ACL Tear Rates In and Across Women's Football Leagues: Insights from a Unique 2-Year Database

Anterior cruciate ligament (ACL) injuries are a high injury burden in football, with a notably higher incidence rate among women compared to men. However, epidemiological studies are limited in women’s football so is presently no statistically rigorous or fully quantified context for understanding this difference. This study utilizes public news, blog, and social media data to create a statistical framework for analysing ACL injury rates in women’s football to enable better comparisons and understanding of the probability of the different numbers of injuries per team per season. Employing Poisson distributions, which are widely employed to assess the incidence of discrete events whose occurrence is relatively rare, we are able to quantify ACL injury incidence and compare it across different top women’s football leagues from various counties, and against the English Premier League for men where other longer-term data was available. The analysis includes calculating the raw mean and median injury rates, constructing confidence intervals, and evaluating the number of additional injury-free games and fewer injuries per season (for a league) required for women’s football to match the men’s injury rates. The results reveal significant differences in ACL injury rates between men’s and women’s football with an overall difference of 2.5x (p < 0.05), as expected, with unexpected variability of almost 4x in rates observed across the 12 women’s elite or premier leagues. The Swedish, Netherlands, and Mexican women’s leagues show no statistically significant difference in incidence rates to the men in this comparison though the raw data incidence is slightly higher. These insights offer an empirical foundation for targeted research into causes of these differences. Study limitations highlight the need for improved data collection and reporting practices. The overall study results underscore the importance of applying more rigorous statistical methods to this problem to better target inquiry and to assess future interventions.