Unlike bone and muscle, where estrogen improves function and strength of both, depending on the amount in one’s body during a particular phase, it is in the decrease of stiffness in one (ligament), and in the increase of rigidness in the other (tendon), where performance takes a hit, and injuries arise. Simultaneously, during points in the menstrual cycle where estrogen levels peak, tendons, to a degree, will benefit from an increase in laxity, while conversely, ligaments are bound to suffer the same consequence, despite the need for them to remain rigid.
A conundrum like this continues to stump science and medicine when honing in on the active, premenopausal group, which are two-to-eight times more likely to suffer ACL tears than their male counterparts. It is during the pre-ovulatory (first 10-17 days) and ovulatory phase which follows that estrogen levels spike, and ruptures are most likely to occur.
As controversies, inconsistencies and disagreements abound during such an injury-prone stage in the menstrual cycle, for sports athletes, one practice to combat and keep both sinews in their preferred range of stiffness, is the assignment of oral contraceptives. Specifically, a low-level amount of progesterone.
The goal is to always keep ligaments stiff in order to maintain joint stability. A tendon, however, is trickier. It is there to connect a compliant muscle to a stiff bone. Though some stiffness is beneficial in transmitting force from bone to muscle faster which improves performance, too much rigidness strains the muscle. I.e., more of an unhealthy stretch in movement is concentrated in a muscle connected to a stiff tendon, rather than a compliant one that doesn’t force a muscle into simultaneous excess of lengthening while struggling to contract.
There’s a quote that sums up my feelings when it comes to synthetically adjusting one’s hormones:
“The endocrine system is like a spider web. Touch one strand, and the whole thing shakes.”
Given the juxtaposition of power and fragility when it comes to the said system, it is best to circumvent synthetically adjusting your hormones, unless absolutely necessary, for which you should seek a doctor’s supervision.
For example, athletes, such as ultra-active gym-goers whose bodies are “on-the-go” year-round, and wind up with chronic energy deficiency. In such cases, the occurrence of amenorrhea: an abnormal ceasing of menstruation rises, causing bone mass reduction, and increased risk of musculoskeletal injury. If one’s body has reached such a breaking point, an immediate visit with a doctor is paramount.
An alternative for maintaining homeostasis in an active female’s menstrual cycle, is the natural chemical genistein, found in the phytoestrogen, soy. Regarding the Achilles tendon, studies have shown that unlike native estrogen decreasing tendon stiffness, genistein showed no effect on mechanical properties of the Achilles, while returning collagen content to preferred levels. This was a substantial finding, given that tendons are 60-85% collagen, and ligaments hold steady at 75%!
Due to the bad rap that soy gets, understand that while this genistein bean may act like estrogen, it also possesses anti-estrogen properties. I.e., they block more potent natural estrogens from binding to estrogen receptors. Additionally, they halt formations of estrogen in fatty tissue, and stimulate production of a protein that binds estrogen into the blood, reducing its susceptibility to connect and proliferate within receptors.
Regarding the injury-prone pre-ovulatory and ovulatory phases, and prior to heading into my exercise suggestions for the active pre-menopausal population, it is crucial to recognize emotions that coincide with these phases. It will not be easy, given the overriding factor of adrenaline and serotonin, along with those who listen to music while working out; however, repetition is the mother of learning. Therefore, the more you study your own thoughts, the faster you transition your style of training into a safer pocket.
Because I am not a woman, and am aware of the wide-ranging affects that menstrual cycles have on emotions, per inquiry, the following are mental and physical examples of what you may experience during the subsequent phases.
Pre-ovulation: an overall sense of happiness. Energy and patience increases, with a heightened sense of mental acuity. Pain-masking endorphins rise, making experiences such as a flu-shot more bearable, and a physical challenge increasingly conquerable.
Ovulation: feelings of irritability and depression. Layered emotions pass through in waves, creating a sense of instability. Physical symptoms are increased body temperature, fatigue, mild-to-extreme bloating, and an overall felling of heaviness, “Like legs are stuck in cement.”
Note: because laxity increases in both tendons and ligaments during this time, you should reduce range of motion. I also find it beneficial to NOT perform stretches on or near these laxity-prone areas, as they are already in a perpetual phase of hypermobility.
The four exercise recommendations during an estrogen-spiking, pre-ovulation and ovulation phase are as follows:
-Controlled leg extensions with an isometric hold at the top of each repetition.
-Seated leg curls with an isometric hold at the bottom of each repetition.
-Lateral lunges with an isometric hold at the bottom of each repetition.
-Split squats with an isometric hold at the bottom of each repetition.
-E.E.S-
WEBSITES
Effect of Estrogen on Musculoskeletal Performance and Injury Risk
Nkechinyere Chidi-Ogbolu and Keith Baar
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341375/
Emerging science supporting the health the benefits of genistein.
Rob Winwood. January 17th, 2018.
April 2014 Issue
The Top 5 Soy Myths
By: Judith C. Thalheimer, RD, LDN
Today’s Dietitian
Vol. 16. No. 4. P. 52.