Hindsight: The Black Stars ACL pandemic; separating facts from fiction

On Monday morning, news broke about Ernest Nuamah's ACL injury. Get French Football News reported that the Olympique Lyonnais winger will be out for four months.

Nuamah injured himself in the fifth minute during a duel with Lille's Gabriel Gudmundsson. He had to leave the game just two minutes later.

This injury effectively ends his season. Nuamah has been crucial for Lyon, scoring three goals and assisting another in league play. He has similar stats in nine UEFA Europa League appearances.

Abdul Fatawu Issahaku was the first Ghanaian player diagnosed with an ACL injury. This happened during Ghana’s 1-1 draw with Angola in November 2024.

In that same month, Stade Rennes right back Alidu Seidu also ruptured his ACL against LOSC Lille. This injury came right after he was named Renne’s Player of the Month for September.

In March this year, Abdul Mumin became the third Black Star to suffer an ACL injury. He got hurt while playing for Rayo Vallecano against Sevilla and left the match in the 35th minute.

Before his injury, Mumin had played 24 times out of 26 matches last season. Now, Nuamah joins other Black Stars players who have suffered similar injuries.

There is concern over why so many Ghanaian players are getting ACL injuries lately—four in just four months. Is it bad luck or something more?

The pitches where these injuries occurred were generally well-maintained. Alidu Seidu's injury happened on a comfortable pitch at Decathlon Arena – Stade Pierre-Mauroy.

Finding a medically proven reason for these ligament injuries is challenging. Each case is different from the others.

Of the four players injured, only Fatawu's incident happened while on national duty. The others occurred on good pitches in Europe’s top leagues—twice in Ligue 1 and once in La Liga.

Some suggest fixture overload might be a factor, but this argument lacks merit. Elite European clubs play up to 50 matches per season without major issues.

Last season, Abdul Mumin played only 22 matches across all competitions—20 La Liga games and two Copa Del Rey matches.

If tight scheduling during international breaks caused his injury, it would be misleading since he did not play for Ghana last season.

Mumin featured for Ghana against Angola on September 5, 2024, and again four days later against Niger. The maximum interval between international games is typically four days.

Mumin’s injury occurred three weeks before Ghana faced Chad and Madagascar. Similarly, Nuamah's injury happened two weeks after an international break.

Last season, he made a total of 39 appearances—a normal amount for a player in France's league system. His peers often make ten more appearances due to continental responsibilities.

In fact, nine of Nuamah's current season appearances have come from Europa League matches alone. Teammates Issahaku (43 last season) and Seidu (29 last season) also had significant playing time before their injuries.

The Ghana Football Association and other governing bodies cannot be blamed for overloading these players with games within short periods.

Flashback: Fatawu Issahaku smiled after successful surgery to repair his ligament tear.

What causes an ACL injury? In 2023, former Manchester United physiotherapist Dr. Tom Hughes suggested they may be "an occupational hazard."

His assertion references a study assessing 134 ACL cases over ten seasons of Italian football. It found that up to 56 percent involved indirect contact; most were shoulder-related rather than knee-related impacts.

The remaining cases were confirmed as non-contact injuries. Midfielders and defenders tend to suffer most ACL injuries due to sudden changes in direction or excessive force when landing awkwardly after jumps or twists—not because of too many games or poor pitches.

Arsenal striker Gabriel Jesus tore his ACL during an FA Cup match against Manchester United earlier this year as well.

For prevention strategies: Last year Dr. Hughes collaborated with Professor Nick London on knee injury prevention studies focusing on diverse movements through multi-sport programs.

These programs aim to build various muscles and ligaments instead of specializing too early in one sport which can lead to imbalances and higher injury rates.

However, these recommendations have yet to be implemented by any African country effectively enough to see results regarding ACL occurrences among African players.

Until then, as Dr. Hughes noted again: it remains "just an occupational hazard."