Hormonal Contraceptive Use and Musculoskeletal Injury Risk in Female Athletes: A Prospective Cohort Study

Area of Science:

• Sports Medicine
• Female Athlete Health
• Biomechanical Analysis

Background:

• Female athletes experience higher rates of musculoskeletal (MSK) injuries compared to males, potentially linked to reproductive hormones.
• Understanding the influence of hormonal contraceptives (HCs) on injury risk is crucial for female athlete well-being.

Purpose of the Study:

• To investigate the association between hormonal contraceptive (HC) use, joint laxity, and injury incidence in female athletes over one year.
• To analyze the impact of HCs on hormonal profiles, joint laxity, and lower extremity biomechanics during athletic movements.

Main Methods:

• A cohort study involving professional and collegiate female athletes, divided into HC and non-HC groups.
• Measurement of serum relaxin, estrogen, and progesterone levels, knee laxity, and lower extremity kinematics during a single-legged jump.
• Tracking of injuries over a 1-year period post-testing during the luteal phase of the menstrual cycle.

Main Results:

• Athletes using HCs exhibited lower levels of progesterone, estrogen, and relaxin compared to non-HC users.
• Non-HC athletes showed greater hip flexion and knee adduction (valgus) during a single-legged jump landing.
• A significant correlation was found between higher circulating relaxin levels and increased injury count.

Conclusions:

• A link exists between elevated relaxin levels and increased risk of musculoskeletal injury in female athletes.
• Hormonal contraceptive use was associated with reduced peak knee adduction angles during jump landings, potentially offering a protective effect.
• Further research into specific HC formulations could inform strategies to reduce sport-related injuries in female athletes.