How to reduce the risk of ACL injuries in football

 

Injuries in football are not uncommon, whether that is an overuse or a trauma injury.  But the number of injuries to high profile players in the Womens Super League and on the international field continue to make news headlines. 

  

What is an ACL injury 

According to Cootes (2023) no less than 25 top women’s players have torn their ACLs in the last 25 years. High profile players such as Beth Mead, Vivienne Meidema, Leah Williamson and Alexia Putellas, have all had knee injuries recently. But as players, what can we do to limit the risk of getting this type of knee injury?   

Firstly, let’s look at what the injury is. ACL stands for Anterior Cruciate ligament but it’s not the only ligament in the knee.  You also have the posterior cruciate ligament and medial and lateral collateral ligament. 

How can knee injuries occur 

In womens football, 88% of injuries are non-contact and are associated with rapid deceleration, combined with single leg loading and a change of direction (www.boa.ac.uk).  Although knee ligament injuries are not the most common injuries in womens football, they do have the highest burden in terms of return to playing time. 

According to the British Orthopedic Association there has been a steady rise in the number of young athletes sustaining knee ligament injuries, with the biggest rise in teenage girls.  Biologically female athletes have 3-6 times higher risk of an ACL injury than males. Biomechanics and the impact of the menstrual cycle on female athletes account for some of these factors.  There continues to be much discussion around the rate of injuries in young players, not just female players. With consideration given to the impact of a high training load, rest periods, footwear and synthetic pitch impact. 

 

How can you limit the risk 

There is strong evidence to suggest that injury prevention programmes can help reduce the rise in the number of knee injuries and below are some of the suggestions to help support players. 

1. 1. Strengthening exercises 

In order to help stabilize any joint you need to strengthen the muscles around it. Strong quadriceps, hamstrings, calf muscles will all help stabilize the knee, absorb shock and provide support.  Exercises such as squats, lunges, leg press, hamstring curls and calf raises can help.

   

2. 2. Warm up and stretch 

Warming up using dynamic stretches will help increase the blood flow to the muscles and tendons making them more flexible.  Create a warmup routine for yourself incorporating moves you will carry out in a game, to help your muscles prepare for that motion.  Spend at least 10 minutes warming up and stretching before training and playing.  

3. 3. Footwear selection 

If you’ve been following the news and social media, you would have read a few opinions around the impact of having a football boot for women. Football boots are such a personal opinion. I’ve had womens football boots from different brands and each brand has its benefits and drawbacks. In my opinion, you need different boots for different purposes. But more importantly, don’t just focus on match and training days, you also need to consider what you wear on your feet, throughout everyday activities. Properly fitting shoes will provide support, stability and cushioning which can reduce impact on your knees.  Buying supportive trainers rather than flat sole trainers will keep your feet and knees more stable as you move around. 

4. 4. Rest 

Overtraining and inadequate rest will lead to fatigue. Ensure you allow your body to rest by incorporating rest days into your schedule. Consider cross training to help take the load off your body.  For example, go for a cycle instead of another run, or swim to help an active recovery rather than a jog. 

 

Of course, these factors may not stop injuries occurring. I’ve been fortunate to not sustain a serious knee injury over many years of playing, but that does not mean I’ve not had other serious injuries.  I have, however, watched my teammates be impacted by knee injuries.  All you can do is try and follow the steps above to help reduce the likeliness of the injury occurring, and move towards being a better footballer.