Artificial turf has transformed modern sport. From football and hockey to school playgrounds, synthetic surfaces are now ubiquitous due to their durability and cost-effectiveness. However, a growing body of scientific literature has raised important concerns about injury patterns associated with these surfaces.
The Rise of Artificial Turf
Artificial turf was introduced as a solution to the limitations of natural grass: susceptibility to weather, high maintenance costs, and limited usage capacity.
It first gained attention in 1966, when AstroTurf, a short-pile synthetic turf, was installed in the Astrodome in Houston, Texas. It was however developed by Monsanto and others to address a 1958 study, revealing lack of school green space.
In the 1950s, the Ford Foundation conducted a study. It found out children from rural backgrounds were more active than those from urban areas. The foundation sought to develop a synthetic playing surface that could be used to make urban spaces more appealing and to give children in cities a better quality of play area. In 1964, the first installation of this new playing surface, originally called ChemGrass, was completed at Moses Brown School in Providence, Rhode Island.
The use of AstroTurf and similar products became widespread in the US and Canada in the early 1970s.
Initially, nylon was used to create the original artificial turf surface, however, the material had a tendency to cause friction burns and blisters.
In the 1980s, makers began using polypropylene yarn instead of nylon. A sand infill meant the playing surface could be stabilised to produce more natural reactions for sports use. Unfortunately, the sand caused the problems of grazes and burns.
In the 1990s, another new generation of artificial grass was developed. It was made using polyethylene, which was softer and could be used for making longer and more realistic fibres. It was installed with a granulated rubber infill. These advances resulted in fewer contact burns and grazing.
Modern day processes also use shock-pads, which are made from polyester foam or rubber. These materials are installed underneath the artificial grass.
They are designed to mimic the feel of grass.
Development Timeline
• First Generation: Short, dense nylon fibers (1960s).
• Second Generation: Sand-filled, shorter, curly grass fibers (1970s–80s).
• Third Generation: Longer, upright fibers with sand and rubber infill (1990s–2000s).
• Fourth Generation: Non-infill, even more realistic fibers (2010s).
Its widespread adoption has been particularly prominent in high-density urban areas and regions with extreme climates. Yet, as usage has increased, so too has scrutiny over its health implications.
Types of Injuries Associated with Artificial Turf
1. Abrasion Injuries (“Turf Burns”)
One of the most well-documented risks is skin abrasion. A systematic review published in the Journal of Science and Medicine in Sport found clear evidence that abrasion injuries occur frequently on artificial turf, especially in sports involving sliding or falling. These injuries, while often superficial, can increase the risk of infection and discomfort, particularly in contact sports.
2. Lower Extremity Injuries
A major area of concern is injury to the lower body—knees, ankles, and feet. A systematic review in The American Journal of Sports Medicine examined injury rates across multiple sports and surfaces, highlighting the importance of understanding lower extremity injury risks on artificial turf versus natural grass. Injury incidence varies in football, but certain injuries—especially ankle sprains and ligament damage—may be more common on turf. One explanation lies in biomechanics: artificial turf tends to have higher surface friction, which can “lock” the foot during rapid directional changes, increasing stress on ligaments.
3. Non-Contact Injuries
Emerging research points to a higher incidence of non-contact injuries—those not caused by collisions but by sudden movement. Studies cited in sports medicine literature suggest that artificial surfaces may contribute to Achilles tendon ruptures and ACL injuries, especially during pivoting actions. Differences in shock absorption and energy return between turf and grass are thought to influence these injury patterns.
4. Overuse Injuries
Artificial turf’s uniform and often harder surface can contribute to repetitive stress injuries like Shin splints, Stress fractures and Tendinitis.
5. Chemical and Environmental Exposure
Beyond musculoskeletal injuries, newer research has raised concerns about chemical exposure: Artificial turf infill materials may contain substances such as heavy metals. Preliminary findings suggest athletes may experience increased exposure through skin contact and inhalation, particularly during play. However, long-term health effects remain under investigation.
Why Does Artificial Turf Influence Injury Risk?
Several biomechanical and environmental factors explain the differences:
Surface stiffness: Turf is often less forgiving than natural grass
Friction coefficient: Higher grip increases torsional stress on joints
Heat retention: Turf can reach very high temperatures, contributing to fatigue and dehydration
Consistency: While uniformity reduces uneven ground injuries, it may increase repetitive stress
The Case for Artificial Turf: Advantages
Despite these concerns, artificial turf offers significant benefits:
1. Durability and Availability
Unlike natural grass, turf can withstand heavy usage and adverse weather, making it ideal for schools and community sports facilities.
2. Lower Maintenance Costs
No watering, mowing, or fertilizing reduces long-term operational expenses.
3. Consistent Playing Surface
Uniformity can reduce unpredictable injuries caused by uneven or poorly maintained natural fields.
4. All-Weather Playability
Matches and training sessions are less likely to be cancelled due to rain or poor ground conditions.
Some studies find no significant difference in overall injury rates between turf and grass. Others highlight higher rates of specific injuries, particularly in the lower extremities.
Experts suggest several ways to reduce injury risk on artificial turf:
Using sport-specific footwear designed for turf
Improving turf design (shock absorption, safer infill materials)
Monitoring field temperature and limiting play in extreme heat
Ensuring proper athlete conditioning and training
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