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GENDER BIAS IN ACL INJURY

sured during a closed kinetic-chain movement indicated a decreased ability for the female musculature to counteract delete- rious forces in the knee. A single study has implicated fluctuating levels of active stiffness across the menstrual cycle for the higher rates of ACL injuries at the time of ovulation. It is hoped that ongo- ing research will clarify whether oestrogen supplementation in the form of the female contraceptive pill can regulate active muscle stiffness across the menstrual cycle.

THE AUTHORS Dr Adam Bryant, BHMSc (Hon), is a lecturer within the School of Physiotherapy at the University of Melbourne, Australia having com- pleted his PhD in the area of neuromuscular adaptations following ACL injury and reconstruction. His research has examined changes in the mechanical properties of skeletal muscle across the menstru- al cycle. and he is currently working on the development of footwear to compensate for the changes in musculotendinous stiffness across the menstrual cycle. Adam has won a number of major awards including Best Young Investigator (2004 Australian Sports Medicine Conference) and the 2005 Victorian Minister for Sport and Recreation, Research Excellence Award.

Associate Professor Erik Hohman is an orthopaedic surgeon who trained as an undergraduate in Germany and as a postgraduate at the University of the Witwatersrand, Johannesburg, South Africa. He completed a Fellowship in Orthopaedic Sports Medicine at the Department of Orthopaedic Sports Medicine at the University of Technology, Munich, Germany and since 2002 has been staff orthopaedic surgeon at Rockhampton Hospital and appointed as a

UNIVERSITY OF WALES INSTITUTE, CARDIFF ATHROFA PRIFYSGOL CYMRU, CAERDYDD

senior lecturer at the University of Queensland, Australia. In 2003 Erik helped co-found the Musculoskeletal Research Unit at Central Queensland University and was appointed an associate professor.

Postgraduate Certificate/Diploma/ MSc Sport & Exercise

Further information: Yvonne Saker,

Course Co-ordinator Tel: 029 2041 6569 email:

ysaker@uwic.ac.uk

Or Fran Forrester, Tel: 029 2041 6591 email: css@uwic.ac.uk uwic.ac.uk

Medicine COMBINING SPORT AND EXERCISE MEDICINE AND SCIENCE

The course provides expertise in Sport and Exercise Medicine for Doctors and Chartered Physiotherapists.

Taught Modules are delivered over two, five-day residential sessions per year; students are supported between taught phases via a virtual learning environment and through on-line support.

Managed by the Cardiff School of Sport at UWIC, the programme is delivered by experts in Sport and Exercise Medicine and Sport and Exercise Science to provide the latest academic and practical developments in the field.

References 1. Arendt E, Agel J, Dick R. Anterior cruciate ligament injuries among col- legiate men and women. Journal of Athletic Training 1999;34:86-92 2. Souryal TO, Freeman TR. Intercondylar notch size and anterior cruciate ligament injuries in athletes: a prospective study. American Journal of Sports Medicine 1993;21:535-539 3. Wojtys EM, Ashton-Miller JA, Huston LJ. A gender related difference in the contribution of the knee musculature to sagittal-plane shear stiffness in subjects with similar knee laxity. Journal of Bone and Joint Surgery America 2002;84:10-16 4. Cowling EJ, & Steele JR. Is lower limb muscle synchrony during land- ing affected by gender? Implications for variations in ACL injury rates. Journal of Electromyography and Kinesiology 2001; 11:263-268 5. McNair PJ, Wood G, Marshall R. Stiffness of the hamstring muscles and its relationship to function in anterior cruciate ligament deficient individ- uals. Clinical Biomechanics 1992;7:131-137 6. Blackburn TJ, Riemann BL, Padua DA, Guskiewicz KM. Sex comparison of extensibility, passive, and active stiffness of the knee flexors. Clinical Biomechanics 1992;19:36-43 7. Johns RJ, Wright V. Relative importance of various tissues in joint stiff- ness. Journal of Applied Physiology 1962;17:824-828 8. Andersen HN, Dyhre-Poulsen P. The anterior cruciate ligament does play a role in controlling axial rotation in the knee. Knee Surgery, Sports Traumatology, Arthroscopy 1997;5:145-149 9. Granata KP, Wilson SE, Padua DA. Gender differences in active muscu- loskeletal stiffness. Part I. Quantification in controlled measurements of knee joint dynamics. Journal of Electromyography and Kinesiology 2002;12:119-126 10. Gardner-Morse M, Stokes IAF, Laible JP. Role of muscles in lumbar sta- bility in maximum extension efforts. Journal of Orthopedic Research 1995;13:802-808 11. Granata KP, Marras WS. Cost-benefit of muscle co-contraction in pro- tecting against spinal instability. Spine 2000;25:1398-1404 12. Waite LR, Ford SP, Young DF, Conley AJ. Use of ultrasonic Doppler waveforms to estimate changes in uterine artery blood flow and vessel compliance. Journal of Animal Science 1990;68:2450-2458 13. Magnusson SP. Passive properties of human skeletal muscle during stretch manellvers: a review. Scandinavian Journal of Medicine and Science in Sport 2001;8:65-77 14. Mansour JM, Audu ML. The passive elastic moment at the knee and its influence on human gait. Journal of Biomechanics 1986;19:369-373 15. Cholewicki J, Simons APD, Radebold A. Effects of external trunk loads on lumbar spine stability. Journal of Biomechanics 2000;33:1377-1385 16. Zhang LQ, Nuber G, Butler J, Bowen M, Rymer WZ. In vivo human knee joint dynamic properties as functions of muscle contraction and joint posi- tion. Journal of Biomechanics 1998;31:71-76 17. Granata KP, Padua DA, Wilson SE. Gender differences in active muscu- loskeletal stiffness. Part II. Quantification of leg stiffness during func- tional hopping tasks. Journal of Electromyography and Kinesiology 2002;12:127-135 18. Farley CT, Blickhan R, Saito J, Taylor CR. Hopping frequency in humans: a test of how springs set stride frequency in bouncing gaits. Journal of Applied Physiology 1991;71:2127-2132 19. McMahon TA, Cheng GC. The mechanics of running: how does stiffness couple with speed? Journal of Biomechanics 1990;23:65-78 20. McNitt-Gray J, Yokoi T, Millward C. Landing strategy adjustments made by female gymnasts in response to drop height and mat composition. Journal of Applied Biomechanics 1993;9:173-190 21. Eiling E, Bryant AL, Petersen W, Murphy A. & Hohmann, E. Effects of menstrual-cycle hormone fluctuations on musculotendinous stiffness and knee joint laxity. Knee Surgery, Sports Traumatology, Arthroscopy 2007;15:16-132 22. Wojtys EM, Huston LJ, Boynton MD et al (2002) The effect of the men- strual cycle on anterior cruciate ligament injuries in women as determined by hormone levels. American Journal of Sports Medicine 2002;30: 182-188

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