What Research Reveals About ACL Injuries in Women’s Football
Why we need to stop blaming women’s bodies and start fixing the game around them.
Women’s football has never been more visible, more powerful, or more globally followed than it is today. The professional game is expanding rapidly: bigger leagues, more fixtures, increased travel, higher physical demands, and unprecedented levels of media attention and commercial interest.
But with the rise of the women’s game has come something else - something far more troubling:
🚨 A silent epidemic of ACL injuries. Women footballers are up to eight times more likely to tear their ACL than men.
This is not news to players, coaches, or fans who’ve watched one superstar after another fall victim: Beth Mead, Viv Miedema, Leah Williamson, Catarina Macario, Christen Press, Marie-Antoinette Katoto, and so many more.
But despite the number of injuries - and the pain, fear, and frustration that come with them - the conversation has stayed stuck in the past, focused on claims about women’s “naturally weaker bodies,” “wider hips,” or “hormonal fluctuations.”
FIFPRO, the global players’ union, has a different message:
Stop blaming women’s bodies. Start fixing the environment.
This is the foundation of Project ACL, a groundbreaking three-year research initiative from FIFPRO, the Professional Footballers’ Association, Leeds Beckett University, Nike, and the English Women’s Super League.
The project’s goal is simple:
👉 Understand why ACL injuries are skyrocketing—and fix what can be fixed.
For FC Game Changer, where performance, player health, and smarter training is at the core of our mission, this topic deserves deep examination. So let’s break it down.
1. The Old Narrative: “Women Are Just More Prone to ACL Tears”
For decades, the dominant narrative has been that women tear their ACLs more often because of biological differences:
Wider hips
Q-angle differences
Hormonal fluctuations
Menstrual cycle changes
Ligament laxity
But experts say this narrative is outdated, overly simplistic, and in many cases flat-out wrong.
Dr. Alex Culvin, former pro (Everton, Liverpool) and Head of Strategy & Research for Women’s Football at FIFPRO, told Reuters:
“We want to move away from these stereotypical views that women are more susceptible because of the way their bodies are… They can’t take the workload—that’s illogical and overly feminized.”
These narratives do more harm than good. They frame women’s injuries as unavoidable, predetermined by biology.
And if it’s “biology,” then no one is responsible.
But the truth?
We can change many risk factors. We just haven’t invested in them.
2. The Real Story: Poor Conditions, Poor Support, Poor Planning
FIFPRO’s early findings show that modifable factors—not biological differences—play the biggest role in ACL injury risk.
Dr. Culvin breaks them down into three categories:
A. Calendar Congestion
Women’s football is growing fast - but often without enough planning to support the players.
Many women’s teams now deal with:
Multiple consecutive matches
Increased international duties
Heavy travel schedules
Short turnarounds between games
Long flights without recovery protocols
Limited preseason
This creates fatigue, and fatigue creates ACL injuries.
If the men’s game is over-crowded (and it is), the women’s game is now exploding without proper structures in place.
B. Working Environment & Facilities
Players in Project ACL describe:
Uneven, poor-quality pitches
Shortage of physios
Limited access to strength coaches
Inconsistent medical staffing
Overlapping commitments (club + national team)
Lower pay requiring additional jobs or schooling
Inferior gym facilities
Fewer recovery tools
These are not minor issues—they’re contributors to injury.
Dr. Culvin stresses:
"We can’t change women’s physiologies but we can change the environments in which ACL injuries occur.”
C. Lack of Data
Shockingly, despite decades of ACL fear, there is very little research on ACL injuries in professional women’s football.
Most of the research is on:
Young athletes
Recreational players
American sports
Small sample sizes
Men’s data extrapolated onto women
Professional women footballers—the ones experiencing the worst injury rates—remain largely unstudied.
Project ACL aims to fix that by gathering real, actionable data.
3. Psychological Stress: The Invisible Risk Factor No One Talks About
One of the most eye-opening components of Project ACL is the attention given to psychological risk factors—a dimension of injury that often goes completely unrecognized.
Dr. Dale Forsdyke, lecturer in sports injury management at York St. John University, delivered a major talk to over 500 medical professionals at UEFA’s Medical Symposium. His message was blunt:
“We often forget footballers are human.”
Stress isn’t just emotional—it’s biological.
Chronic stress can:
Alter cortisol levels
Impair muscle repair
Reduce coordination
Narrow attentional focus
Worsen sleep
Slow recovery
Increase fatigue
Change movement patterns
Raise injury risk
Forsdyke explains:
“There’s a behavioral mechanism with stress… It impacts sleep quality and quantity. And sleep is crucial for recovery.”
Women players often deal with:
Unstable contracts
Low pay
Less job security
Media scrutiny
Social media abuse
Double careers (school, work + football)
Family responsibilities
Unequal support structures
All of these compound to create a perfect storm.
And in most clubs?
Psychologists are brought in only after players are injured—rarely before.
For many teams, mental health is still considered a “luxury,” not a core part of performance and injury prevention.
This must change.
4. Prevention Works—But It Needs Buy-In (Especially From Coaches)
One of the most important messages from UEFA’s symposium came from the federation’s chief medical officer, Zoran Bahtijarevic:
“Prevention starts with you.”
