Connect with us

Published

on

Keyhole surgery is perhaps a misleading term: despite the technology, expertise and extreme finesse involved, it’s also hugely physical. 

Sky News watches as surgeon Luke Jones performs an anterior cruciate ligament reconstruction in an operating theatre in King Edward VII’s hospital in central London.

Mr Jones (male surgeons are referred to as Mr rather than Dr) doesn’t just remove a hamstring: he pulls it out with force.

Drills bore through bone. Flesh smokes as it is cauterised. There’s a fair amount of hammering: “Mallet, please,” Mr Jones asks his assistant.

The ACL is a small band of tissue running through the middle of the knee that keeps it stable.

But watching the operation, it’s easy to understand why tearing it is so devastating. Even though the patient will only have three tiny scars, their knee has taken a pummelling.

“There’s 90 minutes in theatre with me,” Mr Jones tells Sky News, adding: “And then there is one year of rehabilitation with your physiotherapist afterwards.”

That’s why ACL injuries are so feared, especially by one type of athlete: female footballers.

‘Way too many’ women’s players with ACL injuries

Between 25 and 30 players – enough for an entire extra squad – will miss the upcoming World Cup because of ACL injuries. England stars Beth Mead and Leah Williamson have been ruled out. Data from ACL Women Football Club suggests 195 elite players have suffered the injury in the last year.

It has been described as an “epidemic”. And it is an epidemic that affects women far more than men: they are 2.5 to 3.5 times more likely to rupture an ACL than a male athlete. And we don’t really know why. Even as the women’s game has boomed, research has lagged behind.

One player who is going to the World Cup is England defender Jess Carter. Speaking before departure at St George’s Park, England’s national football centre, she tells Sky News: “There’s been way too many women’s players who have had ACL injuries and not enough research that’s been done about it.

“Why are there so many injuries? How can we prevent it? Why are they happening? A question I sometimes ask is: if this was happening to high profile men’s players, would more work be going in to try and improve things?”

England's Leah Williamson. Pic: AP
Image:
England’s Leah Williamson. Pic: AP

Nature versus nurture

The problem is that there isn’t just one answer.

“I’ve made a list the other day, and I think there are 30 reasons that have been discussed in the literature that I could find,” says Kat Okholm Kryger, a sports rehabilitation researcher at St Mary’s University Twickenham and a medical researcher for FIFA.

“And I think we can split it into two main categories. And I like to call them nature and nurture.

“So the nature is like the biology: the genes, the way the body is shaped and muscle mass, etc… But also the nurture of the environment that the women are in. So the way that young female players are managed compared to male players, the facilities, the professionalism around the sport, the quality of the staff that they have available.”

I ask whether research into injuries in the women’s game has received as much attention as men’s.

“Attention? No. But generally that’s across all research in football and in sports medicine. The male has been the norm,” she adds.

Research will end up benefiting the men’s game too

Take one issue from the realm of ‘nurture’ that Kat is studying: football boots. The male foot was the norm. It’s only in recent years that boots designed specifically for women have become available. And even then we don’t understand the differences properly, which is why Kat has done 3D scans of hundreds of feet, to map them.

That research will end up benefiting the men’s game too because Kat is also charting the differences between ethnicities. Because the default foot isn’t just a man’s, it’s a white man’s.

The male is also the norm when it comes to other environmental factors, like booking a pitch.

On a Thursday evening in Kent, the Gravesham Girls and Women’s Football Club, founded in 1999, is training ahead of the start of the season. About 20 players, kitted out in yellow, are doing shooting drills and balls are flying. A Sky News camera operator cops one in the belly but bravely continues.

Click to subscribe to the Sky News Daily wherever you get your podcasts

Toni Allen and Keylie Oliver have both ruptured their ACL in the past. “I just screamed – everyone thought it was a fox,” Allen says. Both were out for a year.

“It’s quite daunting, and especially when you realise it’s not just football that it can impact, Oliver says.

“We have lives outside of football and it impacts that as well… At grass roots, the ladies always have a two o’clock kick-off. And that is because in our world, men’s football takes priority over women. We always have to play after – so the pitch is always ruined.”

