Elite women’s football: Evolution and challenges for the years ahead

The first recorded women's football international match happened in Easter Road, Edinburgh in 1881, between the sides of Scotland and England. The women's game has evolved slowly since, though experiencing an important growth with the First World War because most men joined the military and women took their place in factories and also at the pitch.1 A major setback happened in December 1921, when women were banned from playing by the Football Association, in England. Other countries, such as France in 1932 and Germany in 1955 also banned women's football. In most countries, it was still possible for women to play but in some countries, such as Brazil, the ban lasted until 1979.2 The first international FIFA men's World Cup was held in 1930, while the first FIFA World Cup for women took place 61 years later in 1991.3 Since then women's football has experienced a constant growth. This increase in popularity has accelerated in the last decade. The last World Cup in France 2019 was the most watched Women's World Cup ever with more than 993 million viewers, a 30% increase from the 2015 edition in Canada.4 The increase in popularity has attracted more scientists into the field.5, 6 Indeed, the number of studies on women's football has grown from 20 in 2000 to 400 in 2020 of which about 10% focus on elite women's football.5 The aim of this editorial was to discuss challenges that women's football may face in the short and the longer term. The realization of such challenges will allow practitioners and scientists to work more effectively in finding solutions to overcome them. To fulfill the aim above, we adopted an integrated performance health management and coaching model.7 According to this model, all stakeholders (eg, players, coaches, sports science and medicine staff, and club management) can have a say in the decision-making with regards to sports science- and medicine-related issues. Though, in the current editorial, we provided a shared opinion of several sports scientists, a top-class woman football player, an experienced elite women's football coach, and a team physician working in elite women's football. Our methodology included the following steps: (1) idea conception: The initial idea was discussed between two senior sports scientists; they developed the first draft and invited other stakeholders to contribute; (2) stakeholders contribution: This was on a voluntary basis, and colleagues commented on the first draft and either rejected the idea(s) or accepted and added their comments; and (3) document finalization: Following a number of emails exchange and amendments, the final draft was approved by all co-authors; authors were free to add or delete comments at any stage during the process. In this editorial, we have captured some of the concerns with regards to the women's football development from the sports science and sports medicine perspective. We have attempted to be as inclusive as possible, by including opinions from different stakeholders. One of the strengths of our approach is that we have involved an active elite player and a coach in addition to sports science and medicine experts. The bottom line is that there is a large knowledge gap in evidence-based practice in women's football. An increase in research output, based on players’ and coaches’ needs-driven questions, is vital. A collaborative atmosphere between stakeholders (eg, players, coaches, clubs’ management, federations, researchers, sports science, and medicine staff) is key for the creation and dissemination of knowledge for the benefit of the game and player's health. The authors have no competing interest to declare.