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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2006

01-04-2006 | Sports Medicine

Knee joint kinaesthesia and neuromuscular coordination during three phases of the menstrual cycle in moderately active women

Authors: Cecilia Fridén, Angelica Lindén Hirschberg, Tönu Saartok, Per Renström

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2006

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Abstract

An increased incidence of sports related injuries in the premenstrual phase as well as in the menstrual phase of the menstrual cycle has been described. This may be explained by alterations in proprioception and neuromuscular coordination due to hormonal variations. Prospective, within women analysis of knee joint kinesthesia and neuromuscular coordination were performed by repeated measures analysis of variance in three hormonally verified phases of three consecutive menstrual cycles. Thirty-two healthy, moderately active female subjects volunteered to participate in the study. Twenty-five of the subjects performed at least one hormonally verified menstrual cycle. A specially designed device was used to investigate knee joint kinaesthesia and neuromuscular coordination was measured with the square hop test. These tests were carried out in the menstrual phase, ovulation phase and premenstrual phase determined by hormone analyses in three consecutive menstrual cycles. An impaired knee joint kinaesthesia was detected in the premenstrual phase and the performance of square hop test was significantly improved in the ovulation phase compared to the other two phases. The results of this study indicate that the variation of sex hormones in the menstrual cycle has an effect on performance of knee joint kinaesthesia and neuromuscular coordination.
Literature
1.
go back to reference Arendt E, Dick R (1995) Knee injury patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am J Sports Med 23:694–701PubMed Arendt E, Dick R (1995) Knee injury patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am J Sports Med 23:694–701PubMed
2.
go back to reference Huston LJ, Greenfield ML, Wojtys EM (2000) Anterior cruciate ligament injuries in the female athlete. Potential risk factors. Clin Orthop 50–63 Huston LJ, Greenfield ML, Wojtys EM (2000) Anterior cruciate ligament injuries in the female athlete. Potential risk factors. Clin Orthop 50–63
3.
go back to reference Myklebust G, Maehlum S, Engebretsen L, Strand T, Solheim E (1997) Registration of cruciate ligament injuries in Norwegian top level team handball. A prospective study covering two seasons. Scand J Med Sci Sports 7:289–292PubMed Myklebust G, Maehlum S, Engebretsen L, Strand T, Solheim E (1997) Registration of cruciate ligament injuries in Norwegian top level team handball. A prospective study covering two seasons. Scand J Med Sci Sports 7:289–292PubMed
4.
go back to reference Myklebust G, Maehlum S, Holm I, Bahr R (1998) A prospective cohort study of anterior cruciate ligament injuries in elite Norwegian team handball. Scand J Med Sci Sports 8:149–153PubMed Myklebust G, Maehlum S, Holm I, Bahr R (1998) A prospective cohort study of anterior cruciate ligament injuries in elite Norwegian team handball. Scand J Med Sci Sports 8:149–153PubMed
5.
go back to reference Boden BP, Dean GS, Feagin JA Jr, Garrett WE Jr (2000) Mechanisms of anterior cruciate ligament injury. Orthopedics 23:573–578PubMed Boden BP, Dean GS, Feagin JA Jr, Garrett WE Jr (2000) Mechanisms of anterior cruciate ligament injury. Orthopedics 23:573–578PubMed
6.
go back to reference Griffin LY, Agel J, Albohm MJ, Arendt EA, Dick RW, Garrett WE, Garrick JG, Hewett TE, Huston L, Ireland ML, Johnson RJ, Kibler WB, Lephart S, Lewis JL, Lindenfeld TN, Mandelbaum BR, Marchak P, Teitz CC, Wojtys EM (2000) Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. J Am Acad Orthop Surg 8:141–150PubMed Griffin LY, Agel J, Albohm MJ, Arendt EA, Dick RW, Garrett WE, Garrick JG, Hewett TE, Huston L, Ireland ML, Johnson RJ, Kibler WB, Lephart S, Lewis JL, Lindenfeld TN, Mandelbaum BR, Marchak P, Teitz CC, Wojtys EM (2000) Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. J Am Acad Orthop Surg 8:141–150PubMed
7.
