New Study Aims to Improve Understanding of ACL Injuries in Women’s Football

The FA and WSL launch a groundbreaking research project to improve understanding of ACL injuries in women’s football

The Football Association and WSL Football have announced a major new research project, in collaboration with Imperial College London and Sports Knee Surgeon Simon Ball, to better understand why anterior cruciate ligament (ACL) injuries occur in women’s football and generate practical insights that could help reduce the incidence of these injuries in the future.

Sponsored by The FA, the PhD research will be carried out by Hanna Lehtovirta at Imperial College London, working closely with The FA and WSL Football.

ACL injuries are among the most serious injuries in women’s football, often sidelining players for many months and affecting careers, clubs and team performance. As the women’s game continues to grow, understanding why these injuries occur – and how they can be prevented – has become one of the sport’s most important research priorities.

While previous research has identified a range of factors that may influence ACL injury risk – including anatomical, hormonal, neuromuscular, biomechanical and environmental factors – many studies have examined these in isolation or within laboratory settings. Less is known about how these factors interact in the day-to-day realities of elite women’s football.

This new study will go beyond the existing research by combining scientific data with lived experiences of players and staff working in the professional game. By bringing together multiple and diverse perspectives, the research will build a more complete understanding of ACL injuries in the women’s game and help inform future injury prevention strategies.

Every club in the Barclays WSL and WSL2 will be invited to take part, with players and staff from medical, performance and coaching teams all contributing to what will become one of the most comprehensive studies of ACL injuries in women’s football.

The study will comprise two key research phases. The first will collect data via player surveys, completed by both players who have experienced an ACL injury and those who have not. The survey will collect information on injury history, training and match load, as well as capturing hormonal, nutritional and psychological factors. For players who have sustained an ACL injury since the 2018/19 season, their data will be compared with those of uninjured players to help identify factors that may be associated with ACL injury risk.

The second phase will build upon the survey data, with information gathered through interviews with the same players, as well as bringing staff into the study group to offer a different perspective. These interviews will capture individual perceptions on ACL injuries as well as offer further context around current approaches to training and injury prevention.

By combining large-scale data with the lived experiences of players and practitioners, the research aims to provide the most complete picture yet of ACL injuries in elite women’s football, helping shape future approaches to injury prevention, rehabilitation and player welfare.

Ritan Mehta, Head of Women’s Medical at The FA, said: “We are proud to be partnering with Imperial College London, WSL Football and Simon Ball from the Fortius Clinic on this important research project. By working collaboratively, we can bring together expertise, data and lived experiences to deliver one of the most comprehensive studies into ACL injuries in the women’s game.  

“ACL injuries remain one of the biggest challenges facing female footballers. While significant progress has been made in understanding the factors that may contribute to these injuries, there is still much more to learn. We hope that this research will help shape future approaches to injury prevention and rehabilitation, and help more players to stay healthy and perform at their best.”

Dr Abosede Ajayi, Medical Governance Lead at WSL Football, said: “What makes this project particularly exciting is the partnership between football, healthcare and academia. The insights generated have the potential to strengthen ACL injury prevention strategies, inform medical standards across the women’s game, and ultimately create safer, healthier environments for current and future generations of players.”

Mr Simon Ball, Sports Knee Surgeon at Fortius Clinic, said: “ACL injury is devastating for professional athletes. Whilst we have made huge progress in the management of ACL injury there is no doubt that prevention is better than cure! There is still a lot to learn, and we owe it not only to the current generation of players, but to all future female footballers to deepen our knowledge and understanding with the aim of reducing the incidence to as low as possible.”

Hanna Lehtovirta, Research Postgraduate in Imperial’s Department of Mechanical Engineering, added: “Working with The FA and WSL Football gives us a valuable opportunity to study ACL injuries with elite players in their real-world context, looking at a wide range of potential risk factors – from minutes played and injury prevention practices at clubs to how players developed before they entered professional football. By bringing together different types of data and a diverse range of perspectives, we can build a better understanding of the factors that may contribute to ACL injury risk and generate findings that can help inform practical approaches to tackling an issue that impacts so many people in the sport.”