He stresses that ACL prevention programs do work, but they require:
Consistency
Repetition
Commitment
Coach education
Parent education
Organizational standards
The best-known prevention plan is FIFA 11+, a warm-up system that focuses on:
Neuromuscular control
Balance
Strength
Jumping & landing technique
Agility
Cutting form
But the biggest challenge?
It’s boring.
Bahtijarevic admits:
“It’s boring because you have to repeat it two or three times a week.”
Players get bored.
Coaches skip it when training time is short.
Clubs assume it’s optional.
But the evidence is clear:
🔥 ACL prevention programs can reduce injuries by up to 50%.
The problem is not the program.
The problem is consistency.
5. A Culture Shift: Minimum Standards in Women’s Football
Culvin and FIFPRO are advocating not for optional recommendations—but for minimum global standards, including:
✔ Adequate number of full-time physiotherapists
✔ Regular screenings and strength assessments
✔ High-quality pitch surfaces
✔ Limits on match & training load
✔ Minimum preseason length
✔ Proper recovery windows after travel
✔ Club psychologists as core staff, not consultants
✔ Standardized ACL prevention protocols
✔ Research-backed guidelines for menstrual cycle awareness
✔ Clear medical pathways for rehabilitation
✔ Career-long health tracking
This isn’t luxury support—it’s the support that men’s teams have had for decades.
Women deserve the same.
6. Why This Matters for Players—Youth, College, and Professional
ACL injuries are devastating:
6–12 months of recovery
Risk of re-injury
Loss of confidence
Loss of playing time
Financial insecurity
Emotional and psychological toll
Potential early retirement
For young athletes, college players, and adult amateurs, the lessons from FIFPRO’s research are key:
A. Focus on Movement Quality
Practice landing, deceleration, agility, cutting, and single-leg strength.
B. Manage Your Load
Overtraining increases injury risk just as much as undertraining.
C. Sleep Is Non-Negotiable
Sleep is one of the most powerful injury-prevention tools.
D. Balance Strength Across the Chain
Weak hips and glutes = higher ACL risk.
E. Advocate for Yourself
If your team doesn’t provide:
Proper warm-ups
Strength training
Prevention programs
Recovery time
…you can still take ownership of your own body.
F. Normalize Conversations About Stress
Pressure, burnout, anxiety—these are performance factors and injury factors.
7. The Big Shift: Women’s Bodies Are Not the Problem. The System Is.
The most crucial takeaway from FIFPRO and Project ACL is this:
❌ Women are NOT “injury-prone” because they’re women.
✔ Women are getting injured because the game is not built around their needs.
When you add up:
Poor working conditions
Inadequate recovery
Overloaded schedules
Limited medical support
Psychological stress
Lack of research
Low pay/resource disparity
Inconsistent training environments
Inadequate strength foundations
The result is predictable—not biological destiny.
8. A Call to Action (For Clubs, Coaches, and Governing Bodies)
The ACL injury crisis is reversible.
But only if everyone involved in the sport commits to change:
Clubs:
Invest in medical teams, strength coaches, psychologists. Prioritize pitch quality.
Coaches:
Commit to warm-ups, injury-prevention, and load management. Educate yourself.
Parents:
Support balanced training, adequate rest, and mental well-being.
Governing Bodies:
Establish mandatory minimum standards. Protect players.
Players:
Understand your own body. Prioritize recovery. Speak up.
Brands & Sponsors:
Help fund research, facilities, and player education.
This isn’t just a women’s issue.
It’s a football issue.
A player safety issue.
A human issue.
9. What FC Game Changer Athletes Should Learn from This Research
As a platform dedicated to improving the performance, mindset, and career longevity of soccer players, here’s how we translate FIFPRO’s research into actionable insights.
1. Master the Fundamentals of ACL Prevention
Include neuromuscular warm-ups 2–3 times/week.
Learn proper landing and cutting mechanics.
2. Build Strength Year-Round
Strength is protective. Weakness is risky.
3. Manage Stress & Sleep
Your mental health is your physical health.
4. Advocate for Better Conditions
Whether you’re in youth soccer or at the college level, demand:
Consistent training surfaces
Proper warm-ups
Adequate staff
Reasonable scheduling
5. Understand Your Menstrual Cycle—But Don’t Fear It
Cycle awareness is useful.
But biology does NOT doom women to ACL injuries.
6. Focus on the Total Environment
The ACL crisis is a symptom of a broader issue:
Women’s football has outgrown the infrastructures built to support it.
Players are pushing harder.
The system must catch up.
Conclusion: The Future of Women’s Football Depends on Doing Better
FIFPRO, Leeds Beckett, Nike, and the WSL are leading a long-overdue movement:
🔥 Stop blaming women’s bodies. Start fixing the system.
ACL injuries are not the price women must pay for progress. They’re not fate. They’re not biology alone. They’re the result of decades of underinvestment, lack of research, inadequate facilities, overloaded calendars, and a medical system built around men.
The women’s game deserves better.
Players deserve better.
Fans deserve better.
And if we finally start taking ACL prevention seriously—from youth soccer to the elite level—the next generation of footballers will grow up safer, stronger, and unstoppable.
For every young girl dreaming of the World Cup, for every pro fighting back from a knee injury, and for every coach trying to build a safer, smarter training environment—this research matters.
Because prevention isn’t boring.
It’s not optional.
It’s not “extra.”
Prevention is the difference between a season and a setback, a dream and a detour, a career and a crisis.
And the work starts now.