Please use Chrome browser for a more accessible video player

Women’s football: The ACL epidemic

The importance of the factors can change

Another difficulty is not just that there are lots of factors involved, it’s that the importance of the factors can change.

Professor Kirsty Elliott-Sale is professor of female Endocrinology and Exercise Physiology at the Manchester Met Institute of Sport.

She works closely with clubs, including Arsenal, to study how the menstrual cycle, or taking the Pill, can influence injuries. Research seems to suggest that some hormones can make ligaments looser, increasing the risk of rupture.

So over the course of the season Prof Elliott-Sale measures the laxity of players’ knees, charting that against their hormones, and cross referencing it with other factors like match congestion.

“It’s definitely a jigsaw,” she says. “And it’s about sort of putting all the pieces together.

“But once we have all the pieces, we don’t necessarily know which factor is going to play a bigger role on any given day. So it’s not like all of the pieces are the same size. Some days, a particular factor that might influence this type of injury might be amplified, whereas on another day, it might be turned down.”

Biology remains a large part of the answer

But even then the difference between female and male body types – which in the past led to some dismissing women as too “fragile” to play traditionally male sports – may not be as much of a factor as previously thought.

Because in some sports, the ACL injury discrepancy disappears.

“If you compare sports, where males and females start at the same age, have the same training intensity throughout their sporting life, and perform the same movements during that sport, then actually, the rupture rates equalise,” Mr Jones, the surgeon, says.

“And a very good example for that is elite dancers. So elite dance athletes, where the males and females start their training at the same age, they perform the same pivoting, jumping, twisting movements, and they have the same intensity of training and the same conditions. If you compare their rupture rates, they’re actually equalised.”

“And what that suggests is the impact of your training and your conditioning is really essential and avoiding this injury.”

Every expert I spoke to stressed the role of strength and conditioning in preventing injury. Here, nurture influences nature.

“We have that attitude of, you know, women do yoga, and pilates and men lift heavy things in the gym,” Ms Kryger says.

“But the reality is everyone needs to lift heavy things occasionally to prevent injuries and have a healthy body.”

England's Beth Mead has also been ruled out due to injuries. Pic: AP
Image:
England’s Beth Mead has also been ruled out due to injuries. Pic: AP

Read more:
Women’s World Cup warm-up match abandoned after 20 minutes
World Athletics criticised over decision to exclude trans women from female events

The good news is that quantifiable progress is being made here.

Matt Whalan is a sports scientist who works with the Australian men’s and women’s football teams – the Matildas who will be competing in the World Cup. He spoke to me from the men’s under 23s camp there.

Football Australia introduced a programme called ‘Perform+’, which can be worked into warm ups, that has reduced injuries, including ACLs, by 40%.

And crucially, it’s not just for elite players.

“This is designed so that mom and dad coaches can just go online, take down the programme, all the videos are there, there’s information about how you can deliver it with your athletes, and from under-sevens through to 55-year-olds, 95-year-olds, if you want to, you can do these exercises,” Mr Whalan says.

“The benefit of that for us at the higher end level, working with national teams, is if we have players that have been doing that, since they’re 12,13,14 years old, it makes our lives a lot easier.”

That remains in the future. When the World Cup starts next week, it will do so without a host of stars.

As England forward Chloe Kelly tells Sky News: “Having suffered the ACL injury myself, it’s so sad when you see so many players suffering that injury. Hopefully, we get the research that we need to stop these injuries happening so often.”

Continue Reading

UK

Madeleine McCann suspect won’t face charges for foreseeable future, prosecutor tells Sky News

Published

on

By

Madeleine McCann suspect won't face charges for foreseeable future, prosecutor tells Sky News

The man suspected of abducting Madeleine McCann won’t face any charges in the foreseeable future, a prosecutor has told Sky News.

German drifter Christian B, who cannot be fully identified under his country’s privacy law, is expected to be freed from an unrelated jail sentence this year while police in three countries continue to search for evidence against him.

Prosecutor Hans Christian Wolters said: “There is currently no prospect of an indictment in the Maddie case.

