Incidence, mechanisms, and severity of match-related collegiate women's soccer injuries on FieldTurf and natural grass surfaces: a 5-year prospective study

Am J Sports Med. 2013 Oct;41(10):2409-20. doi: 10.1177/0363546513498994. Epub 2013 Aug 13.


Background: Numerous injuries have been attributed to playing on artificial turf. Over the past 2 decades, however, newer generations of synthetic turf have been developed to duplicate the playing characteristics of natural grass. Although synthetic turf has been determined to be safer than natural grass in some studies, few long-term studies have been conducted comparing match-related collegiate soccer injuries between the 2 playing surfaces.

Hypothesis: Collegiate female soccer athletes do not experience any difference in the incidence, mechanisms, and severity of match-related injuries on FieldTurf and on natural grass.

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

Methods: Female soccer athletes from 13 universities were evaluated over 5 competitive seasons for injury incidence, injury category, time of injury, injury time loss, player position, injury mechanism and situation, primary type of injury, injury grade and anatomic location, field location at the time of injury, injury severity, head and lower extremity trauma, cleat design, turf age, and environmental factors. In sum, 797 collegiate games were evaluated for match-related soccer injuries sustained on FieldTurf or natural grass during 5 seasons.

Results: Overall, 355 team games (44.5%) were played on FieldTurf versus 442 team games (55.5%) on natural grass. A total of 693 injuries were documented, with 272 (39.2%) occurring during play on FieldTurf and 421 (60.8%) on natural grass. Multivariate analysis per 10 team games indicated a significant playing surface effect: F₂,₆₉₀ = 6.435, P = .002, n-β = .904. A significantly lower total injury incidence rate (IIR) of 7.7 (95% confidence interval [CI], 7.2-8.1) versus 9.5 (95% CI, 9.3-9.7) (P = .0001) and lower rate of substantial injuries, 0.7 (95% CI, 0.5-1.0) versus 1.5 (95% CI, 1.2-1.9) (P = .001), were documented on FieldTurf versus natural grass, respectively. Analyses also indicated significantly less trauma on FieldTurf when comparing injury time loss, player position, injury grade, injuries under various field conditions and temperatures, cleat design, and turf age.

Conclusion: Although similarities existed between FieldTurf and natural grass during competitive match play, FieldTurf is a practical alternative when comparing injuries in collegiate women's soccer. It must be reiterated that the findings of this study may be generalizable to only collegiate competition and this specific artificial surface.

Keywords: artificial surface; head; knee; trauma.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Athletic Injuries / epidemiology*
  • Body Weight
  • Craniocerebral Trauma / epidemiology
  • Environment
  • Female
  • Humans
  • Incidence
  • Knee Injuries / epidemiology
  • Prospective Studies
  • Shoes
  • Soccer / injuries*
  • United States / epidemiology
  • Young Adult