Why women's ACL injuries need more attention and investment

Ruptured ACL. Two dreaded words no athlete -- professional or amateur -- ever wants to hear.

The sad reality is that it's an injury which has become far too common across a range of sports. But did you know it's exponentially more likely to affect female athletes than male? So much so that the frequency of these 12-month physical and mental setbacks among women is now being viewed as somewhat of an epidemic.

Already in Season 8 of the AFLW, two players have ruptured their anterior cruciate ligaments - Kalinda Howarth of the Gold Cast Suns, and Elle Bennetts of the Dogs.

For years, research in this area has been neglected and many have been happy to turn a blind eye to the issue. But last month's Women's World Cup has helped highlight the severity of the issue, with over two dozen athletes suffering ACL injuries and being forced to miss their sport's biggest tournament of the year.

So why are women more susceptible to this horror injury?

While we know females have smaller ACLs and a wider pelvis -- which creates more stress on the knee ligaments and increases the likelihood of a rupture -- why these injuries continue to occur at such an alarming rate remains a million-dollar question. AFLW icon Erin Phillips believes "if we knew the answer to what was happening, someone would be very well off."

Phillips, a pioneer of the AFLW competition and someone who has achieved everything there is to achieve in the sport, knows as well as any about the trials and tribulations of a ruptured ACL. Twice in her glittering career she suffered the devastating injury, prompting her to partner with Medibank's 'ACL United' campaign -- joining the likes of Lauren Jackson and Sarah Blicavs -- in an effort to raise awareness around it.

"We want to be able to put more resources into research to be able to find some way of reducing ACLs, because at the moment women are five times more likely to do their ACLs than men," Phillips tells ESPN. "It needs to start by figuring out why this is happening. We have to put more resources, awareness into this injury and figure out what we can do to reduce it."

Research by Medibank shows only 8 percent of Australians are aware of the higher risk of ACL injuries in females compared to males. What is common knowledge is the 12-month stint on the sidelines, something which is even tougher for female athletes to swallow, given the majority are part-time and forced to seek a secondary source of income. Some who suffer these injuries are unable to work these secondary jobs.

The other downfall for women competing in part-time professional sporting leagues who suffer these injuries is having to rehabilitate around their other work commitments. Sometimes it's just not possible or feasible. There's also a lack of full-time staff able to assist in recovery.

"I've done two ACLs, both my left and my right, and I had to miss a significant amount of time," said Phillips. "Both of my rehabs were about 12 months. I missed literally 12 months of playing with the teams. I missed income. I wasn't getting paid. It's very stressful when you are missing out on employment, and that's your main income.

"It was very debilitating early days because you can't really do too much, and the rehab is very slow. I was very anxious because I was such a get up and go, run and move person and I had been pretty much flawed, and so mentally it was very challenging."

The overwhelming success of the Matildas at the Women's World Cup earned a AU$200 million investment into women's sport from the Australian government. Some of these funds must be allocated towards research in this area to avoid scaring off the next generation of potential athletes, regardless of which sport they are looking to pursue. After all, research shows 45 percent of female athletes who suffer an ACL injury never compete in sport again, and 35 percent won't return to the same level of athleticism.

Initiatives like Medibank's ACL United is the stepping stone for change.

Investment is also needed in education. Currently, female athletes are learning about injury prevention far too late and not being exposed to the importance of strength training, a stark contrast to males who are taking part in these exercises from around the age of 12 in their representative or academy programs.

Even at the elite level, with short seasons in competitions such as the AFLW and NRLW, it's difficult for players to remain participating in strength programs when they aren't being paid full time wages.

Another area of concern is the grounds used at the elite level. The majority of professional female sports are played on local grounds in the local community. Henson Park, which occasionally hosts AFLW games, doubles as a dog park on weekends and is open to the public the rest of the time. Grounds played on by professional female athletes should not be to the same standard as community sport.

Imagine the uproar if the MCG allowed morning dog walkers on the turf just days before a blockbuster Collingwood vs. Carlton game.

The dryness and hardness of many of these ovals, through lack of care, puts more stress on joints, especially with constant jumping and landing movements.

Women's sport continues to grow in Australia and today there is far greater opportunity for females to compete at a professional level. But ongoing investment is key. There's no doubt that if there were as many ACL injuries in men's sport as there are in women's sport things would be handled completely differently.