Leah Williamson on ACL epidemic: ‘Football’s schedule is unsustainable’

Exclusive: As the Arsenal and England star nears her comeback from injury, she issues a stark warning for the game

Dark humour has always been a go-to for Leah Williamson and her mother. So as she sat in the away changing room at Leigh Sports Village after her early substitution in Arsenal’s match at Manchester United last year, it was natural for Amanda to quip: “Six hours in the car for 12 minutes.” On the night of April 19, 2023, though, nothing anybody said could make her daughter laugh.
“I looked at her as if to say, ‘I think this is a really bad one. Mum, I really need you to prepare for what’s coming: I’ve done my ACL’,” the Arsenal centre-back recalls. “It felt like somebody had sliced both sides of my knee and hit a hammer through the middle of it.”
As soon as she had caught her knee innocuously and hit the turf, Williamson realised it was serious. Speaking exclusively to Telegraph Women’s Sport to discuss her past nine months in detail for the first time, the 26-year-old says: “Instantly I knew, that was my World Cup, gone, bang. It went deadly silent and I remember a fan shouting in the stands, ‘Get up’, and I remember thinking, ‘If I could get up, I’d come straight for you, because this is serious and this is a really emotional moment’.
“The physios came in [at half-time] and said, ‘We’re looking at an ACL’, then everyone went back out on to the pitch, and from that moment, I was in pieces. I just cried. That journey back home was horrendous. I was thinking, ‘I don’t have the energy for this. I’m so tired already’. So much had been taken from me in that year, it felt like it was just a take, take, take. But the irony is, after not the best year for me personally in life, that month beforehand was probably the best football I’d played in a long time and I was having so much fun. Then that happens.”
Williamson, who captained her country to glory at the 2022 European Championship nine months before the injury, feels the ongoing “epidemic” of anterior cruciate ligament ruptures in the sport is symptomatic of the lack of a meaningful off-season. Speaking about her rehabilitation at Arsenal’s training ground, there is a smile on her face as she recalls moments like her mother’s joke, but once she starts speaking about the global calendar, her exasperation is abundantly clear.
“Sorry, the tone of the room just changed, but it really does my head in,” she says. “We’re not bred for this. Nowadays we get to October and girls are saying, ‘I’m tired’ because you’re carrying so much from the previous season.
“Ultimately, I think the way you’re taking women’s football right now, you won’t be able to increase the ticket prices or get bigger crowds in the stadiums because you won’t have players to watch. We are driving ourselves into the ground with it, so some sort of solution needs to be found soon, in terms of the schedule, otherwise it’s not sustainable.”
A total of 37 players missed last summer’s Women’s World Cup because of ACL injuries alone and the issue is showing no signs of going away. This month, Chelsea and Australia striker Sam Kerr suffered the same injury. Williamson says the news is crushing every time she hears it.
“It rocks you. We’re devastated for her [Kerr]. There was silence on our bus, because we know what that means,” Arsenal’s vice-captain says.
“I don’t want football to get to a point in 10 years’ time where actually it’s a squad of 40 players and it’s bit like NFL [which allows unlimited substitutions], or you have a first-half team and a second-half team, because we’re having to rotate because no player can sustain that all year round.
“Everything is done the wrong way round, when we do the schedule. I’ve been in some of these meetings now and listened to the process and I still don’t understand how, when something is bad, why it’s not taken so seriously. It’s black and white – it’s not the only cause of all these injuries but it’s 100 per cent one of the main reasons.
“When they, Fifa, Uefa, all the main people, do the scheduling, it should always be, ‘Rest first’. [They should say], ‘as a professional athlete, to be able to perform all year round, you have to have four weeks off at the end of the season and six weeks pre-season, to be at no detriment to your health’. But at the end of the World Cup, some of the girls came back and had five days off. Five days, after getting to the final.
“Put in time when neither club nor country can touch a player, and just let them have a rest. But instead what we do is say, ‘You need to play this, this, this’ and then say, ‘I’ll give you two days off in between’. It’s impossible. It’s unsustainable.”
This summer, there are international windows immediately after the Women’s Champions League final on May 25, before another in July, and then the Olympic football tournament, which begins on July 25, with some national teams facing a third consecutive summer tournament. England’s players will not be involved, their attempt to qualify on behalf of Team GB having come to an end in December. Naturally, Williamson says she was “upset” for her team-mates that they missed out, but another thought came into her mind.
“It’s horrendous that one of the first things that popped into my head about the Olympics was, ‘At least they’ll probably all get another two or three years on their career now, because they’ll get a summer off, everyone needs a rest and now they’ll get one’. How horrendous is that? And then I find out that you don’t actually get a rest because we have a camp anyway [in July]. I just think it’s ludicrous. And it happens in men’s football, too.”
It is because of the high number of ACL ruptures in the sport that, when posting a statement on Instagram in the days after her initial scan, Williamson said she felt it was simply “my time” to suffer the injury. She also asked for “time and space” to deal with it. But perhaps what she did not say gave more of an insight into her frame of mind.
