Incidence of Injury Among Adolescent Soccer Players: A Comparative Study of Artificial and Natural Grass Turfs

OBJECTIVE: To investigate the incidence of acute injuries and soccer-related chronic pain from long-term training and during matches in adolescent players using natural grass turfs (NT) and artificial turfs (AT). DESIGN: Case-controlled prospective study. SETTING: Institutional-level Fédération Internationale de Football Association Medical Centre of Excellence. PARTICIPANTS: Youth soccer players (12-17 years of age) from 6 teams, with a predominant tendency to train on either NT or AT, were included. Of 332 players enrolled in this study, 301 remained to completion. INTERVENTIONS: Medically diagnosed acute injuries and chronic pain were recorded daily by team health care staff throughout 2005, and reports were provided monthly to the authors. ASSESSMENT OF RISK FACTORS: Noninvasive prospective study. INDEPENDENT VARIABLES: Age and turf type. MAIN OUTCOME MEASURES: Acute injuries per 1000 player hours on each surface and chronic complaints per 1000 player hours were evaluated according to frequency of surface used > or = 80% of the time. Incidence rate ratio (IRR) of acute injuries and chronic complaints during play on NT and AT was calculated. RESULTS: There was no significant difference in the incidence of acute injuries between the 2 surfaces during training and competition. However, the AT group showed a significantly higher incidence of low back pain during training (IRR, 1.62; 95% confidence interval, 1.06-2.48). Early adolescence and prolonged training hours were factors associated with an increased incidence of chronic pain in the AT group. CONCLUSION: Adolescent players routinely training on AT for prolonged periods should be carefully monitored, even on AT conforming to new standards.