A new research project hopes to reduce ACL injuries in women's football
Today, a three-year research project has been launched to investigate and reduce the number of anterior cruciate ligament (ACL) injuries in women’s football, which have become a point of increasingly fierce contention due to their alarming frequency.
FIFPRO, an organisation which represents professional footballers globally, has joined with the Professional Footballers Association (PFA), Nike, and Leeds Beckett University to form ‘Project ACL’ with the aim of ‘increasing player availability by reducing ACL injuries,’ reports Sky Sports.
The main focus of the research will be the Women’s Super League (WSL) clubs – the highest-level women’s football association in England, established in 2010 – but the findings will be applied across the game worldwide.
Over half of the 12 WSL clubs are taking part and will be examined on environmental factors that can increase ACL-injury risk, such as facilities, staff to squad ratios, playing and travel schedules, and frequency of access to training facilities.
According to sports publication The Athletic, key targets for the project, supported by the England and Barcelona right-back Lucy Bronze and the former England striker Ellen White, include:
- Reviewing existing academic research related to ACL injuries in professional women’s football;
- Conducting an assessment of the WSL teams’ needs and structures;
- Tracking of player workload and travel, and frequency of playing in the ‘critical zone’ (playing back-to-back games with less than five days’ rest in between) through the FIFPro Player Workload Monitoring tool; and
- Translating research into actionable strategies to support clubs and players in implementing best practices to prevent injury.
‘We need to do this finely-tuned research so that we can (pinpoint) the key factors and focus points,’ Bronze said to The Independent.
Project ACL will track player workload, travel and playing frequency and come up with actionable strategies to to prevent injury.
What is an ACL injury?
An ACL injury is a tear or sprain of one of the strong bands of tissue that connects your thigh bone (femur) to your shinbone (tibia).
‘The ACL is a major stabilising ligament in the knee, which prevents excessive rotational movement as well as limiting excessive motion,’ Dr Joanne Parsons, Associate Professor at the College of Rehabilitation Sciences at the University of Manitoba, previously told WH.
Two thirds of ACL injuries in women’s football occur when there is no physical contact involved. They’re typically caused by a sudden change in speed or direction, or because of impact when landing on the ground. Last year, 37 players missed the Women’s World Cup due to these types of injuries. According to a British Journal of Sports Medicine (BJSM) review, as of 2021, the ACL injury rate for girls and women has not changed in over 20 years, and they are three to six times more likely to experience it than boys or men.
Last year, England women’s captain, Arsenal player and former WH cover star, Leah Williamson, suffered this physical blow, as did other Gunners Beth Mead and Viv Miedema, all within the space of 12 months.
‘It was like someone had gone inside my knee and whacked it with a hammer,’ Mead said to The Mirror.
ACL tears can sometimes be devastating, as players may not make it back to their previous level of physicality even after recovery. The BJSM notes only 65% of those impacted return to their pre-injury level of sport, but male players are almost twice as likely as female players to make a full recovery.
What are the findings from previous research on ACL injuries in women’s football?
Up until now, studies have centred around physiological factors like football boots, body positioning and menstrual cycles, with some research noting previous theories stipulating ‘female biology’ as the root cause, as ‘female hormones’ mean women are ‘made differently’.
‘We want to move away from very singular and binary understandings of ACL injury,’ Dr Culvin told The Athletic. ‘Whenever an ACL happens we point to workload or female physiology when the primary objectives of this project is to understand the holistic risk factors and the environmental risk factors, and that comes down to the conditions in which players play.’
‘Most of the research to date on ACL injury in women has focused on single sex-based risk factors like the mechanics of female bodies,’ said Stacey Emmonds, reader in sports performance at Leeds Beckett University, to CBC.
Continuing in a conversation with the BBC, she elaborated: ‘[A] lot of the language [says] some of these risk factors are inherent to females and suggests that we just need to accept that – but we know they can be influenced,’ she said. ‘For example, from a younger age girls receive less strength and conditioning training – that underpins reducing some of the injury risks.’
The ‘slow and disparate response’ to ‘disproportionately high’ rates of ACL knee injuries in women’s football reflects a lack of understanding and attention given to female health and physiology-related needs, the Women and Equalities Committee warned.