Could the menstrual cycle be a contributing factor in Anterior Cruciate Ligament (ACL) injuries in women's football?

A new FIFA-funded study will see academics at Kingston University investigate whether there is a possible link in an attempt to reduce occurrences of the injury.

 FIFA, football's international governing body, is keen to increase research conducted into injuries in women's football with Kingston University successful in a funding bid from the FIFA Research Scholarship scheme.

The study will examine the link between the menstrual cycle and ACL injuries in women's football – which have been on the rise in recent years and seen high-profile players such as Beth Mead, Vivianne Miedema and Sam Kerr suffer the injury.

 The year-long study, which will analyse hormone concentrations in blood samples collected from elite and grassroots women's footballers, will be led by PhD student Blake Rivers alongside sports and exercise science experts at Kingston University, Dr Simon Augustus, Dr James Brouner, and Dr Michelle Richards. 

The study will kick off in June with Kingston University experts working with clubs in the South West London area, including Chelsea and Fulham, to recruit footballers who will visit campus to have regular blood and physical performance tests throughout the study.

These tests will examine the concentrations of female-specific hormones, such as oestrogen and progesterone in the blood, both of which have been linked to increasing ligament laxity and a decrease in neuromuscular reaction times.

 The blood analysis will then be able to be cross-referenced against the athlete's physical performance data to pinpoint whether there is a correlation between the menstrual cycle and ACL injury risk factors.

Senior lecturer in Sport Biomechanics, Dr Simon Augustus, said although research had been conducted elsewhere on women's injuries in football, injury rates had continued to increase. However, he hopes this study could be a game changer.

He said: "We want to examine whether athletes may be more predisposed to injuries because of the functional changes in terms of their anatomy and physiology during the menstrual cycle.

"We know hormones fluctuate during different phases of the cycle, but we don't yet know how much of an influence that may have on the risk of injury."

The research team will also look at the most common ways athletes injure their ACL through drop landing tasks (landing on the ground after heading the ball) and changing direction quickly, to see if hormone concentrations in the blood relate to the performance of these movement tasks.

 Dr Augustus added: "There are so many different factors involved with ACL injuries. We are starting to research this from an individual approach and look at an athlete's whole profile and putting protocols in place to reduce risk.

"We know some injuries are unavoidable, for example, if a player is involved in a bad tackle, but we're attempting to help those individuals who injure their ACL outside of impact actions – those are the ones where we might have more chance to intervene and prevent them from taking place by utilising strength training or tweaking technique."

 It is hoped the research results and intelligence gained from the study will help clubs put plans in place to mitigate the risk of ACL injuries such as reducing training loads or adapting an individual's personal training plans to meet their needs and requirements.

This would be particularly helpful at non-elite levels with clubs often operating without the financial resources of top-level clubs.