A condition that causes increased tremor, greater postural sway, dangerous ligamentous laxity AND flat feet?

I often think female athletes get a bit of a raw deal. They do not get paid as much as their male peers, they often do not have access to the same levels of sports medical care, and, their injuries are probably under-reseached.

About a million years ago, I was involved in a program at Melbourne University that looked at injury patterns in female athletes, particularly around the knee and Achilles tendon, and asked what might be the physiological differences between men and women that led to different injury rates between the sexes?

To give you an idea of the discrepancy, generally, women are believed to sustain 2 to 8 times more noncontact anterior cruciate ligament (ACL) injuries than men. Studies have shown that these injuries were due to ACL laxity caused by changes in body temperature during the menstrual cycle and the effect of 17-b oestradiol receptors in connective tissue. An increase in core and shell temperatures is associated with the latter half of a regular menstrual cycle.

Therefore, both oestrogen and core temperature may exert complex effects on ligamentous laxity.

Now, we published 3 or 4 papers on this topic, specifically looking at how oestragen affected the compliance of the Achilles tendon, and how this compliance altered over the course of a 28 day menstrual cycle.

But, if we read the litany of changes that occur as a result of the ovulation cycle -  increased tremor, increased postural sway, flattening of the foot, ligamentous laxity -  it makes being a woman athlete sound like a risky business!

Simon Bartold
Director of Bartold Clinical

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