Moving the Goalposts | Putellas and other female footballers fight on despite ACL injury curse

It happened again last week. As we were all excited about the start of the Women’s European Championship and getting ready to cover the biggest edition of the tournament yet, through came the news that Alexia Putellas had suffered a knee injury. Then, on the eve of the opening game at Old Trafford, the Spanish federation confirmed our worst fears: it was a rupture of the anterior cruciate ligament (ACL) in her left knee. The injury will rule out the best player in the world for some time.

She is far from the only one to have suffered this horrendous injury. A few days later it was confirmed that Northern Ireland’s Simone Magill had ruptured her ACL while two players from the European champions, Lyon, Catarina Macario and Ellie Carpenter, were also hit this spring.

Research has shown that female players are four to six times more likely to suffer an ACL injury than male footballers so we spoke to Kirsty Elliott-Sale, a professor at the Manchester Metropolitan University Institute of Sport, to try to understand more about the injury and why it happens so often in women’s football.

She is keen to point out that, while the injury is common, not all players will experience it during their careers. “They are common enough to be disruptive, especially to the player and their team, but not so common as to stop the growth or development of the women’s game in general”, she explains.

It feels as if we are seeing more and more of these injuries but Elliott-Sale points out that the rise in coverage of women’s football also brings more awareness of this issue – especially when the best player in the world has to miss a major tournament. “More women are playing football than before, professional players have more games than before and we hear it reported more,” she says.

Even though ACL injuries are more common in women’s football than men’s, researchers have still not pinpointed why. There are possible biological reasons but the environment in which the women perform also plays a part, particularly the gap in resources, different pitch surfaces, equipment and access to professional healthcare.

Even stress can increase the risk. “In my opinion, ACL injuries are multi-factorial and stress certainly has the ability to have both direct and indirect consequences for a player’s health and performance.” Some research studies have suggested that the hormone oestrogen may influence the risk of ACL injuries but this is only one aspect within a complex system.

An ACL tear can keep a player off the pitch for an entire season, and it is a tough recovery process. For one of our first newsletters, we interviewed German international Sara Däbritz, who said she was shaped not only as a player but also as a human being. “I could feel that it made me stronger mentally and also in the end on the pitch,” she told us. Likewise, Putellas was upbeat when she shared her feelings on social media soon after the injury. “This process will be quite a challenge but I am confident that I will recover, get back on track and finish what I started,” she said.

The recovery from an ACL tear may take between six and nine months, sometimes even longer and it is important that each player takes their time. One of the main risks, according to Elliott-Sale, is returning to the pitch too soon and getting injured again. “I’m not sure that I would consider the recovery time long. We need to return the player not just ‘fixed’ but in their best health, and these things take time.”

Quote of the week
“The first thing this situation has confirmed for me is the real and pure love I feel for this sport. I could blame it. Why now? Why one day before the start of the Euros, that I’ve been looking forward to and working on for so long? But I don’t. I feel like I’ve been privileged for a long time. I am only grateful for this daily joy that is so difficult for anyone to achieve” – Alexia Putellas.

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This just has to be Beth Mead’s goal against Austria. Classy, with a touch of brilliance. The way she received the ball on her chest, and having just a second to figure out how to score, and then executing it. An amazing goal to kick off what is already an amazing tournament.