Monday, February 12, 2007

Hormonal Hogwash

So I get this headline from the BBC this evening (link to the full article). It got my dander up:
Menstrual cycle injury risk link
Women are more likely to injure themselves at specific times in their menstrual cycle, research suggests.

London's Portland Hospital surveyed 1,000 osteopaths, and studied 17 women with a regular menstrual cycle.

The study suggests the risk of injury is linked to fluctuating hormone levels which affect the muscles and ligaments.

Both tissues appear to be vulnerable midway through the menstrual cycle, while the ligaments are at greater risk at the end.

This is significant for women everywhere who can plan their schedules around their cycles and avoid potentially painful injuries
Rebecca Morrison
British School of Osteopathy

Quick ladies! Grab your calendar and start plotting the days you need to lie still in bed and refrain from moving. You know how physically fragile (we won't go into the mental fragility) you are when those hormones start raging.

I'll have to say, I find a sample size of 17 to be pretty small and the use of "laxity of the forefinger joint" as hard and fast proof we are so vulnerable to these variations in blood hormone levels fairly weak. If there are any really good studies, please, send the references to me. Has ANYONE (coach, ATC, therapist) EVER really plotted this data with their patients/athletes?

I don't recall noting any trends of myself, or female teammates in grade school, high school, or college, or at the master's level of competition.

From a clinical view, back injuries, knee injuries--in ANYONE--much less just women, usually occur because of faulty mechanics/coordination/strength, not just simple joint laxity. Many young females athletes have more ACL injuries because they don't decelerate well, and they don't have enough eccentric control and strength for the skill level at which they play. It is not because we are freaks with wider hips and different hormones.

Maybe the woman in the article needs to find a Pilates or Yoga instructor to teach her how to tie her shoes without putting her back in a problematic position? Sounds like a plan to me!

Women need to TRAIN to move and be strong so they can play and compete at high levels, regardless of their hormonal status, controlled or not. No female athlete can schedule competitions or training around their hormonal fluctuations, nor should the average woman plan their physical activity around their menstrual cycle. How in the hell do you think women have survived over the last few thousand years cooking, cleaning, having umpteen kids, feeding the livestock, tending the fields, menstrual cycles just raging away? It just doesn't matter; there is no reason to perseverate on these minor physiological variations.

Unless you plant an idea in my head that says "you're in a dangerous state" or "you're different" because you're female and have this little issue men and boys don't. Then we create a medicalized, reductionist issue that really isn't meaningful, but people begin to THINK it is. This is the same type of historical gender bias crap (oh, but it is medically based so it is ok, right?) that kept women from running the Olympic marathon until 1984 and continues to keep them out of ski jumping and the longer distance races in swimming, running, etc.

We don't possess the same absolute strength as our male counterparts, but we can achieve the same or better relative strength and endurance levels if you teach us to train hard enough; to train properly; to train early enough to keep up with our early physical maturation. Support us to get the movement experiences our male childhood counterparts are encouraged to experience. Then we will have fewer injuries.

And finally, we are not hysterical patients when we come to your office with complaints of joint pain. Maybe physicians should learn to take a thorough history of our movements and activities, and evaluate HOW we move, rather than focus on what point of our menstrual cycle we are in. This is the REAL issue in my mind: Women with musculoskeletal injuries getting blown off or mis-diagnosed by physicians who will simply attribute the pain/injury to "hormones" and tell us to just stop moving that time of the month.


Bryan McCloskey, ATC said...

It is frustrating, Tracy, how research like this can be promoted through a large media outlet like the BBC, despite its obvious limitations and broad assumptions.

In my opinion, it comes across as more ammunition for the lazy individual who is looking for a reason not to get up and move.

For those of us who get up and move no matter tired we are, the amount of other stuff we have to do, what time of the month it is (for females)...more power to us. keep it up and dont let a simplistic generalization get in the way!


climber511 said...

Someone woke up on the wrong side of the bed this morning? About as accurate as that research I think.

The Iron Maven said...

Well, Climber511, why don't you contribute something insightful regarding the actual issue? Do you know anything about rates of injury/per exposure or joint laxity and horomone status? Please, enlighten us with your wisdom on this issue!