Our Senior Sports Therapist Tyler Johnson has put together a fantastic article discussing Women's Football, the injuries that can occur within this and how to prevent them.
Read below to learn the key strategies for female footballers, to significantly reduce their risk of injury and improve their long-term performance and durability on the pitch.
1. Are Female Football Players More Prone to Injury Than Males?
Yes, studies indicate that female footballers face a higher risk of injury than male players, particularly for non-contact injuries such as anterior cruciate ligament (ACL) tears. Research in The Journal of Orthopaedic & Sports Physical Therapy (Benjaminse et al., 2015) suggests that hormonal fluctuations, particularly oestrogen levels, influence ligament laxity, which may increase injury risk during certain menstrual cycle phases. Some other factors include:
Several factors contribute to this increased injury risk, including:
Anatomical Differences: Women generally have a wider pelvis, which can affect lower limb alignment and place greater stress on the knees.
Neuromuscular Differences: Studies suggest that women tend to have different muscle activation patterns, often relying more on their quadriceps than hamstrings when decelerating or landing, contributing to reduced knee stability, making ACL injuries more common in female athletes as it puts more strain on the ACL (Gokeler et al., 2015).
Biomechanical Factors: Female athletes often display differences in jump-landing mechanics, with a tendency to land with straighter knees, which can contribute to knee injuries. Biomechanically, women typically have a wider pelvis and greater knee valgus (inward knee collapse) when landing, which alters the load on knee ligaments.
Further reading: Benjaminse et al. (2015). Optimization of the ACL Injury Prevention Paradigm. Journal of Orthopaedic & Sports Physical Therapy, 45(3), 170–182. DOI: 10.2519/jospt.2015.4986
2. Common Injuries in Female Football Players Compared to Male Players
Female footballers are particularly prone to ACL injuries, patellofemoral pain syndrome, and stress fractures. NCAA data indicates female athletes have a 2.4–3.1 times higher ACL injury risk than males due to neuromuscular and biomechanical differences (Springer’s Sports Medicine, 2023).
Anterior Cruciate Ligament (ACL) Injuries: Female players are up to six times more likely to suffer ACL tears than male players.
Patellofemoral Pain Syndrome (PFPS): Due to differences in knee alignment, women are more prone to this type of knee pain.
Ankle Sprains: Female footballers often experience a higher rate of lateral ankle sprains, potentially due to differences in neuromuscular control and joint stability.
Bone Stress Injuries: Conditions like stress fractures and shin splints are more common in female athletes, sometimes linked to the ‘female athlete triad’ (low energy availability, menstrual dysfunction, and reduced bone density).
Further reading: Gokeler et al. (2015). The Effects of Attentional Focus on Jump Performance and Knee Joint Kinematics in Patients after ACL Reconstruction. Physical Therapy in Sport, 16(2), 114–120. DOI: 10.1016/j.ptsp.2014.06.002
3. Rehabilitation Differences Between Male and Female Footballers
The fundamental rehabilitation principles are similar, but are adjusted based on biological and physiological differences between male and female players. There are key differences in recovery timelines and training techniques. Research (Wu et al., 2012) suggests oestrogen affects collagen metabolism, potentially slowing ligament healing in female athletes. This may lead to longer recovery periods for ACL injuries and soft tissue damage. Women may also require greater focus on neuromuscular training, including balance exercises and landing mechanics, to counteract biomechanical risk factors. Additionally, managing training loads according to the menstrual cycle may aid recovery.
Hormonal Variations: Recovery rates may be influenced by hormonal fluctuations, so rehab plans should consider the menstrual cycle’s potential impact on pain perception, muscle function, and healing.
Neuromuscular Training: Female athletes often benefit from additional neuromuscular and proprioceptive training to improve landing mechanics and reduce injury risk.
Strength Training Focus: Given that women tend to have a greater quadriceps-to-hamstring strength ratio, rehab programmes often emphasise strengthening the hamstrings to restore balance and protect the knees.
Bone Health Considerations: If stress fractures or bone-related injuries are present, ensuring proper nutrition and addressing any underlying issues related to bone density (e.g., low energy availability) is crucial.
Recovery Timelines: While individual variation exists, some studies suggest that women may take longer to recover from ACL injuries due to different collagen properties and muscle activation patterns.
Further reading: Wu, W. F., Porter, J. M., & Brown, L. E. (2012). Effect of Attentional Focus Strategies on Peak Force and Performance in the Standing Long Jump. Journal of Strength and Conditioning Research, 26(5), 1226–1231. DOI: 10.1519/JSC.0b013e318231ab61
4. Strength & Conditioning for Injury Prevention
Strength and conditioning training is vital for both male and female players but is especially critical for women due to their increased susceptibility to lower-limb injuries. A well-structured programme can:
Improve muscular strength, joint stability, and neuromuscular control.
Enhance movement efficiency, reducing stress on vulnerable structures like the knees and ankles.
Correct muscle imbalances that may predispose athletes to injury.
However, rehab will have a more tailored approach for women due to differences in biomechanics and injury risk factors. For example, female footballers may need more emphasis on:
Hamstring and glute activation to counteract quadriceps dominance.
Landing and deceleration mechanics to reduce ACL injury risk.
Core stability work to improve overall movement efficiency.
Plyometric and neuromuscular training programmes, such as Sportsmetrics ACL Training Program, have also been shown to significantly reduce ACL injury risk in female athletes (Ramirez-Campillo et al., 2014). Strength training focusing on hamstring activation, hip stability, and core control can help reduce knee valgus stress and improve overall injury resilience.
Further reading: Ramirez-Campillo et al. (2014). Effects of Plyometric Training on Injury Prevention in Female Athletes. Journal of Strength and Conditioning Research, 28(5), 1401–1410. DOI: 10.1519/JSC.0000000000000279
5. Key Strategies for Female Footballers to Reduce Injury Risk
To minimise injury risk, female footballers should prioritise:
Strength & conditioning training – Focusing on hamstring, glute, and core strength to enhance stability (particularly knee stability) and reduce knee and ankle injuries.
Neuromuscular training – Incorporating plyometrics, balance, and proprioception exercises to improve movement and landing mechanics.
Injury prevention programmes – Using evidence-based warm-ups like the FIFA 11+ programme, which has been shown to reduce ACL injuries.
Menstrual cycle-informed training – Adjust workload based on menstrual phases to reduce injury risk.
Optimised nutrition, Bone health & Recovery – Addressing sufficient energy intake, calcium, and vitamin D levels to support muscle and bone strength.availability and bone health to reduce stress fractures
Monitoring Workload & Recovery: Managing training intensity to avoid overuse injuries, ensuring adequate rest and recovery.
Biomechanical Assessments: Screening for movement inefficiencies and correcting them through targeted training.
By addressing these areas, female footballers can significantly reduce their risk of injury and improve their long-term performance and durability on the pitch.
Are you suffering from any of the above injuries that Tyler mentioned?
Book an appointment with Tyler now, he would love to serve you!
Call 0203 494 4343, email reception@svsportstherapy.com or you can also book online too!
Have you seen our YouTube channel? There's always a great exercise that can help with injury or recovery! Check it out here.
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