scholarly journals Surface-Related High School Football Game Injuries on Pad and No Pad Fields (101)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0025
Author(s):  
Michael Meyers

Objectives: Today’s new generations of artificial turf infill systems are increasingly being installed with lighter weight infill systems, which often incorporate interlocking polypropylene or thermoelastomer pad systems under the fiber-infill layers, reportedly to reduce surface shock, decrease concussions, and enhance shoe: surface stability. At this time, however, the effects of pad systems on high school football trauma during game conditions are unknown. With more than one million athletes playing competitive football, the rise in medical costs, and the increasing popularity of base pads being installed today as an alternative to heavier infill weight systems, this study focused on quantifying the potential influence of this practice on the incidence, mechanisms, and severity of game-related, high school varsity football injuries. Methods: Artificial turf playing fields were divided into two groups based on a pad underlayer or a no pad system. Fifty-eight high schools participated across three states over 7 seasons. Outcomes of interest included injury severity, injury category, primary type of injury, injury mechanism, anatomical location of trauma, type of tissue injured, and elective imaging/surgical procedures. Data were subject to multivariate analyses of variance (MANOVA) and Wilks’ λ criteria using general linear model procedures. Data were expressed as injury incidence rates (IIR) per 10 game season. Results: Of 658 varsity games documented, 260 games were played on fields containing pads, and 398 on no-pad fields, with 795 total injuries reported. MANOVA indicated a significant main effect across pad and no pad playing surfaces by injury severity (F3,791 = 11.436; P < .0001), knee trauma (F9,785 = 2.435; P = .045), injury category (F3,791 = 3.073; P < .0001), primary type of injury (F10,785 = 2.660; P < .0001), injury mechanism (F13,781 = 2.053; P < .001), anatomical location of trauma (F16,778 = 1.592; P < .001), type of tissue injured (F4,790 = 4.485; P < .0001), and elective imaging and surgical procedures (F4,790 = 4.248; P < .002). Post hoc analyses indicated significantly higher ( P < .05) substantial injury [10.3, (95% CI, 10.0-10.5) vs 3.0 (2.5-3.4)], player-to turf trauma [6.5, (95% CI, 5.9-7.1) vs 2.0 (1.6-2.4)], patellofemoral syndrome [1.3, (95% CI, 0.9-1.7) vs 0.3 (0.2-0.5)], neck strain [2.0, (95% CI, 1.5-2.5) vs 0.3 (0.2-0.5)], lower leg strain [3.9, (95% CI, 3.3-4.5) vs 1.1 (0.8-1.4)], and a higher number of lower extremity elective imaging and surgical procedures requested [7.2, (95% CI, 6.7-7.7) vs 3.2 (2.8-3.7)] when competing on artificial turf fields with pads as compared to no pad systems, respectively. In regard to reducing the frequency of concussions, there was no significant difference in concussion rate attributed to turf impact [0.3, (95% CI, 0.2-0.6) vs 0.1 (0.1-0.3)] between pad and no pad fields, respectively. Conclusions: The addition of a pad under an artificial turf surface increases injury rates when compared to non-pad fields across most injury categories. At this time, findings do not support the current trend of installing lightweight padded infill systems at the high school level of play. This is the first longitudinal study to investigate the influence of a pad on sport trauma, when integrated with an artificial turf infill system.

