Date Approved


Embargo Period


Document Type


Degree Name

M.S. Athletic Training


Health & Exercise Science


School of Health Professions


Spencer, Leslie

Committee Member 1

Weaver, Robert

Committee Member 2

Willis, Shari


Knee--Wounds and injuries; Women athletes


Medicine and Health Sciences | Rehabilitation and Therapy | Sports Sciences


Female athletes are three to six times more likely than males to sustain a ligamentous knee injury due to hormonal risk factors. Hormones of the menstrual cycle have been shown to alter the physiological component of ligamentous structures during the three phases of the cycle. Use of hormonal contraceptives (HCs) may influence the incidence and severity of ligamentous knee injuries in female athletes. The objective of this cross-sectional study was to determine the relationship between HC use and the type and severity of ligamentous knee injuries sustained among female collegiate athletes using an online survey distributed to NCAA female athletes who experienced a ligamentous knee injury during the study time period (n=336). The electronic survey assessed demographic information, ligamentous knee injury and menstrual cycle characteristics, and HC use. Chi-Square analyses showed significant relationships between injury type and severity of injury, and injury type and menstrual cycle phase. The majority of respondents sustained ACL injuries, were in the luteal phase of the menstrual cycle, and HC users. Of the HC users, there were a greater number of respondents who were combined hormonal contraceptive users and oral contraceptive pill users. The type of ligamentous knee injury (ACL) impacted the severity of the injury. Female athletes were at the greatest risk for ligamentous knee injury in the luteal phase of the menstrual cycle. Future work should aim to identify injury prevention programs, protective equipment, and HC for decreasing the risk for ligamentous knee injury.