New research highlights how menstruation affects injuries in women's football

The study monitored all of England's international female teams over four years
New research highlights how menstruation affects injuries in women's football

Players; shadows at a WSL match Photo by Catherine Ivill/Getty Images

Female footballers may be more than twice as likely to suffer muscle and tendon injuries in the days preceding ovulation, according to the first study of its type into injury incidence across the menstrual cycle.

The research has also identified initial evidence that injury risk may be elevated in the days after an athlete is 'overdue', ie when the next menstruation was expected to start.

The study, funded by the FA, was carried out over four years at the School of Sport and Exercise Science, University of Lincoln. It monitored players selected for England from U15 level upwards. Only injuries sustained on England duty were recorded.

The players self-reported information on menstrual cycle characteristics at the point of injury.

Over the time of the study, 156 injuries from 113 players were eligible for analysis.

According to the study authors: “Muscle and tendon injuries occurred almost twice as often in the late follicular phase compared to the early follicular or luteal phase. Injury risk may be elevated in typically eumenorrheic women in the days after their next menstruation was expected to start.” 

You can read the full report on the study here

While the researchers do not recommend the findings should influence decisions around participation, they say the research “provides further evidence of the need to consider the menstrual cycle and menstrual dysfunction in athletic populations”.

“As this research is in its infancy, we do not recommend that this data is used to inform exercise practice or participation as further work is needed before clear guidelines on the menstrual cycle phase and injury risk mitigation can be generated.” 

Previous studies have shown the overall injury incidence in women’s football is similar to men's football, although the proportion of severe injuries has been higher in the women's game.

Previous research has identified a greater risk of ACL knee injuries in the late follicular/ovulatory phase when estrogen concentrations are highest.

This week, Professor Kay Crossley, director of the La Trobe Sport and Exercise Medicine Research Centre, told Australian’s The Age that AFLW players are nine times more likely to rupture an ACL than a male counterpart.

Her team of researchers have launched a new study in partnership with the AFL aimed at reducing ACL injuries.

“We know very little about Australian football and that’s why we’re doing this study, but in other sports it’s often the position of a woman’s hips and knees when they jump or land, so we need to change the way they move,” Crossley said.

“A woman who has had an ACL injury is up to six times more likely to develop osteoarthritis and twice as likely to require a knee replacement, so getting this data is critical to improving long-term health outcomes.″⁣ 

Menstrual tracking will be incorporated in the study, Crossley added.

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