In the space of just seven weeks, or 58 days if you prefer, seven Premier League players have torn the anterior cruciate ligament (ACL) in their knee. It’s an injury that, at best, can leave the individual on the treatment for six months or more; at its worst, a torn ACL can end careers.
Lisandro Martínez was the seventh victim of the year of the ACL curse in February – a staggering body count at such an early stage of 2025, mirroring that of the women’s game, where a staggering 37 players missed out on the World Cup in 2023 due to being sidelined with their knee injury.
It’s also the tenth ACL injury of the 2024/25 Premier League season to date; with more than a dozen game weeks of the campaign left at the time of writing, it’s likely that the ‘record’ of 12 in a single term will be broken. One respected knee surgeon who Pep Guardiola personally uses at Manchester City, Dr. Ramon Cugat, has claimed that there’s two primary reasons for the stark increase in ACL injuries: players having to sprint more – and most pertinently play more – with each passing season.
With the schedule getting even more cramped with the expansion of the Champions League and the Club World Cup, as well as pre-season tour demands, it’s likely that the situation will continue to worsen.
Hoy, después de haber transitado varios días tormentosos en donde me permiti sentir y aceptar mi tristeza, la impotencia, inseguridades, miedos y un gran desequilibrio emocional, vuelvo a conectar con mi esencia y mis valores que me ayudan a ver las cosas desde un lugar más… pic.twitter.com/mi44uio5p2
— Lisandro Martinez (@LisandrMartinez) February 15, 2025
High Intensity, Low Recovery
Doing more – harder and faster – without the adequate amount of recovery time for the body can take its toll. It is a disaster waiting to happen. According to Dr. Cugat, higher intensity games and inadequate recovery time are the root cause of the current ACL endemic. In his opinion, players aren’t getting the downtime that will help their bodies recover from micro-injuries that can, in turn, develop into something more serious. He stated:
Soccer is an increasingly athletic sport. The number of accelerations, decelerations, jumps and contacts increases with each passing season. This makes the sport more attractive for the fan, but it also implies a greater risk of injury for those who practise it.
Players with a Torn ACL in 2025 (So Far)
That risk has been well evidenced in the Premier League in the first seven weeks of the year. Martínez, Gabriel Jesus, Radu Dragusin, Wes Burns, Orel Mangala, Chadi Riad and Eres Unal are the unfortunate septet to have suffered an ACL injury in 2025 already, with each set to miss the rest of the campaign. Ballon d’Or winner, Rodri, Leicester City winger, Abdul Fatawu, and Wolves defender, Yerson Mosquera, had also injured their ACLs in the period between August-December 2024.
For the seven that have suffered their injury since the start of the year, it will come as no surprise that increased workload is seemingly directly correlated to ACL damage. December and January are historically the busiest periods of the English football season. For context, between December 4 and January 4, Arsenal played nine games – one every 3.5 days, for four weeks solid.
Most Common Causes of a Torn ACL
Just some of the most common causes of a torn ACL include stopping/starting suddenly, extreme changes of direction, landing awkwardly from a jump and contact from a tackle. In each of these cases, softened joints – made weaker by playing too many games in a short space of time – are made more vulnerable. It’s interesting to compare the strife Premier League players are suffering with that of the German Bundesliga, where they get to enjoy a winter break from playing.
At the time of writing, only two players in the competition had suffered ACL injuries: Grischa Promel, who was injured before Christmas, and Jeanuel Belocian, the Bayer Leverkusen defender who, in a tragic yet ironic twist, suffered a tear while playing in a post-winter break friendly in January. It’s only a small sample, of course, but it’s interesting that the knees of German Bundesliga players – post winter break – seem to be in stronger order than those of their EPL counterparts.
What Is an ACL Injury?
It’s difficult to downplay the importance of the anterior cruciate ligament when you consider the function it plays within the knee. The ACL is a tube of tough ligament that connects the patella (the bone of the knee) to the femur (thigh bone) above it, as well as the tibia (shin bone) below it. Therefore, it’s crucial in stabilising the knee joint and the leg as a whole.
If you tear your ACL… well, the problems caused are obvious. Players can be out for as long as a year, while older players may never take to the pitch again. For an individual of any age, an ACL injury can actually prevent them from playing at the same level ever again.
Female Footballers Six Times More Likely to Suffer an ACL Injury
If the situation looked bad in the Premier League, spare a thought for the women’s game. According to research, female footballers are six times more likely to suffer an ACL injury than men, with no exact scientific explanation as to why – some have suggested that the wider hips of women means that their range of motion is different to men, while oestrogen produced during the menstrual cycle is thought to make joints ‘looser’.
Of course, women’s football has embraced professionalism in recent years, which has led to higher standards of play and more intense games, exacerbating a pre-existing problem. Sam Kerr, Beath Mead, Chloe Kelly, Leah Williamson and Vivianne Miedema are just some of the stars of the women’s game to have ruptured their ACL, but thankfully, all have since recovered and returned to their respective first teams.
As Williamson so vividly described the moment she tore her ACL: “It felt like somebody had sliced both sides of my knee and hit a hammer through the middle of it.” It’s an epidemic caused by the modern sickness of always wanting more. More games, more competitions, more effort – unfortunately, there is a very human cost to such footballing gluttony, with some of the world’s best missing the key years of their career. And, we’re all suffering because of it.
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