Playing Surface and Injury Risk: Artificial Turf Vs. Natural Grass

Artificial turf’s developmental history spans 6 generations and includes design improvements that transformed an injury-inducing 1st generation field into a modern 3rd generation natural grass substitute. Artificial turf has become a widely adopted playing surface with a $2.7 billion United States Dollar (USD) valuation in North America. Turf’s popularity is due to its increased functionality and decreased cost compared to natural grass that allows more sports to play on the surface for longer time periods with decreased maintenance costs. From a biomechanical perspective, artificial turf exhibits higher frictional coefficients than natural grass resulting in higher foot and ankle injury rates. Concussion rates on turf are decreased compared to natural grass due to lower G-max values on well-maintained artificial surfaces. Hip, knee, and overall injury rates are equivalent between the two surfaces except in specific populations including elite-level American football players that exhibit increased knee injury rates on artificial turf. Due to these tradeoffs, the authors suggest that athletic organizations with funding to support professional groundskeeping should consider investing in natural grass due to athlete preference and decreased injury risk. In contrast, organizations without sufficient funding for professional groundskeeping operations may consider investing in modern artificial turf due to its associated long-term benefits and decreased costs