'We're seeing a tsunami of ACL injuries in women's football'

Vivianne Miedema of Arsenal lies on the ground after picking up a serious leg injury during the Women's Champions League group match against Lyon at Emirates Stadium on 15 December 2022
Arsenal and Netherlands forward Vivianne Miedema missed the World Cup after rupturing her anterior cruciate ligament

Players are “scared” and “worried” at the raft of anterior cruciate knee ligament injuries in women’s football, says Birmingham City’s Siobhan Wilson.

Star players such as Leah Williamson and Vivianne Miedema have suffered the injury in the past few months.

“There were three of four players in the space of two weeks,” defender Wilson, who injured her ACL in April, told The Sports Desk podcast.

“That’s no coincidence. Every female player probably does have a worry.”

Scotland midfielder Caroline Weir is the latest high-profile player to suffer the injury, rupturing her anterior cruciate ligament playing for her country against Belgium on Tuesday.

Surgeon Nev Davies, who has expertise in treating knee problems, told the podcast there had been a “tsunami” of cases in the women’s game at grassroots level.

Davies said: “The data we are getting through, not just from the UK but from around the world, you talk about an endemic of ACL injuries and obviously we’re hearing about the elite game and the Lionesses because that’s in the media.

“Unfortunately there is this tsunami of ACL injuries that we’re seeing.”

With the 2023-24 Women’s Super League season starting on Sunday, what is the solution to the ACL crisis in the game?

‘I lost my identity’

As well as the injury to Real Madrid’s Weir, Manchester United midfielder Emma Watson suffered an identical injury – also playing for Scotland this month – while Arsenal forward Beth Mead is close to returning after missing England’s World Cup campaign with cruciate ligament damage.

“People are finally switching on that this is serious,” added Wilson, who suffered her injury playing against Southampton in a Women’s Championship fixture in April.

“I rode the challenge and as I planted my right foot to change direction on to my left, my knee has gone in and out. I heard a weird noise, like a pop, and I knew I had done something wrong.

“It didn’t really sink in until I couldn’t walk and I was on crutches.

“When you get an injury and it prevents you from doing the one thing you know, you feel like you lose your identity a little bit.”

Anxiety building around ACL injuries

Research shows female athletes are up to six times more likelyexternal-link to have a non-contact ACL injury than male counterparts.

“It’s a devastating injury for anyone at any stage of their career,” added Davies, who said the knock-on effects of the injury were challenging.

“I won’t let my patients get back to playing football for 12 months following surgery because we want to give it the best chance of a good result.

“It ultimately has a knock-on effect on their mental health.”

Recently, Arsenal’s Jodie Taylor – who announced her retirement from football on Thursday – described the link between menstrual cycles and anterior cruciate ligament (ACL) injuries in women’s football as “scary”.

“I do think menstrual cycles are a huge part of it. I think it’s loads, load management, it’s the amount of games that we’re playing, and it all ties together,” she said.

“Hopefully, the more research that comes out will help. Because it is an issue. It is scary.”

Women’s health specialist and sports scientist Dr Emma Ross told The Sports Desk podcast that more investment was needed in the women’s game.

She added: “Anxiety is brewing around ACL injuries that is impacting girls in the game right now.

“More money and resources into women’s football will help because it means there will be more performance support teams, strength and conditioning coaches, physios.

“We assume that if you’re in a women’s team attached to a big club, they will get access to all of the things that the men’s team get access to. That often isn’t the case.

“We cannot expect the women’s game to grow at the rate it is growing if we aren’t putting in the infrastructure to stop the players breaking.”

With the new WSL about to start, Dr Ross said it was “critical” the elite women’s calendar was looked at to prevent ACL injuries.

“Some of these players were at the Euros in 2022. They then had a domestic season and then went to the World Cup. Now they are going into another domestic season,” she added.

“We need to look at the scheduling and the calendar, and protect players. Otherwise we are going to lose them [to injury].”

‘A lot of work to do’

Emma Hayes, manager of defending WSL champions Chelsea, said “there’s still a lot of work still to do” when asked about the reasons behind the number of ACL injuries in the women’s game.

“One of the biggest pieces of research, my medical team are going to kill me – I think this is an important point – [about the] valuable lessons to learn around injury analysis is that the vast majority come within 10 days of changes from international breaks to club, or from club competition to international breaks.”

Hayes added: “It’s not as simple as saying that different teams have a different training load or travelling schedule, or recoveries etc. We need to really reflect on what we do.

“This is why I think it needs to be looked at by Uefa or Fifa.

“If you want to do a piece of research, go back through all those major injuries and how quickly they coincided with big changes, combined with menstrual stuff, training, pitches etc. That’s just my opinion. There’s a lot of work still to do.”

Additional reporting by Elizabeth Conway


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