Are soccer injuries more common on synthetic surface than natural grass? – Dr Andrew Ullo (Chiropractor) 

Ever since the introduction to synthetic fields, aka FieldTurf or Astroturf, there has been the controversy about the use of artificial grass playing surfaces compared to natural grass when it comes to injuries. A lot of players and coaches believe that the synthetic turf leads to more injuries, whereas others believe it’s safer. In spite of this controversy, synthetic surfaces have been used for a wide range of different sports and can be found on many public and professional fields.

So what does the Data say?

One study published by Michael Meyers in The American Journal of Sports Medicine in 2004 titled

“Incidence, Mechanisms, and Severity of Game-Related College Football Injuries on FieldTurf Versus Natural Grass:  A 3-Year Prospective Study,” followed 24 Division IA NCAA football teams for three years and investigated a total of 465 games (230 on Synthetic Turf and 235 on natural grass) over that period.

The results from the synthetic turf had a higher incidence of zero-day time injuries lost, non-contact injuries, surface injuries, muscle related trauma and injuries during high temperatures. Whereas natural grass had a higher incidence of 1-2 days loss of playing time, 22+ day injuries, head and neural trauma and ligament injuries.

This paper concluded that there was no difference in the overall injury risk between synthetic turf and natural grass, but concussions were more common on natural grass.

A recent epidemiologic study that was published in 2012 in The American Journal of Sports Medicine which demonstrated the effect of turf on the incidence of ACL injuries in NCAA football. This retrospective study illustrated that between 2004 and 2009, NCAA football players experienced a greater number of ACL injuries in games compared with practices and when playing on artificial turf surfaces. There are other high-quality studies that support an increased rate of ACL injury on synthetic playing surfaces in football, but there is no apparent increased risk in soccer.

An even more recent study lead by Alessandro Ciompi, an orthopedic surgeon at the University of Rome showed that professional soccer players suffer the same number of injuries whether they play on natural grass or artificial fields.

Dr. Ciompi and his team followed 4, 1st division Italian professional soccer teams in the 2011/12 season. The home fields of the Cesena and Novara teams were made of artificial turf, and the home fields of the Torino and Juventus teams were made of natural grass. They showed that soccer injury rates equivalent on artificial fields and grass. These findings are consistent with other studies of soccer played on third-generation artificial fields.

My thoughts

I believe the jury is still out and that more research is needed for this debatable subject. There is still a lot of work to be done, mainly understanding what particular injuries are more common on different surfaces. Other areas that could be researched include the amount of energy expended when training on turf compared to grass or boots used for different surfaces. Also safety issues to be looked at include risk of skin infections due to different surfaces, exposure to harmful chemicals, surface temperatures and when are they at their peak during the day.

At the end of the day, I believe based on the current research, players, coaches and parents should feel comfortable about playing soccer on artificial fields. The likelihood of suffering an injury is no greater than when playing on grass.


Dragoo JL, Braun HJ. The effect of playing surface on injury rate a review of the current literature. Sport Med 2010; 40 (11): 981–90

Meyers MC, Barnhill BS. Incidence, causes, and severity of high school football injuries on Field Turf versus naturalgrass: a 5-year prospective study. Am J Sports Med 2004; 32 (7): 1626–38<?p>

American Academy of Orthopaedic Surgeons (AAOS) 2014 Annual Meeting: Abstract P443. Presented March 11, 2014.

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Photo Credit: El Ronzo –