Can science tackle ACL threat to women players’ World Cup success?
20 Aug 2023
The knee injury England midfielder Keira Walsh narrowly avoided at the World Cup has been identified as a key threat to women football players on the pitch.
New data presented to the Isokinetic Football Medicine Conference in London has pinpointed four match situations most associated with anterior cruciate ligament (ACL) injuries and the most effective rehabilitation techniques.
Damage to the ACL, which connects the thigh bone or femur and the shin bone or tibia, is a common affliction in football but especially prevalent among female players.
Andrea Tartaglia, Managing Director of Isokinetic London, part of the Isokinetic Medical Group recognised as a FIFA Medical Centre of Excellence, said: “There is an epidemic of ACL injuries that has sidelined many stars and sparked fear among players. The exact reasons for higher ACL tear rates in women vs men are debated and amongst the theories are anatomy, hormones, and other factors.”
Walsh who played in her national team for the final against Spain, suffered a debilitating injury during an earlier game against Denmark but was fit to play again when it was revealed she had not suffered an ACL injury.
Former Real Madrid CF Medical Director and isokinetic sports expert Dr Jesus Olmo said: “In specific relation to Keira Walsh’s injury, it is non-contact and abrupt stop when lunging to reach a ball. There is probably a last milliseconds mechanical perturbation caused by the ball, but not from other opponent.”
However, the conference hear that two categories of non-contact injuries – ‘defensive pressing and abrupt stop’ or landing and twisting – together comprised 43% of all injuries, according to a recent German study.
The research Four Distinct ACL injury Match Situations in Professional Women’s Football analysed 35 ACL injuries in professional women’s football from 2016-2022 and identified these two variants and two other causes as the greatest contributors to cruciate ligament damage.
The other two categories include indirect contact involving parallel sprint and tackle which account for 40%, plus ‘knee to knee’ injuries accounted (17%).
It was notable that of the two types of non-contact injury nearly half (47%) the cases considered were sustained during the first 15 minutes. And within this group horizontal movements made up nearly two thirds of cases.
Isokinetic practitioner and former Brentford FC medic Dr Matthew Stride, said: “In direct relation we should note that in the 2021 Euros, England women’s national team did not have any injures and there is a strong correlation between success and player availability.”
Other research submitted at the conference stressed the importance of early use of hydrotherapy pools and the need for early access to rehabilitation to prevent loss of overall performance. It also revealed a strong demand amongst players for staff education and better menstrual cycle monitoring.
Tartaglia pointed out that preventing recurrent ACL tears is a challenge with 40% of injuries tearing again within five years, while multiple ACL rehabs took a mental toll with some players retiring early out of fear of re-injury.
Added Tartaglia: “We want to further the pool of research to alleviate the uncertainty and anxiety for players. Data is beginning to show us that a heavy game workload and intensity with insufficient recovery resources may contribute. There are also structural issues like poor fields, unsuitable gear and shoes.”
“Women’s football needs more resource and better injury prevention.”
PIC: Jeffrey F Lin
