Location
Suwanee, GA
Start Date
6-5-2025 1:00 PM
End Date
6-5-2025 4:00 PM
Description
Background: The widespread adoption of artificial turf in professional and collegiate football and soccer has raised concerns about its influence on anterior cruciate ligament (ACL) injury rates. While artificial surfaces may increase lower extremity injury risk due to greater surface friction and cleat-turf interaction, some studies report no significant difference compared to natural grass. This review assesses the correlation between playing surface types and ACL injury incidence in football and soccer athletes.
Methods: A comprehensive literature review was conducted in November 2024 across PubMed, Embase, Scopus, and Google Scholar using terms such as “ACL injury,” “artificial turf,” “natural grass,” and “FieldTurf.” Studies comparing ACL injury rates on artificial turf and natural grass among National Football League (NFL), National Collegiate Athletic Association (NCAA) football, and professional soccer players were included. Exclusion criteria encompassed studies focused on non-ligamentous injuries, youth athletes, or surfaces outside of competitive play. Key data on injury incidence, risk ratios, and biomechanical factors were extracted and analyzed.
Results: Forty-two articles were initially identified, of which fifteen studies met the inclusion criteria, representing 7,800 athletes across football and soccer. Among NFL players, ACL sprains were 67% higher on FieldTurf than on natural grass (p < .001), though overall ACL injury rates per team game showed no significant difference (p > .05). NCAA Division II and III football players experienced 1.63 times higher ACL injury rates on turf compared to grass (p < .05). In professional soccer, ACL injury rates were higher on natural grass (1.16 per 10,000 athlete exposures) than on artificial turf (0.92 per 10,000 AEs) (p < .0001). However, female soccer players had an 18% higher ACL injury risk on artificial turf compared to natural grass (p = .004), whereas male players showed no significant difference. Biomechanical studies indicated that higher rotational forces and cleat-surface traction on artificial turf may increase ACL injury risk, particularly in football and female soccer players.
Conclusion: ACL injury risk on artificial turf varies by sport and athlete demographic. While NFL data remains inconclusive, NCAA football players and female soccer athletes show a higher ACL injury risk on artificial turf, whereas male soccer players experience no significant difference. Increased surface friction and cleat engagement may explain these findings. Further longitudinal studies are needed to refine injury prevention strategies for athletes competing on artificial surfaces.
Embargo Period
5-28-2025
Included in
The Impact of Artificial Turf versus Natural Grass on Anterior Cruciate Ligament Injury Rates in Football and Soccer: A Scoping Review
Suwanee, GA
Background: The widespread adoption of artificial turf in professional and collegiate football and soccer has raised concerns about its influence on anterior cruciate ligament (ACL) injury rates. While artificial surfaces may increase lower extremity injury risk due to greater surface friction and cleat-turf interaction, some studies report no significant difference compared to natural grass. This review assesses the correlation between playing surface types and ACL injury incidence in football and soccer athletes.
Methods: A comprehensive literature review was conducted in November 2024 across PubMed, Embase, Scopus, and Google Scholar using terms such as “ACL injury,” “artificial turf,” “natural grass,” and “FieldTurf.” Studies comparing ACL injury rates on artificial turf and natural grass among National Football League (NFL), National Collegiate Athletic Association (NCAA) football, and professional soccer players were included. Exclusion criteria encompassed studies focused on non-ligamentous injuries, youth athletes, or surfaces outside of competitive play. Key data on injury incidence, risk ratios, and biomechanical factors were extracted and analyzed.
Results: Forty-two articles were initially identified, of which fifteen studies met the inclusion criteria, representing 7,800 athletes across football and soccer. Among NFL players, ACL sprains were 67% higher on FieldTurf than on natural grass (p < .001), though overall ACL injury rates per team game showed no significant difference (p > .05). NCAA Division II and III football players experienced 1.63 times higher ACL injury rates on turf compared to grass (p < .05). In professional soccer, ACL injury rates were higher on natural grass (1.16 per 10,000 athlete exposures) than on artificial turf (0.92 per 10,000 AEs) (p < .0001). However, female soccer players had an 18% higher ACL injury risk on artificial turf compared to natural grass (p = .004), whereas male players showed no significant difference. Biomechanical studies indicated that higher rotational forces and cleat-surface traction on artificial turf may increase ACL injury risk, particularly in football and female soccer players.
Conclusion: ACL injury risk on artificial turf varies by sport and athlete demographic. While NFL data remains inconclusive, NCAA football players and female soccer athletes show a higher ACL injury risk on artificial turf, whereas male soccer players experience no significant difference. Increased surface friction and cleat engagement may explain these findings. Further longitudinal studies are needed to refine injury prevention strategies for athletes competing on artificial surfaces.