WOMEN, REDUCE YOUR CHANCES OF WORKOUT PAINS, STRAINS,
AND INJURY
Ross Hauser, M.D.

Puffy knees, aching joints, sprains, strains, and tears. While these pains are usually attributed to "over doing it", researchers have found that workout and sports related injuries may be triggered by changes in hormonal levels during the menstrual cycle.
 

Studies have shown that women can be up to 800% more susceptible to athletic related injuries than men. To find out why, researchers began to zero in on the menstrual cycle as a possible answer.
 

At the University of Michigan at Ann Arbor, women who suffered non-contact tears of their anterior cruciate ligament (ACL), were asked to provide a detailed history of their menstrual cycles, including frequency and regularity, date of last menstrual period, average length of cycle, premenstrual symptoms, and oral contraceptive or hormone replacement use. When compared to the timing of their injuries, researchers were surprised to find that women were more likely to injure themselves in workouts or sporting activities during menstruation with more injuries occurring during the ovulatory phase.
 

The hormones estrogen and relaxin negatively effect injury healing. Estrogen, in both endogenous estrogens (naturally produced in the body) or exogenous (birth control pills or hormone replacement after menopause) inhibits the growth and repair of connective tissues (collagen, ligaments, and tendons). Relaxin, causes laxity in ligaments and tendons and is at its highest levels during pregnancy to allow the pelvic ligaments to loosen up so the newborn can be born through vaginal delivery. To prepare for the possibility of pregnancy, relaxin increases coinciding with the menstrual cycle causing a systemic relaxation or laxity in all the soft tissues of a woman’s body.
 

Since workout and sport activity's beneficial effects of muscle growth and strength involves the breakdown of collagen tissue in muscles, tendons, ligaments, and joint tissues, in order to rebuild new and stronger tissue, an understanding of how to counteract the effects of hormones is needed.
 

Tips To Help Avoid Injury By Counteract Hormonal Effects

1. Lighten or avoid working out during the peak estrogen and relaxin days

During a normal menstrual cycle, relaxin levels are highest during the middle of the luteal phase of the menstrual cycle (days 20-23). Estrogen concentration rises during day 10 and peaks on day 12. By avoiding heavy or any workouts on these days, the greatest risk of injury can be avoided.
 

2. Watch Your Eating Habits

Avoid foods that may increase estrogen levels, such as food heavy in sugar and watch your in take of caffeine. Do not binge eat or binge starve.
 

3. Drink a lot of water.

Collagen is made up of nearly 70% water by weight. Drinking filtered or natural water should be considered your number one defense for preventing workout and sport injuries.
 

4. Go to the bathroom.

Drinking a lot of water also has the beneficial effect of increasing your number of bowel movements. Increase your intake of raw vegetables and roughage. Bowel movements eliminate toxins in the body. Too many toxins, among other things, increases the levels of estrogens.
 

5. Talk to your physician about contraceptives.

Many doctors and researchers have speculated that oral contraceptive pills are a risk factor for low back and pelvic pain among women. The theory proposes that steroid hormones affect joints and ligaments, leading to joint laxity and low back pain. Increasingly many physicians now feel that the estrogen "overload" caused by the pill are why many women suffer chronic injuries and pain. In Sweden, many general practitioners, gynecologists, and orthopedists, recommend that some women with back problems abandon their use of oral contraceptives.
 

6. Talk to your physician about Progesterone

Progesterone, a naturally occurring hormone found in wild yams, is often prescribed to help stimulate the body's own progesterone production and keep the estrogen in check. Progesterone and estrogen are involved in a delicate check and balance system during the menstruation cycle. If this balancing act is disrupted, with estrogen being dominant or progesterone being deficient , severe symptoms of PMS may develop. These symptoms of mood swings, cramping, and migraines should alert you that you are at high risk for injury during your workout.

7. Talk to your doctor about Prolotherapy
 

Many women will continuously push themselves through chronic pain and injury because of their need to continue aerobics, tennis or other activities. They will continue to do so until one or more joints become so painful that they can no longer perform the activity. In this situation a trip to the doctor will usually mean a suggestion of surgery, NSAIDS (nonsteroidal anti-inflammatory drugs), or cortisone shots. Since NSAIDs and cortisone shots have come under attack in increasing numbers in numerous medical journals for their side effects, and the thought of surgery and missing time from work scares away many others, sufferers have begun to look at other options.
 

One procedure is usually rarely prescribed because of the limited amount of physicians who can perform the technique (presently about 300 in the United States) is Prolotherapy.
 

Used in conjunction with a nutritional and hormonal supplementation plan, the rebuilding process of Prolotherapy results in new ligament growth which can be 40% stronger than the original ligament. Consequently, the physical structure supported by this connective tissue becomes stronger and more stable, thereby eliminating or greatly diminishing the pain triggered by the corresponding nerves and muscles and quickly returning people to active sport participation.
 

Prolotherapy is not an immediate cure although many patients report it is. Usually treatments require two or three sessions over a six week interval. As reported in the prestigious medical journal Lancet, Prolotherapy has been shown to effectively eliminate chronic pain in over 90% of cases.