WSL injury crisis: What impact is fixture scheduling having on players?

The high prevalence of anterior cruciate ligament injuries in the women's game is not a new phenomenon. Female footballers are four to six times more likely to suffer this injury compared to their male counterparts.

Seven of the 12 teams in the WSL have had at least one player absent due to an ACL injury this season, while 20% of the 20 nominees for the 2022 Ballon d'Or - Alexia Putellas, Beth Mead, Catarina Macario and Marie-Antoinette Katoto - are currently rehabbing from this exact injury.

The WSL casualty list extends beyond ACLs. Pernille Harder is a long term absentee for Chelsea after undergoing an operation on her hamstring in November, while Arsenal have been without first choice centre back pairing Rafaelle and Leah Williamson since October due to foot injuries. Emma Hayes and Jonas Eidevall both highlighted the role that the congested domestic and international fixture schedule has in player load and injuries.

"We need to consider in women’s football when we see the calendar, how we put the players health first," said Eidevall. "They are constantly going between really competitive games at club level, onto international level. My gut says that we are not creating something that is good for the players."

During the 2022/23 season, there are four international breaks (including the 2023 World Cup) in the men's football calendar. There are five during the 2022/23 women's season, not including the European Championships and World Cup which bookend the campaign.

Since Euro 2022 concluded at the end of July, there have already been three international windows. Midweek international fixtures have taken place ahead of the league season resuming at the weekend, with players travelling back to their clubs - sometimes on long haul flights - and fitting in a day or two of training or recovery in the best case scenarios before returning to competitive action.

"I think there needs to be a bigger conversation," said Aston Villa boss Carla Ward. "We had one player arrive back [after] 38 hours, three flights, lands the day before the game and is expected to play. And from a player welfare point of view, that's not okay. And in economy, may I add...

"My point is, these players are meant to be elite athletes and they get treated to a certain extent like it, but I think we need to do more.

"It's so important that we look after individuals; not just their physical state, but their mental state as well. The last international break was the World Cup window, some [teams] went out, some went through. You're expected to be back 24 hours later, playing 48 hours later. Some players are still struggling because they've not slept. It needs some serious thought."

There is no sign of this letting up; the Covid-19 pandemic pushing the European Championships back one year means that certain players face participating in a major international tournament five summers in a row.

Concerns were raised over the quick turnaround and lack of rest and pre-season afforded to players between Euro 2022 concluding on 31 July and the 2022/23 season beginning, particularly for those competing in Champions League qualifiers. The 2023 World Cup does not wrap up until 20 August.

The crux of the issue appears to be with the manner in which international fixtures are packed into the domestic calendar as opposed to the volume of WSL games. Reading's Kelly Chambers and Leicester's Willie Kirk both actually called for more WSL matches to be played.

Leicester played just twice in November, but now face three matches in the space of eight days in December - and Kirk highlighted this irregularity as a problem for managing load.

"I don't think there'e enough games in the women's game," said Kirk. "What I think is the issue is the consistency of those games. I think it's the peaks and troughs that are really difficult to manage. I think if it was more consistent it wouldn't be a problem."

During the Covid-19 pandemic, the five substitutions rule was introduced in the WSL to help tackle fatigue and aid player welfare.

WSL teams have used all five subs 30% of the time during the 2022/23 season; Arsenal and Everton have used the maximum number of substitutes in 57% of their league fixtures, Chelsea and Liverpool in 50%, Manchester United in 43%, West Ham in 38% and Manchester City in 29%.

"One [reason we often use five subs] is tactical - we can of course change the different players coming on," explained Everton boss Brian Sorensen. "But it's also I think the demands especially in this league. We don't have in all positions top international players that have been playing in this league for three, four, five years.

"If you look at the players that play a lot for us - Gabby George, Lucy Graham, Megan Finnigan - those type of players that are used to the league, they can do it, but the young ones that we brought in, they need to adapt to this league. So that's probably the biggest reason - we need to manage the load. A player like Aggie Beever [Jones] has been really great for us but there is a step to be taken to be able to play 90, 90, 90. I enjoy that we have the possibility of five subs and I think the player welfare is really important."

However, the five subs rule has been criticised for only benefitting top teams with the greatest squad depth who have the luxury of taking advantage of it.

Brighton and Tottenham have made all five substitutions on just one occasion - both during the latter's 8-0 destruction of the former - while Aston Villa, Reading and Leicester have never used the maximum number of subs in the WSL this season.

"It's not really helpful is it, five subs? It helps the top teams, it helps the teams with big squads," said Ward. "I don't think it helps the majority of WSL clubs."

So, what's the solution?

Hayes suggested having fewer, longer international breaks to reduce the amount of travel and disruption to players' training and recovery schedule.

Eidevall meanwhile has previously given players time away from football for the benefit of their freshness, even when Arsenal have fixtures. Caitlin Foord, Steph Catley and Lydia Williams all had a break after the 2022 Asian Cup in February instead of returning immediately to north London, while Vivianne Miedema was recently granted a leave of absence to rest and recover. The Arsenal boss suggested this kind of break should be introduced across the game.

"My idea was to have protected periods for the players with no club football and no international football for a period," said Eidevall. "At the moment there are players who get barely any vacation and it’s consecutive, year after year after year. It’s great if we’re going to have more competitive games but let’s have a calendar that allows players to recover so we can keep the quality too."