With the announcement of both Sophie Ingle and Jorja Fox for Chelsea and Lotta Lindström for London City Lionesses all sustaining an Anterior Cruciate Ligament injury in very recent times, the epidemic of ACL injuries continues to stay prevalent in current times.
As we continue to watch the incredible growth of women’s football, it is crucial we still acknowledge the challenges along the way, and this is one that certainly requires our attention.
The impacts of these serious injuries are severe and the disparity of research between females and males when it comes to these injuries is something that definitely needs changing.
The anterior cruciate ligament is a tough band of tissue which connects the thigh bone (femur) to the shin bone (tibia) at the knee joint which is the size of your little finger, and there are a range of factors which can contribute to this rupturing or tearing. Current research we do have highlights that women are 2 to 8 times more likely to suffer an injury to their ACL compared to their male counterparts.
If we would like to reduce this crisis, it is important to understand what exactly the causes of this devastating injury are.
At present, there are three main causes for concern underlined contributing to these injuries: the anatomy of a female, hormones, and gender disparities.
To start with, anatomy is a factor which is believed to be a key contributor. Firstly, women typically have wider hips than men increases the angle of the leg into the knee. As a result, underdeveloped muscles prohibit the knee from turning in upon landing, supposedly leading to a higher number of ACL injuries in the women’s game. The joints of a female, most importantly including the knee, usually has greater looseness and also range of motion.
On top of this, the muscle mass of a woman is much less around the knee which could potentially decrease stability. Thus, if a ligament is overworked or overstretched, the probability of this injury occurring increases.
Due to these differences, technique can also come into play when factors accumulate towards these injuries. On the latter part of a jump, a female would tend to land in a collapsing sequence and as a result the knee turns inwards and often aren’t bent enough for a typical landing. The blend of these contribute to the increased ACL injury rates within females.
Secondly, another factor which plays a role too is hormones. During the menstrual cycle, generally in the second week when oestrogen levels are higher, raises the laxity of the ligament, meaning the placement or rotation of the tibia in relation with the femur is atypical. Therefore, the ligaments and muscles are more unstable but also weaker at this time. In turn, during this week in the month a female athlete can become more susceptible to sustaining an injury in general.
Physical differences most certainly cannot easily be changed so the question of whether the
implementation of hormonal birth control methods will be a successful way in trying to give female athletes a higher protection against an ACL injury.
In addition to this, with 7 studies a meta-analysis was conducted on the effect of hormonal birth control on ACL injuries rates. This highlighted that oral contraception can indeed provide a reduced risk of 20% of this injury.
In most of these methods, there is a content of progesterone which is likely to decrease laxity but increase the strength and stability of muscles and ligaments, so the fear of these injuries is lowered for some knowing this.
In 2020, Chelsea Women became the first club to tailor their training programme around the
players’ menstrual cycle in aim to enhance performances and reduce the risk of injury. After
introducing this, just 4 players suffered an ACL injury between this adaption and mid 2023, 2 of which were on loan elsewhere at the time. However, this may not be the main factor in injuries for others as the Blues now have 5 members of their team unavailable to play after sustaining an ACL injury.
Thirdly, disparities between men and women in football is thought to be another cause for these injuries. For example, this can include differences between pitches played on and training facilities provided for men compared to women. Plenty of women’s teams do not have accessibility to the same or equal standard of training equipment that their male counterparts do, making them more at risk to any form or type of injury.
Also, many women’s teams play at different grounds than the male teams at their clubs. Whilst the men’s teams in the topflight are playing at high quality Premier League stadiums, the women typically play at grounds owned by non-league, League Two or League One clubs which can often be of a lower standard. Due to the clubs that own these grounds being lower down in the football hierarchy, they do not have as much money for ground maintenance as those higher up and therefore the pitch can potentially become an uneven playing surface when used multiple times over one weekend. This too contributes to the injury levels as landing the way women do on an uneven surface puts them in an uncomfortable situation, especially with other key factors playing a part such as their anatomy and hormones.
Whilst it hasn’t been completely proven that these elements are the cause of such injuries, these factors are the three main concerns highlighted at this moment in time leading to the higher rates of injuries in women.
Aside from these elements, plenty of managers across the Women’s Super League have reason to believe that the vicious scheduling of the women’s game also has ties with the injury rates being through the roof.
Captain of Chelsea and England Defender, Millie Bright, played approximately a total of 2,226
minutes in the space of just six months. This number is roughly the amount a mid-table WSL player would play over the course of the entire season. This included playing 8 times in 31 days, then had 10 days rest before playing 3 matches in 8 days. As a result, high-profile players like Bright have very little to no time between training, recovering, and playing which is a huge factor in making an athlete more inclined to a serious injury such as this.
It is not unreasonable for some people to think more research goes into male footballers as the popularity of the game has been higher for longer but it is however impossible to reason with why there is such a imbalance in research when ACL injuries dominate the women’s football world so greatly, especially as the fan bases and interest is continuing to expand.
FIFPRO recently announced the launch of ‘Project ACL’, a three-year project working with WSL players to take action on the concerning numbers of ACL injuries. By joining forces with Professional Footballers Association (PFA), Nike and Leeds Beckett University the aim is to provide practical solutions to reducing ACL injury levels. This is most certainly a step in the right direction for the future of women’s football.
In 2022 alone, 57 players in the top 6 leagues suffered this injury - 5 of which were in the running for the Ballon d’Or that year.
There were 14 ACL injuries in Liga F, 13 in the WSL and 11 in the NWSL.
4 players from Arsenal WFC at the time - Beth Mead, Vivianne Miedema, Leah Williamson and Laura Wienroither - suffered an ACL tear two seasons ago with Teyah Goldie too in preseason following.
By November in the last WSL campaign, 3 players from Manchester United had been side-lined also after sustaining an ACL injury.
Despite women having a much higher chance of experiencing an injury, just 6% of research is done exclusively on women’s injuries generally.
If an injury like this is so damaging in the women’s game, why should ACL research for them be so disregarded?
Comentários