“As things stand, the accused Christian B’s imprisonment will end in early September.”

Madeleine, aged three, was asleep with her younger twin siblings in the family’s Portuguese rented holiday apartment before mother Kate discovered her missing at around 10pm on 3 May, 2007.

Her parents were dining nearby on the complex with friends and taking turns to check on all their sleeping children every half an hour.

Madeleine’s disappearance has become the world’s most mysterious missing child case.

Undated handout file photo of Madeleine McCann who disappeared from a holiday flat in Portugal seventeen years ago. Her parents, Kate and Gerry McCann, released a statement on the 17th anniversary of her disappearance, saying "the absence still aches". Earlier this week, it was confirmed that up to a further £192,000 has been granted by the Home Office for the Scotland Yard investigation into Madeleine's disappearance. Issue date: Friday May 3, 2024.
Image:
Madeleine McCann, who disappeared from a holiday flat in Portugal. Pic: PA

Philipp Marquort, one of Christian B’s defence lawyers, welcomed the prosecutor’s pessimism about bringing charges.

He said: “This confirms the suspicions that we have repeatedly expressed, namely that there is no reliable evidence against our client.

“We regret that we have not yet been granted access to the investigation files. We have not yet been able to effectively counter the public prejudice arising from statements made by the prosecutor’s office.”

Christian B, 47, is in jail and coming to the end of his sentence for the rape of an elderly American woman in Praia da Luz, the Portuguese resort where Madeleine disappeared.

In October, he was acquitted on a series of rape and indecent assault charges after a non-jury trial in Germany, in which several references were made to his status as the main suspect in the Madeleine case.

Read more from Sky News:
MP admits punching man
Hollyoaks star dies aged 46
Russian drone shot down near PM’s Ukraine visit

File photo dated 30/04/17 of Kate and Gerry McCann, whose daughter Madeleine disappeared from a holiday flat in Portugal seventeen years ago. They have released a statement on the 17th anniversary of her disappearance, saying "the absence still aches". Earlier this week, it was confirmed that up to a further ..192,000 has been granted by the Home Office for the Scotland Yard investigation into Madeleine's disappearance. Issue date: Friday May 3, 2024. PA Photo. See PA story POLICE Portugal. Photo credit should read: Joe Giddens/PA Wire....
Image:
Kate and Gerry McCann. Pic: PA

The prosecutor said he was awaiting the court’s written judgment before launching an appeal against the acquittal. He believes the trial judges were biased against the prosecution.

If successful, he could apply for a new arrest warrant for Christian B to keep him in custody until a retrial with new judges.

He said: “We hope that the Federal Court of Justice will decide before the end of the accused’s imprisonment. If the Federal Court follows our legal opinion, we could apply for a new arrest warrant for the accused’s offences, so that the accused would then remain in custody beyond September 2025.

Mr Marquort said the defence team would oppose the prosecution’s appeal against the acquittal.

Prosecutor Mr Wolters has said in the past that he believes Madeleine is dead and that Christian B was responsible for her death. The suspect denies any involvement.

The case against Christian B is purely circumstantial; he’s alleged to have confessed to a friend that he abducted Madeleine, he has convictions for sex crimes against children, he was living in the area at the time, his mobile phone was close by when the young girl vanished and he re-registered one of his vehicles the next day.

The prosecutor won’t say what evidence he has to convince him Madeleine is dead, but he admitted he is still trying to find forensic evidence to link Christian B to the girl.

Christian B is acquitted of sex attacks not related to the Madeleine McCann case
Image:
Christian B coming to the end of his sentence for the rape of an elderly woman

Jim Gamble, former head of the UK Child Exploitation and Online Protection centre, said he had expected the prosecutor to charge Christian B soon.

“He’s implied the whole way through that he has something more than the public are aware of,” he said.

“He’s made fairly definitive statements about whether Madeleine is alive or dead so you would expect their strategy to have been to charge him sooner rather than later.

“From what he’s said today I wonder if we’re witnessing the re-positioning of something to manage the disappointment that’ll come.”

