2025 Volume 3 Issue 1 Pages 41-47
Objective: Female athletes are at high risk for lower body ligament injuries, which are likely related to fluctuations in female hormonal balance. One of the most common cases is an injury to the distal tibiofibular ligament while jump landing. This may be related to fluctuations in tibiofibular ligament length and jump landing sway with each menstrual cycle, however, this is still unclear. The purpose of this study was to determine the variation in tibiofibular ligament laxity and dynamic balance during jump landing at each menstrual cycle and to examine the risk of injury occurrence according to the menstrual cycle.
Methods: The participants were seven women. The width of the tibiofibular clear space (TFCS) and dynamic balance were measured at four phases: during menstruation, follicular, ovulation, and luteal. The menstrual cycle was determined using a basal thermometer and ovulation kits. TFCS was measured at the height of the anterior inferior tibiofibular ligament by ultrasonography, and the measurements were conducted in standing and sitting. The dynamic postural stability index (DPSI) was used to assess dynamic balance stability. Participants were asked to jump forward over a 30 cm hurdle. Kruskal Wallis test and Bonferroni correction were performed to compare the measurements for each menstrual cycle.
Result: The width of the TFCS in the standing position was significantly different depending on each menstrual period (p<0.05), and was longer during the ovulation period than other phases of the cycle. DPSI was maximal during the ovulation phase, and showed statistically significant high postural sway (p<0.05).
Conclusion: The previous study reported that an increase in TFCS of only 1 mm can significantly decrease the contact area of the tibiotalar joint, resulting in significant ankle instability. Changes in the length of the fine ankle ligaments due to hormonal fluctuations during each menstrual cycle may affect the landing motion and lead to injury occurrence. This study suggested the need to propose measures to prevent ankle injuries according to female’s menstrual cycles.
