On Sunday, Beth Mead received a standing ovation at the Emirates on her tremendous return to the WSL after enduring a torturous 11-month ACL injury. The incredible reception was amplified when Mead assisted Alessia Russo’s 94th-minute winner against Aston Villa.
Whilst a special moment in the sport was being celebrated, over in Manchester Gabby George encountered a devastating setback on the pitch.
The Manchester United full-back suffered an ACL injury nine minutes into their match against Leicester City. This is not the first time George has suffered the injury in her career after previously rupturing her ACL in 2020, and unfortunately her experience is not uncommon. George joins an ever-growing list of players who have been sidelined from the sport due to ACL injuries.
It’s almost as if when one player returns from this gruelling injury, it’s not long before another falls victim to it.
The ACL injury is currently one of the hottest topics in women’s football. It’s a problem that has dominated the sport with a concerning number of female players encountering the nasty injury. Last season Arsenal were the WSL side to be hit the hardest, losing four players to ACL injuries. Additionally, over 25 players were ruled out of this summer’s World Cup after sustaining ACL injuries, enough to make up a whole squad. Included in this list were England’s very own captain, Leah Williamson and previous Golden Boot winner, Beth Mead.
WHAT IS AN ACL?
The Anterior Cruciate Ligament is a small band of tissue situated within the knee, connecting the thigh bone and shin bone. Rupturing or tearing the ligament usually requires surgery and a prolonged recovery period.
Typically in the women’s game, players sustain the injury via non-contact methods. For example, the injury can be triggered by a sudden change in direction or heavy impact to the ground. Rehabilitation for this type of injury is usually around 12 months and the recovery is incredibly challenging, both physically and mentally. It is extremely debilitating, and the longevity of the injury can cause players to experience a sort of identity crisis.
ACL injuries are arguably one of the worst injuries an individual can experience, particularly feared by one type of athlete - the female footballer.
Female footballers are up to six times more likely to suffer an ACL injury than their male counterparts.
It has the potential to be a career-ending injury, with 25% of female players less likely to return to the pitch compared to male players. This constant fear and anxiety surrounding ACL injuries needs changing. But unfortunately, the solution isn’t straightforward at all.
The issue remains complex, with medical experts still struggling to understand why the injury is considerably more prevalent in female players than male. This overwhelming plague of ACL injuries leaves clubs, managers and players all asking the same question: how do we tackle this epidemic?
To put it simply - we need more research, and we need it fast.
There has not been enough research into the causes, and more importantly, the prevention of ACL injuries in female players.
The women’s game is constantly playing catch up to the men’s game. It is easy to forget how new women’s football is in terms of a professional sport. The WSL was only established in 2010, eventually turning fully professional in 2018. The novelty of the women’s game has meant female athletes have been significantly under researched. Despite these past failings, now more than ever, players are calling for more research into the female body and prevention of such serious injuries.
The gender disparities within football has meant that from a young age female players are not exposed to the same level of elite training as male players. Limited access to structured training programmes and facilities in the past, means top players are now making up for lost time in the height of their careers. Professional female players are typically introduced to resistance training and strength and conditioning programmes far later than professional male players, putting them at an immediate disadvantage in terms of their endurance and muscle development.
Similarly, the difference in pitch quality may be an underlying factor contributing to the rise in injuries. Pitches used in the WSL are arguably not to the same standard as the Premier League. The women’s game cannot afford the same quality measures or technologies as the men, such as under-soil heating.
This all centres around one crucial issue – the lack of funding in women’s football.
The astronomical growth of women’s football in recent years has significantly increased the demand on players. Frequency of fixtures and rapid growth in the schedule has had a sizeable impact on players physically, and for most clubs, their medical teams are not fully equipped to deal with such heavy demands. Although medical provision has been improving in women’s football, there is still a lot of work to be done.
The resources and medical support available to the top performing women’s teams is not even a fraction of what is available to the men’s teams. People tend to assume that the bigger clubs give their women’s team the same access to the resources and facilities they give their men’s team. Sadly that is very often not the case.
More money needs to be pumped into the women’s game, so clubs have greater access to facilities, resources, physios, team doctors, strength and conditioning coaches and relevant support systems. If we want women’s football to succeed, then we need solid foundations to support and protect our players. Until we see such investment, there is a fear that we will continue to see an alarming number of these injuries in the women’s game.
There is also a suggested link between ACL injuries and the physical differences between men and women.
The female anatomy is considerably different to the male anatomy. Therefore, the answer is not to simply mirror the men’s game. What might work for male players does not mean the same can be said for females.
Difference in body shape, hip width, and underdeveloped muscles all contribute to the increased injury risk for women. Female players are more susceptible to muscle strength imbalances. This is why strength and conditioning training is so important, especially from a young age.
Changing hormones during the menstrual cycle can also impact the biomechanics of the female body. When oestrogen levels peak, it can affect the stability of joints, making them looser and more vulnerable to injury. However, limited research means it is difficult to conclude whether this is an underlying risk factor.
Traditionally, football kit and footwear has been designed for the male physique. A staggering number of elite female players are currently competing in ill-fitting boots, designed for the opposite sex. Research has highlighted the fundamental differences between male and female feet, including heel shape, arch height, and foot width. Women run differently to men, yet boots are designed around male movement. This call for change has prompted manufacturers to develop boots specifically designed for female players. Although a step in the right direction, the lack of options is still a cause for concern.
For too long football has failed women, with players not receiving the proper care and treatment they need. But now the industry is starting to listen. As women’s football continues to grow, hopefully we will witness significant medical advancements in the women’s game.
Injury prevention is vital and ongoing investment is key for future research.
There is no doubt that more would be done if there were as many high-profile male footballers sustaining ACL injuries.