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Coventry University research finds lack of basic movement skills leaves girls at higher risk of ACL injuries than boys
Coventry University research shows rate of children suffering ACL injuries is increasing
University news / Research news
Thursday 30 October 2025
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Children who fail to master basic physical skills such as running, jumping and hopping at a young age are at higher risk of severe knee injuries as they get older.
The rate at which children are suffering anterior cruciate ligament (ACL) injuries has increased significantly over the past two decades - with girls more likely to suffer the injury which then requires surgery.
This pattern continues as females get older, with those involved in sport - particularly football - suffering ACL injuries at a higher rate than their male counterparts.
High-profile ACL injuries in the women’s game include that of England captain Leah Williamson who missed the World Cup in 2023 and Arsenal striker Beth Mead who was sidelined for nearly a year. England penalty hero Chloe Kelly also suffered an ACL and was out for 11 months in 2021.
Research from Coventry University has now shown that children with a ‘poor’ rating for functional movement skill (FMS) are significantly more likely to be at risk of ACL injuries. FMS includes the likes of running, hopping, jumping, skipping, throwing and kicking.
The study of 105 children aged 13 to 16 who played grassroots football revealed that those who had poor FMS were significantly more likely to have poor drop landing mechanics – the ability to land in the best way to absorb shock in the knees when running or jumping - with this being more pronounced in girls compared to boys.
It has consistently been shown that British children are not mastering their functional movement skills which they should be able to do well by the end of Key Stage 1.
This means they are not competent in the basic skills and then when being asked to do football focused training with more complicated movements, they can struggle to do them.
We are seeing more children needing surgery for ACL injuries and the earlier in life that happens you are more likely to have arthritis when older so there is a knock-on effect.
Professor Mike Duncan, Director of the Research Centre for Physical Activity, Sport and Exercise Sciences
Professor Duncan believes that targeted intervention and programmes to improve functional movement in children can help them potentially avoid injuries in the future.
The link between FMS and injury risk is much stronger in girls. People think PE will sort it out but PE in many primary schools is taken by the class teacher who isn’t specifically trainedin primary PE, and they are also squeezed by time constraints, while grassroots sports coaches aren’t generally trained in embedding FMS into their sessions.
Hormones also play a part as females get older – their hips grow wider than boys and so the force on their knees is different. Therefore, FMS when younger is even more important for girls than boys as when we are better at FMS, our brains are better at adapting to situations where we might need to unexpectedly land a certain way when running or jumping, which then helps reduce the risk of injury.
Professor Duncan
Find out more about the Research Centre for Physical Activity, Sport and Exercise Sciences.
