{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:34:49Z","timestamp":1792805689596,"version":"4.5.0"},"reference-count":41,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,6,5]],"date-time":"2022-06-05T00:00:00Z","timestamp":1654387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS)","award":["19K11358"],"award-info":[{"award-number":["19K11358"]}],"id":[{"id":"https:\/\/ror.org\/00hhkn466","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The purpose of this study was to investigate the changes in anterior knee laxity (AKL), stiffness, general joint laxity (GJL), and genu recurvatum (GR) during the menstrual cycle in female non-athletes and female athletes with normal and irregular menstrual cycles. Participants were 19 female non-athletes (eumenorrhea, n = 11; oligomenorrhea, n = 8) and 15 female athletes (eumenorrhea, n = 8; oligomenorrhea, n = 7). AKL was measured as the amount of anterior tibial displacement at 67 N\u2013133 N. Stiffness was calculated as change in (\u0394)force\/\u0394 anterior displacement. The Beighton method was used to evaluate the GJL. The GR was measured as the maximum angle of passive knee joint extension. AKL, stiffness, GJL, and GR were measured twice in four phases during the menstrual cycle. Stiffness was significantly higher in oligomenorrhea groups than in eumenorrhea groups, although no significant differences between menstrual cycle phases were evident in female non-athletes. GR was significantly higher in the late follicular, ovulation, and luteal phases than in the early follicular phase, although no significant differences between groups were seen in female athletes. Estradiol may affect the stiffness of the periarticular muscles in the knee, suggesting that GR in female athletes may change during the menstrual cycle.<\/jats:p>","DOI":"10.3390\/jcm11113222","type":"journal-article","created":{"date-parts":[[2022,6,5]],"date-time":"2022-06-05T10:47:11Z","timestamp":1654426031000},"page":"3222","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Menstrual Cycle Changes Joint Laxity in Females\u2014Differences between Eumenorrhea and Oligomenorrhea"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8632-3489","authenticated-orcid":false,"given":"Sae","family":"Maruyama","sequence":"first","affiliation":[{"name":"Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Niigata City 950-3198, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0687-605X","authenticated-orcid":false,"given":"Chie","family":"Sekine","sequence":"additional","affiliation":[{"name":"Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Niigata City 950-3198, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayuu","family":"Shagawa","sequence":"additional","affiliation":[{"name":"Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Niigata City 950-3198, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0752-5574","authenticated-orcid":false,"given":"Hirotake","family":"Yokota","sequence":"additional","affiliation":[{"name":"Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Niigata City 950-3198, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9698-9276","authenticated-orcid":false,"given":"Ryo","family":"Hirabayashi","sequence":"additional","affiliation":[{"name":"Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Niigata City 950-3198, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoya","family":"Togashi","sequence":"additional","affiliation":[{"name":"Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Niigata City 950-3198, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Yamada","sequence":"additional","affiliation":[{"name":"Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Niigata City 950-3198, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rena","family":"Hamano","sequence":"additional","affiliation":[{"name":"Department of Health and Sports, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata City 950-3198, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Health and Sports, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata City 950-3198, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3227-3129","authenticated-orcid":false,"given":"Daisuke","family":"Sato","sequence":"additional","affiliation":[{"name":"Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Niigata City 950-3198, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2784-6466","authenticated-orcid":false,"given":"Mutsuaki","family":"Edama","sequence":"additional","affiliation":[{"name":"Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Niigata City 950-3198, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1806","DOI":"10.1177\/0363546514540862","article-title":"The Effects of Level of Competition, Sport, and Sex on the Incidence of First-Time Noncontact Anterior Cruciate Ligament Injury","volume":"42","author":"Beynnon","year":"2014","journal-title":"Am. J. Sports Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1177\/0363546505284183","article-title":"Anterior cruciate ligament injuries in female athletes: Part 1, mechanisms and risk factors","volume":"34","author":"Hewett","year":"2006","journal-title":"Am. J. Sports Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1177\/0363546505282624","article-title":"The relationship between menstrual cycle phase and