In Short: Is Synthetic Grass Safe?

Author: Grant Jones, MD

Synthetic playing surfaces were initially developed in the 1960’s with the reported advantages over natural surfaces of being a durable, versatile surface, less affected by weather conditions, allowing multi-sport use, having easier maintenance, and being more cost-effective.

However, the early generation of synthetic grass did not provide much shock absorption and allowed for increased traction between the surface and athletic shoes, predisposing athletes to more impact type injuries such as concussions and non-contact twisting injuries such as ACL tears.

Newer Surfaces are Better

The new generation surfaces of synthetic grass such as Field Turf were developed to decrease the injury rates found in the early generation of synthetic grass surfaces. These newer surfaces more closely replicate natural grass in terms of consistency and are more compliant with greater shock absorption compared to the older surfaces.

Several studies have investigated whether Field Turf is as safe as natural grass. At the lower levels of football competition, including high school, it appears that Field Turf is as safe or, in some cases, safer than natural grass in terms of overall knee ligament injuries. Another study showed that even at the collegiate football level, Field Turf is just as safe.

More Knee Injuries but Less Concussions

However, studies looking at the highest levels of competition, including professional football, have shown an increased rate of knee injuries, including ACL tears and overall knee injuries when playing on synthetic grass. In terms of knee injuries in soccer, investigations have shown that, at the collegiate level, Field Turf is as safe or safer than natural grass. Finally, the concussion rate and the severity of concussions appear to be the same on both surfaces, with the concussion rate actually being less on Field Turf at the high school level.

Overall, Field Turf does not seem to substantially increase an athlete’s risk of injury at the high school and collegiate level compared to natural grass. However, there does appear to be an increased risk of injury at the professional football level on Field Turf. More studies need to be performed to more completely evaluate the safety of Field Turf at the highest levels of competition.

References

  1. Hershman EB, Anderson R, Bergfeld JA, Bradley JP, Coughlin MJ, Johnson RJ, Spindler KP, Wojtys E, Powell JW. An analysis of specific lower extremity injury rates on grass and FieldTurf playing surfaces in National Football League Games: 2000–2009 seasons. Am J Sports Med. 2012. 40:2200-2205.
  2. Powell JW, Schootman M. A multivariate risk analysis of selected playing surfaces in the National Football League: 1980 to 1989. Am J Sports Med. 1992. 20:686-694.
  3. Orchard JW, Powell JW. Risk of knee and ankle sprains under various weather conditions in American Football. Med Sci Sports Exerc. 2003. 35:1118-1123.
  4. Powell JW. Pattern of knee injuries associated with college football 1975–1983. Athletic Training. 1985. 20:104-109.
  5. Powell JW, Schootman M. A multivariate risk analysis of natural grass and Astroturf playing surfaces in the National Football League 1980–1989. International Turfgrass Society Research Journal. 1993. 23:201-211.
  6. Scranton PE Jr, Whitesel JP, Powell JW, et al. A review of selected noncontact anterior cruciate ligament injuries in the National Football League. Foot Ankle Int. 1997. 18:772-776.
  7. Clarke KS, Powell JW. Football helmets and neurotrauma: An epidemiological overview of three seasons. Med Sci Sports. 1979. 11:138-145.
  8. Guskiewicz KM, Weaver NL, Padua DA, Garrett WE Jr. Epidemiology of concussion in collegiate and high school football players. Am J Sports Med. 2000. 28:643-650.
  9. Naunheim R, McGurren M, Standeven J, Fucetola R, Lauryssen C, Deibert E. Does the use of artificial turf contribute to head injuries? J Trauma. 2002. 53:691-694.
  10. Meyers MC, Barnhill BS. Incidence, causes, and severity of high school football injuries on FieldTurf versus natural grass: A 5-year prospective study. Am J Sports Med. 2004. 32:1626-1638.
  11. Meyers MC. Incidence, mechanisms, and severity of matchrelated collegiate men’s soccer injuries on FieldTurf and natural grass surfaces: A 6-year prospective study. Am J Sports Med. 2016. 45:708-718.
  12.  Orchard J. Is there a relationship between ground and climatic conditions and injuries in football? Sports Med. 2002. 32:419-432.
  13. Williams S, Hume PA, Kara S. A review of football injuries on third and fourth generation artificial turfs compared to natural turf. Sports Med. 2011. 41:903-923.
  14. Dragoo JL, Braun HJ, Harris AH. The effect of playing surface on the incidence of ACL injuries in National Collegiate Athletic Association American football. Knee. 2013.20:191-195.
  15. Balazs GC, Pavey GJ, Brelin AM, Pickett A, Keblish DJ, Rue JPH. Risk of anterior cruciate ligament injury in athletes on synthetic playing surfaces. Am J Sports Med. 2014. 43:1798-1804.
  16. Ekstrand J, Timpka T, Hagglund M. Risk of injury in elite football played on artificial turf versus natural grass. Br J Sports Med. 2006. 40:975-980.
  17. Mechan WP III, d’Hemecourt P, Comstock RD. High school concussions in the 2008–2009 academic year: Mechanism, symptoms, and management. Am J Sports Med. 2010. 38:2405-2409.

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