Football as a sport for women is continuing to gain momentum and becoming an ever-increasing first choice of sport for young girls.
In fact, FIFA reports that 10% of the footballing population is female, which equates to approximately 29 million players. Numbers grew by 50% between 2000 and 2006 alone.
The first women’s World Cup was held in 1991 and since 1994 women’s football has been a part of the Olympic Games. This year’s World Cup held in Canada was the first to have 24 teams, eight more than the last World Cup. In terms of player numbers, Australia ranks fifth in the world for both total registered female footballers and female youth footballers behind USA, Germany, Canada and Sweden. In male football Australia’s numbers are not in the top 10.
Although men and women both play football under the same rules with the same skill sets required injury trends are starting to develop which highlight the difference between male and female footballers. Generally female footballers experience a significantly lower number of injuries per playing/training hours compared to male counterparts. However, one big difference is that female footballers are sustaining a large amount of knee injuries.
Studies report that women are four times more likely to injure their knee than men. The most significant knee injury that women sustain is a rupture of the anterior cruciate ligament (ACL). This is a serious injury that requires surgery and a rehabilitation period of around 10 months to recover. Studies report women are up to ten times more likely to rupture their ACL than men. Female footballers also suffer from irritation around the knee cap (patella), however this injury is less debilitating.
Why is this?
There are many factors that predispose women to knee injuries, however no definitive cause. Some of the factors include:
- Joint laxity
- Limb alignment (valgus)
- Ligament size (ACL thickness)
- Muscle activation and control
Some of these factors are uncontrollable however limb alignment and muscle activation/control are two factors that we have some control over. But what does this actually mean?
Women have a wider hips than men which means the leg’s angle into the knee is wider. This puts the knees at a disadvantage and in a position that leaves the knees vulnerable. Women are also generally weaker in their gluteal (bottom) muscles and hamstrings. More specifically the gluteus medius muscle which is a stabiliser of the hip and prevents the knee falling inwards during running and landing is often under-developed in female athletes.
Recent research by Holly Silvers at the University of Santa Monica has also found that men and women jump and land differently, mainly due to muscle activation patterns. To simplify it men tend use both their quadriceps and gluteus muscles when then jump and land, whereas women are very quadriceps dominant, putting a lot more force through their knees.
How can we change this?
Through biomechanical assessment of running, jumping and squatting techniques we are able to identify areas of weakness and develop strategies to improve them. This can be done quite simply by a treating physiotherapist.
Additionally, Holly Silvers and her team have developed a program known as the PEP Program: Prevent Injury and Enhance Performance. This is a 15-20 minute program consisting of a warm-up, stretching, strengthening, plyometrics and sport specific agility drills designed to address potential deficits in the strength and coordination of the stabilising muscles around the knee joint.
The PEP Program can be accessed online.
This program has been implemented in some of the biggest women’s leagues around the world and is showing positive signs in terms of reduction of knee and ACL injuries with some reports suggesting a reduction in up to 85% of incidences.
This information is provided to Sutherland Shire Football Association by Jubilee Sports Physiotherapy as part of its commitment to Shire football and the SSFA.