Sports Medicine

, Volume 40, Issue 11, pp 981–990 | Cite as

The Effect of Playing Surface on Injury Rate

A Review of the Current Literature
  • Jason L. Dragoo
  • Hillary J. Braun
Review Article

Abstract

Synthetic playing surfaces are widely used for field and court sports. Artificial turf surfaces are commonly used as an alternative to natural grass, while outdoor surfaces like clay and acrylic are also prevalent. The effect of these synthetic surfaces on injury rates has not been clearly established. The available literature is largely limited to football and soccer data and the majority of studies are short-term. Confounding variables such as climate, player position and footwear, as well as varying definitions of injury, also make it difficult to draw firm conclusions about the general effect of artificial playing surfaces on injury rates. Many peer-reviewed studies cite a higher overall rate of injury on first- and second-generation artificial turf surfaces compared with natural grass. Despite differences in injury type, the rate of injury on third-generation and natural grass surfaces appears to be comparable. It also appears that clay is significantly safer than either grass or hard court tennis surfaces, but this is a conclusion drawn with limited data. Further research investigating overall injury trends as well as sport-specific data is needed to draw more definitive conclusions regarding the effect of artificial playing surfaces on injury rates.

References

  1. 1.
    Andresen BL, Hoffman MD, Barton LW. High school football injuries: field conditions and other factors. Wis Med J 1989 Oct; 88 (10): 28–31PubMedGoogle Scholar
  2. 2.
    Orchard J, Seward H, McGivern J, et al. Rainfall, evaporation and the risk of non-contact anterior cruciate ligamentinjury in the Australian Football League. Med J Aust 1999 Apr 5; 170 (7): 304–6PubMedGoogle Scholar
  3. 3.
    Orchard J. The AFL penetrometer study: work in progress. J Sci Med Sport 2001 Jun; 4 (2): 220–32PubMedCrossRefGoogle Scholar
  4. 4.
    Chivers IH, Aldous DE, Orchard JW. The relationship of Australian Football grass surfaces to anterior cruciateligament injury. Int Turfgrass Soc Res J 2005; 10: 327–32Google Scholar
  5. 5.
    Orchard JW, Chivers I, Aldous D, et al. Rye grass is associated with fewer non-contact anterior cruciate ligamentinjuries than bermuda grass. Br J Sports Med 2005 Oct; 39 (10): 704–9PubMedCrossRefGoogle Scholar
  6. 6.
    Bowers Jr KD, Martin RB. Turf-toe: a shoe-surface related football injury. Med Sci Sports 1976; 8 (2): 81–3PubMedGoogle Scholar
  7. 7.
    Clanton TO, Butler JE, Eggert A. Injuries to the metatarsophalangeal joints in athletes. Foot Ankle 1986 Dec; 7 (3): 162–76PubMedGoogle Scholar
  8. 8.
    Coker TP, Arnold JA, Weber DL. Traumatic lesions of the metatarsophalangeal joint of the great toe in athletes. Am J Sports Med 1978 Nov-Dec; 6 (6): 326–34PubMedCrossRefGoogle Scholar
  9. 9.
    Rodeo SA, O’Brien S, Warren RF, et al. Turf-toe: an analysis of metatarsophalangeal joint sprains in professionalfootball players. Am J Sports Med 1990 May-Jun; 18 (3): 280–5PubMedCrossRefGoogle Scholar
  10. 10.
    Larson RL, Osternig LR. Traumatic bursitis and artificial turf. J Sports Med 1974 Jul-Aug; 2 (4): 183–8PubMedCrossRefGoogle Scholar
  11. 11.
    Adkison JW, Requa RK, Garrick JG. Injury rates in high school football: a comparison of synthetic surfaces andgrass fields. Clin Orthop Relat Res 1974 Mar-Apr; (99): 131–6PubMedCrossRefGoogle Scholar
  12. 12.
