ACL in Women's Soccer

Dr Nico Furlan
3rd August 2023

IS THERE A PROBLEM? 

As the Women's World Cup approaches, concerns are rising about the participation of top female football players, as many are recovering from ACL injuries. Women's Football faces a higher risk of ACL injuries compared to men, leading to inferior outcomes after ACL reconstruction (ACLR) for females. Additional research focusing on female players is necessary to address this issue. 

WHAT ARE THE COMPONENTS OF REHABILITATION AFTER ACLR 

Rehabilitation after ACLR is crucial for athletes to return to their sport successfully. The approach and goals for both male and female athletes are the same, aiming to identify movement strategies and strength deficiencies while developing resilient athletes. The return-to-play process involves multiple phases, and psychological factors, such as fear of re-injury, play a significant role. 

Tailoring rehabilitation to the individual is vital, considering the nature of the injury, the athlete's competitive demands, and their response to the injury. Sports-specific rehabilitation, including on-pitch drills and gym-based conditioning, helps athletes restore dynamic sport-specific qualities. 

GOALS

The rehabilitation process should focus on achieving normalized knee function and psychological readiness, restoring biomechanics and performance metrics, and improving strength, reactivity, and cardiovascular endurance. Restoring proper mechanics during forward landing and change of direction is also crucial. 

RETURN TO SPORT CRITERIA

Clearance for unrestricted competition should be based on objective criteria and controlled exposure to contact within the sport. A battery of tests assessing several important factors should be used. Assessment of the knee’s mobility / stability and the absence of symptoms should be complemented by evaluation of strength, balance, hopping & changing direction biomechanics and integrated with measures of psychological readiness and confidence. 

WHERE TO START – PRACTICAL APPLICATIONS 

To address ACL injuries in professional football the following actions are recommended: 

• Clubs should invest in backroom staff, including strength and conditioning coaches and physios.
• Daily preparation for elite-level competition is crucial. Lower competitive and recreational players can largely benefit from 2 strength & conditioning sessions per week.
• Addressing social, socio-economic, and environmental factors, along with gender-based biology, is essential for effective ACL injury prevention and rehabilitation for female athletes.
• Improving training, coaching, and resources in female sports will positively impact ACL injury rates