It is commonly surmised that environmental conditions and concomitant sport use dictate the quality and degree of decline of natural grass over a season of competitive football. Although artificial turf infill systems have been purported to duplicate the playing characteristics of natural grass while maintaining surface quality throughout a season of play, no long-term studies have specifically compared injury incidence rates between the two surfaces at the high school level of competition.
PURPOSE: To quantify seasonal incidence of game-related high school football trauma on artificial turf versus natural grass.
METHODS: 77 high schools (4A-6A) from six states (CA, GA, MI, MT, PA, TX) were evaluated from August to December over 8 competitive seasons (2010-2017). Injury incidence rates (lIR) were calculated using injuries per 10 games = (number of injuries ÷ number of games) x 10.
RESULTS: Of the 665 games documented, 343 games (51.6%) were played on artificial turf versus 322 games (48.4%) played on natural grass. A total of 1,241 injuries were documented with 514 (41.4%) occurring on artificial turf, and 727 (58.6%) on natural grass. Analyses per 10 games indicated a significant main effect (Wilks’ Lambda F = 18.925; p<0.0001) between surfaces by month. Subsequent post hoc analyses indicated a significant lower incidence of injury while competing on artificial turf (p<0.05) during August [5.6 (95% CI, 2.7-8.1) vs 23.1 (19.9-24.8)], September [11.8 (95% CI, 10.4-12.9) vs 29.3 (27.8-29.7)], October [6.0 (95% CI, 4.9-7.0) vs 26.6 (24.5-27.6)], November/ December [8.0 (95% CI, 6.6-8.9) vs 36.0 (31.4-37.4)], and by total seasonal trauma [26.6 (95% CI, 25.5-27.3) vs 31.3 (30.4-31.8)] when compared to injuries reported on natural grass, respectively.
CONCLUSION: A significantly lower incidence of trauma was documented on artificial turf when compared to natural grass throughout all months of the competitive high school season. Further investigation is warranted to quantify seasonal surface influence across severity of injury, surface impact trauma, shoe surface-contact and noncontact trauma, specific extremity joints/muscles, and elective medical procedures in high school football. The findings of this study may be generalizable only to this level of football competition and this specific artificial surface.