go back to reference Zeller BL, McCrory JL, Kibler WB, Uhl TL (2003) Differences in kinematics and electromyographic activity between men and women during the single-legged squat. Am J Sports Med 31:449–456PubMed Zeller BL, McCrory JL, Kibler WB, Uhl TL (2003) Differences in kinematics and electromyographic activity between men and women during the single-legged squat. Am J Sports Med 31:449–456PubMed
8.
go back to reference Huston LJ, Wojtys EM (1996) Neuromuscular performance characteristics in elite female athletes. Am J Sports Med 24:427–436PubMed Huston LJ, Wojtys EM (1996) Neuromuscular performance characteristics in elite female athletes. Am J Sports Med 24:427–436PubMed
9.
go back to reference Malinzak RA, Colby SM, Kirkendall DT, Yu B, Garrett WE (2001) A comparison of knee joint motion patterns between men and women in selected athletic tasks. Clin Biomech (Bristol, Avon) 16:438–445 Malinzak RA, Colby SM, Kirkendall DT, Yu B, Garrett WE (2001) A comparison of knee joint motion patterns between men and women in selected athletic tasks. Clin Biomech (Bristol, Avon) 16:438–445
10.
go back to reference Chappell JD, Yu B, Kirkendall DT, Garrett WE (2002) A comparison of knee kinetics between male and female recreational athletes in stop-jump tasks. Am J Sports Med 30:261–267PubMed Chappell JD, Yu B, Kirkendall DT, Garrett WE (2002) A comparison of knee kinetics between male and female recreational athletes in stop-jump tasks. Am J Sports Med 30:261–267PubMed
11.
go back to reference Moller-Nielsen J, Hammar M (1989) Women’s soccer injuries in relation to the menstrual cycle and oral contraceptive use. Med Sci Sports Exerc 21:126–129PubMed Moller-Nielsen J, Hammar M (1989) Women’s soccer injuries in relation to the menstrual cycle and oral contraceptive use. Med Sci Sports Exerc 21:126–129PubMed
12.
go back to reference Wojtys EM, Huston LJ, Boynton MD, Spindler KP, Lindenfeld TN (2002) The effect of the menstrual cycle on anterior cruciate ligament injuries in women as determined by hormone levels. Am J Sports Med 30:182–188PubMed Wojtys EM, Huston LJ, Boynton MD, Spindler KP, Lindenfeld TN (2002) The effect of the menstrual cycle on anterior cruciate ligament injuries in women as determined by hormone levels. Am J Sports Med 30:182–188PubMed
13.
go back to reference Darlington CL, Ross A, King J, Smith PF (2001) Menstrual cycle effects on postural stability but not optokinetic function. Neurosci Lett 307:147–150CrossRefPubMed Darlington CL, Ross A, King J, Smith PF (2001) Menstrual cycle effects on postural stability but not optokinetic function. Neurosci Lett 307:147–150CrossRefPubMed
14.
go back to reference Fridén C, Hirschberg AL, Saartok T, Bäckström T, Leanderson J, Renström P (2003) The influence of premenstrual symptoms on postural balance and kinesthesia during the menstrual cycle. Gynecol Endocrinol 17:433–439CrossRefPubMed Fridén C, Hirschberg AL, Saartok T, Bäckström T, Leanderson J, Renström P (2003) The influence of premenstrual symptoms on postural balance and kinesthesia during the menstrual cycle. Gynecol Endocrinol 17:433–439CrossRefPubMed
15.
go back to reference Södergård R, Bäckström T, Shanbhag V, Carstensen H (1982) Calculation of free and bound fractions of testosterone and estradiol-17 beta to human plasma proteins at body temperature. J Steroid Biochem 16:801–810CrossRefPubMed Södergård R, Bäckström T, Shanbhag V, Carstensen H (1982) Calculation of free and bound fractions of testosterone and estradiol-17 beta to human plasma proteins at body temperature. J Steroid Biochem 16:801–810CrossRefPubMed
16.
go back to reference Beynnon BD, Renström PA, Konradsen L, Elmqvist LG, Gottlieb D, Dirks M (2000) Validation of techniques to measure knee proprioception. In: Lephart SM, Fu FH (eds) Proprioception and neuromuscular control in joint stability. Human Kinetics, Pittsburg, pp 127–138 Beynnon BD, Renström PA, Konradsen L, Elmqvist LG, Gottlieb D, Dirks M (2000) Validation of techniques to measure knee proprioception. In: Lephart SM, Fu FH (eds) Proprioception and neuromuscular control in joint stability. Human Kinetics, Pittsburg, pp 127–138
17.
go back to reference Östenberg A, Roos E, Ekdahl C, Roos H (1998) Isokinetic knee extensor strength and functional performance in healthy female soccer players. Scand J Med Sci Sports 8:257–264PubMed Östenberg A, Roos E, Ekdahl C, Roos H (1998) Isokinetic knee extensor strength and functional performance in healthy female soccer players. Scand J Med Sci Sports 8:257–264PubMed
