Why
are women more prone to knee injuries than men?
UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Researchers from The University of Texas Medical Branch at Galveston have found that women who take the birth control pill, which lessen and stabilize estrogen levels, were less likely to suffer serious knee injuries. The findings are currently available in Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine.
Female athletes are 1.5 to 2 times more likely than their male
counterparts to injure their anterior cruciate ligament, or ACL. The ACL is a
ligament that connects the top and bottom portions of the knee.
Damage to this
ligament is a serious athletic injury that can be career altering.
Return-to-play rates after ACL injury are as low as 49 percent among soccer
players. Also, this injury may lead to lifelong issues with knee instability,
altered walking gait and early onset arthritis.
Using a national insurance claims and prescription database of
23,428 young women between 15 and 19, the study found that women with an ACL
knee injury who were taking the birth control pill were less likely to need
corrective surgery than women of the same age with ACL injuries who do not use
the birth control pill.
Researchers have proposed that the female hormone estrogen makes women more vulnerable to ACL injury by weakening this ligament. A previous investigation found that more ACL injuries in women occur during the points of their menstrual cycle when estrogen levels are high.
"Birth control pills help maintain lower and more
consistent levels of estrogen, which may prevent periodic ACL weakness,"
said lead author and M.D. - Ph.D. student Aaron Gray. "With this in mind,
we examined whether oral contraceptive use protected against ACL injuries that require
surgery in women."
Women between15-19 y in need of ACL reconstructive surgery, the
age group with the highest rates of ACL injuries by a wide margin, were 22
percent less likely to be using the birth control pill than non-injured women
of the same age.
Gray said that puberty might explain the high number of ACL
injury cases in young women of this age. During puberty, there is a sharp rise
in estrogen levels as well as growth spurts in the legs. Following one of these
growth spurts, it takes time for the adolescent to develop good coordination
with their newly elongated limbs.
"Young athletes currently use birth control pills for
various reasons including more predictable cycles and lighter periods,"
Gray said. "Injury risk reduction could potentially be added to that list
with further, prospective investigations."
Other authors include UTMB's Zbgniew Gugala and Jacques
Baillargeon.
