Solving the ACL mystery: How is the FA tackling the injury blighting women's football?

Women footballers suffering ACL seven times more than men, ITV News Sports Editor Steve Scott explains the spike in high profile injuries

Before too long, the FA will receive details from research it commissioned into the plague of anterior cruciate ligament (ACL) injuries that have threatened the Lionesses chances at this summer’s World Cup in Australia and New Zealand.

European Champions England have already lost their captain Leah Williamson, and it’s doubtful their most prolific striker Beth Mead will be fit enough in time to take part in the tournament.

The women’s game has seen a spike in this career-threatening injury, and nobody can put their finger on why female footballers are up to seven times more likely to suffer the injury than men - or what makes them more susceptible.

Four international players from Arsenal’s women’s team are currently out of action and recovering from an ACL tear.

The FA has also instigated an innovative data-sharing scheme between them and the top clubs in an effort to solve the mystery of why women are more vulnerable, and what conditions lead to this specific injury.

Baroness Sue Campbell , director of women's football at the FA, said: ''I had some time with Beth and Leah, and you know, it almost brings you to tears because their pain is so obvious.

"They are two wonderful players, very committed to their clubs but also very committed to England, who had a wonderful Euros. To see the pain and anguish that they are so suffering is horrible.

''The clubs are still evolving, the professional clubs, [they] were playing in virtually amateur football two years ago and now they are playing professional football.

"And although we've got a lot of great experts in football in terms of physical preparation and [in the] medical case... quite a lot of them don't have experience in the women's game.''

Northern Ireland international Simone Magill’s long journey back to fitness ended only recently - 10 months after the devastating injury that every elite athlete fears.

“It kind of makes the long, tough process of rehab worth it when you actually step back out in the grass again,” she said, after running out for Aston Villa in the Women’s Super League.

Magill tore her anterior cruciate ligament while playing in the Euro’s last summer.

“You hear a pop or feel something, I just felt the tendon almost tear away,” she said.

"And I just knew exactly what it was in that moment, this is my ACL for sure."

In part, Magill blames the support women footballers get off the pitch.

“We’re trying to mimic all of the demands of the man's game but we're not getting the same level of resources that they're getting," she said.

“That's what we need to start looking at, especially this year, we can't just keep accepting that ‘oh, there's another knee injury', because it's certainly not okay.

“You want to be able to blame it on one thing - it's the pitches, or it's the boots or, you know, if females are on their menstrual cycle.

"But I just think it's loads of different things that need to all be looked at individually and then we can figure out what's the best way to prepare the female athlete. What is the best way moving forward?

"What does it look like to be a female footballer, instead of just mimicking what the men say... because we're very, very different.”

Knee surgeon Andy Williams has operated on hundreds of sports stars including Virgil Van Dijk, John Terry, Andrew Flintoff, and England’s Euros match-winner Chloe Kelly, among others.

He believes a combination of many factors - from women’s physiology, their menstrual cycle, the pitches they train on to an unrelenting fixture list - may contribute to their vulnerability.

More research, he says, would help protect women footballers because it would identify tell-tale trends.

“Traditionally, female athletes were chosen quite late in their development physically, and it was just good enough to be skillful to get selected," he said.

“There's no doubt if you play when you're tired and fatigued, the door is more open for a new injury. And the intensity they play at is increasing, it really is a very high level.”

Some researchers also believe there is one key factor that puts women at risk.

Katrine Okholm Kryger is a senior lecturer at St Mary’s University in Twickenham and a specialist in football medicine.

"We don't have football boots for women on the market at the moment, not from major manufacturers at least," she said.

"They need to measure and design football boots women, not just marketing but actually doing the measurements before.

"So that the boots actually are designed for women, not just look like they're designed for women.

"Women are lighter and do not generate the same speed as men, so they need a different design."

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