Title : Artificial turf vs. natural grass: A comparative analysis of ankle injury risk in soccer players
Abstract:
Ankle injuries are one of the most common injuries sustained among soccer players. Of the factors that may contribute to these injuries, playing surfaces, i.e., artificial turf or natural grass, has been the subject of considerable debate. It is still not clear whether artificial turf increases the risk of ankle injury compared with natural grass. Understanding this factor may help players, coaches, and different organizations make better decisions about playing surfaces and reduce the chance of injury to players. To address this gap, this work examines whether playing soccer on artificial turf poses a higher risk of ankle injuries compared with natural grass in soccer players. Nine studies, representing twelve different cohorts, were reviewed in this work. All selected studies were included because they directly compared ankle injuries incurred on artificial turf and natural grass among soccer players. These studies included both male and female soccer players across a range of ages and competition levels to evaluate whether the relationship between playing surface and injury risk is consistent across sexes.
Using the injury counts and player exposure hours from these studies, injury incidence rates (injuries per 1000 player-hours) on both surfaces, as well as Incidence Rate Ratios (IRRs) were calculated to statistically compare ankle injury risk between the two playing surfaces. Our IRR analysis indicates that an almost equal number of cohorts had IRR values greater than 1 and less than 1, suggesting similar ankle injury risk on either surface. Furthermore, we used the log-transformed standard error of each study cohort to calculate the respective 95% confidence intervals for possible IRR ranges. Taken together, our analysis does not support consistent evidence that playing soccer on either artificial turf or natural grass leads to a higher risk of ankle injuries. This also reveals that the type of playing surface may not be the sole risk factor for ankle injuries among soccer players. Other factors such as age, sex, training time, experience, competition level, and injury definition, could also have an impact on injury rate. Overall, this work suggests that there is no significant difference in the rate of ankle injuries between artificial turf and natural grass among soccer players.
