ACL tears in female and male professional soccer players

Women's football has experienced significant growth, with approximately 16.6 million female players worldwide, emphasizing the need for research focused on injuries. Anterior cruciate ligament (ACL) ruptures are a major concern, particularly among elite players, and understanding differences of sex in injury incidence and recovery is crucial for developing effective prevention and rehabilitation strategies.

This retrospective study analyzed ACL injuries in male and female players from the top five European leagues (Serie A, Premier League, Ligue 1, La Liga, and Bundesliga) during the 2022-2023. A total of 169 players (68 female, 101 male) who underwent ACL reconstruction were included. Data on age, body mass index (BMI), injury history, affected side, playing position, and return-to-play (RTP) outcomes were collected. Statistical analyses were performed using SPSS® software with a significance level of P < 0.05.

Female players had a significantly longer average RTP (300 days) compared to male players (248 days) (P < 0.001). Furthermore, 8.8 % of female athletes did not return to play, while 20.7 % of male athletes failed to achieve RTP (P = 0.031). The defender position had the highest non-return rate (25 %).

This study highlights significant sex differences in ACL injury recovery in professional football. Professional female soccer players appear to require a longer rehabilitation period with a significant increase in return to play (RTP) compared to male soccer players, but with a lower risk of dropout (8.8 % vs 20.7 %). Further research and targeted interventions are essential to improve rehabilitation for female players.