsky (2018) Differences Between Men and Women in Balance and Tremor in Relation to Plantar Fascia Laxity During the Menstrual Cycle. Journal of Athletic Training: March 2018, Vol. 53, No. 3, pp. 255-261.
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