Mr Wolters, who is based in Braunschweig, Lower Saxony, is investigating the case with the help of Portuguese police and detectives from Scotland Yard.

Continue Reading

UK

UK will play its ‘full part’ in peacekeeping efforts in Ukraine, says Sir Keir Starmer

Published

on

By

UK will play its 'full part' in peacekeeping efforts in Ukraine, says Sir Keir Starmer

The UK will play its “full part” in peacekeeping in Ukraine, Sir Keir Starmer has said.

The prime minister told Sky News’ political editor Beth Rigby that the conflict with Russia was not just about “sovereignty in Ukraine” but about the impact it also had on the UK, including the cost of living crisis.

Sir Keir was speaking to Sky News while on a surprise visit to Ukraine on Thursday – his first since his party’s landslide election win six months ago.

The purpose of the trip was to discuss the next steps for Ukraine, with the situation now more uncertain following Donald Trump’s election victory in November.

Politics latest: Tories made mistake by leaving EU without growth plan, admits Badenoch

Mr Trump, whose inauguration takes place on 20 January, has said he wants a peace deal between Russia and Ukraine within 100 days.

But some European leaders fear pushing Kyiv into a deal could lead to Ukraine ceding some of its territory to Vladimir Putin.

More on Ukraine

Sir Keir said he did not want “to get ahead of ourselves” but that the UK would play its “full part” in any peace negotiations – including by deploying British troops for peacekeeping.

Asked if he would be prepared to do that, the prime minister replied: “Well, I don’t want to get ahead of ourselves, but I do have indicated that we will play our full part – because this isn’t just about sovereignty in Ukraine.

“It’s about what the impact is back in the United Kingdom and our values, our freedom, our democracy. Because if Russia succeeds in this aggression, it will impact all of us for a very, very long time.”

On arriving in Ukraine to meet President Volodymyr Zelenskyy, a Russian drone was shot over the sky over the presidential palace.

Sir Keir said the drone threat was “a reminder of what Ukraine is facing every day” and that the war was brought about by “Russian aggression”.

Elsewhere in the interview, Sir Keir was asked about his views on Ukraine’s longstanding desire to join NATO – something President Putin strongly opposes.

Read more:
With Donald Trump’s inauguration imminent, the Chagos deal appears to be on ice

MP Mike Amesbury admits punching man

At a NATO summit in Washington last summer, the alliance’s members announced that Ukraine was on an “irreversible” path to NATO membership.

“We fully support Ukraine’s right to choose its own security arrangements and decide its own future, free from outside interference. Ukraine’s future is in NATO,” the declaration said.

However, Mr Zelenskyy has somewhat tempered his language around NATO membership, telling Sky News in an exclusive interview in November that a ceasefire deal could be struck if Ukrainian territory he controlled falls “under the NATO umbrella” – allowing him to negotiate the return of the rest later “in a diplomatic way”.

However, Mr Trump has acknowledged Moscow’s opposition to Ukraine joining NATO, saying: “Russia has somebody right on their doorstep, and I can understand their feeling about that.”

Watch the full interview with Beth Rigby and Sir Keir Starmer on the Politics Hub with Sophy Ridge at 7pm.

Continue Reading

UK

Abusive boyfriend whose partner Kiena Dawes blamed him for her death in suicide note jailed

Published

on

By

Abusive boyfriend whose partner Kiena Dawes blamed him for her death in suicide note jailed

An abusive boyfriend whose girlfriend blamed him for her death in a suicide note – after he subjected her to years of violence – has been jailed for six-and-a-half years for controlling and coercive behaviour and assault.

Ryan Wellings, 30, was found guilty of the offences but was cleared of Kiena Dawes’s manslaughter by a jury at Preston Crown Court on Monday.

He was the first defendant in England to face trial for the unlawful killing of his partner after her suicide following domestic violence.

Shortly after Ms Dawes wrote her note on her phone, in which she described Wellings as a “monster”, the 23-year-old hairdresser left it with a friend before she took her own life on 22 July 2022.

Prosecuting, Paul Greaney KC cited the suicide note at Wellings’s trial. In it, Ms Dawes said he had “killed [her]”.

