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01-12-2021 | Research | Uitgave 1/2021 Open Access

Journal of Foot and Ankle Research 1/2021

A preliminary study exploring the change in ankle joint laxity and general joint laxity during the menstrual cycle in cis women

Journal of Foot and Ankle Research > Uitgave 1/2021
Tomomi Yamazaki, Sae Maruyama, Yuki Sato, Yukako Suzuki, Sohei Shimizu, Fumiya Kaneko, Masahiro Ikezu, Kanta Matsuzawa, Mutsuaki Edama
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The purpose of the present study was to examine the relationship between ankle joint laxity and general joint laxity (GJL) in relation to the menstrual cycle, which was divided into four phases based on basal body temperature and ovulation, assessed using an ovulation kit.


Participants were 14 female college students (21–22 years) with normal menstrual cycles (cis gender). Anterior drawer stress to a magnitude of 120 N was applied for all participants. Anterior talofibular ligament (ATFL) length was measured as the linear distance (mm) between its points of attachment on the lateral malleolus and talus using ultrasonography. Data on ATFL length from each subject were used to calculate each subject’s normalized length change with anterior drawer stress (AD%). The University of Tokyo method was used for evaluation of GJL. AD% and GJL were measured once in each menstrual phase.


There was no statistically significant difference between AD% in each phase. GJL score was significantly higher in the ovulation and luteal phases compared with the early follicular phase. AD% and GJL showed a positive correlation with each other in the ovulation phase.


Although it is unclear whether estrogen receptors are present in the ATFL, the present study suggests that women with high GJL scores might be more sensitive to the effects of estrogen, resulting in ATFL length change in the ovulation phase.

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