This year, 25 women weren’t able to compete in the World Cup due to sustained anterior cruciate ligament (ACL) injuries. This number is disproportionate to the amount of men that suffered similar injuries in the 2022 World Cup. The astonishing number of ACL tears raises concern and questioning among doctors, athletes, and spectators. Many are wondering how these injuries occur, why women are more susceptible, and what players and coaches can do to prevent them in the future.
This injury is incredibly devastating for athletes. Not only is an ACL tear painful, but the recovery process is long and hard. Most players can’t return to the field for 9-12 months, and some never do. Without a healthy ACL, the knee is very unstable during lateral movement. When players return, playing soccer isn’t the same. Returning players typically won’t have as much lateral movement and need to wear a brace.
“I don’t think they typically occur in a specific instance. I think it can happen at any point at any place. One of my old teammates tore hers in a low-intensity play in practice because she got caught between a couple players at the wrong angle,” Olivia Penney, 25 said. ACL tears occur in many different ways. Despite soccer being such a high-contact sport, some ACL tears can happen when a player isn’t around anyone else and simply shifts or changes directions the wrong way. The unpredictability of these injuries makes it hard to pinpoint the main cause.
“Women’s ACLs tend to be smaller. Women also have larger Q angles — the ratio of hip width to femur length. This matters because this angle can cause someone to more easily go into a knocked-knee position and that puts more stress on the ACL,” Andrew Pearle, chief of sports medicine at the Hospital for Special Surgery in New York City said in an article by CNN. Dr. Holly Silvers-Granelli suggests that, “hormonal surges during a woman’s menstrual cycle can affect the laxity or looseness of ligaments therefore causing ACL tears to be more prevalent,”Jeff Carlsie, writer for ESPN, said. However, many disagree on one specific reason for women being more susceptible to ACL tears.
“This topic has been studied over the past 20 to 30 years, and some studies suggest it has to do with the difference in anatomical features between men and women. Others have said it has to do with hormonal differences in men and women,” Dr. McAllister said. “Some believe it has to do with the difference in how they train. There are all these different theories but no concrete evidence.”
This issue is frequent and leaves many female soccer players wondering how they can prevent this injury from affecting them. Almost all doctors and researchers say that strengthening the correct muscle groups can reduce the risk by about 72 percent. “In 2000, Silvers-Granelli was part of a group that developed one of the first PEP Programs (Prevent Injury, Enhance Performance), which comprised a 15-minute dynamic warmup — without the ball — of exercises designed to improve strength, balance, jumping technique, etc. The program was tried on 14- to 18-year-olds in Southern California. The results were staggering, including an 88% drop in ACL injuries.” These strength training practices reduce the risk by high amounts and young athletes should start implementing them into their workout routine. “My coach just started a new weight training program that helps with all types of injury prevention. He specifically will run sprinting drills for your ACL, but all weight lifting in general is strongly recommended because it’s good for mobility,” Penney said.
This issue is challenging in the sports medicine field. “I’m sick of operating on 16-year-old high school soccer players, knowing what their destiny is with this stuff, ” Pearle said. While the issue is daunting, more research is being done everyday to discover how to prevent these injuries.