anterior cruciate ligament injury: A case-control study of recreational alpine skiers","volume":"34","author":"Beynnon","year":"2006","journal-title":"Am. J. Sports Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1177\/03635465020300020601","article-title":"The effect of the menstrual cycle on anterior cruciate ligament injuries in women as determined by hormone levels","volume":"30","author":"Wojtys","year":"2002","journal-title":"Am. J. Sports Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1177\/0363546516634682","article-title":"Multivariate Analysis of the Risk Factors for First-Time Noncontact ACL Injury in High School and College Athletes: A Prospective Cohort Study With a Nested, Matched Case-Control Analysis","volume":"44","author":"Vacek","year":"2016","journal-title":"Am. J. Sports Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1177\/03635465030310061801","article-title":"Risk factors associated with noncontact injury of the anterior cruciate ligament: A prospective four-year evaluation of 859 West Point cadets","volume":"31","author":"Uhorchak","year":"2003","journal-title":"Am. J. Sports Med."},{"key":"ref_7","first-page":"446","article-title":"Factors associated with anterior cruciate ligament injury: History in female athletes","volume":"47","author":"Kramer","year":"2007","journal-title":"J. Sports Med. Phys. Fit."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1177\/0363546505275149","article-title":"The effect of estradiol and progesterone on knee and ankle joint laxity","volume":"33","author":"Beynnon","year":"2005","journal-title":"Am. J. Sports Med."},{"key":"ref_9","first-page":"594","article-title":"Sex differences in knee joint laxity change across the female menstrual cycle","volume":"45","author":"Shultz","year":"2005","journal-title":"J. Sports Med. Phys. Fit."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1111\/j.1651-2227.2004.tb02749.x","article-title":"General joint laxity in 1845 Swedish school children of different ages: Age- and gender-specific distributions","volume":"93","author":"Jansson","year":"2004","journal-title":"Acta Paediatr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"389","DOI":"10.2519\/jospt.2007.2487","article-title":"Sex differences in clinical measures of lower extremity alignment","volume":"37","author":"Nguyen","year":"2007","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1002\/jor.21145","article-title":"A comparison of cyclic variations in anterior knee laxity, genu recurvatum, and general joint laxity across the menstrual cycle","volume":"28","author":"Shultz","year":"2010","journal-title":"J. Orthop. Res."},{"key":"ref_13","first-page":"287","article-title":"Knee joint laxity and its cyclic variation influence tibiofemoral motion during weight acceptance","volume":"43","author":"Shultz","year":"2011","journal-title":"J. Orthop. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1177\/0363546508326713","article-title":"Changing hormone levels during the menstrual cycle affect knee laxity and stiffness in healthy female subjects","volume":"37","author":"Park","year":"2009","journal-title":"Am. J. Sports Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1007\/s00167-006-0143-5","article-title":"Effects of menstrual-cycle hormone fluctuations on musculotendinous stiffness and knee joint laxity","volume":"15","author":"Eiling","year":"2007","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1097\/00042752-200007000-00003","article-title":"The association of the menstrual cycle with the laxity of the anterior cruciate ligament in adolescent female athletes","volume":"10","author":"Karageanes","year":"2000","journal-title":"Clin. J. Sport Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2325967121993045","DOI":"10.1177\/2325967121993045","article-title":"Relationship Between Anterior Knee Laxity and General Joint Laxity During the Menstrual Cycle","volume":"9","author":"Maruyama","year":"2021","journal-title":"Orthop. J. Sports Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Shagawa, M., Maruyama, S., Sekine, C., Yokota, H., Hirabayashi, R., Hirata, A., Yokoyama, M., and Edama, M. (2021). Comparison of anterior knee laxity, stiffness, genu recurvatum, and general joint laxity in the late follicular phase and the ovulatory phase of the menstrual cycle. BMC Musculoskelet. Disord., 22.","DOI":"10.1186\/s12891-021-04767-8"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/s00421-013-2771-z","article-title":"Differences in anterior cruciate ligament elasticity and force for knee flexion in women: Oral contraceptive users versus non-oral contraceptive users","volume":"114","author":"Lee","year":"2014","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1111\/jog.14523","article-title":"Advancement in female sports medicine and preventive medicine","volume":"47","year":"2021","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1111\/sms.13385","article-title":"Low energy availability, menstrual dysfunction, and impaired bone health: A survey of elite para athletes","volume":"29","author":"Brook","year":"2019","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1111\/sms.13464","article-title":"Risk factors of stress fractures due to the female athlete triad: Differences in teens and twenties","volume":"29","author":"Yoshino","year":"2019","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1249\/MSS.0b013e3181bbeaa6","article-title":"Joint laxity is related to lower extremity energetics during a drop jump landing","volume":"42","author":"Shultz","year":"2010","journal-title":"Med. Sci. Sports. Exerc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1249\/MSS.0b013e3182a03b8b","article-title":"Low bone density risk is higher in exercising women with multiple triad risk factors","volume":"46","author":"Gibbs","year":"2014","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S0015-0282(16)44888-0","article-title":"Prediction and detection of ovulation","volume":"34","author":"Moghissi","year":"1980","journal-title":"Fertil. Steril."