SAN FRANCISCO (KCBS RADIO) – Artificial turf has been found to cause an increased risk of a lower extremity injury – including to an athlete’s ACL and Achilles tendon – according to recent research from UCSF Health.
More athletic facilities have turned to artificial turf as a playing surface instead of grass to lower water use and better manage maintenance costs.
Dr. Brian Feeley, Director of Sports Medicine at UCSF Health, led the research on the injury impact this turf has on athletes compared to natural grass, motivated in part by an injury to San Francisco 49ers star Nick Bosa at Metlife Stadium in New Jersey.
He discussed his findings on this week’s episode of “As Prescribed” with KCBS’ Bret Burkhart.
“Over the last 50 years since Astroturf was first developed, artificial turf has gotten much better. In the ‘80s and early ‘90s – when it really was Astroturf, which was developed for the Astrodome – we knew that the injury rates in Major League Baseball and the NFL were much higher,” Dr. Feeley explained. “But with this new field turf, the injury rates have gotten better and better and a lot of science and engineering has gone into making it closer [to grass].”
But it is still not a one-for-one match to the natural thing.
“Overall, what we found was there’s a slightly, but statistically significantly higher risk of having what we would call a ‘serious injury’, meaning that you are going to have a season-ending surgery after that injury when you play on artificial turf compared to natural grass,” the orthopedic surgeon explained. “It’s about a 1.6-fold increase.”
Dr. Feeley said he and his co-authors on this study were able to do their research in a well-controlled environment, allowing him and his team to accurately rule out other potential causes for injuries beyond what was below the athlete’s foot on the ground.
Despite the increased odds, the research found the actual number of injuries in this study is relatively low.
Another aspect to keep in mind with this research is that it was done looking only at NFL-quality facilities.
“Just like grass, where there are different types of grass, there are different types of turf. Unfortunately, in our study, even though we were able to look at which stadiums this [injury] happened, we’re not able to have enough numbers to say that ‘turf from company X is better than turf from company Y’.
He noted that since this study only focused on NFL turf facilities, it also only looked at natural grass facilities across the league – which is seen as having a higher standard of maintenance compared to a grass field at a local park.
The doctor said innovations in artificial turf technology continue to get better with each iteration, further improving the safety of the product.
“Overall, it is an excellent idea. It is water-saving, it is cost-saving, but the upkeep is still significant. Many fields across the U.S., especially in areas where you have a high risk of drought, field turf has become much more common because it is easier and cheaper to maintain.”
What impact does this have beyond an NFL-level facility?
Dr. Feeley noted that turf and grass facilities in an NFL stadium are maintained to a higher standard than comparable fields elsewhere due to the stakeholders that are involved in the league processes – from the players union to investors dedicated to a high-level product.
“That doesn’t necessarily trickle down to female athletic leagues and it certainly doesn’t trickle down to high school athletic leagues or recreational parks where we see that these field turfs are not kept in as good conditions.”
The doctor said that this does put kids at a higher risk of injury.
“We know even the difference in where the male athletes perform and the female athletes perform at a high level, the fields are not as good for the women – and the field turf fields are not as good for the women as they are for the men in equivocal sports,” Dr. Feeley explained.
His wish is for more effort on all levels of athletics to improve the level of quality of their fields to be closer to that of professional levels.
“Ideally, we would see a little bit more effort put into the recreational fields that we see across San Francisco and across the Bay Area and across the country,” the surgeon stated.
The top soccer injuries he sees are ACL injuries in people that are playing club or recreational soccer played in a variety of settings with different levels of quality.
Despite this, he said the risk – beyond the natural risk of playing any sport – is minimal for kids and athletes.
The key is not worrying specifically about where the sports are being played, but rather what equipment you are using with that facility. An example would be using cleats on a wet field with long grass and indoor soccer shoes at a facility that has a very flat surface.
“The benefits of playing sports far, far, far outweighs the risk of each individual event going out and participating in recreational sports or club sports or high school sports.”
Listen to this week's "As Prescribed" to learn more. You can also listen to last week's episode to learn how coffee can improve your heart health, here.