Incidence of Anterior Cruciate Ligament Injuries in Female Soccer Players Across Age Groups and Competition Levels
Abel Gomez-Caceres, Iván Medina-Porqueres, Manuel Benavides-Propp, Iskandar Tamimi-MariñoBackground:
Anterior cruciate ligament (ACL) injuries are a major concern in female soccer, yet population-based data across age groups and competition levels remain limited.
Purpose:
To evaluate the incidence of ACL injuries in federated female soccer players and to assess the association between injury risk, age, and competitive level.
Study Design:
Descriptive epidemiology study.
Methods:
A retrospective cohort study was conducted including all federated female soccer players (≥14 years) in the Málaga Football Federation (Spain) between 2020 and 2024. ACL injuries were identified through federation and medical records. Incidence rates were calculated per 1000 hours of participation, along with cumulative risk and relative risks across age groups and competition levels.
Results:
A total of 64 ACL injuries were identified among 4937 players. Most injuries occurred during matches (79.7%) and were predominantly noncontact (82.8%). Across the 2020-2024 study period, professional players demonstrated the highest incidence (0.3125 injuries per 1000 hours; 95% CI, 0.0644-0.9133 injuries per 1000 hours), followed by players aged 16 to 18 years (0.1020 injuries per 1000 hours; 95% CI, 0.0666-0.1495 injuries per 1000 hours). In contrast, players aged 14 to 15 years had the lowest incidence (0.0201 injuries per 1000 hours; 95% CI, 0.0081-0.0413 injuries per 1000 hours). Compared with the 14- to 15-year group, relative risk was higher in players aged 16 to 18 years (RR, 5.08; 95% CI, 2.44-11.5) and in professional players (RR, 15.62; 95% CI, 4.36-55.7).
Conclusion:
ACL injury incidence in female soccer varies across age groups and competition levels, with higher rates observed in older and higher-level players. These findings help identify high-risk groups and support the development of targeted injury prevention strategies.