2021 ◽  
pp. 2489-2497
Author(s):  
Michael C. Meyers

Background: Artificial turf fields are increasingly being installed with lighter weight infill systems that incorporate a pad underlayer, which is reported to reduce surface shock and decrease injuries. At this time, the effects of a pad underlayer on football trauma are unknown. Hypothesis: Athletes would not experience differences in surface-related injuries between pad and no-pad fields. Study Design: Cohort study; Level of evidence, 2. Methods: Artificial turf fields were divided into 2 groups based on a pad underlayer or no-pad system, with 58 high schools participating across 3 states over the course of 7 seasons. Outcomes of interest included injury severity, head and knee trauma, injury category, primary type of injury, injury mechanism, anatomic location of trauma, tissue type injured, and elective imaging and surgical procedures. Data underwent multivariate analyses of variance (MANOVA) using general linear model procedures and were expressed as injury incidence rates per 10-game season. Results: Of 658 varsity games, 260 games were played on fields containing pads, and 398 games were played on no-pad fields, with 795 surface-related injuries reported. MANOVA indicated significant main effects by injury severity ( F3,791 = 11.436; P < .0001), knee trauma ( F9,785 = 2.435; P = .045), injury category ( F3,791 = 3.073; P < .0001), primary type of injury ( F10,785 = 2.660; P < .0001), injury mechanism ( F13,781 = 2.053; P < .001), anatomic location ( F16,778 = 1.592; P < .001), type of tissue injured ( F4,790 = 4.485; P < .0001), and elective imaging and surgical procedures ( F4,790 = 4.248; P < .002). Post hoc analyses indicated significantly greater incidences ( P < .05) of substantial and severe injury, player-to-turf trauma, patellofemoral syndrome, neck strain, lower leg strain, and elective imaging and surgical procedures when games were played on padded turf fields. No differences in concussion rate from turf impact between pad and no-pad fields were observed. Conclusion: In contrast to conventional wisdom, the addition of a pad under an artificial turf surface increases injury rates when compared with nonpadded fields across most injury categories. At this time, findings do not support the current trend of installing lightweight padded infill systems at the high school level of play.


2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0041
Author(s):  
Michael Clinton Meyers

Objectives: Artificial turf surfaces are developed to duplicate playing characteristics of natural grass. With the newer generations of sand and rubber infill systems, infill weight is a common component that varies between fields. With the increasing concerns of rising medical costs, the potential for long-term articular changes, and perceived higher incidence of articular trauma while playing on artificial turf, infill weight could be a critical factor that could influence sport trauma and subsequent elective medical decisions. Therefore, this study quantified the incidence of game-related, high school football lower extremity and surface impact trauma requiring elective medical procedures across artificial turf systems of various infill weight. Methods: Artificial turf systems were divided into two sand/rubber infill weight groups by lbs per square foot: 6.0 to ≥9.0, and 0.0-5.9. Fifty-seven high schools participated across four states over 5 seasons. Outcomes of interest included elective medical procedures by injury category (player-turf surface impact trauma, trauma from shoe: surface interaction during physical collision/contact, trauma from shoe: surface interaction during physical noncontact). Data were subject to multivariate analyses of variance (MANOVA) and Wilks’ λ criteria using general linear model procedures. Results: Of 1,837 games documented, 1,049 games were played on 6.0 to ≥9.0 lbs infill/sq. ft, and 788 on 0.0-5.9 lbs infill/sq. ft, with 4,655 total injuries reported. MANOVA indicated a significant main effect across elective medical procedures by injury category (F3,3977 = 16.574; P < .0001). Post hoc analyses indicated significantly lower injury incidence rates (IIR per 10 game season) requiring radiography and MRI procedures following player-turf surface impact trauma [1.7, (95% CI, 1.5 -1.9) vs 3.2 (2.9-3.5); P = .001], trauma from shoe: surface interaction during physical collision/contact [2.4, (95% CI, 2.1-2.6) vs 3.2 (2.9-3.5); P = .001], and trauma from shoe: surface interaction during physical noncontact [0.4, (95% CI, 0.3-0.5) vs 0.7 (0.5-0.9); P = .01], while competing on the 6 to ≥9.0 lbs infill/sq. ft when compared to the lighter infill weight systems, respectively. No significant differences in surgical procedures by injury category were observed between infill weight. Conclusion: As the artificial infill surface weight decreased, the incidence of game-related, high school football lower extremity and surface impact trauma, and subsequent elective medical procedures significantly increased. Based on findings, high school football fields should minimally contain 6.0 to ≥9.0 lbs infill/sq. ft. This is the first longitudinal study to investigate the influence of artificial infill weight influence on high school sport trauma and elective medical decisions.


2014 ◽  
Author(s):  
Chris Brown ◽  
Taryn J. Acosta ◽  
Bethany Mealy ◽  
Conrad T. Mueller ◽  
Lauren T. Dashjian

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