Women's Football Hub

Edited by Carolyn Kent – Women’s Football Hub

Introduction

In this week’s episode of the Women’s Football Hub podcast, we welcome Miss Morgan Bailey, a consultant trauma and orthopaedic surgeon specialising in children and adolescent knees. As Chair of the Women’s ACL Orthopaedic Steering Group and an ambassador for the injury prevention charity Power Up to Play, Miss Bailey shares her expertise on the growing issue of ACL injuries in youth football. With co-host Lotte Black, we explore myths, risk factors, surgical options, and crucial prevention strategies for the next generation of female footballers.

Why Are ACL Injuries on the Rise in Teenage Girls?

Miss Bailey explains that ACL injuries in adolescents have increased 20-fold over the past 20 years. Why?

• 🏃 Early sport specialisation and reduced varied physical play
• ⚽ Increased training intensity and volume
• 🧠 Improved diagnostics – more injuries are being picked up via MRI

For girls, the risk is even higher due to both sex-based factors (e.g. hormonal fluctuations, anatomy) and gendered issues (e.g. poor access to S&C, ill-fitting kits and boots, fewer resources).

“Teenage girls are my highest priority. They’re the ones we can help most through prevention.”

Surgical Considerations in Adolescents

Surgical decisions in teenagers depend heavily on whether the growth plates are still open:

• 🦴 Younger patients often receive ITB grafts to protect growth plates
• 🧵 Quadrupled single hamstring grafts offer strength without compromising growth
• ⛔ BTB grafts are typically avoided in still-developing knees

“You have to tailor every surgical plan to the individual – there’s no one-size-fits-all.”

The Hormonal Question

Hormones are often blamed, but evidence is limited. Miss Bailey explains:

• 🧬 Injury risk may rise in the pre-ovulatory phase, but data is still emerging
• 🧪 Salivary and urinary hormone testing is replacing invasive blood samples
• 🧠 Until research catches up, the focus should be on controllable external risk factors

“We won’t know how much hormones matter until everything else is equal.”

Psychological and Social Impact

The emotional toll of an ACL injury in youth players is often underestimated:

• 😞 Identity loss, social exclusion and anxiety are common
• 🤝 Informed decision-making is crucial – players must feel heard
• 💬 Support from coaches, parents, and MDTs helps athletes stay motivated

“Teenagers see the now – not the long-term consequences. That’s our job to help balance.”

Cross-Bracing and Surgical Innovation

Miss Bailey discusses the cross-bracing protocol, which aims to heal rather than reconstruct the ACL, and surgeons still need more data before they can consider it as an option for non surgical management.

• 📉 What is important is that most youth cases don’t fit the criteria due to meniscus damage or delayed diagnosis

Prevention > Cure: The Role of Warmups

Miss Bailey champions injury prevention as the most effective strategy, especially for young female athletes:

• 🔁 Neuromuscular warmups reduce ACL risk by up to 70% in teenage girls
• 💪 Strength training must start earlier and be normalised for girls
• 🧍 Buy-in from players, coaches and parents is essential

“Society doesn’t tell girls to be strong. But we should – it saves knees and futures.”

Barriers to Prevention in Youth Sport

Why aren’t prevention programmes standard yet?

• 🧑‍🏫 Coaches lack training and time
• 🧠 Teenagers want to know “why” before committing
• 🎓 Cultural shifts are needed to make strength & conditioning the norm for girls

Final Thoughts

Miss Bailey leaves us with a strong call to action: make injury prevention a mandated part of grassroots football. Through education, resources, and open conversations, we can reduce the number of young girls facing long, emotionally taxing ACL recoveries.

📢 Resources: Visit Power Up to Play to connect with ambassadors and access warmup protocols.

🎧 Listen to the full episode now on Spotify, Apple Podcasts, or your favourite platform.

---

This blog post was created with assistance from OpenAI’s ChatGPT (OpenAI, 2025).