Synthetic playing fields for sports may pose increased risk of concussion in youth

ANAHEIM, CA—While rules and playing equipment in sports have changed over time, one area of sports safety that remains largely unexplored is the playing surface itself. In new research presented during the 2022 AAP National Conference & Exhibition, researchers found that concussion risk may be higher for athletes playing on synthetic turf fields compared with natural grass.

While synthetic turf football fields are increasing in popularity due to lower maintenance costs, they have also been associated with more ankle and knee injuries, said the paper’s author, Ian Chun, a third-year medical student at the University of Hawai'i. He will present his research during a presentation called, “Impact Force Differences on Natural Grass Versus Synthetic Turf Football Fields.”

“Injuries in sports have always been an accepted consequence of play and competition but in recent years the national discourse around sports safety has changed,” said author Ian Chun. “Armed with injury prevention strategies and better engineered safety equipment, sports continue to be exciting for players and audiences with the added benefit of better health outcomes for our athletes. The emphasis on player safety is especially important for children as injuries sustained in developing adolescence may have longer-term impacts and unforeseen consequences.”

Chun compared the hardness of natural grass or synthetic turf high school football fields by attaching sensors to a manikin that could measure the rate of deceleration as it hit the ground and compared the decelerating force between fields. He found that synthetic turf football fields had a greater impact deceleration compared to natural grass fields, presenting an increased risk of injury due to contact with the playing surface. While more research is needed to assess all the risks of different playing surfaces, this could help guide sports management decisions and create safer playing environments, he said.

Chun conducted his tests on school playing fields in Oahu, Hawaii, and acknowledged the Hawai’i Department of Education for its support on the project.

“Our findings show that when we consider safety in sports, we need to widen our view to include the spaces where we play,” Chun said.

Ian Chun is scheduled to present an abstract of the study, available below, from 4-5 p.m. PT Saturday, Oct. 8 during the Council on Sports Medicine and Fitness Session at the Anaheim Marriott, Platinum Ballroom 7-8. To request an interview with Chun or another abstract author, journalists may contact him at  ikhchun@hawaii.edu or (360) 509-1130.

In addition, Mr. Chun will be among highlighted abstract authors who will give brief presentations and be available for interviews during a press conference from 8:30 a.m.- 10 a.m. PT Saturday, Oct. 8, in the National Conference Press Room, 213 AB. During the meeting, you may reach AAP media relations staff in the Press Room.]

Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal. 

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org. Reporters can access the meeting program and other relevant meeting information through the AAP meeting website at http://www.aapexperience.org/

Program Name: 2022 AAP National Conference & Exhibition

Abstract Title: Impact Force Differences on Natural Grass Versus Synthetic Turf Football Fields

Ian Chun

Honolulu, HI, United States

Concussions in high school athletes have negative impacts on attention and concentration and negative associations with academic performance. In previous studies of high school sports, over 15% of concussions were attributed to contact with the playing surface. While synthetic turf football fields are increasing in popularity due to lower maintenance costs, they have also been associated with more ankle and knee injuries, with inconclusive data on concussions. In this study, natural grass and synthetic football fields were compared by assessing the deceleration on fall impact. The objective of this study was to determine if there is a difference in decelerating force delivered to pediatric athletes between natural grass and synthetic turf football fields. The primary measure of this study was the deceleration of a manikin on impact with the field.

Accelerometers were placed on the forehead, apex of the head, and right ear of a Century Body Opponent Bag (BOB) manikin. A Riddell football helmet was secured onto the head of the manikin over the accelerometers. This manikin was dropped onto natural grass and synthetic turf high school football fields from a stationary position at a height of 60 cm onto its front, back, and left side. Each of these drops was conducted 10 times at the 40-yard line, 20-yard line, and endzone. The deceleration on impact was calculated for each sensor by calculating a net vector from the x, y, and z vector components.

Data was collected on 1,710 total drops from 10 natural grass and 9 synthetic turf football fields. For the forward and backward falls, all accelerometers showed a significantly greater impact deceleration on the synthetic turf compared to the natural grass surfaces. For the side falls, the apex accelerometer showed a significantly greater impact deceleration on the synthetic turf. The results of the aggregated means and standard errors are displayed in Table 1 and represented graphically in Figure 1.

Impact deceleration was significantly higher in synthetic fields in at least one of the accelerometer locations for each drop type. These findings suggest that concussion risk may be higher for athletes playing on synthetic turf fields.

Table 1

Means and (SE) measured in g’s (9.8m/s^2) for each sensor and type of drop across all grass and synthetic turf fields. Bold indicates significant differences.

Figure 1

Comparing Grass (solid diamond) vs Synthetic Turf (open circle) Fields At Different Head Locations For Three Types of Falls (Means +/- 95% Confidence Interval). The left bubble summarizes the forward falls for the Forehead, Apex, and Right Ear accelerometers. The middle bubble summarizes the backward falls for the three accelerometers. The right bubble summarizes the left side falls for the three accelerometers. *Significant difference (also in italic bold print)