Female Sports Physiotherapy

Why female athletes need a different lens

Female athletes are two to eight times more likely than men to tear an anterior cruciate ligament in comparable sports, depending on the sport and the study. Bone stress injuries are closely tied to under-fuelling, which is more common in women. Leaking during impact affects a surprising number of athletes who've never had children. The menstrual cycle, iron levels and returning to sport after pregnancy all come into play too.

None of this means women are fragile. It means the program should be built around the risks that actually apply.

ACL rehabilitation and prevention

Most ACL tears happen without contact: landing from a jump, cutting or stopping suddenly with the knee collapsing inward. Weak hips, a quadriceps-dominant landing and poor trunk control all contribute, and all of them can be trained. Structured neuromuscular warm-ups such as FIFA 11+ have been shown to reduce knee injuries substantially when teams do them consistently.

If you've already torn your ACL, our ACL tear page and ACL rehabilitation exercises explain the stages. Return to sport after reconstruction usually takes at least nine months and should depend on passing strength and hop tests, not just on time.

Running injuries

Shin pain, plantar fasciitis, patellar tendon pain, pain around the kneecap and the outside of the hip are the common ones. Most come down to load: too much, too soon, or not enough recovery. A running assessment looks at your training history, strength, and how you run, including cadence, and gives you a plan to change the right thing rather than everything at once.

Energy, periods and bone

A missed period while training hard is a warning sign, not a sign of fitness. It often means the body isn't getting enough energy to cover both training and normal functions, a condition known as relative energy deficiency in sport (RED-S). It raises the risk of stress fractures and affects bone health for years. If this sounds familiar, we'll talk it through with you and refer you to a doctor, and to our dietitian if helpful.

Leaking during sport

Leaking while running, jumping, skipping or lifting heavy weights is common in female athletes, including young women who've never been pregnant. It's a pressure management problem as much as a strength problem: the pelvic floor has to cope with repeated high loads at speed. Pelvic floor training, breathing strategy and load adjustments usually solve it. See pelvic floor physiotherapy for how we assess it.

Screening, strength and return to sport

Whether you're coming back from injury or trying to stay injury-free, we measure rather than guess: strength on each side, single-leg hop tests, balance, and movement quality. For return to sport after a lower limb injury, we generally aim for the injured side to be within about ten percent of the other. Our limb symmetry index calculator shows how that's worked out. Strength and conditioning then fills the gaps, whether that's more hip strength for a footballer or more calf capacity for a distance runner.

Returning to sport after having a baby follows its own timeline, covered in our postpartum rehabilitation program. For injuries that aren't specific to women, our general sports physiotherapy page has more.

Frequently asked questions