It’s been over 50 years since the Football Association (FA) lifted the ban on women playing football. Significant efforts have been made since to level the playing field, but there remains a distinct lack of research, and therefore understanding, of women’s needs in sport. Lecturer in Sports Therapy and Rehabilitation and Chartered Physiotherapist, Lisa Walsh, aspires to tackle this.
You’ve had a varied career in industry prior to joining us at Kent. How has this shaped your outlook on sports science?
Working for the NHS, in private practice, and in professional sport has certainly given me varied experiences in all types of Physiotherapy. Coupled with managing Health Clubs and running my own personal training and sports massage business before becoming a physiotherapist, I feel the transferable skills that I’ve developed have helped my career pathway in many ways. For example, as the Lead Women’s and Girls Physiotherapist at Brighton and Hove Albion Football Club, I improved my ability to multi-task, adapt to change and work in an ever-changing environment where staff are constantly under pressure to perform. Working in women’s football has provided me with experience and knowledge that I wish to share with my students – some of whom are aspiring football therapists.
There has been lots of discussion in recent years about the link between periods and performance/participation in sport. How is your work contributing to the conversation?
It’s good to see this is no longer a taboo subject where players and support staff are now regularly engaging in discussion and monitoring the effects it has on performance. When I was at Brighton we monitored the players’ periods on a daily basis which enabled us to support them to manage symptoms, adapt their nutrition and alert coaches to injury risk linked to changes in ligament laxity at different stages in the menstrual cycle.
The jury is still out on whether there is a significant injury risk during the various hormonal changes of the cycle. At Brighton, our internal injury audits held over a number of seasons did not find a correlation between hormonal changes and injury incidence – but that was just scratching the surface. There is still so much more research and practicable application that needs to develop – particularly in a team sport setting where it is hard to individualise someone’s training. It is encouraging to see that there has been more recent investment on this subject, for example, with a number of papers being showcased at the Women in Sport Congress in Australia in March 2024.
ACL injuries are on the rise in the women’s game. Are you able to give some insight into why this is?
The research to date has listed a number of factors but it is hard to say which has more weighting over another. It could be related to biological make-up, as strength to weight ratios in females differ to males and there are a number of theories which suggest that differences in the size and angle of women’s pelvis to lower limb can predispose them to ligament strain. There is also evidence that co-ordination is reduced during various stages of the menstrual cycle. What research does tell us is that the landing mechanics vary between males and females, and this has been cited as being a sizeable injury mechanism in non-contact ACL injuries – so I do feel there is a missing link there.
The use of male football boots by female players doesn’t help the situation. The best boots on the market are developed with a male foot in mind and so have a completely different profile to that of a female foot. In addition, it would be remiss of me to not mention the lack of access to appropriate facilities and personnel in women’s football. Whilst this is improving (Brighton led the way with their purpose-built women’s and girl’s training facility in 2021) I do feel that female players do not have the access opportunities that are given to their male counterparts. With the increase in the competitive side of the game, training load and fixtures, this will only add more fuel to the injury fire.
In an effort to clarify why we’re seeing an increase in female ACL injuries, there is huge research investment into this subject and I myself am considering embarking on a PhD on tendon pain (tendinopathy), in particular the causative factors in female athletes. This may uncover some more conclusive findings over time.
Match action during the Women’s Super League match between Brighton and Hove Albion Women and Arsenal Women at the American Express Community Stadium on the 28th April 2019.
What would your advice be to athletes looking to reduce their risk of injury?
There are many factors that lead to injuries – particularly those that are non-contact. Some have more of an influence than others. I am a great believer in preparing the body to tolerate the sport/activity you are going to do. This means carrying out strength, flexibility, agility, balance and co-ordination training. Secondly, by eating the right foods at the right time and ensuring external factors are well-managed – such as stress, sleep and recovery. Indeed, I have been involved in a project which is due to be published soon on the influence of aerobic fitness and strength on recovery times. I found the outcome of this helped shape the recovery strategies for the players I worked with. Lastly, I would say ensure you have the right equipment/clothing and you increase your weekly activity and training load gradually, as a large number of injuries occur from people doing too much too soon.
Do you think that men and women’s football will ever be equal?
There is no denying that football is seen as the national sport for the UK and winning the Euro’s and coming second in the World Cup has certainly elevated the profile of women’s football. This has been demonstrated by increased television coverage of domestic and international games, increased ticket sales and player media profiling. It is also encouraging to see the number of young players engaging in the sport – something I was not allowed to do when I was a youngster as my School only let me play netball and hockey. Whilst this is all encouraging I do think we are a long way off women’s football being viewed equally as men’s football – but I would very much like that to happen.
Do you think we need more women sports scientists?
I do feel the ratio of male to female sports scientist’s is gradually increasing and it is nice to see higher numbers of female students on our undergraduate degree programs. It is generally known that female athletes are under-represented in all areas of medical research, with little female-specific data that can inform training, rehab, prehab and exercise protocols. With more female sports scientists it is hoped these equality gaps can be closed.
Lisa Walsh is a Lecturer in Sports Therapy and Rehabilitation in the School of Sports and Exercise Sciences. She has gained an MSc in Sports Science, a PGDip in Advanced Neuromuscular Physiotherapy, a PGDip in Musculoskeletal Medicine and a PGCert in Musculoskeletal Diagnostic Ultrasound. Prior to becoming a Physio Lisa was a Health Club Manager, ran a Personal Training and Sports Massage business and taught nutrition, anatomy and strength and conditioning courses at Higher Education Colleges. She has a wealth of knowledge and experience treating sports injuries, particularly hip, ankle and knee injuries, with a special research interest in female ACL injuries, tendinopathies and female athlete health and performance parameters. Lisa is open to being featured in print, on TV and the radio.