Girls’ participation in football (soccer) has grown rapidly over the past decade. With expanding pathways from junior participation through to elite competition, more female athletes are training and competing at higher levels than ever before. While this growth is positive, research shows that female football players have unique physiological and injury risk considerations that should influence how they train, recover, and prepare for competition (Datson et al., 2014).
Understanding these factors allows athletes, parents, and coaches to support long-term athletic development, reduce injury risk, and improve performance. With the support of allied health professionals, female footballers can train smarter, recover effectively, and stay on the field longer.
Injury Risk in Female Football Players
Football places significant physical demands on athletes. Sprinting, cutting, jumping, tackling, and rapid changes of direction create high loads on the musculoskeletal system.
Research shows that female football players experience several common injuries, including:
- Anterior cruciate ligament (ACL) injuries
- Hamstring strains
- Ankle sprains
- Patellofemoral knee pain
- Bone stress injuries
One of the most widely discussed concerns in female sport is the increased rate of ACL injuries. Female athletes are estimated to be two to eight times more likely to sustain ACL injuries compared with males playing the same sports (Hewett et al., 2006).
Several factors contribute to this increased risk.
Biomechanical Differences
Female athletes often demonstrate greater knee valgus during landing and cutting movements. This inward collapse of the knee increases stress on the ACL.
Other contributing factors include:
- Reduced hamstring strength relative to quadriceps
- Less hip strength and stability
- Reduced trunk control during dynamic movements
Neuromuscular training that improves landing mechanics and strength has been shown to significantly reduce ACL injury risk (Sugimoto et al., 2015).
Growth and Development
Adolescent female athletes experience rapid growth spurts during puberty. Limb length increases faster than strength and coordination can adapt, temporarily increasing injury risk (DiFiori et al., 2014).
During this period athletes may experience:
- Reduced coordination
- Increased muscle tightness
- Higher risk of overuse injuries
Proper strength training and load management during these phases are essential.
Strength Training for Female Footballers
Strength training is one of the most effective tools for improving football performance and reducing injury risk.
Despite outdated myths, resistance training is safe and highly beneficial for girls when supervised appropriately. Strength training helps develop key qualities required for football including:
- Sprint speed
- Acceleration and deceleration
- Jumping ability
- Change of direction speed
- Collision tolerance
Importantly, strength training also improves joint stability and neuromuscular control.
Key muscle groups for female footballers include:
- Glutes and hip stabilisers
- Hamstrings
- Quadriceps
- Core musculature
- Calves
Posterior chain strength, particularly in the glutes and hamstrings, is critical for protecting the knees during high-speed running and cutting.
Programs that include plyometrics, strength work, and landing technique training have been shown to reduce ACL injuries by up to 50% in female athletes (Sugimoto et al., 2015).
Strength training should ideally begin in early adolescence and progress gradually with appropriate supervision.
Hormonal Considerations in Female Athletes
Hormonal fluctuations throughout the menstrual cycle can influence training responses, recovery, and injury risk.
The menstrual cycle typically involves variations in the hormones oestrogen and progesterone. These hormones can influence:
- Ligament laxity
- Muscle recovery
- Energy metabolism
- Perceived fatigue
Some research suggests that ligament laxity may increase during certain phases of the cycle due to elevated oestrogen levels (Herzberg et al., 2017). While evidence linking menstrual cycle phase directly to injury risk is still developing, tracking the cycle can help athletes and clinicians identify patterns in performance and recovery.
For example, some athletes may experience:
- Reduced energy levels
- Increased fatigue
- Cramps or discomfort during training
Tracking symptoms can help guide training modifications and recovery strategies.
Open discussions around menstrual health are increasingly recognised as important components of female athlete care.
Nutrition for Female Footballers
Proper nutrition plays a major role in performance, recovery, and injury prevention.
Football is a high-intensity intermittent sport requiring repeated sprints, accelerations, and physical contact. Athletes require adequate energy intake to support both training demands and normal physiological functioning.
One major concern in female sport is Relative Energy Deficiency in Sport (RED-S).
RED-S occurs when athletes consume insufficient energy relative to the demands of training (Mountjoy et al., 2018). This can affect multiple body systems including:
- Hormonal health
- Bone density
- Immune function
- Recovery capacity
- Athletic performance
Signs of low energy availability can include:
- Irregular or absent menstrual cycles
- Frequent fatigue
- Stress fractures
- Reduced performance
- Frequent illness
Adolescent female athletes are particularly vulnerable if training loads increase without corresponding increases in energy intake.
Footballers should prioritise:
- Adequate carbohydrate intake for training fuel
- Protein intake to support muscle repair and adaptation
- Hydration before, during, and after matches
- Nutrient-dense foods to support overall health
Working with qualified dietitians can help athletes develop sustainable fueling strategies that support both performance and long-term health.
