Recently, we have seen a rise in Anterior Cruciate Ligament (ACL) injuries in women’s football. ACL tears are prevalent in women's football, often attributed to factors beyond genetics. Despite numerous studies highlighting the heightened risk for female players, the prevalence of ACL injuries in women remains unabated. Consultant Orthopaedic Surgeon, Nev Davies, highlighted that female players are four to six times more likely of sustaining non-contact ACL injuries than men, with almost 30 players missing at last year’s Women’s World Cup due to ACL injuries. This article delves into potential factors contributing to this issue and explores ongoing initiatives to mitigate the ACL epidemic.
While traditional beliefs point to biological factors, recent research suggests that gendered environmental disparities play a significant role. Dr Joanne L Parsons emphasizes the need to address discrepancies in pre-sport activities, training, competition, research, and rehabilitation environments. Currently, at least 13 WSL (Women’s Super League) players are currently undergoing ACL rehabilitation, including England captain Leah Williamson.
Mismatched football boots designed predominantly for men have been a long-standing concern. Dr Emma Ross underscores the impact of inappropriate footwear on ACL injuries. The emergence of women-specific football boots, like Nike's Phantom Luna Elite, signals a positive shift toward injury prevention. Dr Emma Ross explores the impact that football boots have on ACL injuries in her book 'The Female Body Bible' highlighting that “You make studs, and you make the sole to withstand the capacity of the average man and then you put an average woman 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 got a lighter woman in them and they're getting anchored to the ground by them”. Future of Football: Why ACL injuries have been on the rise in women's game - and the technology and solutions to fix it | Football News | Sky Sports Here, while there is currently no evidence to suggest that the level of support provided by these boots will make a difference when mitigating ACL injuries, it has been argued that new models can certainly measure ACL loads at different points in time.
The surge in women's football popularity has led to an expanded fixture schedule, placing increased demands on players' bodies. This, coupled with major tournaments and league fixtures, has raised concerns about player fatigue and its correlation with ACL injuries. Historically, female footballers faced less favourable contractual terms than their male counterparts, impacting their access to top-notch medical treatment. However, recent changes in benefits, mirroring those in the men's game, aim to rectify this disparity. Playing on artificial pitches has been linked to increased injury rates. Efforts by clubs like Manchester United and Manchester City, as well as government investments in state-of-the-art pitches, seek to address this issue and ensure equitable facilities. In 2019, FIFA announced that both women’s and men’s football are to be played using the same surfaces and field parameters. Natural grass fields were a requirement for the first time at the 2023 Women’s World Cup.
So, who has a duty of care? Players and medical experts highlight the gender disparities in football, emphasizing the need for clubs and governing bodies to provide equal care and support for female athletes. The lack of experienced medical teams in women's football remains a challenge. Sports medicine specialist and former Chelsea club doctor, Eva Carneiro, states that “Gender is still an issue in football. You've got limited funding in the women's game, and you don't have very experienced medical teams.” So, to answer the question, it is the clubs and governing bodies who owe a duty of care to their athletes.
FIFA's existing training programs and UEFA's newly formed expert panel indicate a growing recognition of the need for gender-specific approaches to prevent ACL injuries. The introduction of female-specific prevention programs is crucial to the overall well-being of women in football. As 2024 unfolds, the football community must rally for positive change. From addressing gender-specific challenges to implementing preventive measures, the goal is to create a level playing field for women's football, ensuring a safer and more inclusive environment for all players.
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