K.A. Johnson, M.C. Meyers, FACSM, C. Faure, and K.M. Shuman.

Idaho State University, Pocatello, ID

Concussions with concomitant neural trauma have recently become major concerns in sports. Although newer generations of artificial turf have been developed to duplicate playing characteristics of natural grass, no long-term studies have specifically compared cranial and cervical trauma between the two surfaces. PURPOSE: To quantify incidence, mechanisms, and severity of game-related cranial/cervical high school football injuries on artificial turf versus natural grass. METHODS: 19 high schools were evaluated over 9 competitive seasons for injury incidence, injury category, time of injury, injury time loss, player position, injury mechanism and situation, primary type of injury, grade and anatomical location of injury, type of tissue injured, elective imaging and surgical procedures, and environmental factors. RESULTS: Of the 433 high school games documented, 239 team games (55.2%) were played on artificial turf versus 194 team games (44.8%) played on natural grass. A total of 124 cranial/cervical injuries were documented with 58 (46.8%) occurring on artificial turf, and 66 (53.2%) on natural grass. Univariate analyses per 10 team games indicated no significant injury incidence effect (p > 0.05), between surfaces by severity level, either in minor injury incidence rates (IIRs), 1.5 (95% CI, 1.1-2.0) versus 0.2 (95% CI, 1.4-2.5), in substantial IIRs, 0.8 (95% CI, 0.5-1.2) versus 1.2 (95 % CI, 0.8-1.8), or in severe IIRs, 0.2 (95% CI, 0.1-0.4) versus 0.3 (95 % CI, 0.1-0.6) documented on artificial turf when compared to natural grass, respectively. Analyses indicated a significant playing surface effect (p > 0.05) by field conditions (no precipitation/wet field); [0.0 (95% CI, 0.0-0.0) vs 0.6 (0.3-1.0)], while competing on artificial turf versus natural grass, respectively. No significant surface effects on cranial/cervical trauma were observed in injury category, injury grade, player position, injury mechanism and situation, injury time loss, elective imaging and surgical procedures, environmental factors, type of tissue or across specific joint and muscle. CONCLUSION: Since minimal differences in injury incidence rates existed between artificial turf and natural grass over a 9-year period of competitive play, artificial turf is a practical alternative when comparing cranial/cervical injuries in high school football. It must be reiterated that the findings of this study may be generalizable to only high school football competition and this specific artificial surface.

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