Female footballers are seven times more likely to suffer an ACL injury than their male counterparts, and Inside the WSL sat down with players, physios and doctors to find out why.
Unfortunately, it is not uncommon to see a women’s club announce that a player will be sidelined with a torn ACL. West Ham’s Jessica Ziu, Aston Villa’s Chantelle Boye-Hlorkah and Tottenham’s Kyah Simon and Ellie Brazil are some of the players who need to be looked after this season alone.
This issue also appeared during the summer of the European Championships. Ballon d’Or winner Alexia Putellas missed the tournament after rupturing her ACL just days before Spain’s opener. Simone Magill also suffered the same injury in Northern Ireland’s opening game against Norway, just days after signing for Aston Villa.
French striker Marie-Antoinette Katoto also rested in their second game against Belgium, having torn her ACL again. He was one of the favorites to win the Euro 2022 Golden Boot.
You can keep reeling off the names of female athletes who have gone through long ACL repairs, but at this point, very little scientific research has been done on why women are more likely to suffer from it than men.
There are other theories such as the menstrual cycle playing an important role, although so far, there has not been enough research to support this.
Talking with Within the WSLWomen’s health expert Dr Emma Ross explained: “We know that female athletes are six times more likely to sustain an ACL injury than their male counterparts.
Within the WSL
Thursday 17 November 6:30pm
“We published a paper about a year ago that showed that, in sports and exercise science research, only about 6 percent of studies are done on women only – meaning they study things that are happening to the female body – so we don’t. I don’t have a lot of research on female athletes.
“But what we know about menopause and injury is that hormonal changes throughout the body can affect the body and the biomechanics of the body.
“For example, when estrogen rises during menstruation, and this happens around the second week, it can affect the stability of the joints. It can disrupt the collagen in our joints and can create loose, damaged joints. Such a joint is unstable and prone to injury.
“So we have information about loose joints, but what we don’t have is evidence of whether this increases the risk of injury in female athletes.”
Arsenal Women’s physio Gary Lewin also agrees that menstruation can play a role in the increase in ACL injuries.
He said: “Most of the time, I can say that there is a connection. What is that connection, we have not found in detail that I know. There are some ideas and different phases of the menstrual cycle lead to different levels of fatigue. connection, which can lead to loss of energy.
“This may be related to what causes them to break. But women’s sports need more research because most of the research comes from men’s sports.
“Another thing I discovered in the short time I spent in women’s football, there is something called an osteochondral defect, where the bone starts to react and the bone becomes weak.
“For me, there is something in women’s football where this happens more often than we know. Again, that is the part that I want to investigate and it can be associated with serious injuries.”
One WSL player who has suffered two ACL injuries in recent years is Manchester United defender Aoife Mannion. Shortly after joining Manchester City, he suffered a serious ACL injury in October 2019. Combined with the Covid suspension, Mannion spent 458 days out of action and made 11 appearances for City.
He left the club at the end of his contract, moving to the other side of Manchester last summer. But after a successful start under Marc Skinner, he tore his ACL again in March 2022. He is approaching an eight-month layoff.
“The first time I did it, it looked good about the body,” he said Within the WSL. “I knew something had happened, I would be saved from the pain that other people have but I felt it was going away.
“I’ve had one that was a very simple ACL and the last one was very difficult. In terms of things that help, we’ve talked about menstruation maybe. It’s difficult as a player to start thinking that way. The words ‘my body sometimes makes me be it’s an ACL problem’.
“Everything I’m doing is giving me the best chance to not do it again and get back to good health. I know the research, I like to look at things and hear what people are going through, people who really like ACL rehabs and things like that.
“I think I’m the expert on the team. Right now, I’m rehabbing my ACL so I’d love to hear the research.”
Mannion has been open about his ACL injury and rehabilitation process, often posting on social media to share his progress.
When asked why, he explained: “The motivation is a little selfish because I know when I share, good-hearted people encourage me and why wouldn’t you want that.
“I would encourage everyone to do a little bit, to share what they are doing because people who are on the same level and getting it will encourage you and you should encourage everything you can get.
“I think one of the reasons people don’t share their rehab is because it’s probably too difficult for them to get injured or they’ll back down and look stupid. I think if you’re going to get hurt, you’re going to get hurt, why don’t you share the good things along the way.”
All of this begs the big question – what can be done to prevent more female soccer players from suffering ACL injuries?
Dr Ross offered his opinion, saying: “We need to start measuring hormones because they are changing over a month and we think they can affect things like bone stability and risk of injury.
“It costs a lot of money and it’s a research method because you have to track the athletes and have them track their hormones, track what they’re showing and track their circulation.
“You also have to expect them to get injured. One of the biggest problems with injury research is that it’s often done sequentially because we don’t know who will get injured when and why.
“There are many myths about bathing and injuries. In fact, when we go to talk to athletes and football players, they often say that they are afraid if they take their time and do sports because they think they might get injured, especially if they have been injured before.
“These are the concerns they will take from their practice and unfortunately, we don’t have strong evidence to say ‘yes, there is a definite time in your cycle where you can get seriously injured’, but we have a lot. Players will read this and start to worry.
“At the moment, the best we can do is get the players to follow what’s around them and if they’re someone who feels like their hamstring is tight or their back is starting to explode at a certain point, they’re well informed to work on it. It’s their physios and the coach to take action. on this.
“When people find ways that have worked for them as female athletes working with their female body, sharing that with other female athletes who may not have that knowledge is very helpful.
“We have to consider that everyone is unique and the same method may not work in the same way for someone, but sharing good practices and good rehabilitation is very important to be able to better understand what can work for injuries and injuries. resilience of football players.”
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