Leah Williamson injury: how many more ACLs need to happen before the FA and governing bodies take action?

Leah Williamson fell to the ground within the first 15 minutes of Arsenal’s away fixture at Manchester United on Wednesday evening and every England fan looked on in horror as their Euros winning captain hobbled off the pitch.

Just under 48 hours later, Arsenal have confirmed all of our worst fears - the 26-year-old centre-half has ruptured her anterior cruciate ligament and, as per the Gunners’ statement she ‘is set for an extended spell on the sidelines. She will undergo surgery in due course’.

Not only does this news mean yet another catastrophe for Arsenal’s WSL hopes as their list of injured players rises once again. It also means the captain who has led England to two Arnold Clark Cup wins; a Euros trophy and a Finalissima Trophy will be unable to play at the upcoming World Cup this summer.

She is now the second England star who has succumbed to this injury and will therefore be unable to travel down under. The Lionesses already lost Euros Player of the Tournament and Golden Boot winner Beth Mead back in November and they must now prepare for the FIFA World Cup without their captain.

However, it is not just England who will be forced to power on without some of the most important figures in the squad. Over 20 top women’s footballers have torn their ACL in the last 12 months.

While there are two players out this weekend with ACL injuries in the Premier League, a league which consists of 20 teams, there are at least ten WSL players who have suffered ACL injuries in the 2022/23 season alone from a league which has 12 teams.

Female footballers are reportedly six times more likely to suffer from this crushing injury and despite the consistent announcements of more and more players being capitulated by the problem, little research is being conducted to help reduce the endemic.

Mead is one of many football stars who has previously spoken out about the lack of investigations that are taken when it comes to ACL injuries in women’s sport.

The 27-year-old striker ruptured her ACL during a Gunners’ match in November only for her partner, fellow Arsenal teammate and former BBC Women’s footballer of the year, Vivianne Miedema, to do the same just a couple of weeks later.

The Euros heroine, who spoke after winning the BBC Sports Personality of the Year Award in December said: “I think if that happened with a Messi, a Ronaldo, a Griezmann there’s probably going to be a lot more done when those things happen.

“As a collective we do need to try and get more done for ACLs and research into it. It’s way too common in the women’s game. I think if it ever happened in the men’s game a lot more would have been done sooner. It’s important for us to drive the different factors and aspects around why it’s happening so often.”

Of course, improving the pitches and overall facilities available to the women’s game would be a start. Speaking to the press after United’s 1-0 win over Arsenal, Gunners’ boss Jonas Eidevall was asked about his player’s injury and he replied with a scathing review of the state of the grounds: “You see the pitch, it is a pitch that has a lot more (to be desired). I think it’s going to continue here with the schedule we have and pitches like that, players are going to get injured.

“That is something that we all need to improve on, the facilities where we play, so we can keep players on the pitch.”

The state of a pitch is undoubtedly going to impact the comfortability of players, hindering or helping their movement around the grass. We saw only earlier this year Chelsea’s home fixture against Liverpool was abandoned just six minutes into the match due to the state of the pitch - it’s hard to conceive a Premier League fixture taking place at Stamford Bridge between two of the biggest clubs in the world having to be abandoned because the pitch was in too poor a state.

However, this is not the only problem the women’s game faces when it comes to ACL injuries. In 2022, female health specialist Dr Emma Ross spoke to Sky Sports explaining: “We published a paper about a year ago which showed that, in sport and exercise science research, only about six per cent of the studies are done exclusively on females - meaning they study things that are happening to the female body - so we don’t have a lot of research on female athletes.”

The menstrual cycle is offered as one such reason for the disparity between men and women when it comes to ACL injuries. Ross detailed that ‘changing hormones across the cycle can impact the physiology and biomechanics of the body’ so when oestrogen levels rise - usually in about the second week - it can affect the stability of joints, interfere with collagen in the joints and create looser joints as a result.

Menstrual cycles are, however, not exactly a new concept for females so while they may offer an explanation into why women are more likely to suffer, it does not explain why nothing has been done to help or prevent. Additionally, Ross also points out that this is far from conclusive evidence.

“We do have some information about loose joints, but what we don’t have is the end step of whether that really does increase the risk for injury in female athletes.”

Losing more footballers to ACLs before the World Cup is not an option any country can afford to take, but until the FA and other governing bodies in women’s football take action and prioritise the women’s game to a greater degree than the six percent of aforementioned studies into the female body would suggest, the FIFA World Cup is going to struggle to find enough players physically able to participate.