},{"key":"ref_26","unstructured":"Salimetrics LLC., and Salivabio LLC. (2015). Saliva Collection and Handling Advice, Salivabio. [3rd ed.]. Available online: https:\/\/fnkprddata.blob.core.windows.net\/domestic\/download\/pdf\/SAL_handbook3.pdf."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1136\/ard.32.5.413","article-title":"Articular mobility in an African population","volume":"32","author":"Beighton","year":"1973","journal-title":"Ann. Rheum. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/0268-0033(95)92045-N","article-title":"Quantitative analysis of anterior cruciate ligament instability","volume":"10","author":"Maitland","year":"1995","journal-title":"Clin. Biomech."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3347","DOI":"10.1177\/0363546519886260","article-title":"Risk Factors Associated With a Noncontact Anterior Cruciate Ligament Injury to the Contralateral Knee After Unilateral Anterior Cruciate Ligament Injury in High School and College Female Athletes: A Prospective Study","volume":"47","author":"Davey","year":"2019","journal-title":"Am. J. Sports Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2325967117718781","DOI":"10.1177\/2325967117718781","article-title":"The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis","volume":"5","author":"Herzberg","year":"2017","journal-title":"Orthop. J. Sports Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1002\/jor.1100140405","article-title":"Primary immunolocalization of estrogen and progesterone target cells in the human anterior cruciate ligament","volume":"14","author":"Liu","year":"1996","journal-title":"J. Orthop. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s00418-005-0030-z","article-title":"Oestrogen receptor beta is present in both muscle fibres and endothelial cells within human skeletal muscle tissue","volume":"124","author":"Wiik","year":"2005","journal-title":"Histochem. Cell. Biol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1123\/jsr.18.4.553","article-title":"The effect of menstrual-cycle phase on hamstring extensibility and muscle stiffness","volume":"18","author":"Bell","year":"2009","journal-title":"J. Sport. Rehabil."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"419","DOI":"10.12965\/jer.1836110.055","article-title":"The difference effect of estrogen on muscle tone of medial and lateral thigh muscle during ovulation","volume":"14","author":"Sung","year":"2018","journal-title":"J. Exerc. Rehabil."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1111\/sms.13564","article-title":"Hamstring muscle elasticity differs in specialized high-performance athletes","volume":"30","author":"Avrillon","year":"2020","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2742","DOI":"10.1002\/art.20488","article-title":"Joint hypermobility syndromes: The pathophysiologic role of tenascin-X gene defects","volume":"50","author":"Zweers","year":"2004","journal-title":"Arthritis Rheum."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"171","DOI":"10.11138\/jts\/2013.1.4.171","article-title":"Generalized joint laxity and multidirectional instability of the shoulder","volume":"1","author":"Saccomanno","year":"2013","journal-title":"Joints"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Thompson, B.M., Drover, K.B., Stellmaker, R.J., Sculley, D.V., and Janse de Jonge, X.A.K. (2021). The Effect of the Menstrual Cycle and Oral Contraceptive Cycle on Muscle Performance and Perceptual Measures. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182010565"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1007\/s00167-011-1811-7","article-title":"Menstrual cycle and knee joint position sense in healthy female athletes","volume":"20","author":"Fouladi","year":"2012","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.knee.2012.12.013","article-title":"Knee laxity of Malaysian adults: Gender differentials, and association with age and anthropometric measures","volume":"21","author":"Zyroul","year":"2014","journal-title":"Knee"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/11\/3222\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:24:48Z","timestamp":1760138688000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/11\/3222"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,5]]},"references-count":41,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["jcm11113222"],"URL":"https:\/\/doi.org\/10.3390\/jcm11113222","relation":{"has-preprint":[{"id-type":"doi","id":"10.20944\/preprints202204.0179.v1","asserted-by":"object"}]},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,5]]}}}