Special feature: How players can reduce the risk of an ACL injury (part 2)

By Joan Grey

You’re powering towards the goal with the ball at your feet. With a drop of the shoulder, you feint and slip behind the centre-back. The goal unfolds in front of you.


With a slight, awkward turn, the anterior cruciate ligament (ACL) in your knee tears, and you are out for the rest of the football season.

The ACL rupture is one of the most dreaded injuries in football. So how can you reduce your risk of getting the ACL injury?

Main photo: Warm-up exercises from FIFA 11+ help reduce the risk of injury.

READ MORE: Solving the female football cruciate curse mystery (part 1) >>>>

ONE: Find the balance between hard-work and rest

Rest plays an important role in reducing your risk says Dr Sophia Nimphius, Professor of Human Performance at Edith Cowan University in Australia.

“There is definitely a time for grit but you can’t do that day in and day out, seven days a week. There should be times when you work really hard, and other times you back off.

“Learn to listen to yourself and your body.

“As an athlete, you need to know when to ask for rest. Learning to defend your health and well-being is very hard and the earlier you learn it, the better off you’ll be.”

Holly Payne (left) coaching with former Football Fern Katie Duncan. Photo: David Joseph / www.phototek.nz

Holly Payne, former New Zealand Football Women’s Development Manager and Claudelands Rovers player, fell victim to the ACL injury twice.

Payne played New Zealand age group football. Her second ACL injury ended her football career early, when she was 21.

“I’d love to still be able to play but unfortunately my knees can’t keep up,” says Payne.

Looking back, Payne doesn’t think her ACL injuries were a coincidence.

The first time she injured her ACL was when she was 16 at a National Secondary Schools Tournament.

She was running with the ball and turned awkwardly.

“We were playing a week-long tournament with multiple games a day and it was going to lead to disaster because there was no time for rest and recovery. If you’re going to put those demands on yourself you have to make sure that you’re fit enough and strong enough to cope with that.

“I don’t think I was unlucky. I think it was that I was absolutely exhausted and I’d played eight games of football by then and my body just didn’t agree.” says Payne.

TWO: Start a strength and conditioning programme

Strength and conditioning can reduce your ACL injury risk.

“That is unequivocally demonstrated in the literature. Depending which research, you can reduce risk anywhere in the range of 60% and that’s pretty substantial,” says Dr Nimphius.

Dylan Moxon, Founder of Valiturus strength and conditioning coaching says: “Strength and conditioning is different from a regular gym workout.

“It boils down to improving performance and reducing injury risk by improving the physical qualities relevant to the sport such as strength, power, speed, fitness and helping someone move more efficiently and effectively.

“Training is manipulated based on factors such as age, injury history, sporting demands, and physical assessments to meet where you’re at and give you what you need to reduce injury risk and perform better.”

Suzy Falconer … gym work can help. Photo credit: Cam McIntosh / Photomac.

Suzy Falconer, Head Physiotherapist at Wellington Phoenix A-league Women, agrees that building strength can reduce ACL risk.

“The bigger and stronger you are, the harder you are to break.

“You’re more likely to be strong enough to land funny and get out of it without an injury.

“I think if we can get females lifting more weights and getting stronger through their legs, we might see a decrease in ACL injuries.”

Payne reflects: “I wasn’t in the gym, focusing on strength and conditioning, I was just out playing football. I was just conditioning my legs to play football and wasn’t getting that overall body conditioning.”

THREE: Warm up properly using the FIFA 11+

The FIFA 11+ is a training and game warm-up developed by FIFA specifically designed to prevent football injuries such as the ACL.

“It’s got those movements like hopping, sticking, and landing from jumps which can help prime your brain so that you’re moving better and getting better positions.

“The rates of ACL injuries in females that are doing the FIFA 11+ is significantly lower than those who aren’t doing structured warm-ups like that,” says Falconer.

The FIFA 11+ has strength work, plyometric work single leg stance work, hip control, quad and hamstring strength and explosiveness.

“All of those things are great for making you a better footballer. They’re also really great at allowing you to tolerate the demands of football,” Dr Nimphius says.

FOUR: Land with good technique

Landing with soft knees can help reduce your risk of an ACL injury.

“If you’re landing with your legs straight you are more at risk of doing an ACL. The way you learn to land with soft knees is by having stronger quadricep muscles and stronger glutes so it all sort of links in,” says Falconer.

FIVE: Take a break from football when you’re stressed

Psychological stress can be a warning sign before players injure their ACLs.

Dr Nimphius observed that ACL-injured players have talked of pushing too hard because they were worried about deselection, or they had a series of stressful events such as exams on top of lots of games.

“Even though they felt like they needed a break, they felt they couldn’t ask for that break, and they subsequently had an ACL injury.

“We often push our little inner voice down and try to tell ourselves to suck it up. It’s finding the line between when you want to grit through and when it’s too much.”

Part One: Solving the female football cruciate curse mystery

Click here to read the first part of this special feature at Friends of Football’s website >>>>

Joan Grey

Friends of Football writer Joan Grey loves playing and writing about football. She captains the Strathallan College Girls First XI and represents Franklin United in the NRF Women’s Championship.

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