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I recently had a mother ask me if her daughter was at greater risk of injury playing soccer on a turf field. The American Academy of Orthopaedic Surgeons recently published a paper on this topic. Titled “Synthetic playing surfaces and Athlete’s Health” (Drakos, May 2013), the report outlines both the risks and benefits of playing sports on artificial fields and concludes that the health and injury ramifications have yet to be clearly determined.

In 2012, a study came out that suggested playing sports on turf fields led to higher injury rates as compared to grass fields. This fueled concern among all types of players as well as parents of student athletes. Indeed, the AAOS article points out that “historically, clinical studies have indicated that higher injury rates occur on artificial turf than on natural surfaces. This reason is that biomechanical data suggests that torque and strain may be greater on artificial surfaces than on natural grass”.

The first turf fields were constructed in the 1960’s. Many people remember the Houston Astrodome and its turf field which was installed in 1966. Turf fields are commonly found in urban environments where grass fields and space for multiple sporting activities can be sparse. Turf fields require less maintenance and can be used around the clock without the damage that grass fields would sustain after such use.  Turf fields also provide a consistent surface. Most of us have played on grass fields where the surface is uneven. As a teenager, I personally injured my own knee while playing soccer on a grass field when I stepped in a hole cause by excessive use.

Turf fields are also popular in the high country because they are more durable with regard to seasonal weather conditions. Both Eagle and Summit counties have the latest generation turf fields which are made from a mixture of rubber and sand. They more closely approximate playing on grass and more importantly, are safer for athletes.

These dramatic improvements with respect to synthetic playing surfaces in recent years are important to note. Unlike the turf fields of the 1960’s, the fields that are constructed today are considered third generation with more equivocal risks than earlier generations.

Although I see serious orthopedic injuries from players who have been hurt while playing on turf fields, I have not seen more injuries from turf as compared to grass, except for a higher instance of abrasions sustained on turf fields.

As for limiting the risk of injury, I recommend that athletes use turf shoes with smaller cleats as opposed to regular cleats when playing on turf. Using cleats can result in a higher level of torque across one’s ankle or knee. Athletes should also avoid cleats on the sides of the sole of the shoe as one study showed a higher incidence of ACL tears with this particular cleat pattern.

Aside from musculoskeletal injury, turf fields do present some other potential health risks. There may be a greater risk of concussions, particularly on older generation artificial surfaces which have a harder surface. It is advisable that athletes clean any cuts or abrasions after playing on turf to reduce the risk of bacterial and fungal illness. Finally, there is a more theoretical risk of carcinogenicity related to the crumb rubber infill used in third-generation turf fields, but there is no convincing data to substantiate this as a true risk.