Natural grass may lead to more severe football concussions than artificial turf

Key takeaways:

• Those who sustained a concussion on artificial turf were older than those who sustained a concussion on grass.
• The groups were similar in number of days before evaluation, concussion and headache history.

In young male American football players, concussion symptoms and severity were higher for those who sustained the injury on natural grass compared with artificial turf, according to new research in the Clinical Journal of Sports Medicine.

“Many natural grass fields, especially at the youth level, may not be well-maintained and can be harder and less forgiving than modern artificial turf, which has evolved significantly from the old, hard fields of the past,” C. Munro Cullum, PhD, lead study author and professor of clinical psychiatry in the Peter J, O’Donnell Brain Institute at the University of Texas Southwestern Medical Center, said in a related release.

Cullum and colleagues examined the differences in concussion symptoms for young American football players who were injured on natural grass and artificial surfaces.

Their study culled data from the prospective, longitudinal, multi-institutional North Texas Concussion Registry (ConTex) research project to include 62 male football players aged 10 to 24 years who sustained a helmet-to-ground impact concussion (grass impact, n = 33; artificial turf impact, n = 29) and presented to a specialty concussion clinic within 14 days of the injury.

The main outcome for analysis was self-reported, post-injury number and severity of symptoms measured by the 22-item Sport Concussion Assessment Tool 5th Edition (SCAT5) Symptom Evaluation at the time of participants’ first clinic visit to UT Southwestern Medical Center. SCAT5 scores are combined on a scale ranging from 0 (no symptoms) to six (most severe).

According to the results, both groups had a similar mean number of days since injury before evaluation (6.1 vs. 5.3 days), concussion history and headache history.

However, the researchers wrote that players who sustained a concussion from contact on a grass-playing field reported higher mean total symptom severity scores (26.6 vs. 11.6, P = .005) and total number of symptoms (10.3 vs. 5.9, P = .006) compared with those who were injured on artificial turf.

Data additionally showed those in the artificial turf group were slightly older than those in the natural grass cohort (mean age, 14.6 years vs. 13.6 years).

Cullum and colleagues noted key limitations to their work, chief among them a small sample size as well as a significant mean age difference between the two groups, suggesting that either older athletes are more likely to play on artificial surfaces, or that the result is due to more playing experience.

The findings conflict with previous research that suggest young athletes may be at greater risk for head injuries on synthetic turf. However, several other studies have found “lower rates of football-related concussion on artificial turf versus grass,” Cullum said in the release.

“Our study also suggests that concussions on natural surfaces are more likely to be worse and may require longer recovery times,” he said.

Reference:

Natural grass may pose greater risk for football concussions. https://www.utsouthwestern.edu/newsroom/articles/year-2024/aug-natural-grass-football-concussions.html. Published Aug. 12, 2024. Accessed Aug. 13, 2024.