Are women playing too much football?

When Alexia Putellas picked up her second Ballon d'Or in October, she did so despite having not played since suffering an ACL (anterior cruciate ligament) injury on the eve of the Euros in July. Less than a month after the Spaniard was named the world's best player, the woman she edged in to second, England's Beth Mead, fell victim to the same injury.

The international break just before that saw the woman in fourth, Germany's Lena Oberdorf, suffer a shoulder injury in a friendly match in the USA that her coach didn't her want to play. At the same time, Denmark star Pernille Harder, until recently the most expensive transfer in history, had to have surgery on a hamstring injury suffered playing for her country.

Dutch star Vivianne Miedema (11th in the Ballon d'Or) didn't pick up an injury, but she also didn't play in that international break, after her club, Arsenal, allowed her to take time off to "rest and recharge." Such time out is rare in the men's game and is becoming increasingly so in the women's, with UEFA announcing in early November that a Nations League competition will begin in Europe next year.

While there is some reticence among players and coaches, the new competition will be linked to qualification for the next Euros. It should mean less of the sort of mismatches that saw England crush Latvia 20-0 and Belgium beat Armenia 19-0 in World Cup qualifying. Sarah Gregorius —  the director of Global Policy and Strategic Relations, Women's Football, for players' union FIFPRO — told DW there are other advantages of increased high level competition.

Different needs at different levels

"Globally, underload is one of the biggest issues in the sustainable development of women's football and is putting the brakes on the growth of the sport," she said. "In many parts of the world, national federations and domestic league organizers do not organize enough games across a suitably long domestic and international season. Many talented players therefore do not have football as a viable career option, and may leave football early or not develop to the best of their abilities."

The Nations League and the relatively recently-introduced Champions League group stage go some way to addressing those concerns. But Gregorius also acknowledged that it is "important to ease fixture congestion and associated workload on a few individual players at the top of the game to protect their health and performance." Some players and coaches worry this isn't yet the case.

"I feel players playing in World Cups and European Championships being given two weeks rest between seasons is unacceptable," said Harder's coach at Chelsea Emma Hayes after the forward's injury. "We need to start putting the players first. It's killing the players. I'm not talking on behalf of my own, it's across the board. Look at the injuries in the women's game."

Harder's teammate and partner Magdalena Eriksson is one of those players whose international and club commitments, with Sweden and Chelsea, mean she travels and plays almost constantly for much of the year. This is particularly true at the moment, with the COVID-delayed Euro 2022 and next year's World Cup played back to back.

Decisions for women's football

"I definitely hope that everyone is keeping the player's best interests in mind," she told DW after Chelsea's win over Real Madrid. "As with all of these new tournaments, I'm hoping that the creation of a Nations League won't just add more games, but add more tough games.

"But this is why you have to have big squads like we do here at Chelsea, you have to use your full squad in order for everyone to rest and recover. So I think it's on everyone to keep the players best interests in mind."

As in ticketing, away fan blocks, TV deals and transfers, women's football has a decision to make here: whether to follow the men's lead and decide more is always better, or to think carefully about the impacts on players, coaches and fans.

One area where there's a growing belief that women need to be distinct from men is in footwear. A recent study in the Sports Engineering journal, that featured input from England captain Leah Williamson, found that wearing men's boots, as most female players do, can cause blisters and stress fractures because women's feet, heels and arches are shaped differently. The studs also don't help. They are designed for male running patterns, and could increase the chances of studs getting caught in the turf when worn by women.

Travel a burden at the top

It's not only the football, but the travelling that can be a significant factor. "It's the fatigue level that sets in," Joanne Parsons, from the University of Manitoba's Department of Physical Therapy, told DW earlier this year. "There is some thought that there's a link between how your brain signals to your muscles, how to control your leg and space, and your risk of ACL injury, for example.

"I would imagine that fatigue, mental fatigue, physical fatigue, could contribute to your mental ability to control your body and its movements."

There are no easy answers. But it's clear that the increasing profile of the women's game needs to come with increased understanding of injury prevention and load management, particularly for those at the top level, who travel and play the most. That said, outside of the elite, more high level competition is required to grow the game. It's a tough, but essential, balance to strike.

Edited by James Thorogood