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17 PLAYING SURFACE AND
PROTECTIVE EQUIPMENT
Jeffrey G Jenkins, MD
Scott Chirichetti, DOPLAYING SURFACE- In many sports, the athlete or event organizer has no
choice with regard to playing surface: only one option
exists; however, in some sports, different options offer
their own advantages and disadvantages. These are
addressed below.
TURF SPORTS•Turf sports (e.g., football, soccer, and field hockey)
may be played on either artificial turf or natural grass.
Natural grass is generally held to be safer and is asso-
ciated with lower rates of significant injury owing to
the lack of “give” or “cushion” afforded by synthetic
turf. The literature, however, has been inconclusive.- The Stanford Research Institute study found that
among National Football League (NFL) players,
major ligamentous injuries occurred more frequently
on artificial turf (Grippo, 1973). (This study also
found that concussions occurred 33% more often on
synthetic turf, presumably owing in part to increased
player speed and, consequently, increased collision
forces.)
•Powell’s landmark NFL study confirmed these find-
ings, showing a statistically significantly higher rate
of anterior cruciate ligamentsprains on astroturf
among NFL players between 1980 and 1989 (Powell
and Schootman, 1992).
•However, two studies of college athletes dispute these
results. A national athletic injury/illness reporting
system study in 1975 concluded that “artificial turf
did not constitute an imminent hazard to the... teams
using it (Troy, 1977).” Furthermore, a study from the
University of Wisconsin in 1980 actually reported a
decreased incidence of serious sprains on artificial
surface (Keene, 1996).
•A German study by Gaulrapp et al showed no signifi-
cant increase in rate of injury of soccer players using
artificial rather than natural grass fields (Gaulrapp,
Siebert, and Rosemeyer, 1999). - Certain types of minor injuries are exclusive to artifi-
cial turf. These include turf burns, the common abra-
sions associated with the surface. These injuries can
be accompanied by contamination of the wounds with
102 SECTION 1 • GENERAL CONSIDERATIONS IN SPORTS MEDICINE