Injury Prevention Strategies for Female Footballers
Evidence-based injury prevention programs can significantly reduce injury risk in football.
Key strategies include:
Structured Warm-Ups
Programs such as FIFA 11+ have been shown to reduce injury rates when performed consistently.
Effective warm-ups include:
- Dynamic mobility
- Activation exercises
- Strength and stability work
- Plyometric drills
Strength and Neuromuscular Training
Strength training improves the ability to absorb forces during running, landing, and cutting movements.
Training should include:
- Squats and lunges
- Hamstring strengthening
- Core stability work
- Landing mechanics
Load Management
Monitoring training and competition loads helps prevent overuse injuries.
Gradual progression in training intensity and volume allows the body to adapt safely.
Recovery Strategies
Adequate sleep, hydration, and nutrition support recovery and reduce injury risk.
Athletes who consistently sleep less than eight hours per night have been shown to experience higher injury rates (Milewski et al., 2014).
The Role of Allied Health in Female Football
Supporting female footballers requires a multidisciplinary approach that addresses performance, injury prevention, and long-term health.
Allied health professionals play an important role in helping athletes manage the demands of training and competition.
Physiotherapy
Physiotherapists assist with:
- Injury assessment and treatment
- ACL injury prevention programs
- Movement screening
- Return-to-sport rehabilitation
Exercise Physiology
Exercise physiologists design individualised strength and conditioning programs to improve performance and reduce injury risk.
They also support athletes recovering from injury by guiding progressive rehabilitation.
Dietetics
Sports dietitians help footballers optimise fueling strategies to support training, recovery, and hormonal health.
This is particularly important for managing RED-S risk in female athletes.
Strength and Conditioning Support
Supervised training ensures exercises are performed safely and effectively while progressing strength and power over time.
Supporting Female Footballers at Changez Health and Fitness Daisy Hill
At Changez Health and Fitness Daisy Hill, female footballers have access to a comprehensive allied health team working together to optimise performance and reduce injury risk.
Our integrated services include:
- Physiotherapy for injury management and rehabilitation
- Exercise physiology for strength and conditioning programs
- Dietetics for performance nutrition and energy availability
- Personal training within a fully equipped gym environment
This collaborative approach allows athletes to receive coordinated care across all areas of health, performance, and recovery.
For players returning from injury, our team also provides structured return-to-sport programs designed to safely rebuild strength, confidence, and performance capacity.
Whether athletes are preparing for a competitive season, managing injury, or looking to improve performance, the team at Changez Health and Fitness Daisy Hill provides evidence-based support to help footballers stay healthy and perform at their best.
If you or your child plays football and wants to train smarter, reduce injury risk, or return safely to sport, the Changez allied health team is here to help.
References
Datson, N., Hulton, A., Andersson, H., Lewis, T., Weston, M., Drust, B., & Gregson, W. (2014). Applied physiology of female soccer. Sports Medicine, 44(9), 1225–1240. https://doi.org/10.1007/s40279-014-0199-1
DiFiori, J. P., Benjamin, H. J., Brenner, J. S., Gregory, A., Jayanthi, N., Landry, G. L., & Luke, A. (2014). Overuse injuries and burnout in youth sports. Pediatrics, 133(3), e602–e614.
Herzberg, S. D., Motu’apuaka, M. L., Lambert, W., Fu, R., Brady, J., Guise, J. M., & Sutton, K. M. (2017). The effect of menstrual cycle and contraceptives on ACL injuries and laxity. Sports Medicine, 47(11), 2397–2412.
Hewett, T. E., Myer, G. D., & Ford, K. R. (2006). Anterior cruciate ligament injuries in female athletes. American Journal of Sports Medicine, 34(2), 299–311.
Milewski, M. D., Skaggs, D. L., Bishop, G. A., Pace, J. L., Ibrahim, D. A., Wren, T. A. L., & Barzdukas, A. (2014). Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. Journal of Pediatric Orthopaedics, 34(2), 129–133.
Mountjoy, M., Sundgot-Borgen, J., Burke, L., Ackerman, K., Blauwet, C., Constantini, N., Lebrun, C., Lundy, B., Melin, A., Meyer, N., Sherman, R., & Budgett, R. (2018). IOC consensus statement on Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine, 52(11), 687–697.
Sugimoto, D., Myer, G. D., McKeon, J. M., & Hewett, T. E. (2015). Evaluation of the effectiveness of neuromuscular training to reduce ACL injury in female athletes. American Journal of Sports Medicine, 43(7), 1708–1719.*
