Rise in ACL injuries hitting local football hard

Football player Summer Carkeek is lying face down on the turf in disbelief.

Six months after coming back from rupturing the Anterior Cruciate Ligament (ACL) in her right knee, the 17-year-old from the Hibiscus Coast women’s football team is grasping at her left knee and writhing in pain.

She knows what she’s done.

“I couldn’t believe it,” she recalls.

“I felt it go. I was lying on the field, and I just knew in that moment. I was in total disbelief really. After everything I’d been through to get back, I didn’t want to face the reality that I’d have to go through that same journey all over again.”

All of those emotions came back and hit her like a wave.

“I couldn’t help but cry when I got the news confirmed that I’d done the ACL on my left knee,” says Summer, who is now 19.

“It was a tough moment because I knew how hard it is to come back from this injury.”

Summer did her best to shake off that feeling.

“I kept telling myself, ‘I’ve done this before and I can do it again’,” she says.

“I had one moment of being very emotional and upset and then I had to leave that feeling. I knew I had to be more determined and singled-minded than ever before.”

Summer Carkeek on the ball for the Hibiscus Coast women's team.

An alarming rate of ACL reconstructions

ACL injuries are common in sport but women are more likely to suffer this injury than men.  

The minimum time for an ACL reconstruction rehabilitation is usually nine months. But it can take 12 months to get back to playing a game at pre-injury levels.

A review of ACL reconstructions saw the greatest increase in females aged 15 to 19 years, with the rate of reconstructions increasing by 120 per cent between 2009 and 2019.

These worrying trends aren’t just numbers on a page. The impact of ACL ruptures has hit the Hibiscus Coast women’s team hard.

They’ve had five players – nearly half a team – suffer that injury in just the past few years.

“It’s been challenging for our team,” says Stacey Martin, the Hibiscus Coast captain who was one of the five players to rupture her ACL.

The 27-year-old has played a leading role in supporting her team-mates in their recovery.

“I reassured them of the process they were going through and helped them with the mental struggles. I was there to talk if they needed me. It’s a lonely process coming back from this injury.”

What is being described by many as an ACL ‘epidemic’ has been just as keenly felt at the elite level of football.

More than two dozen high-profile players were missing from the recent FIFA Women’s World Cup after suffering the same injury, including Vivianne Miedema (Netherlands), Beth Mead and Leah Williamson (England), Marie-Antoinette Katoto and Delphine Cascarino (France), Catarina Macario and Christen Press (USA), Janine Beckie (Canada), Hanna Glas (Sweden), Nadia Nadim (Denmark) and Giulia Gwinn (Germany).

Captain Stacey Martin leading by example for the Hibiscus Coast women's team.

The personal cost of a serious injury

It’s late December and a beautiful day on the Whangaparāoa Peninsula. Summer’s family are getting ready for a fun day at the beach, but she can only lie on the couch and watch TV.  

When she ruptured the ACL in her right knee, she also badly damaged her meniscus. She was non-weight bearing on crutches for six weeks and leant on her mum heavily for support.

“I couldn’t really do anything and it had a huge impact on my life,” she says.

Skipper Stacey had a similar experience.

The former Whangaparāoa College student ruptured both her ACL and ALL (anterolateral ligament), and also had a meniscal (knee cartilage) tear.

In her recovery, Stacey damaged her meniscus again and had to have a second surgery.

She remembers the pain of having to learn how to walk again.

“I had to start everything again,” she says.

“Even running or kicking a ball for the first time, you feel so uncoordinated. You think, ‘Do I even remember how to do this?’”

‘Don’t take your body for granted’

Summer and Stacey want to share their stories to help others.

Stacey and Hibiscus Coast women’s coach Asher Trotter introduced the team to strength training programmes and activation routines, as well as doing the 11+ dynamic warm-up before every training and game. It’s a key component of the New Zealand Football Performance and Prevention programme, which is supported by ACC.

“It’s so important, especially for the young ones,” Stacey says.

“It’s their routine now and it will set them up. When our team comes to training, they know exactly what to do.”

Summer agrees on the importance of injury prevention.

“My advice to younger players is to not take your body for granted, invest in it.” 

Addressing the rate of football injuries

In 2022, ACC accepted nearly 40,000 claims for football-related injuries.

That’s we why partner with New Zealand Football to deliver its Performance and Prevention programme, which helps players enhance their performance and reduce the risk of injury.

“There are some unique female-specific considerations when it comes to reducing the risk of injury in sport, we need to expose our girls to strength and neuromuscular training earlier,” says ACC injury prevention partner Nat Hardaker.

“We work with NZ Football to ensure injury prevention is an integral part of the game here. This is critical to ensuring we can support everyone to keep playing and maximise their enjoyment of the game.

“The 11+ is an evidence-based programme designed to prepare players for the demands of the game. It includes exercises that really target strength and control of the lower limbs.”

ACC injury prevention partner Nat Hardaker.

Inspired by the World Cup

Summer grew up on Auckland’s North Shore. She was in Year 9 at Rangitoto College and idolised the football ‘legends’ Anna Leat and Claudia Bunge, who were several years above her in Year 13.

The pair were part of the Football Ferns squad who made history on home soil recently in the FIFA Women’s World Cup and Summer was watching every moment.

“It’s insane seeing Claudia and Anna in the Ferns at a World Cup,” she says. 

“They were the players I wanted to be like. They helped us out a lot when we were younger and their achievement shows the pathway is possible.”

Summer says it’s great to see how the Ferns prepare to play, and that it aligns with her own team’s preparation.

Stacey says it’s been an inspirational time for the next generation of players.

“I used to play with and against a few of the players who are currently in the Ferns, so it’s been great to follow the team’s progress and see them compete with these world-class teams,” she says.

A lifelong passion for the beautiful game

Despite the adversity she’s faced, Summer has never thought about giving up football.

“I always knew I was going to come back,” she says.

“I don’t know what I would do without football. I love it so much and I’d be lost without it.”

Likewise, Stacey will never take playing football for granted. After 12 months of recovery, she still remembers finally being re-united with her Coast teammates in her first training session back.

“I’ve never been happier, I’d missed it so much,” she says.

“I’d stayed with the team the whole season, so when I got back to training and playing with the team it was even more special. They knew what I’d gone through.”

The Hibiscus Coast team did the double in 2022 – they won the league and also the Carol Waller Cup to complete a memorable season.

They’re now competing with the best in the upper North Island in the Northern Women’s Premier League and it’s been a step up.

“Over the years, we’ve seen young players grow up on the Coast and then leave for bigger clubs, which is something I did before coming back,” Stacey says.

“But it’s nice to know the youth in this area now have something to look up to and aim for.”

What is the NZF Performance and Prevention programme?

• It’s a player welfare and prevention programme for all athletes.
• It supports player performance, injury prevention, welfare and wellbeing.
• The 11+ dynamic warm up is an evidence-based programme designed to prepare players for the demands of the game. It includes exercises that target strength and control of the lower limbs.
• Research shows teams performing this warm up at least twice a week have 37 per cent fewer training injuries and 29 per cent fewer game injuries. The risk of severe injuries – such as tearing your ACL – are reduced by almost 50 per cent.
• Find out more at the NZ Football Performance and Prevention website: https://www.nzfpandp.co.nz/