    Alles WF, Powell JW, Buckley W, et al. The national athletic injury/illness reporting system 3-year findings of highschool and college football injuries. J Orthop Sports Phys Ther 1979; 1 (2): 103–8PubMedGoogle Scholar
  13. 13.
    Bowers Jr KD, Martin RB. Impact absorption, new and old Astro Turf at West Virginia University. Med Sci Sports 1974; 6 (3): 217–21PubMedGoogle Scholar
  14. 14.
    Bramwell ST, Requa RK, Garrick JG. High school football injuries: a pilot comparison of playing surfaces. Med Sci Sports 1972; 4 (3): 166–9PubMedGoogle Scholar
  15. 15.
    Keene JS, Narechania RG, Sachtjen KM, et al. Tartan Turf on trial: a comparison of intercollegiate football injuriesoccurring on natural grass and Tartan Turf. Am J Sports Med 1980 Jan-Feb; 8 (1): 43–7PubMedCrossRefGoogle Scholar
  16. 16.
    Stevenson M, Anderson B. The effects of playing surfaces on injuries in college intramural touch football. J Nat Intramural-Recreational Sports Assoc 1981; 5: 59–64Google Scholar
  17. 17.
    Powell JW. Incidence of injury associated with playing surfaces in the National Football League 1980-1985. Athl Train 1987; 22 (3): 202–6Google Scholar
  18. 18.
    Powell JW, Schootman M. A multivariate risk analysis of selected playing surfaces in the National Football League,1980 to 1989: an epidemiologic study of knee injuries. Am J Sports Med 1992 Nov-Dec; 20 (6): 686–94PubMedCrossRefGoogle Scholar
  19. 19.
    Powell JW, Schootman M. A multivariate risk analysis of natural grass and Astroturf playing surfaces in theNational Football League 1980-1989. Int Turfgrass Soc Res J 1993; 7 (23): 201–11Google Scholar
  20. 20.
    Hagel BE, Fick GH, Meeuwisse WH. Injury risk in men’s Canada West University football. Am J Epidemiol 2003 May 1; 157 (9): 825–33PubMedCrossRefGoogle Scholar
  21. 21.
    Gorse K, Mickey CA, Bierhals A. Conditioning injuries associated with artificial turf in two preseason footballtraining programs. J Athl Train 1997 Oct; 32 (4): 304–8PubMedGoogle Scholar
  22. 22.
    Guskiewicz KM, Weaver NL, Padua DA, et al. Epidemiology of concussion in collegiate and high school footballplayers. Am J Sports Med 2000 Sep-Oct; 28 (5): 643–50PubMedGoogle Scholar
  23. 23.
    Scranton Jr PE, Whitesel JP, Powell JW, et al. A review of selected noncontact anterior cruciate ligament injuriesin the National Football League. Foot Ankle Int 1997 Dec; 18 (12): 772–6PubMedGoogle Scholar
  24. 24.
    Orchard JW, Powell JW. Risk of knee and ankle sprains under various weather conditions in American football. Med Sci Sports Exerc 2003 Jul; 35 (7): 1118–23PubMedCrossRefGoogle Scholar
  25. 25.
    Fuller CW, Dick RW, Corlette J, et al. Comparison of the incidence, nature and cause of injuries sustained on grassand new generation artificial turf by male and femalefootball players. Part 1: match injuries. Br J Sports Med 2007 Aug; 41 Suppl. 1: i20–6CrossRefGoogle Scholar
  26. 26.
    Fuller CW, Dick RW, Corlette J, et al. Comparison of the incidence, nature and cause of injuries sustained on grassand new generation artificial turf by male and femalefootball players. Part 2: training injuries. Br J Sports Med 2007 Aug; 41 Suppl. 1: i27–32CrossRefGoogle Scholar
  27. 27.
    Meyers MC, Barnhill BS. Incidence, causes, and severity of high school football injuries on Field Turf versus naturalgrass: a 5-year prospective study. Am J Sports Med 2004 Oct-Nov; 32 (7): 1626–38PubMedCrossRefGoogle Scholar
  28. 28.
