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OBJECTIVES: This study aimed to analyse the mechanisms, injury patterns, biomechanics and neurocognitive factors of anterior cruciate ligament tears in professional female Spanish football players during training and competitive matches. DESIGN: Systematic video-analysis observational study. METHODS: Four hundred and sixty-one players from 16 teams of the Spanish top division (Liga F) were tracked over three consecutive seasons (2021/2022 to 2023/2024). Videos of any confirmed (via magnetic resonance imaging) anterior cruciate ligament tear occurring during training and matches were obtained from the teams and/or TV broadcasting. Three observers independently analysed each video. RESULTS: Thirty-nine anterior cruciate ligament tears were confirmed, and thirty anterior cruciate ligament tears were finally included in the video analysis (matches: 25 injuries; training: 5 injuries). No significant differences were observed for mechanisms and injury patterns during training and matches. Five injuries (13 %) were direct contact, 19 (49 %) indirect contact and 15 (38 %) non-contact. Three main injury patterns accounted for 83 % of injuries: 1) pressing/tackling (42 %); 2) being tackled (26 %) and 3) dribbling (15 %). Two specific tasks were identified accounting for mostly training injuries: small-sided games (56 %) and ball possession games (22 %). Ninety-two per cent of non-contact anterior cruciate ligament tears involved motor-response or attentional inhibition errors. CONCLUSIONS: Training and match anterior cruciate ligament tears occurred under similar conditions, predominantly occurring without direct contact, particularly during pressing/tackling, being tackled and dribbling. Small-sided games may represent training activities with a higher risk of anterior cruciate ligament tear.
Miralles‐Iborra et al. (2025) studied this question.