Immobilization has a predictable effect.
Strength drops. Muscle activation changes. Rehab begins.
But in female athletes, there’s long been a lingering question: Do hormones — specifically oral contraceptives — influence how much strength is lost and how quickly it comes back?
A new study in Medicine & Science in Sports & Exercise suggests the answer may be simpler than expected.
Testing Strength Loss Across Sex and Hormonal Status
Researchers set out to examine whether biological sex — and oral contraceptive (OC) use in females — affects strength loss and recovery after short-term immobilization.
The study design was straightforward.
Thirty participants — 10 males, 10 females using monophasic oral contraceptives and 10 females not using OCs — immobilized their wrist and hand for one week. That was followed by at least one week of rehabilitation.
Grip strength testing and electromyography tracked two key outcomes: peak force and rate of force development (RFD).
Similar Strength Loss Across All Groups
After immobilization, strength dropped across the board: Males: –17%, Non-OC females: –22% and OC females: –21%.
Not identical — but close enough that the differences didn’t reach statistical significance.
The same pattern held for rapid force production. RFD declined after immobilization and rebounded with rehab, regardless of sex or contraceptive status.
Recovery Followed a Familiar Pattern
Rehabilitation worked — and it worked similarly for everyone. Most participants regained strength within about a week. A handful needed longer, but that variability wasn’t tied to sex or OC use.
On the neuromuscular side, extensor muscle activation increased during recovery, while flexor responses were more variable — though again, without meaningful differences between groups.
What about hormones?
The expectation heading into the study was that hormonal differences might drive meaningful variation in strength loss or recovery. That signal never really appeared.
Females — whether using oral contraceptives or not — behaved much like their male counterparts in both magnitude of strength loss and trajectory of recovery.
What This Means Clinically
This is a small, exploratory study. But it pushes back on a common assumption. If hormonal fluctuations — or OC use — meaningfully influence neuromuscular recovery after short-term immobilization, the effect may be smaller than expected.
For surgeons and rehab teams, that suggests that standard protocols may be broadly applicable across sexes, that OC use alone may not warrant different expectations for short-term recovery and that individual variability likely matters more than hormonal status.
Hormones Didn’t Drive the Outcome
Immobilization weakens everyone.
And at least in the short term, recovery appears to follow a similar script — regardless of sex or oral contraceptive use.
Hormones may still play a role in musculoskeletal health. But when it comes to regaining grip strength after a week in a brace, they may not be the deciding factor.
Origin Study Title Link: Effects of Oral Contraceptives and Biological Sex on Grip Strength and Excitation during Immobilization and Recovery: An Exploratory Clinical Trial
Authors: Stock, Matt S.; Bauerlein, Hannah M.; Edwards, Maya F.; Stambaugh, Kelsey E.; Parsowith, Emily J.; Carr, Joshua C.; Smith-Ryan, Abbie E.; Richardson, Randi M.