EWJ June 61 2025 web - Flipbook - Page 46
What’s Causing the ACL Injury
Epidemic in Women’s Football?
by Eleanor Green and Allana Edwards - https://www.brabners.com
approach’, we need to look at gendered discrepancies
in pre-sport activities, training, competition, research
and rehabilitation environments.
ACL (anterior cruciate ligament) injuries are one of
the most common and serious in football. It’s estimated that there have been over 500 ACL injuries
among elite footballers since 2022. Concerningly, female players are up to six times more at risk than
males, with almost 30 missing the FIFA Women’s
World Cup 2023 due to ACL injuries.
Women already face plenty of barriers to participation
in sport. They don’t need the added challenge of unnecessary injuries holding them back. So far, not
enough has been done to tackle this issue by
those who have the power and influence to make a
difference.
From the design of football boots and hormonal
fluctuations to disparities in training facilities, here
Allana Edwards and Eleanor Green investigate the
potential factors behind the prominence of female
ACL injuries and ask — can anything be done to halt
this epidemic?
Nearly 30 female footballers — enough players for an
entire squad — missed the 2023 FIFA Women’s World
Cup due to ACL injuries and at least 13 WSL
(Women’s Super League) players are currently
undergoing ACL rehabilitation including England
captain Leah Williamson.
Why are ACL injuries more common in female
players?
ACL tears most commonly occur as a result of
changing pace or direction or due to repetitive landing and pivoting manoeuvres, rather than contact
between two players.
This has forced prominent players to speak out,
including Beth Mead and Vivianne Miedema in their
Netflix documentary ‘Step By Step’. This saw Arsenal
players talk about their personal experiences of suffering from ACL injuries in the hope of helping the
next generation of female footballers.
Various studies have been conducted to look into why
females are more prone to non-contact ACL injuries,
including consultant orthopaedic surgeon Nev Davies’
study, which showed that female players are four-tosix times more at risk of sustaining non-contact ACL
injuries than males. Female players are also 25% less
likely to make a full recovery and return to the pitch
than their male counterparts.
We spoke with former Canadian international and
Champions League player Kylla Sjoman, who shared:
“It has taken so long for attention to be brought to the indisputable cases of ACL injuries in female athletes. My career
was cut short due to an ACL injury which I know could have
been prevented or at least rehabilitated if I had been afforded
access to the appropriate facilities, resources and coaches”.
Yet following these findings, we haven’t seen a
decrease in the prevalence of ACL injuries in women.
Football boots
While the majority of WSL players now have boot
deals, there are still a number of professional players
who don’t. For them, choosing a new pair of boots
means browsing the shelves in a high street store.
Let’s dig into some potential factors.
Training and recovery facilities
It’s commonly thought that the genetic makeup of the
female body plays a key role in injury risk, with females having wider pelvises and completely different
biomechanics and hormones.
Until recently, the vast majority of football boots have
been designed specifically for men. Given that
women’s feet have completely different bone structures to those of their male counterparts, it comes as
no surprise that up to 82% of female players in Europe experience discomfort when wearing football
boots.
However, female health specialist Dr Emma Ross — a
prominent speaker on this topic — believes there is
“no good evidence” for the roles of “body shape, hip
width and the menstrual cycle” as contributing factors
to injuries, despite being used as arbitrary excuses for
why “women aren't designed to play football.”
Could boots be the Achilles heel to ACL injuries in
females? Dr Emma Ross explores the impact that football boots have on ACL injuries in her book 'The
Female Body Bible':
Fox et al. (2020) also suggested that confining this to
biological causes misrepresents the root causes of ACL
injuries, which are likely to be strongly influenced by
“gendered environmental disparities” — essentially,
different experiences in sport and less access to
training facilities.
“You make studs and you make the sole to withstand the
capacity of the average man and then you put an average
women in them and as fast and as quick as they are, they're not
as strong or as powerful as men. So those boots are now designed to grip a heavy, strong man into the ground but you've
According to Dr Joanne L Parsons’ paper ‘Anterior
cruciate ligament injury: towards a gendered environmental
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JUNE 2025
