Women’s football is booming. Stadiums are buzzing, TV audiences are smashing records, and young girls are taking up the sport in record numbers. As someone who runs a team in a recreational 9 a side league, it also appears to me that huge numbers of women in their 30s and 40s are taking up the sport for the first time too.
But there’s a major shadow over women’s football right now (no, not Joey Barton) – the rise of ACL injuries.
From seasoned internationals to emerging young stars, ACL tears are cutting careers short and wrecking seasons at a worrying rate. So why exactly are female footballers more prone to these serious injuries? Let’s dive into what the research says and what can be done about it.
How Common Are ACL Injuries in Women’s Football?
In short, too common.
ACL (anterior cruciate ligament) injuries are common in sport in general, but shockingly, female athletes are between two and six times more likely to suffer one than male athletes, according to research published in the British Journal of Sports Medicine. In elite women’s football, it’s becoming alarmingly routine.
In 2023 alone, England captain Leah Williamson, Euro 2022 star Beth Mead, and Ballon d’Or winner Alexia Putellas were all ruled out of major tournaments with ACL tears. The scale of it has led many players and coaches referring to it as an “epidemic”.
This isn’t just about individual heartbreak either. Clubs lose vital players, national teams are weakened and fans miss out on seeing the best talent at the biggest moments.
Why Are Women More Prone to ACL Injuries?
Science is helping us understand why women might be at higher risk and the research really is finally being invested in. So here are some of the reasons we know about so far.
Anatomy: Women tend to have wider hips than men, which changes the angle where the thighbone meets the knee (known as the “Q-angle”). A wider Q-angle can increase stress on the ACL. Research from the American Journal of Sports Medicine backs up this anatomical link.
Hormones: Fluctuations in oestrogen over the course of our menstrual cycles might also play a role. Some studies suggest that higher oestrogen levels can make ligaments more flexible and potentially more vulnerable during certain parts of our cycles.
Muscle Activation: Research has shown that women often rely more on their quadriceps than their hamstrings when jumping, landing, or quickly changing direction. Strong hamstrings are critical for stabilising the knee and protecting the ACL.
Does Football Equipment and Training Increase ACL Risk for Women?
It’s not just biology though. It would be naive to overlook the role of the poor way in which the women’s game has been treated historically.
Playing Surfaces and Boots: Women often play on lower-quality pitches or artificial turf, which can increase injury risk. Most football boots are designed for men’s feet too meaning female players often don’t get the right support and traction.
Training Gaps: Much of the way that we coach and train football today was built around male bodies. Without programmes tailored to female bodies specifically, players may be missing crucial injury prevention work.
Match Load: As the game grows, players are playing more matches, but many clubs still don’t have the same medical or conditioning support you’d see in the men’s game.
What Are the Mental and Career Effects of an ACL Injury?
ACL injuries aren’t just physically brutal. They’re emotionally tough too.
Recovery can take 9 to 12 months — that’s a huge chunk of a player’s career gone. For some, it means missing World Cups or losing vital contracts. Mentally, the journey back from a serious injury can trigger feelings of isolation, depression, and anxiety.
Stars like Alexia Putellas have shown that it’s possible to return stronger, but it’s a tough road and not every player has access to the same resources.
What’s Being Done to Prevent ACL Injuries in Women’s Football?
Thankfully, the problem is getting more attention.
Research: Bodies like FIFA and the FA are now funding studies specifically looking into ACL injuries in female athletes. The more we understand the risk factors, the better we can prevent them.
Injury Prevention Programmes: Warm-up routines like FIFA’s “11+” have been proven to help. Some clubs are rolling out specialised prehab work tailored for female squads.
Better Equipment: Some brands are finally designing boots for women’s feet, with improved fit and stability.
Education: Coaches and players are becoming more aware of the risks and how to manage them, including strength training and monitoring menstrual cycles to tailor training loads.
ACL Injury Prevention Tips for Female Footballers
While big changes are happening, there’s lots that players and coaches can do right now:
Strength Training: Build up hamstrings, glutes, and core muscles to protect the knees.
Agility Drills: Improve balance, landing technique, and change of direction control.
Structured Warm-Ups: Programmes that include plyometrics, balance, and strength work can massively lower injury risks.
Right Footwear: Where possible, use boots suited to the playing surface and shaped for women’s feet.
Manage the Load: Track and manage the number of matches and training sessions to avoid overload.
Conclusion
ACL injuries are a major threat to the future of women’s football. But with better research, smarter training, and more investment in the women’s game, we can change the story.
Players deserve the chance to shine without the looming fear of a career-altering injury. By understanding the unique challenges female footballers face, we can build a safer, stronger future for the sport we all love.
Sources
British Journal of Sports Medicine: Epidemiology of ACL injuries in female athletes
American Journal of Sports Medicine: Biomechanical Risk Factors for ACL Injury in Female Athletes
FIFA Medical Network: FIFA 11+ Injury Prevention Programme
UEFA Report: Women’s Elite Club Injury Study
The Guardian: ‘It’s a crisis’: ACL injuries cast shadow over women’s football
BBC Sport: Why are ACL injuries so common in women’s football?
