Dr. Williams, who performed Purce's ACL reconstruction surgery, explains why ACL tears are increasingly common among female athletes, the biggest mistakes athletes make after ACL surgery, and what it takes to return safely to sport.

The conversation also explores the debate over playing on turf versus grass, the risks associated with early youth sports specialization, strategies for preventing lower extremity injuries, and Dr. Williams' ranking of the most challenging lower-limb injuries athletes can face.

Listen to the full podcast here: Confessions of an Elite Athlete with Midge Purce.

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Rather than the “run until you drop” philosophy of the 1980s, strategies promote tissue repair and energy recovery after intense training, Dr. Williams explained.

“These high-functioning players are very valuable, so you want to watch them, you want to preserve them, you want to give them feedback on a day-to-day basis with regard to how can we best preserve their ability,” continued Dr. Williams.

Surgical advances and physical therapy are also having an impact. Torn ligaments and Achilles injuries that used to be devastating can be surmounted with targeted rehabilitation to prevent muscle loss during recovery.

“The list of career-ending injuries has significantly decreased over the past 20 years,” he shared.

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Dr. Williams shared insights on the planning, preparation, and medical considerations involved in helping keep players and fans safe during one of the world's largest sporting events.

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Host, Ayesha Rascoe, spoke with Dr. Williams about aging athletes, and how folks can stay in the game long-term at both the professional and recreational level. 

Listen to the interview at npr.org.

"The 2026 FIFA World Cup presents unique logistical challenges because it’s being hosted across three countries and 16 venues,” said Dr. Williams. “Unlike previous tournaments that were largely confined to a single country, some teams will be required to undertake extensive air travel across multiple time zones. Frequent travel can disrupt normal sleep patterns, alter dietary routines, and contribute to both physical and mental fatigue.”

“Over the course of a five-week tournament, these cumulative physical demands place substantial stress on the musculoskeletal system. Managing lower-extremity fatigue becomes essential for maintaining both performance and injury prevention. Performance staff closely monitor player workloads and use individualized training and recovery programs to ensure athletes can recover between matches,” Dr. Williams shared.

Read the full article at mensjournal.com.

“The most common injuries in elite soccer involve the lower extremities, particularly the ankle, knee, thigh, and calf,” Dr. Williams said. “Ankle sprains, hamstring strains, and calf strains are among the injuries we see most frequently in professional players. These injuries are largely related to the acceleration, deceleration, cutting, and sprinting demands that are inherent to the sport.”

“During a tournament such as the World Cup, players are exposed to repeated high-intensity efforts, significant physical loads, and substantial psychological pressure. In my opinion, the elevated intensity of competition increases the stress placed on the lower extremities and may contribute to a heightened risk of ACL injury over the course of the tournament,” Dr. Williams explained.

Read the full article at mensjournal.com. This article was also syndicated to AOL.com and Yahoo! Sports.

It’s more than 20 years since the U.S. hosted a FIFA World Cup and in the coming weeks, thousands of expectant fans from all over the world are due to jam-pack its stadiums in anticipation of soccer greatness. Behind the scenes, however, an essential strategy for keeping the athletes healthy is in play, and Dr. Williams will be integral to this process for the New York and New Jersey area. His role will include the coordination of medical care during one of the world’s most demanding tournaments.

“Traditionally, the World Cup is the most viewed sporting event worldwide. I cannot stress how much of an honor and privilege it is to have the World Cup final being played here in the New York/New Jersey area. I have been a team physician for over 25 years and the ability to participate in this esteemed event is the cherry on top of what has already been a very satisfying and professionally fulfilling part of my career.” expressed Dr. Williams.

“I am humble that FIFA would trust me with this role,” he continued. “And after over two years of detailed preparation for this specific event, I look forward to the games and all the energy and excitement that I’m sure will be a part of the tournament!”

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The New York/New Jersey area will host matches, including the final, taking place in East Rutherford, N.J., at MetLife Stadium. Dr. Williams will serve as the liaison between FIFA and local medical providers, coordinating 24-hour medical care for all athletes and FIFA officials competing at the New York/New Jersey World Cup location.

Read the full article at sportico.com.

“While it’s not an open fracture dislocation, it can be a devastating injury for athletes as it takes a long time to be strong enough to return to play and can leave them with a permanent amount of some weakness,” said Dr. Elliott.

“Many elite athletes have returned to a high level of play post Achilles rupture and repair. There are examples across sports – Football (Soccer), American Football, Basketball – of top players making successful returns," he continued.

“Football forwards may lose a little of their top sprint speed, but they can still be highly effective and successful competitors.”

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Nealis is expected to be sidelined for approximately six to eight weeks as he completes rehabilitation.

