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. 2019 Mar 25;7(3):2325967119832878.
doi: 10.1177/2325967119832878. eCollection 2019 Mar.

Incidence, Mechanisms, and Severity of Game-Related High School Football Injuries Across Artificial Turf Systems of Various Infill Weights

Michael C Meyers  1
Affiliations

Incidence, Mechanisms, and Severity of Game-Related High School Football Injuries Across Artificial Turf Systems of Various Infill Weights

Michael C Meyers. Orthop J Sports Med. .

Abstract

Background: Artificial turf surfaces are developed to duplicate playing characteristics of natural grass. With the newer generations of sand and rubber infill systems, the infill is a common component that varies between fields and is a critical factor that could influence the player-surface interaction. Because the influence of infill weight on sport trauma is unknown, this study quantified football trauma in high schools in the United States across artificial turf systems of various infill weights.

Hypothesis: Athletes would not experience differences in game-related injuries across artificial turf systems of various infill weights.

Study design: Cohort study; Level of evidence, 2.

Methods: Artificial turf systems were divided into 4 sand/rubber infill weight groups by pounds per square foot: ≥9.0, 6.0-8.9, 3.0-5.9, and 0.0-2.9. A total of 57 high schools in 4 states participated over the course of 5 seasons. Outcomes of interest included injury severity, as a function of infill weight, across head, knee, and shoulder traumas; injury category; primary type of injury; tissue type; specific body location of injury; cleat design; environmental factors; and turf age. Data were subject to multivariate analyses of variance (MANOVAs) and Wilks λ criteria through use of general linear model procedures.

Results: Of 1837 games documented, 528 games were played on infill weights of ≥9.0 lb/ft2, 521 on 6.0-8.9 lb/ft2, 525 on 3.0-5.9 lb/ft2, and 263 on 0.0-2.9 lb/ft2, with 4655 total injuries reported. MANOVAs indicated significant infill weight effects across injury severity (F 2,4648 = 5.087; P = .0001), with significant main effects also observed by injury category, tissue injured, lower extremity joint and muscle, cleat design, environmental factors, and turf age. Post hoc analyses indicated significantly lower (P < .05 to .0001) total and substantial traumas, concussions, shoe-surface interaction during contact trauma, surface impacts, muscle-tendon overload, cleat design influence, adverse weather trauma, lower extremity injuries, and turf age effect while athletes were competing on the 6.0 to ≥9.0 lb/ft2 infill weight systems compared with the lighter infill weight systems.

Conclusion: As infill surface weight decreased, football trauma significantly increased across numerous playing conditions. Based on findings, high school football fields should minimally contain 6.0 pounds of infill per square foot.

Keywords: artificial surface; knee; trauma; turf.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: This research was partially funded by FieldTurf USA, Calhoun, Georgia. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

References

    1. Arden CL, Taylor NF, Feller JA, Whitehead TS, Webster KE. Sports participation 2 years after anterior cruciate ligament reconstruction in athletes who had not returned to sport at 1 year: a prospective follow-up of physical function and psychological factors in 122 athletes. Am J Sports Med. 2015;43(4):848–856. - PubMed
    1. American College of Sports Medicine. Guidelines for Exercise Testing and Prescription. Philadelphia, PA: Lippincott Williams & Wilkins; 2006:19–54, 115-173.
    1. Bahr R, Krosshaug T. Understanding injury mechanisms: a key component of preventing injuries in sport. Br J Sports Med. 2005;39:324–329. - PMC - PubMed
    1. Balazs GC, Pavey GJ, Brelin AM, Pickett A, Keblish DJ, Rue JPH. Risk of anterior cruciate ligament injury in athletes on synthetic playing surfaces. Am J Sports Med. 2015;43(7):1798–1804. - PubMed
    1. Bjorneboe J, Bahr R, Andersen TE. Risk of injury on third-generation artificial turf in Norwegian professional football. Br J Sports Med. 2010;44(11):794–798. - PubMed