Rash of ACL injuries robs World Cup of top stars

If it seems to you like there’s been an epidemic of anterior cruciate ligament (ACL) injuries in women’s football of late, you’re not wrong. There absolutely has been one.

A number of big-name players have spent months on the sidelines with knee injuries over the past few years. While some of the lucky ones will have recovered in time to play at the Women’s World Cup in Australia and New Zealand, many others won’t have that good fortune.

Studies have shown that women are four to six times more likely to incur an ACL tear than male counterparts.

"We know female athletes are up to six times more likely to have a non-contact ACL injury than their male counterparts,” Dr. Emma Ross told Sky Sports’ Inside the WSL earlier this year. "We published a paper about a year ago which showed that, in sport and exercise science research, only about six per cent of the studies are done exclusively on females - meaning they study things that are happening to the female body - so we don't have a lot of research on female athletes.”

Arsenal and England star Beth Mead is one of the players not at the World Cup. The 28-year-old Mead ruptured her ACL last fall in a league match with Manchester United and could not be fit in time to make Sarina Wiegman’s roster. Her partner and Gunners teammate, Vivianne Miedema, tore her ACL in December and will also miss out on the Netherlands squad in Australia and New Zealand. Mead believes that if this kind of rash of injuries were occurring in men’s football, more would be done to fully illustrate the causes.

“Unfortunately, this has happened to [her and Miedema], but hopefully it can kick somebody up the arse to go on [and] start doing something,” Mead said late last year at the BBC Sports Personality of the Year Award ceremony. “If you look, it’s 50 per cent of the top 10 [of the] Ballon d’Or [finishers] who have done it or something silly like that, so you have to look at that, I think. I see myself as quite a robust player, but this has still happened. You look at Viv, she’s quite a robust player and we’ve not been players generally hit with injuries, so I do think we need to look into it a lot more.”

Unfortunately, Mead and Miedema aren't the only women not in Australia and New Zealand for the World Cup because of ACL injuries. Here’s a look at some of the other high-profile stars who are missing out on the quadrennial tournament.

FW Janine Beckie (Portland Thorns), Canada – Janine Beckie’s NWSL season was ended before it even began. The 28-year-old forward tore her ACL in a Mar. 19 preseason friendly as the Portland Thorns met the United States under-23 side. "Having worked so hard during the off-season for what was set to be one of the biggest seasons of my career, defending the title for Portland Thorns and of course playing in the World Cup for Canada, being out for an extended period of time is a difficult pill to swallow,” Beckie wrote on Instagram at the time. Her absence leaves manager Bev Priestman without one of her more consistent goal threats at her disposal in a tough Group B. Capped 101 times, Beckie has 36 international goals, including five during Summer Olympics play.

DF Leah Williamson (Arsenal), England – Few teams have been ravaged with injury the way the 2022 Euro winners have been. Along with Mead, Arsenal teammate and captain Leah Williamson is unavailable. The 26-year-old Williamson ruptured her ACL in an April match with Manchester United. “I had my tears and made my peace with it the night it happened and since then I have been following the steps I’m told to, in order to best help myself in the short and long term,” Williamson said after the injury. “Ultimately, I think it’s just my time. In the past couple of years alone I have watched teammates beat serious illnesses and adversity with the biggest of smiles on their faces. I also hold perspective that globally there are much greater difficulties and therefore my circumstances right now are just that, circumstantial, and I’ve seen a lot worse.” Williamson’s partner in the centre of the Lionesses’ backline, Millie Bright, has been named England captain in Williamson’s absence, and she, too, is coming off of a knee injury. But Bright says there has been an upside to her time off. “I think the amount of minutes I’ve played leading up to this has been ridiculous, through the roof, so if anything, I feel mentally and physically fresher than I’ve ever felt,” Bright said during training. “I can’t remember the last time I had longer than two weeks off. It’s been a fair few years now. A blessing in disguise I call it, that I’ve mentally and physically been able to completely just have a clean slate and let my body recover. I’ve played through many injuries but this one, I just couldn’t quite get there.” Veteran midfielder Fran Kirby also misses out on the World Cup, recovering from a knee injury.

MF Catarina Macario (Chelsea), United States – That Catarina Macario is not on the United States’ roster as the defending World Cup champions take on the Netherlands, Portugal, and Vietnam in Australia comes as somewhat of a surprise. The 23-year-old midfielder incurred her injury in June of 2022 in Lyon’s match with Issy. It was initially thought that she would be ready for the World Cup. But as 2023 progressed, it started to become clear that the Stanford product, who has eight international goals in 17 appearances, wasn’t as far along in her rehab process as was hoped. A potential return date for Macario was pushed back on two occasions with her return to the OL lineup by the end of the 2022-2023 season never materializing. Then in late May, the USWNT’s worst fears were confirmed when she announced that she would not be ready for the World Cup. “While I’m excited and super optimistic about my future as a footballer, I’m sad to share that I won’t be physically ready for selection to our U.S. World Cup team,” Macario wrote. “The desire to return to play for my club and country has driven my training and fueled my everyday life. However, what’s most important right now is my health and getting fit and ready for my next club season.” Macario will not be back in France next season, joining a growing contingent of North American players in the Women’s Super League by signing for Chelsea on a three-year deal. Samantha Mewis and Mallory Swanson are also absent from the USWNT entry with ACL injuries.

FW Delphine Cascarino (Lyon), France – Catarina Macario wasn’t the only Lyon player to be lost to an ACL rupture. Cruelly, Delphine Cascarino’s injury came so very close to the World Cup. The 26-year-old forward incurred her injury during the team’s 1-0 victory over Paris Saint-Germain on May 21. The Saint-Priest native knew almost immediately her dream of playing in the World Cup was over. "As you could see in the last game against PSG, unfortunately I came out inured, and after several medical examinations, the verdict was dropped,” Cascarino wrote on Instagram the next day. "I have a partial rupture in my ACL, so I will have to go into surgery in the next few days. Unfortunately I won't be able to participate in the World Cup this summer with my teammates, which I'II support from here. I have a long way to come back stronger. A big thank you to everyone for your messages of support." A five-time Champions League winner with OL, Cascarino made her senior debut for Les Bleues in 2016 and has scored 14 times in 56 appearances.

FW Katie Rood (Hearts), New Zealand – Katie Rood’s opportunity of a lifetime to play in the World Cup in front of home fans in Auckland was ended this past spring when the veteran forward, in her own words, “joined the ACL Club.” Rood ruptured her ACL in Hearts’ Apr. 19 game against Celtic. Rood had only recently returned to the Lady Ferns’ setup after having gone 18 months without a call-up. “I’m doing okay,” Rood wrote after the injury. “Obviously gutted about it. Had intended to return to NZ in June for a training camp to have one final crack at making the World Cup team. Looks like life has other plans for me … and as gutted as am about the World Cup dream being over, I’m beginning to look forward to seeing what other opportunities are out there for me.” Rood, who was born in Middlesbrough, England, has scored five goals in her 15 appearances for New Zealand. Like Mead, she used the occasion of her own injury to ask questions about a lack of support for injured women players throughout football. “What’s hit me quite hard in this situation is just how many times I’ve been asked ‘Is the club looking after you?’” Rood wrote. “It’s a reminder that health care and medical treatment isn’t often the norm in the women’s game and we all know of players being left to fend for themselves after getting seriously injured with their clubs. I’m grateful for the support I’ve received here and will endeavour to keep you updated on the journey as navigate my way through it.”