Tackling The Epidemic Of Knee Injuries In Women’s Football

Tackling The Epidemic Of Knee Injuries In Women’s Football

Tackling The Epidemic Of Knee Injuries In Women’s Football. Hello everyone, I hope you are well. In today’s post, I will be sharing a guest post from biomechanics expert Christophe Champs of PODO, who specialises in working with female football players. Christophe will explore why football boots are to blame for the ‘epidemic’ of knee injuries in women’s football and what players can do about this to mitigate the risks of injury. There is no ignoring the significance of Anterior Cruciate ligament (ACL) injuries (aka knee injuries) in women’s football. However, while numerous individuals and groups rightly ask why and call for action, very little seems to be being done or achieved at this stage.

Tackling The Epidemic Of Knee Injuries In Women’s Football

The Anterior Cruciate Ligament (ACL) is the main knee stabilising ligament, and injuries to this part of the knee are serious. This type of injury is becoming increasingly worrying in women’s football. Female footballers are six times more likely to suffer ACL injuries compared to men and 25 per cent less likely to return after recovery.

To illustrate the scale of the problem more clearly, consider that approximately 25 to 30 players missed the Women’s World Cup last summer because of ACL tears. It’s not something that happens in the men’s game.

While numerous individuals and groups are rightly asking why and calling for action, very little seems to be being done or achieved at this stage.

Here at PODO, through our experience of regularly working with women football players, we have a pretty good idea of what a large part of the problem is, and we are taking action with our campaign, PODO – FROM THE GROUND UP.

In our experience, footwear plays a huge, if not the biggest, role in the epidemic of ACL injuries in women’s football. Why? Well, it boils down to poorly fitted football boots not designed with a woman’s foot, gait, or body in mind.

Most boots are designed for men or are what brands call ‘unisex’ or ‘gender neutral’. This means they need to be customised for female players, not with a symmetrical orthotic that ignores the asymmetry in the body, but with a customised orthotic for each foot.

If we are to tackle ACL injuries, then we need to do so ‘From the ground up’, in other words, we need to start with the feet.


Although the solution starts with the feet, the answer is not a one-size-fits-all, as multiple factors contribute to the reasons a woman might suffer an ACL injury. This makes the problem more complex, with several factors to consider.

Using a biomechanics approach, we can address and, if necessary, modify structural and postural factors to help a player avoid ACL (and other) injuries. Others, such as the environment and the player’s biology, will be acknowledged and allowed for, as far as possible, but won’t be explicitly modified using our approach.

For example, factors such as the width of the pelvis (women generally have wider pelvises than men – perfect for childbirth, less efficient for movement) or bow-leggedness all play a part, so we adapt and work around those factors, assessing each of them to integrate the uniqueness of a player into their unique treatment plan.

Conversely, factors such as a foot/ankle over-pronating, a knee rolling inwards or being pushed outward or pelvic tilting—all of which are among the most common sources of injuries—are addressed, from the ground up, by applying the rules of biomechanics and crafting a pair of asymmetrical orthotics.

How Bones Affect The Performance Of Muscles

In short, the bones tell the muscles what to do. That means that any misalignment that affects either a bone or a joint will create a muscle imbalance, with one (group of) muscle(s) overworking and its opposite (group of) muscle(s) underworking.

This is why a player’s alignment, balance, and posture must be optimised at every level of her body. This underpins our approach to ensuring the risk of muscle damage is dramatically reduced.

Since your two feet are different, and everyone has a dominant leg, there is a naturally occurring misalignment or asymmetry. If you put your asymmetrical form into a pair of symmetrical football boots, it will inevitably put a strain on your muscles, increasing your risk of injury. Therefore, it makes sense to match the asymmetry of your symmetrical pair of football boots with an asymmetrical pair of orthotics. These are not orthotics you can buy off-the-shelf; they must be custom-made. PODO believes this should become a preventive measure for every woman playing football.


Women’s Football Insoles

Good muscle strength can be aided by good conditioning and stretching sessions, for example, and this can help create magic on the field. But don’t forget that muscles are still susceptible to pain, fatigue and injuries. Not only that, women, on average, are shorter in stature than men, but the football pitch length is the same, and they still play for 90 minutes every match.

This is where a properly designed pair of football boots comes in with an adequately moulded pair of orthotics. Both must be precisely fitted to each woman’s feet and to the requirements for playing football. Only then can the player feel secure physically, at a foot level, and mentally, thus increasing her confidence and trust in her body. PODO is contributing to tackling knee injuries in women’s football with the PODO Women’s Football Insoles.

After trying the new insoles, Lucy Spours, Midfielder on the Clapton CFC Women’s First team and physiotherapist by background said: “I really enjoyed wearing my insoles for our first training session back; my feet felt more secure, and I felt like my legs were able to do what I told them!”


Last summer, the Women and Equalities Committee Chair, Caroline Nokes MP, wrote to football boot brands, including Adidas and Nike, questioning the lack of football boots designed specifically for women and girls.

In my opinion, this was a fantastic move and one that had been sorely needed. However, it has yet to change anything significantly. It seems it may have been done on paper, but in reality, things are heading in the wrong direction.

The response from one of the boot manufacturers questioned in the letter particularly worried me concerning the future of female footballers. The manufacturer boldly stated, “We have a gender-neutral football approach to football footwear informed by our partnerships, industry experience, and research.”