18.
go back to reference Keizer HA, Rogol AD (1990) Physical exercise and menstrual cycle alterations. What are the mechanisms? Sports Med 10:218–235PubMed Keizer HA, Rogol AD (1990) Physical exercise and menstrual cycle alterations. What are the mechanisms? Sports Med 10:218–235PubMed
19.
go back to reference Sarwar R, Niclos BB, Rutherford OM (1996) Changes in muscle strength, relaxation rate and fatiguability during the human menstrual cycle. J Physiol 493(Pt 1):267–272 Sarwar R, Niclos BB, Rutherford OM (1996) Changes in muscle strength, relaxation rate and fatiguability during the human menstrual cycle. J Physiol 493(Pt 1):267–272
21.
go back to reference Smith MJ, Keel JC, Greenberg BD, Adams LF, Schmidt PJ, Rubinow DA, Wassermann EM (1999) Menstrual cycle effects on cortical excitability. Neurology 53:2069–2072PubMed Smith MJ, Keel JC, Greenberg BD, Adams LF, Schmidt PJ, Rubinow DA, Wassermann EM (1999) Menstrual cycle effects on cortical excitability. Neurology 53:2069–2072PubMed
22.
go back to reference Smith MJ, Adams LF, Schmidt PJ, Rubinow DR, Wassermann EM (2002) Effects of ovarian hormones on human cortical excitability. Ann Neurol 51:599–603CrossRefPubMed Smith MJ, Adams LF, Schmidt PJ, Rubinow DR, Wassermann EM (2002) Effects of ovarian hormones on human cortical excitability. Ann Neurol 51:599–603CrossRefPubMed
23.
go back to reference Smith SS (1994) Female sex steroid hormones: from receptors to networks to performance–actions on the sensorimotor system. Prog Neurobiol 44:55–86CrossRefPubMed Smith SS (1994) Female sex steroid hormones: from receptors to networks to performance–actions on the sensorimotor system. Prog Neurobiol 44:55–86CrossRefPubMed
24.
go back to reference Sundström I, Andersson A, Nyberg S, Ashbrook D, Purdy RH, Bäckström T (1998) Patients with premenstrual syndrome have a different sensitivity to a neuroactive steroid during the menstrual cycle compared to control subjects. Neuroendocrinology 67:126–138CrossRefPubMed Sundström I, Andersson A, Nyberg S, Ashbrook D, Purdy RH, Bäckström T (1998) Patients with premenstrual syndrome have a different sensitivity to a neuroactive steroid during the menstrual cycle compared to control subjects. Neuroendocrinology 67:126–138CrossRefPubMed
25.
go back to reference Rickenlund A, Carlström K, Ekblom B, Brismar TB, von Schoultz B, Hirschberg AL (2003) Hyperandrogenicity is an alternative mechanism underlying oligomenorrhea or amenorrhea in female athletes and may improve physical performance. Fertil Steril 79:947–955CrossRefPubMed Rickenlund A, Carlström K, Ekblom B, Brismar TB, von Schoultz B, Hirschberg AL (2003) Hyperandrogenicity is an alternative mechanism underlying oligomenorrhea or amenorrhea in female athletes and may improve physical performance. Fertil Steril 79:947–955CrossRefPubMed
26.
go back to reference Lebrun CM (1993) Effect of the different phases of the menstrual cycle and oral contraceptives on athletic performance. Sports Med 16:400–430PubMed Lebrun CM (1993) Effect of the different phases of the menstrual cycle and oral contraceptives on athletic performance. Sports Med 16:400–430PubMed
27.
go back to reference American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. Department of Health and Human Services, Washington, DC, pp 714–718 American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. Department of Health and Human Services, Washington, DC, pp 714–718
28.
go back to reference Keenan PA, Lindamer LA, Jong SK (1995) Menstrual phase-independent retrieval deficit in women with PMS. Biol Psychiatr 38:369–377CrossRef Keenan PA, Lindamer LA, Jong SK (1995) Menstrual phase-independent retrieval deficit in women with PMS. Biol Psychiatr 38:369–377CrossRef
29.
go back to reference Resnick A, Perry W, Parry B, Mostofi N, Udell C (1998) Neuropsychological performance across the menstrual cycle in women with and without premenstrual dysphoric disorder. Psychiatr Res 77:147–158CrossRef Resnick A, Perry W, Parry B, Mostofi N, Udell C (1998) Neuropsychological performance across the menstrual cycle in women with and without premenstrual dysphoric disorder. Psychiatr Res 77:147–158CrossRef
30.