    Ekstrand J, Timpka T, Hagglund M. Risk of injury in elite football played on artificial turf versus natural grass: aprospective two-cohort study. Br J Sports Med 2006 Dec; 40 (12): 975–80PubMedCrossRefGoogle Scholar
  29. 29.
    Steffen K, Andersen TE, Bahr R. Risk of injury on artificial turf and natural grass in young female football players. Br J Sports Med 2007 Aug; 41 Suppl.1: i33–7CrossRefGoogle Scholar
  30. 30.
    Cross R. Grand Slam injuries 1978–2005. Med Sci Tennis 2006; 11 (1) [online]. Available from URL: http://www.stms.nl/index.php?option=com_content&task=view&id=521&Itemid=350 [Accessed 2010 Aug 11]
  31. 31.
    Miller S. Modern tennis rackets, balls, and surfaces. Br J Sports Med 2006 May; 40 (5): 401–5PubMedCrossRefGoogle Scholar
  32. 32.
    Kulund DN, McCue III FC, Rockwell DA, et al. Tennis injuries: prevention and treatment. Am J Sports Med 1979; 7 (4): 249–53PubMedCrossRefGoogle Scholar
  33. 33.
    Bastholt P. Professional tennis (ATP tour) and number of medical treatments in relation to type of surface. Med Sci Tennis 2000; 5 (2) [online]. Available from URL: http://www.stms.nl/index.php?option=com_content&task=view&id=881&Itemid=263 [Accessed 2009 Apr 19]
  34. 34.
    Olsen OE, Myklebust G, Engebretsen L, et al. Relationship between floor type and risk of ACL injury in team handball. Scand J Med Sci Sports 2003 Oct; 13 (5): 299–304PubMedCrossRefGoogle Scholar
  35. 35.
    Pasanen K, Parkkari J, Rossi L, et al. Artificial playing surface increases the injury risk in pivoting indoor sports: aprospective one-season follow-up study in Finnish femalefloorball. Br J Sports Med 2008 Mar; 42 (3): 194–7PubMedCrossRefGoogle Scholar
  36. 36.
    Ramirez M, Schaffer KB, Shen H, et al. Injuries to high school football athletes in California. Am J Sports Med 2006 Jul; 34 (7): 1147–58PubMedCrossRefGoogle Scholar
  37. 37.
    Nicholas JA, Rosenthal PP, Gleim GW. A historical perspective of injuries in professional football: twenty-sixyears of game-related events. JAMA 1988 Aug 19; 260 (7): 939–44PubMedCrossRefGoogle Scholar
  38. 38.
    Dick R, Putukian M, Agel J, et al. Descriptive epidemiology of collegiate women’s soccer injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989through 2002-2003. J Athl Train 42 (2): 278–85Google Scholar
  39. 39.
    Agel J, Evans TA, Dick R, et al. Descriptive epidemiology of collegiate men’s soccer injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 through 2002–2003. J Athl Train 2007 Apr-Jun; 42 (2): 270–7PubMedGoogle Scholar
  40. 40.
    Arnason A, Gudmundsson A, Dahl HA, et al. Soccer injuries in Iceland. Scand J Med Sci Sports 1996 Feb; 6 (1): 40–5PubMedCrossRefGoogle Scholar
  41. 41.
    Bylak J, Hutchinson MR. Common sports injuries in young tennis players. Sports Med 1998 Aug; 26 (2): 119–32PubMedCrossRefGoogle Scholar
  42. 42.
    Dick R, Hertel J, Agel J, et al. Descriptive epidemiology of collegiate men’s basketball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. J Athl Train 2007 Apr-Jun; 42 (2): 194–201PubMedGoogle Scholar
  43. 43.
    Agel J, Olson DE, Dick R, et al. Descriptive epidemiology of collegiate women’s basketball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. J Athl Train 2007 Apr-Jun; 42 (2): 202–10PubMedGoogle Scholar

Copyright information

© Adis Data Information BV 2010

Authors and Affiliations

  • Jason L. Dragoo
    • 1
  • Hillary J. Braun
    • 1
  1. 1.Department of Orthopaedic SurgeryStanford UniversityPalo AltoUSA
  2. 2.Department of Orthopaedic SurgeryStanford UniversityRedwood CityUSA

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