Dr. West’s study will include approximately 180 female college athletes from Pace University. Her hypothesis: the risk of injury in female athletes increases during a particular phase of the menstrual cycle due to hormonal shifts.

Estrogen makes ligaments, like the ACL, stretchy and loose. Because of this, most ACL injuries occur right before ovulation when estrogen peaks. Dr. West’s study will examine another possible source of these injuries — which women are three to six times more likely than men to suffer.

“In the second half of the menstrual cycle, the hormone progesterone is more dominant and impairs your body’s ability to recover,” Dr. West explained. “If women aren’t adjusting their training and recovery at the latter part of the menstrual cycle, does that set them up to have more injury at the beginning of the next cycle?”

To determine whether this is the case, the study team is outfitting each of the participants with a WHOOP bracelet, a device that monitors heart rate, sleep quality, recovery and more. In addition, participants will answer daily questions about whether they are ill, injured and/or menstruating. Researchers will review the collected data and use it to affirm or reject the hypothesis.

A necessary undertaking

There is little known about the influence hormones have on women’s athletic performance. What is known has more to do with the shape and structure of the female body. “In general, women tend to land in a more valgus position, meaning they’re more knock-kneed when they jump and land. In recent years, that’s something that’s changed as far as teaching girls how to land,” Dr. West explained.

This has been a meaningful step forward for female athletes, but the picture of women’s orthopedics remains dangerously incomplete.

On top of being insufficiently understood, athletic training — and strength training in particular — is stigmatized for women, who, Dr. West said, run the risk of being seen as unladylike if they gain muscle mass. “It’s not true,” she explained. “It’s like saying you don’t want to drive a car because you’re afraid you’re going to become a NASCAR racer.”

Dr. West advises that women should not be concerned about aesthetics but rather the many benefits of strength training, such as injury prevention, denser bones and even a longer life.

What comes next?

Dr. West pointed to a variety of benefits the study could produce. For instance, if the researchers do establish a link between the menstrual cycle and injury risk, the study’s findings could inform the way college sports teams, as well as the NCAA, arrange training and playing schedules for their athletes. “If we could find any correlation there, we could say, ‘Okay, having back-to-back games three weeks in a row, you’re more likely to get injured.’ We could say to the NCAA, ‘Hey, this travel schedule isn’t ideal,’” Dr. West said.

She also notes that the study will benefit its participants in the short term by providing them with information about their own bodies. Having their physical readings at hand, Dr. West hopes, will empower them to understand how their habits and diet affect their sleep and recovery and make informed decisions for their health.

Whether or not the study bears out the hypothesis, Dr. West is simply happy that research is finally taking place around women’s orthopedics. “Even if we don’t find anything, that is actually something, because there’s no data right now for any of this stuff. So, if we can say, ‘Hey, we looked at this and we didn’t find any trends,’ that’s actually important information to have.”

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