Lack of supports leaving women footballers in Ireland more prone to injuries, study finds

Citing a 2001 Football Association of Ireland (FAI) strategy document regretting the neglect of “non-elite football such as women’s football”, University College Dublin’s Dr Ann Bourke a few years later suggested this “begs the question as to the meaning of elite – men only?”

Today the same question remains, with the title of a recent study on elite-level women’s football (soccer) in Ireland beginning: “More than likely the men come first.”

Injuries are occupational hazards in elite-level women’s football, with knee injuries such as anterior cruciate ligament (ACL) tears more common in female than male players. A team of sports medicine and football management researchers led by Dr Dan Horan – a lecturer at Munster Technological University, Cork and the FAI’s former head of football science and research – investigated injury prevention and management in the Irish Women’s National League (WNL). Funded by the Irish Research Council, between March and June 2020 Dr Horan conducted one-to-one interviews with 17 players, eight medical personnel and seven head coaches, representing eight WNL clubs.

The main obstacles to injury prevention initiatives and providing effective injury management were academic and work pressures; financial challenges; conflicts with college football; inadequate facilities; and gender inequity. These interviews, Horan said, highlighted “many participants’ frustrations relating to inadequate medical care and strength and conditioning input, despite playing elite-level women’s football”.

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WNL players are part-time, unpaid amateurs – either students or full-time/part-time employees – which most study participants found “a major impediment to players’ technical and tactical development, and reduced the time needed for the physical preparation that helps reduce injury risk during match play”.

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Further, says Horan, the recently introduced option whereby clubs can offer professional contracts to WNL players (permitted since December 2022) will only work if clubs can support professional playing staff.

Horan cites studies showing that academy-level women players typically get less strength and conditioning (S&C) access during their formative years than their male counterparts, with “our research suggesting that access to S&C input for young female players in Ireland is insufficient to prepare players for top-class football”. He explains that the authors of a 2021 Canadian study “suggest that female athletes’ exclusion from the same-quality training and medical environment as their male peers from childhood onwards could increase the risk of female athletes incurring catastrophic ACL tears as much as biological factors like joint laxity and body composition”.

Without such investment, Irish football will be poorly placed to capitalise on the rise of women’s football resulting from our national team’s historic first appearance at the 2023 World Cup

—  Dr Dan Horan

Players were aggrieved at the absence of qualified medical staff at some training sessions and matches, says Horan, “and some believed that constrained financial and infrastructural resources at most League of Ireland clubs meant that men’s teams within their clubs took priority over women’s teams, with medical staff attending men’s training sessions and matches, not women’s”.

Several participants considered exclusion from high-quality facilities such as full-size training pitches restricted preparation for high-level competition. “Some players who had competed abroad were frustrated by the disparity between overseas and WNL facilities.”

This difference, Horan explains, was usually attributed to clubs’ financial constraints, and clubs without their own facilities couldn’t control when or where they trained from season to season. In this context, Fifa’s 2023 benchmarking report on women’s football is telling. The report, says Horan, “found that 12 per cent and 10 per cent of the clubs in these leagues don’t have access to a medical room or gym, respectively. Moreover, 20 per cent and 16 per cent of the clubs don’t have access to a physiotherapist or S&C coach, respectively.”

While Horan welcomes the introduction of club licensing to the Women’s Premier Division, his team’s research suggests that, without substantial investment, clubs will be unable to offer much-needed medical and S&C facilities at the game’s highest level.

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Highlighting the challenge of balancing work and study with top-level football, Horan – who received football scholarships at Irish and US universities – explains that the US’s National Collegiate Athletics Association offers an integrated academic and sporting calendar for athletes, providing medical and S&C support. “This differs from the Irish experience where players, medical staff and head coaches described conflicts that often occur between clubs and universities when WNL and college football seasons clash.”

Several participants described how players on football scholarships at Irish universities, while playing for WNL clubs, suffered injuries attributed to excessive training and fixture congestion. Many players described the pressure they felt to satisfy competing demands of college and club teams. Such difficulties, comments Horan, “align with the findings of a study of elite-level female players in Sweden before incurring an ACL tear”.

What can be done? The FAI’s Strategic Plan 2022–2025 undertakes to be “radical, innovative and open in our approach to growing and developing both men’s and women’s League of Ireland football [and to] facilitate investment into the men’s and women’s League of Ireland”. But with the FAI €50 million in debt, it cannot provide the financial support needed to develop facilities and provide WNL clubs with medical and strength and conditioning expertise. The FAI’s Facility Investment Vision and Strategy 2023 urges the Government to provide the majority of the finance needed to assist women’s (and men’s) chronically underfunded League of Ireland clubs.

Significantly, Dr Horan explains that “the level of investment in football that’s needed from the Government to bridge the existing gap between the facilities and expertise available to top-level footballers in Ireland and their international competitors should cause shock and awe amongst the public”.

“Without such investment,” warns Dr Horan, “Irish football will be poorly placed to capitalise on the rise of women’s football resulting from our national team’s historic first appearance at the 2023 World Cup.”

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