The biggest "nightmare" of women's football, the cultivation time or more than 9 months, what is the ACL injury?

Because of last summer's European Championships, women's football gained unprecedented popularity and commercial influence. The world has high hopes for the huge blue ocean of women's football, and the 2023 Women's World Cup is considered to be an epoch-making node for the all-round outbreak of women's football in the world. However, the biggest "nightmare" of all female football players is the ACL (anterior cruciate ligament) injury. This serious injury that makes female football stars have to rest for more than 9 months, the average probability of occurrence far exceeds that of male football players, and is the biggest concern of female football players in the World Cup.

Of the 16 candidates for the French Football Ballon d'Or last October, as many as five have suffered serious anterior cruciate ligament injuries. These include English women's football star Beth Meide, who became BBC Sports Celebrity of the Year in December, and her team-mate Vivian Midmar, who also suffered a knee ligament injury late last year. The two had to go on crutches to attend the BBC Sports Personality of the Year awards ceremony. In addition, women's Golden Ball winner Putlas, American women's football legends Megan Rapinoe and Ada Hegerberg have all suffered the same serious injuries. American women's soccer stars Macario and Australia's Carpenter, who play in Lyon Women's football, and Catoto of Grand Paris Women's are also victims of serious knee ligament injuries.

England Women's also hopes to win the Women's World Cup this summer, but the serious injuries of the two absolute main players have put a huge question mark on the Lioness' dream of winning the title. Why are female soccer players so vulnerable to knee ligament injuries? Is there enough research in the sports medicine community on this, and to give corresponding preventive and rehabilitation measures? For women's football, this is a difficult problem that needs to be solved urgently. Because the careers of too many female soccer players have been ruined by such a fragile anterior cruciate ligament.

[Men are afraid of thighs, women are afraid of knee ligaments]

The most common serious injury in male soccer players is a thigh muscle strain, which accounts for almost 15% of all injuries and seriously affects the integrity of a player's season. The most feared injury for female soccer players is the anterior cruciate ligament of the knee, and studies have shown that female soccer players are up to 6 times more likely to suffer knee ligament injuries than male soccer players. Although the FA has studied injuries in the last four seasons of the Women's Football League, the anterior cruciate ligament accounts for only 1.3% of all injuries. But this season, 10 top players in the English Women's Premier League have suffered serious injuries to the anterior cruciate ligament, proving that such serious injuries are more likely to occur among top female footballers. In addition to the two stars of Arsenal Women's football, West Ham's Jessica Ziu, Aston Villa's Heroka and Tottenham's Kaia Simon and Ellie Bachi were also reimbursed for the season with a serious cruciate ligament injury.

Beth Meide, winner of last year's Women's European Championship Golden Boot and French Football's Silver Ball Award and BBC Women's Sports Person of the Year award, has missed all leagues leading up to next year's Women's World Cup due to a serious ACL injury, and it is naturally doubtful whether she can recover in time. Women and men differ greatly in size, lower limb muscles and knee ligaments, and as the number of top women's players plays, the probability of serious knee ligament injuries increases.

The Women's World Cup is the biggest soccer event of 2023, with high hopes from the world and sponsors, but the anterior cruciate ligament could be the biggest obstacle to the event's normal operation. Women's Ballon d'Or winner Putlas was injured before last year's European Championships, which led to a missed tournament and shattered Spain's dream of winning the title. French striker Catoto was injured in the second group stage match against Belgium Women, and she was the favorite to win the European Championship Golden Boot, but she withdrew early. At this summer's Women's World Cup, it is not known whether more female soccer stars will be absent with cruciate ligament injuries.

【Special period, especially fragile】

Previous studies have concluded that changes in estrogen levels in women during the menstrual cycle affect the physiology and biomechanics of the body, leading to joint laxity, which increases the pressure and pull on the anterior cruciate ligament. According to women's health expert Dr. Emma Ross, estrogen levels rise in the second week of the menstrual cycle, which directly affects the stability of the knee and interferes with the collagen in the knee joint, resulting in looser joints than at other times. Lewin, a physiotherapist at Arsenal Women, also agreed with the findings: "This is a special injury phase for female players compared to male players. Different phases of the menstrual cycle can lead to varying degrees of fatigue, poor physical coordination and loss of muscle strength. ”

Dr. Katrin Krieger believes that female players have smaller feet than men in shape and volume, and that running and performing technical movements have a greater impact on the knee ligaments. The senior lecturer in sports rehabilitation at St Mary's University in London also admits that female players are at least 2-5 times more likely to suffer an ACL injury than male players. As the intensity and density of women's professional league games increases, so does the probability of injury. Many sports brands are investing more money and researchers than ever before to develop sneakers specifically for the Women's World Cup, but a lack of consideration for the specificity of women's bodies will increase the likelihood of knee ligament injuries in female footballers to some extent.

Manchester United women's defender Aoife Mannion suffered two cruciate ligament injuries in less than two and a half years, missing 458 days and making just 11 appearances during the two injuries. She ruptured her second ligament in March last year and is only recently ready to return to competition after eight months of rehabilitation. Dr. Emma Ross believes that to avoid more cruciate ligament injuries, women's clubs and national teams need to start closely monitoring estrogen levels in female football players, understanding the cycle pattern and injury risk of each female football player.

Kestiy Searle, a professor at Manchester Metropolitan University's School of Sport, stressed that it is more important not to risk a comeback lightly, and returning to the pitch too early could cause more damage, which is the key to affecting a player's career. Because the recovery period for each injury will be as long as 6-9 months, it is difficult for the player to return to the peak after two injuries, which may end his career. In addition, there is also a huge gap between the sports medical resources available to top female football players and men's football, which is also one of the reasons why female football players have a higher probability of cruciate ligament injury.

Women's football has indeed ushered in a blowout in recent years, but it has not followed up in sports medicine research, resources and high-tech facilities, resulting in this huge gap.

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