Anterior cruciate ligament injury

• The Women’s World Cup has also delivered an estimated A$7.6 billion boost to the Australian economy.
• But, as anyone in and around women’s football knows, the Women’s World Cup needs to be more than a four-week football festival.
• It needs to move the dial on the treatment of, and investment in, women’s sport, including with the following big-ticket items.

1. Celebrate and extend the cultural shift

• Encouraging and continuing this cultural shift will be equally, if not more, game-changing.
• We must cement such a shift with good policy and investment to promote further inclusion.

2. Acknowledge no single event can fix everything

• No single sport event can neatly address all gender equality issues (we’ve heard such optimism and hype around women’s sport and its gender-equality-advancing ability before).
• So while it’s important to celebrate the wins, it’s equally important to recognise the tournament isn’t the endgame but an important next step.

3. Use the data to align value with investment

• Until recently, the absence of investment in women’s football and the failure to broadcast matches meant the resulting data have only ever shown us what women’s football is not.
• That lack of data is also why broadcasters were able to lowball FIFA when it was trying to sell the 2023 Women’s World Cup broadcast rights.

4. Invest in gender-specific research and gear

• Oft-cited research confirms women are up to eight times more likely to suffer ACL injuries than men.
• But there remains little women-specific research into ACL injury causes, much less prevention.
• This is symptomatic of wider issues around research overlooking women.
• If ever there were something that summed up how women’s football simultaneously excels while being thwarted, this is it.

5. Appoint women to senior positions, but avoid the 'glass cliff’

• This tournament needs to open the door for women to be making decisions for women’s sport.
• We need to steer clear of the “glass cliff” phenomenon – where women are awarded senior positions only during tumult and the men who usually hold those roles are abandoning ship.

6. Pay them properly

• But there remains one key missing element for them, as it is for all women’s sports: pay and prize money commensurate with their contributions and talent.
• The latter won the netball World Cup last week but received no pay and no bonuses for their efforts.
• However, FIFA Women’s World Cup prize money, still a fraction of the men’s prize money, remains the elephant in the room.

7. ‘Correct the internet’

• This has happened across many domains, including women’s football.
• For example, often the historical record has seen football records such as the world’s leading international goalscorer misattributed to men.

• But one of us (Jamie) recently published research that found exercises that you hold in a static position, such as planks and wall sits, are actually the best way to reduce blood pressure.
• But lower blood pressure is only one of the benefits of doing this type of exercise.

1. They improve heart health

• It found that the best way to lower blood pressure was to perform an average of three isometric sessions per week.
• Jamie’s research group has also shown that isometric exercise improves the function, structure and mechanics of our heart, the health of our vascular system and the performance of our autonomic nervous system.
• All of these changes are important for good cardiovascular health and lower risk of disease.

2. They improve joint health

• Anterior crutiate ligament (ACL) rupture is one example of a ligament injury that has a significant health impact.
• But our muscles play an important role in reducing the force placed on our ligaments by helping create stability around a joint.

3. They help address muscle imbalances

• Known as limb dominance, this partly happens due to something called laterality, our preference to use one side of the body over the other.
• But doing unilateral (one-sided) isometric exercises – such as the split squat or side plank – may help reduce strength differences between limbs as they target one side of the body.

4. They improve performance

• This is because isometric exercises have the ability to activate very specific muscles or muscle groups.
• This may improve athletic performance or physical function in daily life.

5. They’re easily tolerated

• This is because they can be performed with limited mobility and where pain may be a limiting factor.
• As isometric exercises are performed in a static position, it can be more tolerable than exercises which require a lot of movement.

6. They’re time efficient

• This would equate to around four sets of isometric exercises, with each exercise held for around two minutes.
• This makes isometric exercises easy to fit into even the busiest schedules.

Getting started

• Isometric exercise can be performed pretty well anywhere since they only use your body weight to challenge your muscles.
• It’s also recommended you consult with a healthcare practitioner before starting your new exercise plan to ensure it’s safe and effective.

• Both horses and people with endocrine disorders like Type 2 diabetes can suffer multiple types of musculoskeletal disorders.
• For example, horses with pituitary pars intermedia dysfunction – similar to Cushing’s disease in people – suffer from tendon and ligament degeneration.

Human and horse endocrine systems

• Some endocrine disorders change how your body produces and releases hormones and can lead to osteoporosis, arthritis, ligament injury and other orthopedic diseases.
• In fact, approximately 20% of horses and over 34% of people in the U.S. are affected by endocrine disorders such as metabolic syndrome.
• For both species, the degree to which endocrine disorders are connected to obesity and its associated negative health effects is complex.
• As mammals, horses and people share similar anatomy and endocrine physiology, and researchers have noted their parallel genetic links between obesity and metabolic disease.

Research to note

• Because of the similarities between people and horses, research on diagnostics and treatments for metabolic conditions could provide health benefits to both species.
• These drugs alter the kidneys’ ability to absorb sugar from urine such that the body eliminates some of the glucose it would normally absorb.
• This greatly reduces blood insulin spikes, which can help prevent obesity, metabolic syndrome and cardiovascular disease in both horses and people.

Expanding precision medicine

• Instead of the standard one-size-fits-all protocol, precision medicine uses information from a person’s genes, environment and medical history to create a customized treatment plan.
• In horses, precision medicine currently focuses on DNA-based diagnostic tests to inform exercise regimens, treatment and breeding decisions.
• Within precision medicine, doctors aim to get a full-picture view of an individual and their metabolic health by using multiomic analysis.

• The anterior cruciate ligament, or ACL, is a piece of tissue like a rope connecting your shin bone to your thigh bone.
• It’s only 3cm long and 1cm wide but is the most important stabiliser of the knee, alongside your muscles.
• Women are more likely to tear their ACL than men playing the same sports, with women soccer players twice as likely to tear their ACL as men.

Why are women more prone to ACL injury?

• Other contributing factors include women and girls having fewer opportunities, confidence or support to participate in sports such as football, or activities such as gym training.
• Read more:
  Female football players are at much higher risk of career-ending ACL injuries – the science on why

How long will you be out for? And what if you’re not an elite athlete?

• Most young people (elite and non-elite athletes) will require 12 months off sport to physically recover from an ACL tear.
• Many will require longer: up to 80% may have ongoing muscle weakness, 40% have ongoing symptoms, and only half return to sport.
• Surgical repair involves taking a small graft from your hamstring, quadriceps, or patellar tendon to replace your ACL.

What can be done about the high rates of ACL injuries in women?

• Given the high cost of ACL injuries to women athletes, the best thing we can do is to prevent them.
• Injury-prevention programs that address movement patterns and muscle function through training and coaching can reduce the risk of non-contact ACL injuries in women by 67%.
• Research suggests ACL injury-prevention programs are effective regardless of whether they are implemented by a coach or a medical professional.

So why are ACL injuries on the rise?

• ACL surgeries have increased by 43% in Australia between 2000 and 2015.
• In Australia, women’s knee injuries have grown by 3% (compared to 1.3% for men), with the highest growth among girls aged 5–14 years (around 10% a year).
• While injury-prevention programs are effective when tested in clinical trials, their use by sporting clubs outside of research projects can be as low as 10–20%.