Here’s a startling revelation: even athletes at the peak of their physical condition aren’t immune to the early onset of osteoarthritis (OA). But here’s where it gets controversial—new research suggests that professional women’s footballers, despite their youth and fitness, are showing signs of this degenerative joint condition far sooner than expected. And this is the part most people miss: it’s not just the knees that are at risk; ankles may be the real silent sufferers in the world of women’s football.
A groundbreaking sub-study from the Drake Football Study, published in the South African Journal of Sports Medicine (2025), has uncovered alarming insights into the health of 74 professional women’s footballers across Europe and Africa. Led by Dr. D.A. Ramagole, this research is the first to clinically assess OA in active female players, revealing that the condition can quietly take root during their careers—not just after retirement.
Osteoarthritis: More Than Just Wear and Tear
OA is often associated with aging, but this study challenges that notion. It’s a condition where the cartilage cushioning joints wears down, causing bones to rub against each other. What’s surprising is how early it’s appearing in these athletes. Despite their average age of just 25, clinical OA was detected in several players:
- Hip OA: 2.7%
- Knee OA: 5.0%
- Ankle OA: 8.0%
The Ankle: Football’s Overlooked Weak Link?
While knees have long been the focus of football-related injuries, the study found that ankles were the most affected joint. Prof Dr Vincent Gouttebarge, FIFPRO’s Medical Director and a former professional footballer, notes, ‘The ankle emerged as the most affected joint, suggesting it may be a weak link in women’s football biomechanics.’ This raises a critical question: Are we doing enough to protect players’ ankles?
The Role of Injuries and Surgeries
The study also confirms a troubling link between knee injuries, surgeries, and OA. Players who underwent knee surgery were nine times more likely to develop OA compared to those who didn’t. ‘The knee remains the most vulnerable joint for long-term health, especially after ligament or meniscus damage,’ explains Prof Dr Gouttebarge. But here’s the kicker: pain often appears long before scans reveal joint damage, meaning OA can silently progress during an athlete’s career.
Why Ankles Deserve More Attention
Ankle OA was significantly tied to pain and reduced function, hinting that repeated sprains, contact injuries, and overuse could lead to early degenerative changes. This is the first study to highlight ankle OA in active women footballers, signaling an urgent need for better injury prevention, rehabilitation, and load management.
What’s Next?
The research team plans a 10-year follow-up to track how these early signs evolve, aiming to fill gaps in women’s sports medicine. Launched in 2019, the Drake Football Study tracks the physical and mental health of around 170 men’s and women’s footballers, from their playing days into retirement. Recent publications have also explored knee and hip OA in men’s players, mental health in women’s football, and gynecological health issues.
A Call to Action
Early detection is key to protecting players’ health before OA becomes career-limiting. ‘Pain is the earliest sign and should never be ignored as just part of the game,’ warns Prof Dr Gouttebarge. Injury prevention must be a cornerstone of training, not an afterthought.
Controversial Question: Are We Prioritizing the Right Joints in Women’s Football?
While knees have historically dominated injury prevention strategies, this study suggests ankles may need equal, if not more, attention. What do you think? Should football medicine shift its focus to protect players’ ankles as much as their knees? Share your thoughts in the comments—let’s spark a conversation that could change the game.
