ReviewMuscles, ligaments and tendons journal
Effects of the menstrual cycle on lower-limb biomechanics, neuromuscular control, and anterior cruciate ligament injury risk: a systematic review.
Review in Muscles, ligaments and tendons journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Pooled it
- Menstrual Cycle Phase-Dependent Lower Extremity Loading Patterns in Adolescent Female Athletes: Implications for Anterior Cruciate Ligament Injury Risk.Journal of the Pediatric Orthopaedic Society of North America · 2026Article
- A Thematic Narrative Review of Osteoarthritis Risk Factors Across the Female Life Course.International journal of molecular sciences · 2026Review
- The Influence of the Phases of the Menstrual Cycle on Intrinsic Injury Risk Factors in Eumenorrheic Female Athletes or Physically Active Women-A Systematic Review.Sports (Basel, Switzerland) · 2026Review
- Phase-Specific Variations in Lower-Limb Muscle Strength Across the Menstrual Cycle in Female Soccer Players.Sports (Basel, Switzerland) · 2026Article
- Menstrual cycle does not change sagittal plane segments coordination variability during deadlift, a nonlinear dynamical analysis approach.Scientific reports · 2026Article
- Evaluation the Impact of Hormonal Fluctuations During the Menstrual Cycle on the Performance of Female Athletes-Systematic Review.Muscles (Basel, Switzerland) · 2025Review
- Injury Risk and Overall Well-Being During the Menstrual Cycle in Elite Adolescent Team Sports Athletes.Healthcare (Basel, Switzerland) · 2025Article
- Gender Differences in the Incidence and Types of Sports Injuries Among Female Athletes: A Scoping Review.Journal of nursing management · 2025Article
- The Association Between Menstrual Cycle Phase, Menstrual Irregularities, Contraceptive Use and Musculoskeletal Injury Among Female Athletes: A Scoping Review.Sports medicine (Auckland, N.Z.) · 2024Article
- Trunk and Lower Extremity Biomechanics in Female Athletes With and Without a Concussion History.Journal of athletic training · 2024Article
- Menstrual Cycle Patterns After Concussion in Adolescent Patients.The Journal of pediatrics · 2023Article
- "I hardly have a problem […] I have my period quite rarely too": Female football players' and their coaches' perceptions of barriers to communication on menstrual cycle.Frontiers in sports and active living · 2023Article
- The effects of sex hormones during the menstrual cycle on knee kinematics.Frontiers in bioengineering and biotechnology · 2023Article
- Motor Control and Regularity of Menstrual Cycle in Ankle and Knee Injuries of Female Basketball Players: A Cohort Study.International journal of environmental research and public health · 2022Article
- Training, Wellbeing and Recovery Load Monitoring in Female Youth Athletes.International journal of environmental research and public health · 2022Review
- Sex Differences in Endurance Running.Sports medicine (Auckland, N.Z.) · 2022Review
- Canine ACL rupture: a spontaneous large animal model of human ACL rupture.BMC musculoskeletal disorders · 2022Review
- Anterior cruciate ligament injury prevention.Annals of joint · 2022Review
- Relationship between Muscle Flexibility and Characteristics of Muscle Contraction in Healthy Women during Different Menstrual Phases.Physical therapy research · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveAnterior cruciate ligament (ACL) injury has a devastating impact on physical and psychological disability. Rates of ACL rupture are significantly greater in females than males during the same sports. Hormonal mechanisms have been proposed but are complex and poorly understood. This systematic review evaluates the effects of menstrual cycle on: 1) lower-limb biomechanics, 2) neuromuscular control, and 3) ACL injury risk.
methodsThe MEDLINE, CINAHL, SPORTSDiscus, Web of Science, and Google Scholar databases were searched from inception to August 2016 for studies investigating the effects of the menstrual cycle on lower-limb biomechanics, neuromuscular control, and ACL injury risk in females. Three independent reviewers assessed each paper for inclusion and two assessed for quality.
resultsSeventeen studies were identified. There is strong evidence that: 1) greatest risk of ACL injury is within the pre-ovulatory phase of the menstrual cycle, and 2) females with greater ACL laxity in the pre-ovulatory phase experience greater knee valgus and greater tibial external rotation during functional activity.
conclusionFemales are at greatest risk of ACL injury during the pre-ovulatory phase of the menstrual cycle through a combination of greater ACL laxity, greater knee valgus, and greater tibial external rotation during functional activity. LEVEL OF EVIDENCE: Ib.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.