“He ruined every bit of strength I had left,” the note said. “I had dreams. I had a future at one point. That was taken away from me.”

Ryan Wellings. Pic Lancashire Police
Image:
Ryan Wellings. Pic: Lancashire Police

Wellings denied the allegations against him and told jurors “I’m not a monster”.

While a jury cleared Wellings of Kiena’s manslaughter, Mr Greaney invited the court to sentence the defendant “on the basis that [the offending of which he was convicted] formed the background to and set the scene for her death”.

He said the abuse was “both regular and routine across the relationship”.

On one occasion, the court heard the defendant “held a drill to Kiena’s face, switched the drill on and threatened to drill out her teeth”.

‘Breaks my heart’

In a personal statement read out on her behalf in court, Angela Dawes, Kiena’s mother, said: “It breaks my heart that [Kiena’s] beautiful baby doesn’t have her mummy here because of that monster.”

“I truly hope that no other young lady or child has to go through what he did to my daughter and her baby,” she added.

Kiena Dawes took her own life. Pic: Lancashire Police
Image:
Kiena Dawes took her own life. Pic: Lancashire Police

Kiena’s grandmother, Irene Ball, said she had noticed at times during Kiena’s relationship with Wellings that her smile was “false” but recalled her granddaughter “tried to reassure [her]”.

“It was extremely shocking to see my granddaughter hurt and with injuries to her beautiful face,” she said.

“I told Kiena that he would really badly hurt her one day and I pleaded with her not to go back to him.”

Kynan Dawes, Kiena’s brother, said: “I introduced Kiena to this monster and I will regret that for the rest of my life.”

Mr Dawes said he felt “justice [had] been served” as “the world now knows what a monster he is”.

Addressing those who’d been following Kiena’s case online, he added: “I want people to see that domestic violence is not OK and men should respect their partners.”

He also urged anyone experiencing domestic violence to “go to the police”, adding “if you don’t feel like you can do this, speak to family or friends”.

‘Friendly and kind young woman’

In sentencing, Judge Robert Altham said Ms Dawes was “a popular, vivacious, friendly and kind young woman”.

“She pleaded with you to stop hitting her, but you just carried on. You tried to persuade her that it was her fault for upsetting you,” he added.

Ms Dawes had attempted suicide in the past, before her relationship with Wellings, and lawyers for Wellings told the court her death was because of “multiple factors”.

The judge said the defendant was aware of Ms Dawes’s history of mental health issues, he “called her names connected with her illness” and “repeatedly told her that she may as well kill herself”.

However, he said his sentence was based on the jury’s conclusion that the defendant had “no criminal responsibility” for Kiena’s death.

In mitigation, John Jones KC told the court the relationship between Ms Dawes and Wellings, a landscape gardener from Bispham who had a previous conviction for battering an ex-partner, was “inconsistent” throughout its two-and-a-half years.

“It would be wrong to say that that coercive relationship was in existence throughout,” he said.

The court heard the abuse of Ms Dawes included regular slapping and “ragging” by her hair, and threats to use a drill to take out her teeth and throw acid in her face.

After she became pregnant, Wellings gave her a black eye and began criticising her weight, calling her “fat” while contacting escorts and prostitutes online.

Read more from Sky News:
Hollyoaks star Paul Danan dies aged 46
Basketball team ‘unaware’ player was ‘murder suspect’

Police were called more than once, but Wellings threatened Ms Dawes that their daughter would be taken from them if she told them what was happening, so she declined to help prosecute him.

But she did report Wellings following an attack which left her needing hospital treatment and he was arrested.

He broke his bail conditions but was not locked up, leaving Ms Dawes feeling let down by police. Four days later, she killed herself.

Wellings’ sentences, to run consecutively, were for controlling or coercive behaviour in an intimate relationship and for assault occasioning actual bodily harm.

A further count of assault on the defendant’s former friend Scott Fletcher was also included as part of the sentence, an offence to which he had previously pleaded guilty.

Wellings will serve half of the sentence in prison before he is released on licence.

Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.

Continue Reading

Trending