Pressing, pressure and re-aggressing as tactical movement of anterior cruciate ligament injuries in women's soccer.

Introduction: A better understanding of anterior cruciate ligament (ACL) injury mechanisms in female soccer can guide better research on both prevention programs and late-stage rehabilitation for the return-to-sport process. This narrative review investigates the technical and tactical game situations in female soccer linked to ACL injury mechanisms.

Evidence acquisition: Through a literature search, we reviewed scientific literature to identify soccer-specific technical movements and tactical patterns that increase the risk of ACL injuries in female players. Articles were retrieved through Web of Science, SPORTDiscus, ScienceDirect, PubMed, and PubMed Central. Inclusion criteria were: 1) studies on ACL injury mechanisms in women's soccer; 2) studies examining soccer techniques/tactics to identify non-contact injury mechanisms. Gray literature was included to supplement limited indexed data, aiming to stay within author guidelines.

Evidence synthesis: Female athletes experience a 2-8 times higher risk of ACL injury than males, with 70% of these injuries being non-contact. Common scenarios leading to these injuries involve ball possession/non-possession phases, tactical actions (pressing, pressure, re-aggression), and technical movements (cutting, changing direction). Tactical aspects, particularly pressing and re-aggression, are key contributors to ACL injury risk regardless of ball possession.

Conclusions: In female soccer, ACL injuries are related to non-contact injury mechanisms during technical and tactical situations. The knowledge and study of these situational patterns of play, such as pressing, re-aggression, pressure, and cutting maneuvers, are essential to target prevention strategies and return-to-sport processes objectively.