As a university athlete, injury can feel inevitable within your career, yet playing through pain has become far too normalized. The fear of losing your starting position, the identity loss that follows injury, paired with a lack of recovery resources, all place a heavy weight on an athlete’s shoulders.
So the question we need to ask as a sporting community is: what can we do to change injury culture?
The science behind sprains
Each sprain or tear comes down to the basic mechanics of how joints absorb force during sport. Physiotherapist Erinn Foley explains the most common movement pattern for an ankle injury is “plantarflexion and inversion.” This results in what is known as a lateral ankle sprain (LAS), largely due to there being fewer ligaments on the outside of the ankle.
When it comes to knee injuries and ACL tears, Foley explains athletes often describe “planting their foot and it twisting, along with impact coming from outside the knee.”
Understanding the movements that cause these injuries is crucial for student athletes. However, Foley also notes injury risk can vary depending on sex, as she has “seen an increase in ACL injuries in female university athletes.”
Why ACL injuries hit women harder
For many women, ACL injuries occur far more frequently than for their male counterparts. Hormonal changes throughout the menstrual cycle may also play a role. As Sports Scholar netball player Nicola Cosgrove-Clark explains, rehabilitation was vital, but “education on the menstrual cycle and its effects on joint laxity might make athletes more aware of how their body feels.”
The moment everything was taken away
An injury can reshape an athlete’s identity — something Cosgrove-Clark experienced firsthand after tearing her ACL. She described going from “playing netball twice a day to relearning how to walk.”
Following the injury, she felt an “overwhelming dread” while waiting for scan results, struggling even to stand due to pain. In a single moment, she felt her life shift completely.
Although she was “no stranger to injuries prior to this one,” previous niggles had never occupied her mind on court, as her strength and rehabilitation had always been strong. This injury, however, altered her path entirely.
Why knees and ankles take the biggest hit
Knees and ankles are among the most commonly injured body partsin university sport. When speaking to athletes across Scottish universities, torn ankle ligaments, sprains, and ACL injuries were reported far more frequently than in elite-level environments.
Foley explains these injuries are often linked to “poor warmups and lack of strength training.” Student athletes require robustness and high-volume training to cope with multiple games per week — something more commonly seen in elite programs.
This can lead athletes to rely on constant taping of knees and ankles as a quick fix for a long-term problem, when consistent rehabilitation exercises are the real solution.
Hormonal changes during the menstrual cycle may also influence joint stability, potentially increasing injury risk in women, particularly when combined with already vulnerable joints.
However, menstrual factors are only one part of the issue. Limited access to strength and conditioning, alongside insufficient physiotherapy support after injury, can become risk factors in themselves.
When limited physio becomes its own risk factor
Strength and conditioning sessions, combined with proper physiotherapy support, are vital for university athletes training and competing at high intensity. Without these elements, injury risk increases significantly.
For many universities, however, these programs are limited due to funding constraints and lack of specialized coaching.
An Abertay University Coach explains that “many students are not educated on the dangers of not warming up and the benefits of strength training.” Greater education around strength and conditioning — particularly plyometric training — is needed, as they have seen “more people injure their ankles on court and knees than you can count.”
The guidance a physiotherapist provides can be career-changing. Foley frequently sees athletes who believe “the injury will get better on its own or with rest — they do not get better with rest.”
Injuries require proper rehabilitation and professional care, which “isn’t always available to university athletes.” Foley highlights that the lack of “acute advice” immediately after injury is often the biggest issue, as early assessment is crucial to understanding severity and recovery pathways.
So, how do you correctly perform injury prevention?
Injury prevention, combined with strength and conditioning, can begin with small changes athletes make to themselves. However, universities must also provide opportunities and education to help sporting communities advance injury awareness.
Cosgrove-Clark was fortunate to receive subsidized physiotherapy through her university and later through her sports scholarship, alongside sport psychology support during her return to play. While not every institution can fund these programs, understanding what athletes can implement within their own routines remains essential.
How to deal with injury isolation
Cosgrove-Clark believes “preventative strength programs,” alongside strong pre-hab education and warmup routines, can significantly reduce injury risk and help create safer sporting environments.
Injury isolation and identity loss can create a huge emotional challenge. After surgery, Cosgrove-Clark had to learn how to navigate life without netball.
Her injury occurred “just one month into my first year of uni while I was still commuting over an hour to campus.” Unable to stand or travel independently, she “isolated herself from teammates and friends,” describing it as “an incredibly lonely period of my life.”
Having a strong support network is invaluable during recovery. Healing is not only physical but mental, and both aspects are essential to an athlete’s well-being.
Looking back, she says, “I would reach out to my friends and teammates instead of carrying the burden myself.” She realized that “shutting myself away for months while I struggled didn’t challenge me to get out of the house,” which intensified feelings of isolation.
How can ‘injury diaries’ help?
One coping method growing in popularity across sporting communities is sharing recovery journeys through “injury diaries” on social media. These platforms allow athletes to openly document recovery and connect with others experiencing similar challenges.
Cosgrove-Clark found comfort in watching other athletes share their journeys, helping her realize she was not alone.
She highlighted semi-professional women’s rugby player Charley (@aclsurvivalclub), whose content served as a “nice reminder that this happens to athletes at any stage, age, and background.” It reassured her that full recovery was “not just possible but an inevitability if that was my goal.”
Connecting with role models and communities online can help athletes feel less alone and rebuild a sense of sporting identity during recovery.
What’s next for the sporting community?
Injury will always exist in sport, but prevention and education can change how athletes respond to it. Establishing consistent warm-up routines and incorporating injury-prevention exercises are important first steps.
University athletes must understand when their body is fighting a losing battle. Listening to your body, seeking medical advice when necessary, and committing fully to both rehabilitation and pre-habilitation are essential for long-term health and performance.
