Evidence map›Paper›PMID 41954418›Full record

ReviewScience progress

ACL injury in female soccer players: Risk, resilience, and prevention in the modern game.

Riccardo D'Ambrosi, Philipp Baumert, Christian Fink

Abstract readReview
In one paragraph

Review in Science progress. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Riccardo D'AmbrosiIRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy.ORCID 0000-0002-1216-792X
Philipp BaumertResearch Unit for Orthopaedic Sports Medicine and Injury Prevention, Institute for Sports Medicine, Alpine Medicine and Health Tourism, Private University for Health Sciences, Hall in Tirol, Austria.
Christian FinkGelenkpunkt-Sports and Joint Surgery FIFA Medical Centre of Excellence, Innsbruck, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Anterior cruciate ligament (ACL) injury is one of the most impactful conditions in female soccer, with major consequences for knee function, osteoarthritis risk, and professional longevity. As participation and competitive demands in women's football continue to rise, the disproportionate ACL burden has become a critical clinical and public health concern.This narrative review provides a contemporary synthesis of current evidence on ACL injury in female soccer players, integrating data on epidemiology, injury mechanisms, intrinsic and extrinsic risk factors, surgical outcomes, return to sport (RTS), and prevention strategies. Across multiple cohorts, female players sustain ACL injuries at rates two to nine times higher than males, predominantly through noncontact mechanisms. Video analyses indicate that approximately 90% of injuries occur during cutting, pressing, deceleration, or landing tasks.Key intrinsic risk factors include a reduced hamstring-to-quadriceps strength ratio, quadriceps dominance, generalized joint laxity, hip abductor weakness, and longer playing experience. Biomechanical deficits such as dynamic knee valgus, trunk instability, and suboptimal change of direction mechanics further increase susceptibility. Psychological factors, particularly fear of reinjury, also influence movement patterns and RTS.Although ACL reconstruction generally yields favorable outcomes, reinjury remains a major concern in athletes returning to pivoting sports, with reported RTS rates ranging from 70% to 78%. Neuromuscular-based prevention programs, including FIFA 11+-derived protocols, can reduce ACL incidence by 40-45% when consistently implemented; however, adherence and limited sex-specific tailoring remain significant barriers.ACL injury in female soccer players is a multifactorial and largely preventable condition, requiring integrated, sex-specific prevention and rehabilitation strategies to effectively reduce risk and support long-term athletic health.

Indexed as

Anterior Cruciate Ligament InjuriesAthletic InjuriesSoccerAnterior Cruciate Ligament ReconstructionBiomechanical PhenomenaFemaleHumansReturn to SportRisk FactorsAnterior cruciate ligament injurybiomechanicsfemale soccer playersgraft choiceinjury preventionneuromuscular controlosteoarthritis riskreturn to sport

Identifiers

PMID41954418
PMCPMC13070141

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.