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Peer-reviewedCC BY-NCBMJ open sport & exercise medicine

'ACL epidemic in women's football': the epidemiological evidence does not support the narrative.

  • Katrine Okholm Kryger1,2
  • Madeleine Pape3
  • Sophia Nimphius4
  • Colin Lewin5
  • G Lewin6
  • Zoran Bahtijarevic1
  • Evert Verhagen1,7
7 affiliations
  1. 1Medical & Anti-Doping, Football Division, Union of European Football Association, Nyon, VD, Switzerland.
  2. 2Manchester Metropolitan University, Manchester, UK.
  3. 3Institute of Social Sciences, University of Lausanne, Lausanne, Switzerland.
  4. 4Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
  5. 5The Lewin Sports Injury Clinic, London, UK.
  6. 6Arsenal Women's Football Club, London, UK.
  7. 7Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
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Abstract

Media narratives commonly portray elite women's football as experiencing an 'ACL epidemic', suggesting a sharp and alarming rise in ACL injuries. Such claims warrant scrutiny as they may influence perceptions of women's sport. This paper combines published injury surveillance data over the past 25 years to observe trends in ACL injury incidence and volume in elite women's football. Data were extracted from 10 peer-reviewed studies identified through recent systematic reviews and targeted searches, covering top leagues in six countries and UEFA competitions. ACL injury incidence rate in training, match play and overall, as well as the number of injuries per team per season, were examined across leagues and time periods. Despite limitations in geographical coverage and gaps in longitudinal data, findings consistently demonstrate low stable ACL injury incidence rates, with fewer than one ACL injury per team per season in almost all studies. Notably, some of the lowest match incidence rates were reported in the most recent seasons. Overall, the available evidence does not support the notion of an ACL injury 'epidemic' in elite women's football with similar trends of <1 ACL injury in all studies collected apart from one study assessing the German league 2003-2004 season with 1.2 ACL injuries per team per season. This highlights the need for evidence-based, non-sensationalist discourse.

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Cite

BibTeXRIS
BibTeX
@article{kryger2026epidemic,
  title = {{'ACL epidemic in women's football': the epidemiological evidence does not support the narrative.}},
  author = {Katrine Okholm Kryger and Madeleine Pape and Sophia Nimphius and Colin Lewin and G Lewin and Zoran Bahtijarevic and Evert Verhagen},
  journal = {BMJ open sport \& exercise medicine},
  year = {2026},
  month = oct,
  doi = {10.1136/bmjsem-2026-003416},
  url = {https://europepmc.org/article/MED/42920964},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - 'ACL epidemic in women's football': the epidemiological evidence does not support the narrative.
AU  - Katrine Okholm Kryger
AU  - Madeleine Pape
AU  - Sophia Nimphius
AU  - Colin Lewin
AU  - G Lewin
AU  - Zoran Bahtijarevic
AU  - Evert Verhagen
PY  - 2026
DA  - 2026/10/22
JO  - BMJ open sport & exercise medicine
DO  - 10.1136/bmjsem-2026-003416
UR  - https://europepmc.org/article/MED/42920964
AB  - Media narratives commonly portray elite women's football as experiencing an 'ACL epidemic', suggesting a sharp and alarming rise in ACL injuries. Such claims warrant scrutiny as they may influence perceptions of women's sport. This paper combines published injury surveillance data over the past 25 years to observe trends in ACL injury incidence and volume in elite women's football. Data were extracted from 10 peer-reviewed studies identified through recent systematic reviews and targeted searches, covering top leagues in six countries and UEFA competitions. ACL injury incidence rate in training, match play and overall, as well as the number of injuries per team per season, were examined across leagues and time periods. Despite limitations in geographical coverage and gaps in longitudinal data, findings consistently demonstrate low stable ACL injury incidence rates, with fewer than one ACL injury per team per season in almost all studies. Notably, some of the lowest match incidence rates were reported in the most recent seasons. Overall, the available evidence does not support the notion of an ACL injury 'epidemic' in elite women's football with similar trends of <1 ACL injury in all studies collected apart from one study assessing the German league 2003-2004 season with 1.2 ACL injuries per team per season. This highlights the need for evidence-based, non-sensationalist discourse.
SN  - 2055-7647
ER  -