Why Do Female Footballers Have A Much Higher Risk Of Serious Knee Injuries?

Why Do Female Footballers Have A Much Higher Risk Of Serious Knee Injuries? - Leading Edge Physiotherapy

AFL-W is still only in its’ infancy – but its popularity is booming, with more and more girls getting involved in the game at all levels.  Whilst its popularity is booming, so too is its injury rate – particularly of serious knee injuries, such as anterior cruciate ligament (ACL) tears.


We’re only a few weeks into pre-season for the AFL-W competition, and already we’ve seen a number of ACL injuries reported in the media to some of the high profile stars of the competition.

It’s a staggering statistic, but female footballers in the AFL-W competition are over 9 times more likely to damage their ACL than their male counterparts; and between 2-5 times more likely to damage their ACL with any sport compared to males.

So Why Is This?

Why are females at such higher risk of hurting their knees playing footy?

Whilst footy carries some inherent risks due to the nature of the game, with its fast-pace, changes of direction and collisions, there are some important differences between female and male athletes which influences risk.

Skeletal Anatomy

Structurally, there are some significant differences in our skeletal anatomy – the shape and orientation of our bones – which can play a big role.  Compared to males, females have a wider pelvis, and greater inward angling of their thigh – and it is the inward angling of the thigh and knee that plays a big role in the mechanism of how many ACL injuries occur.

Hormonal Influences

Hormonal differences can also play a role – particularly those that affect the laxity of our ligaments, which means that they are less resistant to stretch.  Movement strategies, in particular with how the body opts to deal with landing and changing direction, are also a big factor – and it’s important to note that males & females, by default, typically recruit different muscles and have different movement strategies when doing those tasks.


The issues of cross-coding, or having a background in different sports is also a really interesting consideration – and its worth noting that many of the players who have sustained serious knee injuries in AFL-W have come into the game late from other sports.

For many females, playing competitive footy wasn’t an option until recently, but now there is a massive expansion in leagues, teams and opportunities to play; right from an amateur to professional level – which is a fantastic thing.  However, this also means that many players haven’t had a big background history of playing the sport and refining the movements involved over time.  Football is a really demanding sport with its intense accelerations, decelerations and changes of direction – and if our bodies are still learning and refining those movement patterns, in a high-intensity environment of a competitive game, this can be where we come unstuck.

So How Can We Prevent ACL Injuries?

Whilst we can’t change things like bony structure and hormonal influence, we definitely can influence and improve our movement strategies – which can have a massive impact on minimising the risk of injury.  Working with your physio, to help train and refine correct movement and motor patterns for high-risk tasks such as jumping/landing and changing direction is a hugely effective step – with research suggesting that specific injury prevention programs targeting these things can reduce the risk of injury by up to half!

The old adage is that failing to prepare is preparing to fail – and it’s much easier to try and train and prepare our bodies to deal with the demands of the sport, than dealing with the effects of injury after the fact.  Speaking with your physio, assessing your movement patterns and seeing what strategies you can put in place to help improve and refine these things can be a really big investment in staying out on the park and playing the game you love!