The ACL Club

Natasha Chahal

Football fans often like to say ‘it’s not about the football.’ Sometimes that’s true: when the England women’s national team won the European Championship last summer, the collective joy felt by women around the country, irrespective of fandom levels, really wasn’t about the football. Although there was some excellent football on display throughout: if you aren’t already familiar with Alessia Russo’s back heel goal against Sweden from every possible angle, I don’t know what to tell you.

I felt hopeful for (as well as envious of) the next generation of women and girls who would see this success at a formative age and know that their bodies were their own, not for others to scrutinise or judge; that the point of exercise was to make them strong, not thin.

Despite their strength, the England women’s journey to the World Cup has been plagued by injury. In too many areas, women’s health is an afterthought. According to the British Heart Foundation, ‘misconceptions around symptoms may make women less likely to seek and receive treatment’ for heart disease. The contraceptive pill is prescribed for anything from migraines to a bad attitude. I was thirty when a doctor attributed my fatigue to age rather than (as I suspected, and as it turned out) a hormonal imbalance.

It's only since 2020 that the football world – largely thanks to the Chelsea manager, Emma Hayes – has been paying more attention to the impact on players of their menstrual cycle, though there’s still a long way to go in understanding it. There have been improvements in kit design, such as materials that absorb leaks, and the Lionesses’ shorts are now blue instead of white, as the players asked.

After winning the Euros, the England captain, Leah Williamson, said that she had been worried she wouldn’t be able to play in the tournament because of the pain caused by endometriosis. England might not have won without her. A torn anterior cruciate ligament (ACL) towards the end of the Women’s Super League season means Williamson has to sit out the World Cup. Her Arsenal teammates Beth Mead (also England), Laura Wienroither (Austria) and Vivianne Miedema (Netherlands) suffered the same injury, as did Fran Kirby (Chelsea and England).

A torn ACL has also eliminated Marie-Antoinette Katoto (France), Janine Beckie (Canada), Catarina Macario and Christen Press (both USA) from the tournament. The injury list would make an impressive subs bench. ‘I won’t be telling you I’ll come back stronger or that I’m looking forward to spend the next however many months in the gym,’ Miedema has said. ‘It will be tough with plenty of difficult days (plenty of crying, which we’ve had a lot of already), but sadly enough it’s part of football.’

It’s part of women’s football especially. ‘If this was happening to high profile men’s players,’ England’s Jess Carter has asked, ‘would more work be going in to try and improve things?’ Probably. The reasons that women are more prone than men to torn ACLs are unclear, but it seems to be a combination of poorer playing conditions, worse footwear and the effects of hormonal fluctuations on ligament laxity. Sam Kerr, the Australian captain who carried the country’s flag at Charles’s coronation, is out for the first couple of World Cup matches with a calf injury. At least it isn’t an ACL.

In the opening game yesterday, co-hosts New Zealand beat Norway 1-0. The fans and players observed a minute’s silence before the match for the victims of a mass shooting in Auckland earlier that day. The game went ahead as FIFA had declared the shooting an ‘isolated incident that was not related to football operations’. The other hosts, Australia, also won 1-0, defeating the Republic of Ireland.

This morning, Dr Nadia Nadim (Racing Louisville FC and Denmark) tweeted that she, too, had joined the ACL club. ‘Female athletes are five times more likely than men to injure their ACL,’ she said. ‘As a doctor, I know the importance of research and unfortunately there is not enough research conducted on female athletes.’ The FA banned women from playing football in England for fifty years. There’s still more to be done to level the playing field.