UEFA Female Expert Health Panel trio discuss key work going on behind the scenes
With ACLs dominating the women's game now, the three doctors who make up the UEFA FEHP speak exclusively WFC about the level of research going into studying injuries in the women's game...
Now more than ever, women’s specific research is at the front of many minds as the women’s game continues to move forward both on and off the pitch.
With an alarming rate of serious injuries, such as ACLs, in the past couple of years, research off the pitch is being fast-forwarded with current information available related to various anomalies in the women’s game far behind that of the men’s game.
To help with this, UEFA set up a dedicated Female Expert Health Panel at the start of 2022, comprised of three experienced female doctors. Eva Ferrer, who between 2018 and 2022 served as club doctor for Barcelona’s women’s team and also works at the Hospital Sant Joan de Deu in the city of Barcelona, is one of them, along with Elke van den Steen who has been Belgium Red Flames doctor since 2008, having started with the Belgian FA in 2005, and she too also works at a hospital in Bruges.
Rita Tomás has been team physician for Portugal’s women’s team and youth teams since 2011, and like her two counterparts again works at a hospital outside of football, the CUF Descobertas hospital in Lisbon.
“It’s something you cannot ignore anymore, there is a growing interest in doing more research…”
All have their various areas of expertise. Ferrer specialises in return to play after giving birth, Van den Steen in ACL injuries and Tomás in menstrual cycles, three current critical topics in the women’s game, and ones which will continue to grow as the game further professionalises.
“We presume we play the same sport, but we are not the same,” says Van den Steen, getting straight to the crux of one of the key misconceptions when it comes to identifying medical issues in the women’s game.
“I became more interested in the specific area of female players, especially the ACLs, but also things like concussions and it triggered me to find out which injuries are quite different between men and women and why those differences exist.”
It was four years when Van den Steen initially joined the UEFA Medical Committee for their medical symposium, held every four years, and first met Zoran Bahtijareviĉ, the Chief Medical Officer of UEFA, and Tim Meyer, Chairman of the Committee.
“We had the idea to do more for female football because it was on the rise and there was not a lot of information,” says the Red Flames doctor. “Last year, we launched the panel to deal with specific issues in the female game, now we target subjects specific to the female game and female footballers. Before that, there was not much attention on things like the menstrual cycle, now there is a lot more talk.”
She adds, “Rita and I started working together with Jan Ekstrand [UEFA Elite Club Injury Study senior expert] because the Elite Club Injury Study has existed for 20 years in the men’s game. They follow professional teams at the highest level, which injuries they get, how long they are out, so we have more information now because we have started doing that for the women [the first issue is yet to be released]. We gather information about every injury, like now we know the hamstring injury is the most prevalent, so that’s always under surveillance now.”
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Tomás, like Van den Steen, recalls meeting Ekstrand six years ago and first put forward the idea of replicating the study in the women’s game, but didn’t truly get involved with UEFA until 2019 when she was appointed Chief Medical Officer of the first UEFA Nations League finals held in Porto, close to where she is based.
“I said ‘why not do this in women’s football?’” Tomas recalls. “We didn’t have a comparison of elite men’s and women’s clubs, but he was very excited about it and he asked someone he worked with who was a former player to convince UEFA to run a women’s study.
“We did a bit of a campaign to clubs to report incidents in training sessions and games so we could run all the same data in a study like the men have for 20 years, and that’s how I met Elke and Eva. Eva was a team doctor at Barcelona who joined the pilot and Elke worked on recruiting clubs.”
Tomás says the results of the first ever women’s-only study will be released soon in the British Journal of Sports Medicine.
“In February, we had our medical symposium in Frankfurt at the German DFB HQ. There were three key topics, one I delivered on menstrual cycles and training adaptions, and Eva spoke about playing after pregnancy,” she recalls. “Since then, UEFA started to ask us to develop work and research on the hottest topics and we are excited these topics are now being discussed in the right forums and with all the relevant FA doctors, they are paying a lot more attention to the growth of women’s football.
“It’s something you cannot ignore anymore, there is a growing interest in doing more research. It’s an area with a lot more questions than answers, if I’m honest. It’s a big work in progress.”
Ferrer doesn’t work directly with the Barcelona women’s team anymore, instead working behind the scenes for the Barcelona Innovation Hub as a Female Health Specialist, and she too admits in the early stages of such research they are only beginning to scratch the surface of key issues within the women’s game on the medical side.
“Not only in the medical area, but in everything,” she says. “It’s not we are better than worse, we are different. You are different to me, we have different individual needs and that has to be taken into account. You have to also have that in mind in academies now.
“We’re talking about elite level and professionals, but it has to start when they are kids. If you don’t have that female-specific approach, it’s difficult to get on that pathway once they’re grown up, and that is part of what we are seeing now. When the girls are young, they need to have those individual plans related to their gender which will help them when they grow up. Education from the academy level is the basics.”
Van den Steen adds, echoing Ferrer’s sentiments “Girls who are playing now didn’t have the same education, access to the same pitches, medical facilities growing up, so there’s a good chance there’s a social aspect to it in terms of growing up from their youth.
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