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Researchers have long known that women are far more likely to tear their ACLs. While precise estimates vary depending on the age group and population, they likely have about three to four times the risk as men,

Gabriella Ode, MD, sports medicine surgeon at HSS, member of the Women’s Sports Medicine Center, and team physician for the New York Liberty, explained that the ACL’s role is to stabilize the knee’s front and back motion, preventing your tibia from sliding out ahead of your femur. It also gives you control over rotation—“the ability to step with your foot and then turn and feel like, ‘Hey, I have good support below me in order to move explosively,'

There's another effect of ACL tears that can’t be understated: The mental impact can be huge. “This is an injury that typically occurs in athletic people who are participating in a sport or doing some sort of high-level activity, and it really derails their mobility and their desires for sport and activity, whether short- or long-term,” Dr. Ode says. “It’s totally okay to have an emotional response.”

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Multiple defensive injury issues have also forced the team to reshuffle at the back. Carvajal is back from his injury while Alaba and Militao played during the Club World Cup.

Riley J. Williams III, MD, Chief of the Sports Medicine Institute at HSS, breaks down whether these players can get back to the top.

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According to Dr. Pareek, the biggest concern for any athlete recovering from an ACL tear is always the risk of re-injury. Returning too quickly or not addressing critical aspects of rehabilitation can significantly increase the chance of another injury, either to the same knee or the opposite one. Beyond that, regaining explosiveness and neuromuscular control is a primary challenge, especially for athletes like Militao, who rely heavily on their ability to accelerate, decelerate, and change direction rapidly. We know that athletes who are highly explosive sometimes take up to two full years to regain their pre-injury level of explosiveness, even if they return to competition earlier. Balancing this timeline with the need to get an athlete back to play—where inactivity is also not helpful to the athlete or the team—is a delicate process. Neuromuscular control for sport-specific tasks, like cutting and pivoting, is critical and must be trained rigorously in a progressive manner. Mental factors also play a significant role. Confidence in the repaired leg is key, as hesitancy or fear of re-injury can limit an athlete’s ability to fully trust their body. Rehabilitation must address both the physical and psychological aspects to optimize performance and reduce the risk of setbacks.

Read the full article at managingmadrid.com. 

Mings’ second injury forced him into a rigorous recovery, recalling the challenges of his first ACL injury years before. Following an awkward fall, Mings pursued a tailored rehab, splitting time between Villa’s facilities and specialists in the U.S. and Qatar. He focused on both physical and mental resilience, even stepping away from social media to maintain focus. 

“There is a very close correlation between mental health and the physical ability to return to play,” says Tony Wanich, MD,  sports medicine surgeon at HSS . “Especially after an injury like an ACL injury that requires a prolonged course of rehab.”

“Fifteen to 30 percent of ACL injuries have associated cartilage injuries,” said Dr Wanich. “All patients following knee surgery develop some degree of atrophy of their muscles. Specifically, we like to see a 90 per cent return of strength on the injured leg compared to the uninjured side.”

Read the full article at the nytimes.com/athletic. A subscription is required to access. 

Beginning in the 2024 season, HSS, which is ranked No. 1 in orthopedics nationally by U.S. News & World Report (2023-2024) and globally by Newsweek for the fourth consecutive year in 2023, will have its logo on the front of both home and away kits for FC Monmouth throughout the duration of the multi-year deal. The new front-of-shirt sponsorship deal will complement the club’s existing partnership with HSS that includes signage throughout FC Monmouth’s home grounds at Count Basie Park.

“This has been a fantastic partnership for over five years now, and HSS is thrilled to have the opportunity of being the official front-of-shirt sponsor for FC Monmouth,” said Danyal H. Nawabi, MD, FRCS, FC Monmouth Head Team Physician and sports medicine surgeon at HSS. “We will continue to provide world-class injury prevention and recovery support to all the club’s athletes, and we look forward to continuing to connect with the local Monmouth community.”

“HSS is the premier provider in musculoskeletal care in the world. Athletes from around the globe come to us for treatment,” said Stavros G. Memtsoudis, MD, PhD, MBA, Chief of Anesthesiology, Critical Care and Pain Management at HSS and co-owner of FC Monmouth. “Being part of such an amazing team is inspiring and truly rewarding. This relationship is hugely important to me personally as it combines my love for soccer, community and my profession. Having a brand like HSS support FC Monmouth inspires us to do more and do it better.”

Read the full article at FCmonmouth.com. 

Dr. Pearle explained the ACL is commonly injured in people who play cutting sports. When an athlete goes to cut or to pivot, they plant and their foot goes one way and their knee goes the other. That puts the ACL at risk. 

