The photograph of Beth Mead and her partner and Arsenal teammate, Vivianne Miedema, on the red carpet before the England forward’s BBC Sports Personality of the Year win, illustrated a problem rocking women’s football. Both were standing there, two of the best female players on the planet, on crutches. Mead ruptured her anterior cruciate ligament (ACL) in her knee in November, before Miedema, the Women’s Super League record goalscorer, did the same this month. Both will probably miss the Women’s World Cup next year in Australia and New Zealand. Their situation is not unique. In the past year a whole host of players have missed significant portions of the season with ACL injuries. Those at the top as well as further down the pyramid have been affected. The double Ballon d’Or winner Alexia Putellas was cruelly ruled out with an ACL injury on the eve of Euro 2022, with Spain the bookies’ favourites to win. France’s Marie-Antoinette Katoto ruptured her ACL during the tournament. Chloe Kelly, Dzsenifer Marozsan, Kyah Simon, Ellie Brazil, Ellie Carpenter, Jessica Ziu, Chantelle Boye-Hlorkah, Simone Magill, Ada Hegerberg, Christen Press and Catarina Macario have all been sidelined by the knee ligament injury in the last year. Research suggests it as injury that women are four to eight times more likely to suffer from than men. There have long been calls for more research to be done on the increased occurrence of ACL injuries in female footballers. This is far from a new issue. There is probably not one answer to the problem, either, with loading, biomechanics, hormonal changes, training opportunities, footwear and pitch quality all potentially having on impact on the increased likelihood of female players suffering ACL injuries. In 2020 the Guardian reported on the four possible neuromuscular imbalances that were being investigated by researchers at the University of Roehampton in London. Some research is being done into the increased likelihood of an ACL injury being suffered by women football players and the preventive measures that can be taken, but it is not enough and it is not being taken sufficiently seriously or tackled quickly enough by the footballing authorities. How quickly would clubs and the governing bodies of the game get to the heart of an injury problem if it was Kylian Mbappé, Lionel Messi and Kevin De Bruyne affected by the same injury within months of each other? Can you imagine if any of those players had suffered the same injury three times in their career, like the two-time World Cup winner Megan Rapinoe has? We would have state-of-the-art research, technology and money pouring in to solve the problem or limit it. There would be a drive to protect the players – not, ultimately, because they deserve protection as people, but because they are assets of huge value commercially. Instead of announcements of mass investment into research around the prevalence of ACL injuries in the women’s game, we have been promised additions to a calendar that is pushing players at the top end of the sport past breaking point. The day after Miedema left the pitch in tears, Fifa revealed plans for the introduction of a women’s Club World Cup and an extension of the current international women’s match calendar to 2025, meaning that the current number of international windows – which is widely viewed to be too many – will remain for two years beyond the current calendar. A Club World Cup is not a bad idea – in fact, it would be a welcome addition – but there needs to be a more holistic and player-centred focus to planning women’s football. Players at the top end who play internationally are in the middle of five years of back-to-back tournaments in June-August without a break. That is hugely problematic. Meanwhile, teams outside Europe struggle for regular fixtures that match the competitive level offered by the Euros and the Women’s Champions League. There is a duality to the problem: some players are playing too much football and some too little, and both scenarios likely affect the chance of injury. It is the same domestically, with teams competing in tournaments such as the Champions League stretched while those without international competition or long cup runs domestically struggle to keep their players physically ready. One part solution to the problem at the top end could be to make the women’s Olympic competition mirror that of the men’s with under-23 teams competing (plus up to three senior players). However, that helps European teams but may hamper the likes of the USA, Canada, Brazil and Japan, who rely on the Olympics to offer a top-level competitive test between World Cups. The recent rejection of the suggestion from a number of international managers to have squad sizes increased from 23 players to 26 players for the World Cup only adds to the impression that little is being done to lift the burden. Now is the time to think differently, to put players at the centre of the future of the women’s game, as well as the men’s. Where is the authenticity and authority of a World Cup if a large number of the world’s best players are missing from it? If the health and welfare of players isn’t enough to prompt serious action, then perhaps the fact it is starting to undermine the product Fifa is trying to sell will do the job.