Women are eight times more likely to tear their Anterior Cruciate Ligament than men. Why is this? There are actually a number of factors:
Women have a wider pelvis - this means the downward angle of their thigh bones is sharper and causes additional stress on the ACL ligaments.
Lax ligaments – in general women are proven to have more elasticity in their ligaments than men. This increases things such as flexibility, but also makes the ACL prone to finding itself being stretched or twisted.
Quad dominance – studies have uncovered that women usually have stronger quadriceps than hamstrings. If a female athlete relies heavily on quad strength for movement, then the knee ends up compensating for the lack of hamstring strength by placing additional stress on the ACL.
Here’s where it gets interesting..
Menstrual cycles – recent studies in the last decade or so have started to look into menstrual cycles as a factor that affects ligament laxity. The research is still in its relatively early stages, but there is mounting evidence that at the pre-ovulatory stage of the menstrual cycle, the high levels of oestrogen increase the laxity of your ligaments.
If your Anterior Cruciate Ligament is more lax, then the risk of suffering an ACL injury is increased.
Why isn't everyone talking about this?
As stated previously, the research still needs more time for further in-depth studies, but it is heading in the right direction.
An athlete at the top flight of women's football that is trying to spark interest in this area is Jordan Nobbs.
Nobbs tore her ACL in 2018 which saw her miss England's fine run in the 2019 World Cup. The Arsenal midfielder has been very vocal about the fact she thinks her menstrual cycle was a contributing factor to her injury.
The research has also inspired changes to the way female players train, more so in the elite divisions of women's football. Most of the teams in the Women's Super League now track the menstrual cycles of their squad and adjust their training schedules and nutrition accordingly. This has proven effective for injury prevention, and has even filtered down to the lower divisions below.
Chelsea manager Emma Hayes also made history earlier this year by announcing a partnership with a leading menstrual cycle company Fitrwoman. The whole squad use the Fitrwoman app to monitor and log their symptoms and the players also receive personal sessions with the co-founder and research scientist Dr Georgie Bruinvels.
It's clear that there's mounting interest and discussion about menstrual cycles in women's football now, but it will need a lot more time, investment and research before we see progress at all levels of the game.
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