- ACL Injuries and World Cup Absences: Impact on female football players
- Nature vs Nurture: Factors contributing to ACL injuries in women’s football
- Importance of Strength and Conditioning: Preventive measures for reducing ACL injuries
ACL injuries are dreaded, particularly among female football players. Due to them, between 25 and 30 players, or an entire extra squad, will skip the upcoming World Cup. The issue is that there is no single explanation for why this is occurring.
Keyhole surgery may be a misnomer: despite the technology, skill, and extraordinary finesse involved, it is also a very physical procedure.
Mr. Jones (male surgeons are referred to as Mr as opposed to Dr.) removes a hamstring with force.
Drills can penetrate bone. As tissue is cauterized, it emits fumes. There is considerable hammering: “Mallet, please,” Mr. Jones requests of his assistant.
The ACL is a thin band of tissue that runs through the center of the knee and stabilizes it.
Observing the operation, however, makes it clear why tearing it is so catastrophic. Even though the patient’s knee will only have three minuscule scars, it has been severely damaged.
Mr. Jones tells, “There will be 90 minutes in the operating room with me, followed by one year of rehabilitation with your physiotherapist.”
This is why ACL injuries are so feared, particularly by female football players.
Far too many female athletes suffer ACL injuries.
Due to ACL injuries, between 25 and 30 players, or an entire additional squad, will miss the impending World Cup. Beth Mead and Leah Williamson, both from England, have been ruled out. According to data provided by ACL Women Football Club, 195 elite athletes have sustained the injury in the past year.
It has been labeled an “epidemic.” And this epidemic disproportionately affects women: they are 2.5 to 3.5 times more likely to rupture their ACL than male athletes. And we do not understand why. Despite the growth of the women’s game, research has lagged.
Jess Carter, a defender for England, will be participating in the World Cup. Before leaving St George’s Park, England’s national football center, she tells, “There have been far too many women’s players with ACL injuries, and not enough research has been conducted on the subject.”
“Why are so many people injured? How can we stop it? Why is this occurring? Sometimes I wonder, “If this were happening to high-profile male athletes, would more be done to improve the situation?”
Nature versus nurture
The issue is that there is no single solution.
Kat Okholm Kryger, a sports rehabilitation researcher at St. Mary’s University Twickenham and a medical researcher for FIFA, states, “I made a list the other day, and I believe I found 30 reasons that have been discussed in the literature.”
“I believe we can divide it into two major categories. I prefer to refer to them as nature and nurture.
Therefore, nature is similar to biology: DNA, body structure, muscle mass, etc… But also the milieu in which the women are raised. How young female players are managed in comparison to young male players, the facilities, the professionalism surrounding the sport, and the quality of the available personnel.”
I am curious as to whether women’s sports injury research has received the same level of attention as men’s.
“Pay Attention? In general, this is consistent with football and sports medicine research. “Males have been the norm,” she continues.
In the end, research will also benefit men’s basketball.
Take football boots as an example of a topic within the domain of ‘nurture’ that Kat is researching. Male feet were the norm. Boots designed specifically for women have only been available in recent years. Even then, we do not fully comprehend the differences, which is why Kat has scanned hundreds of feet in 3D to map them.
This research will ultimately benefit the men’s game as well, as Kat is also documenting ethnic differences. Because the default foot is not just that of a man, but that of a Caucasian man.
The male is also the norm for other environmental factors, such as reserving a pitch.
The Gravesham Girls and Women’s Football Club, founded in 1999, is training in Kent on a Thursday evening before the commencement of the season. Approximately twenty yellow-clad participants are performing shooting drills with balls flying everywhere.
Toni Allen and Keylie Oliver have both previously ruptured their ACLs. “I just screamed – everyone thought it was a fox,” says Allen. Each was absent for a year.
Oliver states, “It’s quite intimidating, particularly when you realize that it can affect more than just football.
“We have lives outside of football, and this affects those… At the grassroots level, the women’s games always begin at 2:00 p.m. Because in our society, men’s football takes precedence over women’s football. We always have to play after, which destroys the pitch.”
The significance of the factors can fluctuate.
Not only is there a large number of variables involved, but their relative importance can also fluctuate.
Professor Kirsty Elliott-Sale is a female Endocrinology and Exercise Physiology professor at the Manchester Met Institute of Sport.
She collaborates closely with clubs, including Arsenal, to investigate the effect of the menstrual cycle and the Pill on injuries. There is evidence that certain hormones can loosen ligaments, thereby increasing the risk of rupture.
Prof. Elliott-Sale analyses the laxity of players’ knees throughout the season, charting it against their hormones and cross-referencing it with other factors such as match congestion.
She states, “It’s a jigsaw puzzle.” “And it’s a matter of fitting the puzzle together.
“However, once we have all the information, we cannot predict which factor will play a larger role on any given day. So it’s not as if each piece is the same dimension. On some days, a specific factor that may influence this form of injury may be amplified, while on other days, it may be diminished.”
Biology remains an important part of the solution.
The difference in body types between men and women, which in the past led some to dismiss women as too “fragile” to perform traditionally male sports, may not be as significant as previously believed.
In certain sports, the ACL injury disparity dissipates.
“If you compare sports in which males and females begin at the same age, have the same training intensity throughout their athletic careers, and perform the same movements during that sport, then the rupture rates are comparable,” explains Mr. Jones, a surgeon.
Elite performers are an excellent illustration of this. Male and female elite dance athletes begin training at the same age, perform the same pivoting, leaping, and twisting movements, and train with the same intensity and under the same conditions. Comparing their rupture rates reveals that they are equivalent.”
And this suggests that the effect of your training and conditioning is crucial in preventing this injury.
Every expert I spoke with emphasized the importance of strength and conditioning in injury prevention. Here, nurture influences nature.
Ms. Kryger states, “We have this mentality that women do yoga and pilates while men lift weights in the gym.”
“However, everyone must occasionally lift heavy objects to avoid injuries and maintain a healthy body.”
