Garefrekes began her career in 1986 at her local football club Grün-Weiß Steinbeck, before joining DJK Arminia Ibbenbüren.

Garefrekes was relegated to the second division with Heike Rheine in 1999, but achieved immediate promotion back to the Bundesliga the following season.

Garefrekes scored Germany's first and ultimately decisive goal in the semi-final win over the United States.

[2] In qualifying for the UEFA Women's Euro 2009, she scored a number of goals, including a hat-trick in Germany's 7–0 defeat of Switzerland.

During Germany's successful title defence at the 2007 FIFA Women's World Cup, Garefrekes was part of the team's starting line-up in all of the six matches.