In Women's Soccer, a Mystery in Need of a Solution

Even if you aren't a major women's soccer fan, you likely know the name Megan Rapinoe. But what you may not know is that she's torn her ACL three times—and in some ways, she's more the rule than the exception. The New York Times calls it a "knee injury epidemic," an issue that's dogging women's soccer but studded with more questions than answers. By the paper's count, the list of affected stars is long: the US' Catarina Macario and Christen Press didn't make the World Cup because of an ACL tear. Ditto England stars Leah Williamson and Beth Mead. Canada, France, and the Netherlands are also down key players.

The numbers are so high—by the Washington Post's count, at least 87 players from the top eight women's leagues since 2021—that players are worried and asking why. While it's known that women have a higher risk of ACL tears, by how much is unclear; ESPN reports estimates range from two to eight times greater. There's no one established cause, but there are myriad theories: Women's knees, legs, and feet are shaped differently; their ACLs are smaller; hormonal changes could impact risk; they wear shoes that were designed for men; they play on fields that aren't as "perfectly manicured" as the men's. Some of the players have another theory. The intensity of the sport has changed: more games, played faster and more physically, and the support structure (think medical staffer, physiotherapists) isn't as beefy as what men enjoy.

"The amount of ACL injuries in professional women's soccer in the last two years has just been shocking," Press recently told ESPN. "If this happened on the men's side, we would've immediately seen a reaction of how are we going to solve this." Alex Culvin, head of women's soccer strategy and research at the FIFPro players union, tells the Post it's "a multi-factorial issue" in need of a "multi-factorial solution." Female players "are expected to be professional footballers," she says. "There's an increase in matches, then there's an increase in new competitions. But on the flip side of that, the professional standards to meet these professional obligations are just not in place." (More US women's soccer stories.)