The top players missed the EC football tournament due to injuries, and the games have not been spared from them either. Docent Mari Leppänen says that knee injuries are common in women’s soccer.
Every match of the European Football Championship can be seen on ‘s channels. Competition games, background stories, news and highlight clips can be found on ‘s competition pages.
European Championship football started darkly when, on the eve of the competition, the best football player in the world, Spain Alexia Putellas got a knee injury.
On the second day of the competition, the Northern Ireland striker Simone Magill the tournament ended (you move to another service) to a serious knee injury. Helmareite Fullback Emma Koivisto played the opening match with his left knee lined with black tape.
– I find knee injuries in women’s football to be an extremely serious problem, says Urheilu’s expert Jonne Kunnas.
The number of games played in women’s football is increased, while the speed and intensity of the game are increasing. Therefore, according to expert Kunnas, football umbrella organizations and clubs should take care that the pace of the match does not “get out of control”.
– As far as I understand, there is a significant difference in the number of knee injuries between men and women. You can’t just ignore the issue by following the men’s model in women’s football – i.e. increasing the amount of games played by top players insanely – because then the health of the players is put at risk.
Leg injuries are indeed a significant problem for soccer players, and ligament injuries are especially prominent in women.
– In football, knee and ankle injuries are more common in women than in men. Muscle injuries are more common in men, docent Mari Leppänen tells.
Leppänen is the director of research and development at the UKK institute and the Tampere sports medical center. For his work, he studies the prevention of sports injuries in various sports.
According to Associate Professor Leppänen, one reason for the prevalence of ligament injuries in women is hormonal factors. The second is anatomy; women have wider hips than men. In addition, women have relatively weaker muscle strength, which may bring challenges to movement control.
Due to the effect of hormones, women have more flexible connective tissues. But how does a wide hip affect injuries?
According to Leppänen, it makes it difficult to control the movement of the lower limb, because the pelvis basically guides the thigh into internal rotation. Reducing this requires muscle strength from the hip external rotators.
– Knee injuries are most typically caused by quick changes of direction, where the knee suddenly sinks into the valgus, i.e. inwards. At that time, the anterior cruciate ligament can be subjected to a shearing force, causing an injury.
In women, the hind thigh is also often weaker than the front thigh, which also affects knee control.
– In a fast situation, keeping the leg alignment good, with the knee and toes in the same direction, requires muscle strength and control, especially from the muscles of the hip and buttocks, Leppänen says.
In February 2020, Urheilu published an article about the connection between the menstrual cycle and knee injuries. Tuollo was told that, for example, during menstruation, the reaction time is longer, and the risk of various soft tissue injuries, i.e. muscle and ligament injuries, is greater.
According to Leppänen, there is very little research evidence on the subject.
– A lot more research evidence would be needed so that recommendations could be given on how female athletes should train at a certain stage of the cycle to prevent injuries.
– I don’t agree with this – changes of direction, and especially their safe execution, should be practiced more. I would not recommend taking a break from them based on current research evidence. And if we think about the matches, would these players be left out of the lineup?
Leppänen says that the menstrual cycle probably affects the elasticity of the ligaments, but the research does not yet know what measures should be taken.
Hegerberg, Hermoso, Sainio, Sällström…
Injuries often force an athlete out of the game for a long time. For example, a 12-month break from playing is usually recommended for the rehabilitation of an anterior cruciate ligament injury.
How could knee injuries be prevented? According to Leppänen, a certain type of exercise program has been able to reduce the risk of knee injuries – especially anterior cruciate ligament injuries that occur without an external cause (for example, a direct blow to the knee).
Training that develops the neuromuscular system includes lower and middle body muscle strength and movement control exercises. Let’s focus on how to make fast changes of direction and landings from jumps safely. In such a way that the knees cannot sink inwards.
Leppänen says that in studies, training has been able to reduce sudden knee injuries by approximately 50%, at best even 80%.
According to Leppänen, the subject has been extensively researched in the previous 15 years. Why then have knee injuries not decreased? The reason is quite clear: the exercises found to be effective are not done widely enough from a young age.
The reason for the lack of exercises has been clarified and it seems that the coaches feel that the exercises are non-specific, and they do not feel that they serve the development of the sport.
According to Leppänen, exercises are not necessarily done regularly, i.e. at least 2–3 times a week throughout the year, as they are designed to be.
Training to prevent injuries is often the responsibility of someone other than football coaches, such as a physical trainer or physiotherapist. Less time is often reserved for their exercises in training, Leppänen believes.
– The program used in the studies takes about 15 minutes each time, which is too much for many players and coaches. Now the research aims to develop effective, time-saving methods that coaches would like to implement. Specific exercises that would last no more than five minutes.
Expert Kunnas also works as the head coach of HJK’s women’s team. He considers the concern raised by Leppänen to be genuine. Kunnas believes that knee injuries will become more prominent in all football clubs, but cannot guess the situation of others than HJK.
– Exercises start with activations, which are preventive. The players do joint exercises, and then there are individual exercises for those whose background requires it. Still, we have also had some injuries, even though we spend a lot of time in training.
He adds that the physical trainer monitors the workload of the players and makes sure that the weeks include different types of training. The workload of the weeks should be in a reasonable relation to each other, so that the variation is not too great, Kunnas describes.
– There is no single explanation for this. Coaches, clubs and federations must together find solutions to this problem.
Kunnas says injuries are part of football, but points out that a knee injury takes a player to a training break of at least nine months.
– It’s a huge blow to the player.
Recurrence is common, and there is almost no way around it
Docent Leppänen reminds that a sudden knee injury is really tricky, and research has not yet shown ways to prevent the injury from recurring.
Efforts have been made to build rehabilitation protocols, but there is still little research evidence of their effectiveness.
– Although it is not yet known exactly what kind of training prevents recurrence of the injury, careful rehabilitation and the development of muscle strength and movement control probably help to prevent recurrence as well, says Leppänen.
Although rehabilitation in top sports is meticulous, knee injuries take a long time to heal. There is no significant difference in duration between women and men, Leppänen states.
– That’s why I would pay special attention to training that prevents injuries, because it has been proven to work.
Could the reason for frequent lower limb injuries be that women have less quality training at a young age than men. Docent Mari Leppänen according to, the matter cannot be generalized in a straightforward manner.
– High-quality training should start at a young age. Unfortunately, often in women’s sports, the resources to guarantee high-quality coaching are less than in men’s sports.
Leppänen says that the importance of good training is emphasized especially for female athletes in high-risk sports. For them, training to prevent injuries should start before puberty and continue regularly throughout their career.
– This requires competent coaches, even for young people.
Every match of the European Football Championship can be seen on ‘s channels. Competition games, background stories, news and highlight clips can be found on ‘s competition pages.