Women's Football Hub

Edited by Carolyn Kent – Women’s Football Hub

ACL injuries are often seen as career-defining moments in women’s football. But what if we could better understand when they happen and why to help prevent them?

In a recent episode of the Women’s Football Hub podcast, I spoke with Wyatt Hampstead, a PhD researcher whose study analysed 208 ACL injuries across 27 professional leagues from 2022 to 2024. His findings challenge some long-held assumptions and offer new directions for injury prevention, especially in the context of fatigue and match intensity.

The Surprising Timing of ACL Injuries

Wyatt’s research revealed that 70% of ACL injuries occur in the first half, with a notable spike between the 15th and 35th minute. This challenges the common belief that fatigue-related injuries happen later in matches. Instead, it may suggest that acute fatigue the kind that builds quickly during high-intensity play may be a key factor.

Players are often asked to press hard from kick-off, engaging in high-speed running, rapid changes of direction, and aggressive tackling. These actions place significant mechanical load on the knee. The early match intensity, combined with tactical urgency to score first, may be creating a perfect storm for injury risk.

Match Intensity and Tactical Demands

Teams often aim to dominate early, knowing that scoring first can shift momentum. But this tactical intensity may come at a cost. Wyatt speculates that players might not be sufficiently warmed up or could be carrying chronic fatigue from congested match calendars and travel schedules.

Interestingly, similar injury timing patterns have been observed in the men’s game, suggesting that match intensity and fatigue are universal contributors, not gender-specific anomalies. This opens the door to shared solutions across both men’s and women’s football.

Positional Risk and Goalkeeper Insights

While midfielders showed a slightly higher proportion of injuries, statistical analysis didn’t find significant differences among outfield positions. However, goalkeepers tended to get injured later in matches, around the 44th minute. This raises questions about positional demands and training specificity.

Wyatt noted that future studies could benefit from more granular data such as distinguishing between central midfielders and wide players to better understand positional risk. Unfortunately, public data sources like SoccerDonna don’t always provide that level of detail.

What Can Be Done?

Wyatt emphasizes the importance of adequate warm-ups that prepare players for high-intensity actions. This includes sprinting, pressing, and change-of-direction drills that activate the neuromuscular system. Conditioning programs should also simulate match scenarios under fatigue to reinforce safe movement patterns.

He also advocates for injury prevention programs like FIFA 11+ or Perform+, even if they’re not widely used in elite women’s football. Something, he says, is better than nothing. These programs may help players build resilience against acute fatigue and improve neuromuscular control.

The Gendered Nature of Injury Risk

Women’s football has grown rapidly, but infrastructure hasn’t always kept pace. Lower wages, limited access to medical support, and dual careers (many players still work second jobs) can all impact recovery and resilience. Wyatt says more research into these gendered environments is needed.

Some players are also parents, which affects sleep and recovery. Others may lack access to private facilities or consistent physiotherapy. These factors compound the physical demands of the game and may increase susceptibility to injury.

Advice for Young Players

Wyatt’s message to aspiring pros is clear: don’t be afraid to play. The benefits of football physical, mental, and social far outweigh the risks. But do engage in injury prevention, seek professional guidance, and prioritise recovery.

He recommends working with physiotherapists or strength coaches who understand the game and can tailor programs to individual needs. Objective measures of strength, mobility, and neuromuscular control can help players track progress and reduce risk.

The Role of Data and Research

One of the most innovative aspects of Wyatt’s study was the use of publicly available data to track injury timing. With help from independent researcher Vanessa, the team used platforms like X (formerly Twitter) and SoccerDonna to identify ACL injuries and locate video footage. This approach helped overcome barriers like limited access to club data and reduced research costs.

The study also used Kaplan-Meier survival analysis to visualise injury timing. While this method doesn’t predict injury risk, it clearly showed that ACL injuries tend to cluster early in matches. This kind of data visualisation can help coaches and medical teams better understand when players are most vulnerable.

What’s Next in ACL Research?

Wyatt’s future research will focus on the biomechanics of ACL injuries, using video footage to analyse movement patterns and contextual factors. He also plans to explore chronic fatigue, looking at how match congestion and travel may contribute to injury risk.

Another area of interest is neuromuscular profiling during fatigue protocols. By testing how players’ movement and control change under fatigue, researchers may uncover new ways to tailor prevention programs and improve resilience.

Changing the Narrative

One of the challenges Wyatt faces is the public perception of ACL injuries as an “epidemic.” While the injury is serious and has long-term consequences, it’s important to note that ACL injuries account for less than 5% of total injuries in women’s football. The real issue is the burden ACL injuries account for over 25% of total time lost due to injury.

Changing the narrative means focusing on evidence, not fear. It means empowering players, coaches, and medical teams with data-driven strategies that reduce risk without compromising the game’s intensity.

Final Thoughts

ACL injuries may never be fully preventable, but with better data, smarter training, and more inclusive environments, we can make football safer for everyone. Wyatt’s research is a step in that direction challenging assumptions, highlighting overlooked factors, and offering practical solutions.

As the women’s game continues to grow, so too must our commitment to athlete care. Injury prevention isn’t just about protecting knees it’s about protecting careers, confidence, and the future of the sport.

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