As far as I can see, a “gender neutral” approach can only produce more unisex football boots, which are, frankly, hazardous for feet and the joints and muscles supported by those feet, including the knee and ACL.

Looking at the differences between a man’s foot and a woman’s foot, a unisex pair of boots is liable to be seriously detrimental for both men’s and women’s feet and biomechanics.

The Reality Of Buying Women’s Football Boots On The High Street

Being located near Oxford Circus and most flagship stores, I regularly take the opportunity to check shoe stores and outlets that sell football boots simply because no orthotics maker wants to send a patient to a shoe shop with bad products and poor advice.

Having trained over 50 sales assistants myself for nine Decathlon stores in the past and contributed to the store strategy, I am often surprised by the low level, or total absence, of merchandising, marketing and staff training when it comes to women’s football boots. I have been handed size 45 boots and told these were the women’s version. I’ve been told women’s football boots are all marketing nonsense, that all boots are now unisex, and even that women’s boots don’t exist! This is just not acceptable.

That said, all credit goes to PUMA on Carnaby Street, as none of the above happened there. Their sales assistant was honest, helpful and informative, saying that one must bring the player into the store to try different brands and not buy a men’s pair as a substitute when the right size is not in stock. She also showed and explained that women’s football boots come with less volume in the forefoot and midfoot area and a lower instep.


In recent years, since the mediatisation of the outbreak of knee injuries in women’s football, many experts have been looking at the physiology of female athletes. I believe examining that physiology should start with the feet and biomechanics. Then, it needs to look at how footwear can support both.

I believe some manufacturers have seriously worked on developing specific moulds or ‘lasts’ to construct the shape of their women’s football boots – including a narrower heel cup and lower instep.

I also recognise that it is challenging to design multiple models that consider a player’s age, size, biomechanical needs, game intensity, past injuries, problems dealing with fatigue and recovery, or even the impact of hormonal ups and downs on her body.

But, as much as shrinking a pair of male shoes will never provide us with a female version, developing “unisex football boots” will undermine the problems female footballers currently face, mislead the customer and put thousands of girls and women around the world at risk of injuries that will prevent them playing football in their future, whether they are professional or play at an amateur level. It can also create entirely new and significant problems in men’s football.

Unsuitable, damaged or ill-fitting shoes generally devastate a patient’s biomechanics and ankle, knee, hip and back health. The consequences of those uneven wear patterns are just exacerbated in football boots because playing football increases challenges to your body. Women’s foot morphology, biomechanics, and lower average body weight must be considered to optimise their football boots’ safety, agility and responsiveness.

Custom Orthotics

Because stores are facing the challenge of stocking extra insoles specifically designed for women in football when the demand is pretty low, it is time for the clinics to step in. Custom orthotics might be as expensive or even more expensive than the boots themselves, but they can save a player from ACL, rehab and, quite possibly, loss of career.

For custom orthotics to make a big difference, they should provide the following:

  • A rigid layer under the forefoot because non-reinforced shoe soles encourage a problematic twist and turn under the forefoot, increasing knee instability.
  • Customised supports – the foot’s medial, lateral and, sometimes, transversal arches must all be supported by moulding multiple thin layers directly onto the player’s foot. Because of the natural strength of the arch and the intrinsic and extrinsic muscles, women will benefit a lot more from a thin support made to measure, particularly during hormonal changes.
  • A custom-moulded narrower heel cup because a broad and loose heel reduces the stability of the ankle and knee joints and the femur’s engagement at a hip level.

At PODO, we are dedicating 2024 to helping women get the support their feet need from the ground up, and we are calling on clubs and players to join us on our journey. We are convinced that improving women’s orthotics and boots will significantly reduce ACL injuries.

I hope you enjoyed that.

Talk soon


Christophe Champs is an expert in Biomechanics and the founder of the PODO Clinic and Workshop. Christophe works with patients to help correct postural and biomechanical issues that are causing pain or putting a client at risk of injury. By testing both the moving gait and still posture, Christophe can correct misalignment and asymmetry by creating custom orthotics to suit each individual’s needs.

Web: www.podo.london
Instagram: https://www.instagram.com/podo.london/
Facebook: https://www.facebook.com/podo.london/
X/Twitter: https://x.com/PodoLondon

Working with Strong women, I help empower women not to give up on their goals and find true happiness within themselves. #lifestyle #womenempowerment #selfcare


  • Luna S

    Ouch! A knee injury would really suck especially in this kind of occupation. Wearing the proper equipment is so helpful, thanks for all the information & insight into this!

  • Ramil Hinolan

    Just the thought of ACL injuries reminds me of the pain they bring to basketball or football players. Thanks to PODO for taking this initiative. Now, we can expect to see more women joining the Women’s World Cup, equipped with better support and protection against such injuries.

  • Ben

    It makes total sense that you should get your football shoes sized to your specific feet. One size definitely does not fit all.

  • Claudia

    It’s so crazy to me that there are so many more knee injuries in women’s football. I wonder if it really is because shoes and gear are designed to be unisex.

  • Beth

    I think the idea of footwear designed specifically for women’s feet is a fantastic idea. Men and women are put together differently. I read there are minor changes in the angles of our joints. Not sure if that’s true, but it makes sense.

  • Stephanie

    Good to know there are champions helping women and girls to protect their bodies while playing sports. Interesting statistics on the number of knee injuries resulting from football and improper footwear.

Leave a Reply

Your email address will not be published. Required fields are marked *