ACL Injuries in Women’s Sport

Anterior Cruciate Ligament (ACL) Injuries have been a hot topic in recent years, with injury rates rising exponentially. Women are up to 6 times more likely to sustain an ACL injury than their male counterparts with teenage girls at the highest risk; and with recovery and absence from sport taking an average of 12 months, this is having a huge knock on effect. Below; we take a look at why ACL injuries are so common in women’s sport and what we can do to help.

The most obvious reason for the disproportionate amount of injury in women’s sport is due to fluctuating hormones throughout the month. Relaxin, a hormone which causes muscle and ligament laxity is present in the second half of the menstrual cycle and research suggests that a large proportion of ACL injury occurs during the phase in which relaxin peaks. There have also been studies in to the effect of oestrogen on injury, however the results have been inconclusive due to the small sample of women studied. It is clear that a lot more research into hormonal fluctuations and injury needs to be done, however this comes at a cost and funding for this is limited.

Speaking in 2023 after her own ACL injury, Arsenal and England star Beth Mead said "I think it's important that we as a collective try and get more done for ACLs and research into it. I think it is way too common in the women's game. If that ever happened in the men's game, a lot more would have been done sooner.”

Next, its worth looking at the impact the female form has on injury. Women generally have wider hips compared to men and often their knees tend to tilt inward. This alignment alters the knee joint, increasing the risk of ACL injuries during movements such as jumping, pivoting and landing. The ACL tissue is also typically thinner in women, so it takes a less force to tear. When women land it’s usually in an upright posture, resulting in straighter knees and less core engagement. This is different from men who usually land with bent knees and with more core engagement.

The rise in ACL injury in women’s football has also been attributed to poorly fitting footwear. Women’s football boots tend to be smaller versions of the boots designed for men, rather than designed with the female foot in mind. This forces the foot into unnatural positions, as women tend to have a higher arch and a difference in heel shape to men. With unsupportive footwear, there is an increased risk of rotational traction at the knee, thereby increasing the risk of ACL injury.

ACL Injury prevention programmes have been proven to reduce injury risk by half across all athletes, and by two thirds in female’s sustaining non-contact ACL injury but with little funding for women’s sports, particularly football; it’s not something that all female athletes have access to.

There is no doubt that much more funding and research needs to be done into why women are so much more susceptible to injury. As mentioned above, injury prevention programmes can have a hugely positive impact; but of course it doesn’t eradicate the risk completely. So what can be done to protect against injury?

Taking just 2 units of Everyday Protect & Active Lifestyle cover at a cost of £20 per month will pay out £2000 for a complete ligament tear, which can be hugely beneficial in covering bills and payments during the recovery period and any time off of work. On top of this, you would also receive £100 per 24 hour hospital admission, as well as access to a virtual GP 24 hours a day, 365 days a year. While we can’t guarantee a reduce risk of injury, we can make sure you’re protected when you need it most.