“I’m a glass-half-empty person so I never put in my statement, ‘I’m going to come back better than ever’ because I didn’t know if I’d make it back. It’s not a given,” she says.
However, a strong sense of perspective soon became prominent in Williamson’s mind, as she compartmentalised the separate parts of her life. In her “football life” she was crestfallen – “I missed the World Cup, which makes this the f—— worst time of my whole life to have ever done this, because of the chances of us winning and the momentum we had” – but in her “real, real life” she seems to have found peace.
Having taken inspiration from paintings by mouth artist Henry Fraser, an Arsenal fan who was left paralysed from the shoulders down after an accident in 2009, and from the resilience displayed by former rugby league player Rob Burrow in his fight against motor neurone disease, Williamson does not want pity. “What happened to me isn’t the end of the world,” she says. “If I’m going to sit and think, ‘This is the worst thing that can happen to me’, then every moral standard that I try and live to can’t be true. My team-mate [Jen Beattie] had breast cancer. Those things are not the same, you can’t compare the two.”
That attitude was reinforced by a trip Williamson made to the Zaatari refugee camp, the world’s largest Syrian refugee camp, in Jordan in late August. The Arsenal Foundation and Save the Children joint-programme Coaching for Life has engaged more than 4,300 children so far and she flew there after visiting her brother, who was living in Australia, during the World Cup.
“In the time leading up to my ACL I didn’t even have time to breathe, let alone do anything like this. Then as soon as I did my ACL, I said, ‘Once I get the all-clear, let’s do it’. Going to Jordan was the best thing I’ve done in the past nine months. The work that Arsenal are doing there is just incredible. The girls there are asking me how my knee is and I’m asking them how they’re coping with the fact they’re all scared of being married off in their teenage years and not being able to play football anymore. I got so much out of that trip.
“When I finish my career I don’t want to look back and think, ‘Who am I?’ so I give my time to all of those different things. Obviously I’d love football to always be the thing I’m known for, but also I want people to remember me as someone who hopefully used my platform for change.
“Existential questions consume my mind, ‘Why am I here?’ and when I’m 125 laying on my deathbed, what am I going to talk about with people? I do think football will be up there, but I want to have other things to talk about, too. It matters that I live my life in a way that I think has served the purpose of being alive, which is to leave it [society] in a better place than you came, don’t do any harm and also have fun.”
Perhaps it is because she has witnessed first-hand some of the realities of life for refugees that Williamson says she “did not want pity” over her ACL injury. But that approach also speaks to her own personality. She admits that the rehabilitation was daunting – “I hadn’t known if I’d wanted to do it, I’d heard so much about this injury and the stigma around it” – but is also proud of how focused she has been during her recovery.
“I’ve never worked this hard in my life, the levels I’ve pushed my body to, I’ve grafted. I just had to get my head down and get through it, there was no negotiation.
“A massive part of it for me is, I’m single, I live on my own, and this is the first time that I’ve been injured while being on my own at my own flat, which makes me so proud of myself because I’m the one who wakes myself up in the morning and who decides I’m going to go to bed at this time and to be ready for training the next morning. It was all my own decisions.”
Williamson is now at the “top of the climb” on her rehabilitation journey, having learnt to walk and then run again, but even before she had surgery, she was already on another journey, mentally.
“I have continued to work with a psychologist the whole way through,” she says. “We had quite an emotional session a couple of months ago because I was so proud of myself. I almost grieved the person I used to be, because I’m different now, for the right reasons. I didn’t know I had this in me, before the start of this journey. I’d been injured so much in my career that I always said, if this [ACL] happened, I didn’t know if I’d be able to do it.
“This is the first time I’ve been comfortable not really knowing what’s coming next, because all I’ve had to focus on is my return, my own little bubble, and it’s all up to me. It made me grow up a lot. I think it was a journey I was on anyway, but when I think about habits I used to have and decisions that would really detriment me, nowadays everything I do has a reason, otherwise that’s what sends me on a dive, mentally, because then I start to lose my way. Last season was so s— for me, with two injuries, so now it’s nice to feel in a good place. This year has been very wholesome.”
Williamson is back training with her team-mates, and while it is too early to put a fixed date on when she will play competitively, that prospect is one she is “giddy” about. Since her injury, Arsenal have twice played in front of a sold-out Emirates and Williamson is yearning to experience it herself, perhaps when Arsenal host Manchester United and Tottenham Hotspur there, in February and March respectively.
“I’m intrigued to see what I do feel like, because I’ve walked out at Wembley in front of a full crowd but I’ve never walked out at the Emirates with a full crowd. And I cried at 35,000 [fans]. I’ve got this kid-like feeling again.
“I don’t know what place I’d be in, with football now, if I hadn’t done it [the ACL], in terms of the direction that all of us are on, which is this downward trajectory of fatigue and pressure. So I’m grateful for the reset. I’ll never, ever be grateful that I did it, but it’s a good thing that’s come out of it. I’m giddy at the minute, which isn’t really like me, I’m a boring b—— most of the time. But now I’m excited and there are good things ahead.”