Numerous studies have been conducted on changes of knee ligament laxity during the menstrual cycle (MC) since there are more injuries in certain phases. Some researchers believe that since estrogen receptor Î² exists in ligaments and tendons in the knee, estrogen may modulate towards a state of laxity. However, increased tissue temperature also observed during the MC can predispose ligament and tendon laxness. The number of women using oral contraceptive pills (OCP) has constantly increased in the United States. This exogenous source of synthetic forms of steroid hormones prevents ovulation by maintaining more consistent daily hormone levels than occurs. Since the estrogen receptor Î² exists on human connective tissue, OCP might have an impact on tendon and ligament synthesis, structure, and biomechanical properties. Therefore, the purpose of this study was to assess in women the relationship between Estradiol (E2) serum concentrations and tissue temperature during the MC and their combined effect on ACL elasticity, force to flex the knee (FFK), and knee flexion-extension hysteresis (KFEH) in OCP users and non-OCP users. Nineteen non-athletic young healthy females were divided into two groups; OCP users and non-OCP users. E2 serum concentrations, ACL elasticity, FFK, and KFEH were assessed both at ambient temperature (22 Â°C) and after 38 Â°C warming of the leg to stabilize the normal temperature during the MC. The result of this investigation showed that ACL elasticity was significantly lower and FFK and KFEH were significantly higher during ovulation compared to menstruation (p<0.05) but after 38 Â°C warming of the leg, there were no differences in KKF and KFEH in non-OCP users. Also, ACL elasticity was significantly lower and FFK and KFEH were significantly higher OCP users than non-OCP users (p<0.05) at ambient temperature. But, no significant difference in FFK and FFEH between the two groups was found after warming to 38 Â°C. In conclusion, OCP users have more knee stiffness and effect of heat on FFK and KFEH when their legs were heated compared to non-OCP users. In addition, ACL elasticity, FFK, and KFEH were affected not only by estrogen but tissue temperature during the menstrual cycle.
School of Allied Health Professions
Petrofsky, Jerrold S.
Berk, Lee S.
Daher, Noha S.
Laymon, Michael S.
Doctor of Science (DSc)
Year Degree Awarded
Date (Title Page)
Library of Congress/MESH Subject Headings
Ligaments, Articular; Physical Therapy Modalities; Contraceptives, Oral; Oral contraceptives - side effects; Menstruation
Subject - Local
Anterior Cruciate Ligament Elasticity, Muscle flexibility, Tendon flexibility, oral contraceptives, menstrual cycles
Loma Linda University Libraries
This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.
Lee, Haneul, "Anterior Cruciate Ligament Elasticity and Force for Knee Flexion during the Menstrual Cycle in Women" (2013). Loma Linda University Electronic Theses, Dissertations & Projects. Paper 132.
Loma Linda University Electronic Theses & Dissertations
Loma Linda University. Del E. Webb Memorial Library. University Archives