Dr. Pearle continued. “Classically people feel a pop. They can feel it or hear it. People usually go down immediately afterwards. If they try and get up, the knee feels loose or unstable.  Usually people can't continue playing.  That day or that night, the knee will often swell. If you have a swollen knee,  that usually means you've damaged the internal structure of the knee. If you can't bear weight, it's certainly time to see a doctor. ”

It's not just professional athletes that are at risk. “A lot of the spotlight has been on elite athletes, but the population that's most vulnerable is high school athletes, particularly girls. They have a 2 to 8 times higher risk of ACL injury than boys.  If you tear your ACL in high school, there's about a 50 to 70 percent chance that you're going to get arthritis in your thirties,” said Dr. Pearle. 

“We have solutions for this. Neuromuscular training can help. This refers to exercises that build muscle memory to optimize athletic movement,” advised Dr. Pearle. 

Watch the segment here on Goodmorningamerica.com. This segment also aired on broadcast on August 14, 2023.

After seeing the headlines of how many of the world’s top players are missing out on this year’s Women’s World Cup — including two from the US team — it’s hard not to think of this injury as an inevitable part of the sport, especially as a woman.

Different studies have found female athletes are two to eight times more likely than their male counterparts to tear their ACLs.

“This issue has been around for a long time, it’s gotten worse and worse,” said Andrew D. Pearle, MD, chief of sports medicine at HSS. 

Over a 10-year period, Dr. Pearle says he saw a 300% increase in ACL injuries in adolescents.

So while the injuries among top professional players have brought this issue into the spotlight, Dr. Pearle said the highest incidences are still in high school athletes — and he is seeing increasing numbers in middle school-age athletes.

Dr. Pearle said this is why parents need to be aware that these injury prevention programs exist.

“If you got a girl’s soccer team, you’d say to the coach or the sports organization, OK, what’s your neuromuscular training plan? What are you guys doing for it? You know, that should be a question that everybody asks,” Dr. Pearle explained.

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In women, the intercondylar notch, the area in the femur where the ACL sits, is narrower; additionally, women’s pelvises are wider, creating a higher angle between the hips and knees that can put greater stress on the quadriceps and the ACL. Female athletes tend to land flat-footed with knees inward on jumps and have more strength in the quads rather than the hamstrings. Those circumstances put female athletes at risk before even taking the field. In movement-heavy sports, a sudden change of direction or an improper landing could spell a tear. 

“The quintessential ACL-busting cohort is in female soccer players,” said Dr. Pearle. “The numbers are really kind of tragic.”

Across soccer, pushes have been made to make injury prevention programs accessible. HSS developed an app called RIIP Reps that condenses essential exercises into seven-minute sessions. 

Read the full article at washingtonpost.com. 

“It’s an invisible injury, so people tend to mask their symptoms,” said Teena Shetty, MD, neurologist at HSS. “It’s not like a heart attack, where you can look at an EKG waveform and bloodwork, or an ACL injury where you can see it on an MRI.”

Dr. Shetty said concussions require a multidisciplinary treatment, which may include physical and cognitive therapy. Longer-term care could require lifestyle modifications or even a change of sport. 

Players can also wear gear such as headbands and collars crafted to help dissipate an impact. Such devices are becoming more readily available, but Dr. Shetty said there’s still not enough evidence to medically support the safety and effectiveness of these early designs.

Read the full article at scientificamerican.com.

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According to Dr. Toresdahl, playing sports can be an effective and fun way to burn calories. “We expend energy ('burn calories') throughout the day, even at rest. How quickly we burn calories is often described in 'METs' (metabolic equivalents). High-intensity sports have METs of 8 or more, meaning we burn 8 times as many calories while playing those sports compared to at rest. The more intense the activity and the more muscle groups involved, the higher the METs,” he explained.

He added, “Since many people find the competitive and social aspects of team sports to be exciting and fun, burning calories while playing sports may not feel as difficult as other forms of exercise.”

Dr. Robinson described sports like soccer and basketball involve periods of higher intensity and sprinting followed by periods of lower intensity such as jogging, and cited studies that put the caloric burn between 500 and 700 per hour (depending on body weight).

Read the full article at Askmen.com.

Dr. Hannifan noted, “Elizabeth and Calyn are both bright, mature and remarkable young women who handled their injuries by working hard to return to their sports. Elizabeth injured her knee playing soccer, which she plays year-round. She was able to return to practice and non-contact drills at 7 months and full return at 10 months. Calyn decided to focus on her running seasons rather than returning as the running sports were more important to her.”

On ACL recovery, Dr. Hannifan counseled, “It is important for the athlete to see progression from being an injured athlete to a recovering athlete to a fully competitive athlete. The process is slow but understanding the process and the goals of recovery seems to help a lot.”

Read the full article at Trumbulltimes.com.