Hormonal influence on knee-stabilizing muscle activity across the menstrual cycle: a scoping review

Background Female athletes are at increased risk of non-contact anterior cruciate ligament (ACL) injuries, with incidence varying across the menstrual cycle (Wojtys et al. , 1998). Hormonal fluctuations, particularly in estradiol and progesterone, have been linked to changes in ligament laxity and may also influence neuromuscular activation. Previous research has demonstrated phase-dependent changes in reflex excitability (Casey et al. , 2014) and motor unit behavior (Tenan et al. , 2013), suggesting potential alterations in the activity of muscles contributing to knee stability. However, the impact of these hor…