Making football safer for women: a systematic review and meta-analysis of injury prevention programmes in 11 773 female football (soccer) players.

Women's football has grown rapidly, but injury rates, particularly serious knee injuries like ACL tears, remain a concern, and this review asked whether structured injury prevention programmes actually reduce injuries in female players. Researchers pooled data from twelve randomised trials, almost all in adolescent soccer teams, comparing exercise-based prevention programmes (often combining strength, balance and jump-landing training) against standard training or no programme. Overall, programmes that combined multiple exercise components were associated with fewer injuries overall and fewer ACL injuries specifically, and exercise-based approaches more broadly were linked to fewer hamstring injuries. These are encouraging signals in a sport where women have been historically understudied, but the authors rate the evidence as low-level, since all but one trial carried a high risk of bias, and most research so far focuses on youth teams rather than adult or elite players.

If you play football or have a daughter who does, you may wonder whether warm-up or training programmes aimed at preventing injuries actually work for women. This review looked at twelve studies, mostly involving teenage girls' soccer teams, that tested exercise programmes built around strength, balance and landing technique against regular training. The pooled results suggest that programmes combining several types of exercise were associated with fewer injuries overall, including a lower rate of serious knee (ACL) injuries, and hamstring injuries were also less common with exercise-based training.

Ankle injuries were the most frequent injury type seen across women's football generally. It's worth knowing that the quality of the underlying studies was mostly rated as having a high risk of bias, so these findings are described as low-level evidence rather than definitive proof. Most research so far has focused on younger players, so how well this applies to adult or professional women footballers isn't yet clear from this review.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This review addresses what physiotherapists working with female footballers can reasonably expect from exercise-based injury prevention programmes, an area where evidence specific to women has lagged behind men's football research. Pooling twelve randomised controlled trials (11,773 players across the review, predominantly adolescent teams), multicomponent exercise programmes combining strength, plyometric and balance training were associated with a 27% reduction in overall injury incidence rate (IRR 0.73, 95% CI 0.59 to 0.91) and a 45% reduction in ACL injury rate (IRR 0.55, 95% CI 0.32 to 0.92); exercise-based strategies generally were linked to a 60% reduction in hamstring injuries (IRR 0.40, 95% CI 0.17 to 0.95). These pooled estimates support including multicomponent exercise in prevention conversations with female players, though subgroup findings for knee, ankle and hip/groin injuries were less precise and the authors note further studies are needed to firm these up.

Baseline injury incidence in women's football was 3.4 per 1000 exposure hours, with ankle injuries most common. The major limitation is methodological: all but one included trial had a high risk of bias, and most evidence comes from adolescent cohorts, so extrapolation to adult, elite or other football codes is not established by this review, and the authors explicitly characterise the overall evidence as low-level.