Published on 07 May 2025
In recent years, the connection between the menstrual cycle and athletic performance has taken centre stage. Emerging research highlights an intriguing link between the different phases of a menstrual cycle and injury susceptibility in athletes.
Are you more prone to injuries on your period?
Have you ever found yourself getting injured at specific times of the month, but are unable to pinpoint the reason? The answer might lie in your menstrual cycle.
While this insight is relatively new, it’s shedding light on how menstruation might play a significant role in injury risk for female athletes.
How does menstruation affect female athletes?
The menstrual cycle impacts athletes differently depending on the phase they’re in. Hormonal fluctuations play a crucial role, and research indicates that during the pre-menstrual phase, the risk of muscle injuries rises compared to the menstruation phase.
These changes could shape not only how athletes perform, but also how they approach training and recovery.
The effects of menstrual cycle phase on athletic performance
Menstrual cycles typically last between 24 to 38 days, but this can vary for each person and may also change over time. There are four phases of the menstrual cycle:
- Menstrual phase: The first day of bleeding marks the start of the cycle
- Follicular phase: The uterine lining starts to rebuild, making this the longest phase
- Ovulation: The release of an egg from the ovary occurs during this phase
- Luteal phase: The uterus prepares for potential pregnancy by thickening its lining
Research led by University College London (UCL), the University of Bath and St Mary’s University, monitored 26 professional female footballers over three years and a total of 593 cycles were tracked.
Findings revealed a connection between the pre-menstrual phase and an increased risk of injuries. The most common injuries affected the following:
- Muscle
- Joint and ligament
- Tendon
- Fracture and bone stress
Why does this happen?
During ovulation, peak oestrogen levels in the body can influence ligament laxity, increasing the vulnerability to ligament injuries. Elevated oestrogen levels contribute to the weakening of ligaments, which in turn raises the likelihood of injuries such as ACL tears.
After the ovulation phase, progesterone levels increase which leads to greater breakdown of amino acids stored in muscles. This can weaken muscle-building properties and raise the risk of muscle injuries during intense training.
Pre-menstrual hormone withdrawal (as oestrogen and progesterone levels drop) triggers inflammation throughout the body. This can delay recovery and increase injury risk, while menstrual symptoms like sleep problems, mood changes, reduced coordination, and pain further reduce readiness for physical activity.
Tracking your cycle for injury prevention and performance optimisation
Modern technology offers several cycle-tracking apps designed to help you monitor your menstrual cycle and better understand your phases.
For athletes, these tools are particularly beneficial, enabling tailored training plans and optimised recovery strategies.
Coaches, physiotherapists, and sports medical teams are increasingly incorporating menstrual cycle tracking to enhance athlete performance and minimise injury risks.
Optimise your performance
If you're recovering from a sporting injury and need private Physiotherapy treatment, our experienced and compassionate team can help with your recovery, supporting you in maintaining your independence.
They can also assist with pelvic floor rehabilitation for certain menstrual conditions (e.g. PCOS and endometriosis). Pelvic floor muscles can be trained like any other skeletal muscle to improve strength and reduce tension. In many cases, retraining the muscles are necessary to improve motor control to reduce over, or under, contraction.
During your initial consultation, our Senior Physiotherapist will take the time to talk to you about your condition, carry out a thorough physical examination and discuss your goals for recovery.
They’ll put together a physiotherapy treatment programme, tailored to your needs, ranging from gentle mobilisations and strengthening to therapeutic pain relief and soft tissue techniques.
These techniques are combined with exercises and education, to help you manage your recovery for the longer term and aim to help you to try and prevent your injury reoccurring.
Physiotherapy gym at Benenden Hospital
The physiotherapy gym is designed to promote a healthy and active lifestyle for patients. It focuses on preventing injuries and treating complaints. The gym offers a variety of exercises using modern equipment to improve cardiovascular fitness, strength, balance, and functional movement.
Physiotherapy gym at Benenden Hospital
The physiotherapy gym is designed to promote a healthy and active lifestyle for patients. It focuses on preventing injuries and treating complaints. The gym offers a variety of exercises using modern equipment to improve cardiovascular fitness, strength, balance, and functional movement. Patients receive personalised programs, including home exercises, to achieve their goals.
The gym caters to sports injuries, musculoskeletal conditions, and orthopaedic patients. Notable equipment includes treadmills, stationary bikes, and the versatile pulley machine. Classes for post-operative patients enhance rehabilitation, and parallel bars help test balance. To access the gym, patients can self-refer through various channels.
So, the physiotherapy gym was constructed to promote a healthy and active lifestyle to our patients. we aim to encourage a lifestyle change that will not only treat their complaints but to prevent injury from occurring. The Physiotherapy team used the gym to create a varied workout using modern equipment to improve cardiovascular fitness, strength, balance and functional movement. We use a patient-centred approach to create a bespoke exercise program to achieve your personal goals and help the recovery process which can include returning to sport or work, functional activities like walking stairs and reaching for the top of the cupboard.
After having an initial consultation with one of our Physiotherapists, patients will understand the cause of the problem. They expect the length of recovery, set realistic goals to their therapists and receive a home exercise program along with advice on how to manage their complaints, which treats a wide range of conditions in the gym such as sports injuries, musculoskeletal conditions, orthopaedic patients and rheumatology problems with persistent pain, help athletes by testing their abilities in a way that reproduces the movements and skills required in their sports to ensure they're safe, to compete and reduce the risk of injury.
One of the most used pieces of equipment in the gym is our treadmill that can be used to test progress on walking, jogging and sprinting. It also has the option to change the angle from incline to decline. Sometimes we need to start with reduced weight bearing exercise. So, we have pedals and an exercise bike to build strength and fitness in preparation for the next stage in their recovery.
In the final stages of the recovery, we use the plyo box which is a great way of working on explosive strength. The Physiotherapy team run classes for orthopaedic post-operative patients as research has shown it improves uptake and rehabilitation and allows patients to share their experiences.
We aim to return patients back to their normal activities of daily living - an important one commonly being independence on the stairs. The parallel bars are used to progress walking and test balance in a safe environment using equipment such as wobble boards and cushions.
The shoulder is one of the most common joints treatments in physiotherapy due to its wide range of motion controlled by a complex network of muscles. Therefore, we needed to bring in equipment that can test a variety of movements. One machine that can do this is a pulley as we can change the angular resistance to treat different muscle groups.
We also have a range of weights including wrist weights, dumbbells and kettlebells to test functional movements under load.
You can access our gym by self-referring into our physiotherapy service through either your Benenden Health membership, private medical insurance, self-paying or after undergoing orthopaedic surgery at Benenden Hospital. Contact our Private Patient Team or arrange your appointment via our online booking tool today.
Booking with our female health specialist
If you’re struggling with frequent heavy painful periods that affect your ability to exercise and go about your daily activities, we offer a range of gynaecology treatments. You can book to see a female health specialist at our comfortable and discreet private hospital in the heart of the Wealden countryside, by contacting our Private Patient Team via Livechat, by completing our online enquiry form or by calling us on 01580 363158.