The harsh reality of ACL injuries outside elite women’s football

For any player, the prospect of an anterior cruciate ligament (ACL) injury is incredibly daunting. The Arsenal winger Beth Mead described her experience as “mentally and physically gruelling,” while the England captain, Leah Williamson, doubted she would return from her own setback.

Suffering an ACL injury means a prolonged period on the sidelines, usually between nine and 12 months. Professional players receive the best treatment to ensure they can return as soon as possible and without financial strain. But that isn’t the case for every player in England, especially female footballers playing outside the Women’s Super League and Championship. The Hashtag United winger Emma Samways, who plays in the third tier of English football, ruptured her ACL during a National League Cup semi-final against Halifax. It was an incident that put her life on pause.

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Having completed the five-hour coach trip from Essex to west Yorkshire, staying overnight at a nearby hotel, Samways and her teammates arrived at the Clayborn Ground to discover the pitch was almost unplayable. Within two minutes, Hashtag found themselves 1-0 up, but for Samways disaster struck in the second half. “I stood flat-footed and my boot got stuck in the mud with the ball coming towards me,” she says. “So I tried to flick it and as I twisted outwards I could hear a pop. I felt pain but I also just thought I could run it off, that it might be a twisted knee or a slight impact injury. Then every time I was blocking the ball my knee was all over the place.” Fear of an ACL injury didn’t cross Samways’ mind at first, but after a few minutes the winger knew something wasn’t right.

“As soon as I came off, the physio was doing all the tests with me and I was fine,” she says. “I was performing, I could move, I could squat, there were no issues, I wasn’t even in pain. Then as I walked off I was limping a bit but I didn’t really think it was that bad. Usually people go down screaming.”

While this was happening, just over 100 miles away, Newcastle United - who Hashtag would go on to face in the final - were hosting Portsmouth at St James’ Park. Over 22,300 fans watched the Magpies defeat Pompey on a pitch many would liken to a carpet - a stark contrast to the surface Samways and her teammates were playing on.

Despite the conditions Hashtag won 2-0 and secured a spot in the final. However, in the days that followed, Samways was told to fear the worst. The 24-year-old soon received the news she was dreading.

Unlike any professional, Samways relies on a job outside of football for income. Working as a police officer she has a proactive and physically demanding role, and after finding out that she had suffered a high-grade ACL tear, she was forced to take a step back. “It really was quite a bad situation to happen,” says Samways. “I don’t think it would’ve been as bad if I was in an office-based role. But now not being able to go out and seeing all my colleagues going out … yeah, it’s not fun.

“Time goes so quickly when you’re with your colleagues and you’re doing work and helping people and suddenly you’re stuck in the office, it’s a long nine-hour shift then,” Samways admits. “I’m feeling a bit useless at times. I feel like I can’t really do anything to fulfil my role and it’s not very motivating going to work every morning.”

Not only did Samways have her job to worry about she also had to find a way of funding ACL reconstruction surgery. As Hashtag United is not a professional club the operation had to be self-funded. The NHS waiting list, approximately 12 to 18 months, was deemed too long given Samways’ desperation to return to the pitch and her normal job. The only option was to go private, but that came at considerable cost. Samways was left stunned after being handed the £9,200 bill, especially when a 15-minute consultation alone cost £250.

Samways’ parents offered to foot the bill but she refused. “They’ve worked their whole life and they’ll probably retire in the next five years so I wanted them to use that money to treat themselves,” she says. “I was really grateful but I thought I’d look at other ways.”

Samways opted to set up a fundraising page instead, which raised over £5,000 in a month. Some members of the club gave money to the fund while donations arrived from as far away as Colombia. It exemplifies the global profile of Hashtag, a club created on social media. The Tags have a bigger following than some Championship sides and, managed by Jason Stephens, produced an outstanding display to defeat fully-professional Newcastle United in the FA Women’s National League Cup final last month at Kenilworth Road.

Touching on the differences between her side and Newcastle, Samways says: “Even in the semi-final they had 26,000 fans at St James’ Park and we had about 200. Obviously they’re getting a wage and in our team we have so many frontline workers, we have a mum and just loads of people who are just trying to make enough money to pay the bills alongside playing football. It’s a very different lifestyle. It’s not jealousy; it’s amazing they’re doing it, but it’s just the difference. It’s amazing how we, out of 72 teams, made it to the final two and beat them. I don’t think anyone would’ve expected it.”

As for Samways’ own journey, she hopes to be back running by September and on the pitch before Christmas. “I’ve got this year to smash recovery and do everything the physios tell me to do. I’m prepared to do that,” she says. “It’ll be difficult with work but that’s the plan.”

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