Even before the 2026 FIFA World Cup has kicked off, the absence of several key players has once again thrust anterior cruciate ligament (ACL) injuries into the spotlight. From Rodrygo and Xavi Simons to Takumi Minamino and Jerdy Schouten, the tournament has been deprived of some of its most eagerly anticipated talents.
Research shows that the risk of sustaining an ACL injury is around twenty times higher during matches than in training. The ligament is most likely to rupture during phases of maximum intensity, with injuries occurring more frequently in the first half.
Contrary to popular belief, direct contact is not the main cause of these injuries. In fact, nearly nine out of ten ACL tears occur without any direct blow to the knee or following only indirect contact. High-intensity pressing, sudden changes of direction, rapid decelerations, and loss of balance are among the situations that pose the greatest risk.
Neuromuscular and cognitive control also play a crucial role in managing sudden movements. As a result, injury prevention is increasingly focused on training movement mechanics and enhancing motor control.
Following surgery, 92% of professional footballers return to competitive action, but not all regain their previous level of performance. In fact, only 80% manage to recover the form they had before the injury.
Three years after an ACL rupture, just 65% of players are still competing at the highest level.
Returning to play should therefore be guided by functional criteria rather than by the passage of time alone.
The 2026 FIFA World Cup will also tell the story of this invisible battle: the one between recovery, injury prevention, and the pursuit of peak performance.
These issues were discussed by Dr. Marco Gastaldo of Isokinetic Turin in an article published in La Gazzetta dello Sport.
