AnnaKubat

The average woman will have her period around 450 times in her lifetime according to Bupa UK, a major global healthcare company. 

This should matter to female athletes most importantly for injury awareness, specifically for Anterior Cruciate Ligament (ACL) tears.

 In the past 20 years, ACL injuries have drastically increased in young women. In this time, there have been around 225,000 ACL tears occurring in the U.S., 25% of them coming from youth, as studied by the National Library of Medicine. 

As ACL tears become more common, it raises the question of why they are rising specifically in women’s and youth sports. Katie Reisbig Cordery ‘97, physical therapist and owner of Omaha Physical Therapy Institute, said that “despite the increasing prevalence of serious injuries among female athletes, the cause of ACL tears are often under-discussed.”

Junior Maddie McGreer said, “I had heard of this injury before, but hadn’t thought much of it until it became a reality for me.” 

McGreer tore her ACL this past June right before club volleyball nationals. McGreer has been undergoing recovery since then. 

At Marian, almost all girls will menstruate throughout high school. Around 400 of these students are athletes in NSAA Class A sporting activities. 

The big surprise regarding ACL injuries is a new potential cause: one’s menstrual cycle.

“I had never really heard of the possible causes… and not the possible connection to my period before,” McGreer said. 

According to Northwell Health, the largest health system in New York, during the menstrual cycle, many ligaments, such as the ACL, become loose and flexible due to the presence of estrogen. 

With this new research, it has been found that natural levels of hormonal estrogen peak during ovulation when most female ACL tears occur. Females produce higher amounts of estrogen than men equating to more laxity of ligaments thus leading to increased risk of female tears.

Frustratingly for Reisbig Cordery, there isn’t much research to back up the potential cause, as only around 6% of injury research is about women’s injuries. This includes all injuries, not just ACL tears.

This is an underwhelming amount compared to the amount of tears occurring. 

  In recent years, there have been more efforts to look into this issue. 

Other possibilities include sports specialization and the makeup of female anatomy. “Looking back at it, it’s so obvious how bad it is for you. But I wasn’t just going to play another sport, you know?” said McGreer who has played volleyball for the past eight years. 

As today’s youth are growing up, many are finding that it is difficult to play multiple sports at once. Most competitive sports go year-round with quite a bit of traveling included, leaving less time for another sport. This constant stress on specific areas can lead to fractures, breaks, and tears that multi-sport athletes don’t have to deal with. 

Along with the menstrual cycle, body structure is another thing that separates the  disparity between male and female injury rates. Women have a much different anatomical structure, causing different kinds of injuries at different rates than males.

As female sports continue to grow, it is vital to understand the injuries that come along with them.

 Though periods cannot be officially determined as the cause for some ACL tears, they are still an important and timely issue as rates continue to increase.

For some, like McGreer, this starts with spreading awareness: “I don’t necessarily think all athletes need a huge speech specifically about ACL tears and possible reasons for them, but I do think it is a good thing to be educated and offer that for students if they are interested. Because you never think it’s going to happen to you until it does, and it’s really hard to look back and realize what more you could have done if only you’d have known.”

This can include injury prevention strategies and understanding the toll sports can take on an athlete’s body.

Sophomore Kaitlyn Cooper urges more research to be done for the safety of young athletes. Cooper tore her ACL during a volleyball game and heard a pop she had never felt before. Cooper claims that there is a “stigma around ACL tears, and the advice of  “land on two feet” and “don’t lock your knees” doesn’t quite suffice, often leaving athletes confused.”  Cooper said that education is a good start to preventing the injury she now has to deal with every day. 

“Athletes need to understand that their daily habits outside of practice are just as important in reducing injuries like ACL tears,” Reisbig Cordery said, “but coaches can absolutely play a role by building injury-reduction strategies into warm-ups and cool-downs, managing practice intensity based on the game schedule, and emphasizing recovery throughout the season.”

The menstrual cycle still seems to be unknown when it comes to injuries. Certain muscles and ligaments are loosened because of estrogen, providing a possible explanation as to why women seem to be more prone to this injury when menstruating. The lack of research makes it disappointingly hard to fully support this argument, but it is something to continue to look into as the ACL tear can, without warning, make or break a season.