go back to reference Wojtys EM, Ashton-Miller JA, Huston LJ (2002) A gender-related difference in the contribution of the knee musculature to sagittal-plane shear stiffness in subjects with similar knee laxity. J Bone Joint Surg Am 84-A:10–16PubMed Wojtys EM, Ashton-Miller JA, Huston LJ (2002) A gender-related difference in the contribution of the knee musculature to sagittal-plane shear stiffness in subjects with similar knee laxity. J Bone Joint Surg Am 84-A:10–16PubMed
31.
go back to reference Wojtys EM, Huston LJ, Schock HJ, Boylan JP, Ashton-Miller JA (2003) Gender differences in muscular protection of the knee in torsion in size-matched athletes. J Bone Joint Surg Am 85A:782–789PubMed Wojtys EM, Huston LJ, Schock HJ, Boylan JP, Ashton-Miller JA (2003) Gender differences in muscular protection of the knee in torsion in size-matched athletes. J Bone Joint Surg Am 85A:782–789PubMed
32.
go back to reference Friden C, Hirschberg AL, Saartok T (2003) Muscle strength and endurance do not significantly vary across 3 phases of the menstrual cycle in moderately active premenopausal women. Clin J Sport Med 13:238–241CrossRefPubMed Friden C, Hirschberg AL, Saartok T (2003) Muscle strength and endurance do not significantly vary across 3 phases of the menstrual cycle in moderately active premenopausal women. Clin J Sport Med 13:238–241CrossRefPubMed
33.
go back to reference Gur H, Akova B, Kucukoglu S (1999) Continuous versus separate isokinetic test protocol: the effect of estradiol on the reproducibility of concentric and eccentric isokinetic measurements in knee muscles. Arch Phys Med Rehabil 80:1024–1029CrossRefPubMed Gur H, Akova B, Kucukoglu S (1999) Continuous versus separate isokinetic test protocol: the effect of estradiol on the reproducibility of concentric and eccentric isokinetic measurements in knee muscles. Arch Phys Med Rehabil 80:1024–1029CrossRefPubMed
34.
go back to reference Gur H (1997) Concentric and eccentric isokinetic measurements in knee muscles during the menstrual cycle: a special reference to reciprocal moment ratios. Arch Phys Med Rehabil 78:501–505CrossRefPubMed Gur H (1997) Concentric and eccentric isokinetic measurements in knee muscles during the menstrual cycle: a special reference to reciprocal moment ratios. Arch Phys Med Rehabil 78:501–505CrossRefPubMed
35.
go back to reference Lebrun CM, McKenzie DC, Prior JC, Taunton JE (1995) Effects of menstrual cycle phase on athletic performance. Med Sci Sports Exerc 27:437–444PubMed Lebrun CM, McKenzie DC, Prior JC, Taunton JE (1995) Effects of menstrual cycle phase on athletic performance. Med Sci Sports Exerc 27:437–444PubMed
36.
go back to reference Janse de Jonge XA, Boot CR, Thom JM, Ruell PA, Thompson MW (2001) The influence of menstrual cycle phase on skeletal muscle contractile characteristics in humans. J Physiol 530:161–166CrossRefPubMed Janse de Jonge XA, Boot CR, Thom JM, Ruell PA, Thompson MW (2001) The influence of menstrual cycle phase on skeletal muscle contractile characteristics in humans. J Physiol 530:161–166CrossRefPubMed
37.
go back to reference Hewett TE (2000) Neuromuscular and hormonal factors associated with knee injuries in female athletes. Strategies for intervention. Sports Med 29:313–327PubMed Hewett TE (2000) Neuromuscular and hormonal factors associated with knee injuries in female athletes. Strategies for intervention. Sports Med 29:313–327PubMed
38.
go back to reference Myklebust G, Engebretsen L, Braekken I, Skjolberg A, Olsen O, Bahr R (2003) Prevention of anterior cruciate ligament injuries in female team handball players: a prospective intervention study over three seasons. Scand J Med Sci Sports 13:272CrossRef Myklebust G, Engebretsen L, Braekken I, Skjolberg A, Olsen O, Bahr R (2003) Prevention of anterior cruciate ligament injuries in female team handball players: a prospective intervention study over three seasons. Scand J Med Sci Sports 13:272CrossRef
Metadata
Title
Knee joint kinaesthesia and neuromuscular coordination during three phases of the menstrual cycle in moderately active women
Authors
Cecilia Fridén
Angelica Lindén Hirschberg
Tönu Saartok
Per Renström
Publication date
01-04-2006
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2006
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-005-0663-4

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