How Australian football is tackling the ACL injury problem for women athletes

Holly McNamara knew what had happened even before she hit the ground.

In the 72nd minute of Melbourne City's A-League Women's match against Sydney FC last week, the City forward accelerated towards opposition midfielder Taylor Ray, trying to close her down.

As Ray cleverly nipped the ball away, McNamara's unexpected change of direction caused her left knee to cave inwards.

McNamara immediately yelped in pain, recoiling and grasping at her leg as she collapsed into a heap in the grass.

Her shrieks echoed around the AAMI Park stands. Everybody knew what they meant.

Ray, a veteran of two serious knee injuries herself, recognised the sound: of pain, of disappointment, but also fear — fear of what it could mean for a young player whose football career was only just starting to blossom.

«I was heartbroken, to say the least,» Ray told ABC Sport.

«At first I didn't know what was going on when the ref stopped the game, but then I turned around and was like, 'Oh no, something's happened.'

»I watched the replay on the big screen and I knew straight away that it was an ACL injury."

McNamara now joins Ray in that most unwanted of clubs: sustaining multiple ACL tears before the age of 20.

Having suffered her first as a 15-year-old, McNamara burst back onto the domestic scene this season with Melbourne City.

Her form, dynamic style, and output – with four goals and three assists – earned her a call-up to the senior Matildas for February's Asian Cup. She is widely touted as one of the brightest young stars in the Australian game.

But the 20-year-old will have to put everything on hold once again and potentially plan a different future for herself.

Ray knows what it's like to be in those dark places, too.

«You literally question your whole career,»