Field Surface Type and Season-Ending Lower Extremity Injury in NFL Players.

There is growing concern over the safety of artificial turf when it comes to the incidence of player injuries. The artificial surfaces can withstand more play, are cheaper to maintain, and are more predictable. However, there is concern that this beneficial durability comes at the expense of the forgiveness of the surface, leading to more injuries. In this study, we aim to compare the incidence of in-game season-ending lower extremity injuries on natural and artificial playing surfaces in the National Football League (NFL) during the 2020, 2021, and 2022 seasons. For this study, we used publicly available data to determine and classify the specific injury, where the injury occurred, field surface type, and duration of recovery. All data were collected, and significance was determined using two-sample -tests. Only in-game injuries were included in this study. Over the course of 2020, 2021, and 2022, there were 199 season-ending lower-extremity injuries. Of these, 79 occurred on natural turf (39.7%) and 120 on artificial turf (60.3%). Of the 891 games played in this three-year period, 396 were played on natural turf (44.4%) and 495 were played on artificial turf (55.6%). Natural turf saw an injury rate of 0.199 per game, and artificial turf saw 0.242 injuries per game. We determined that there is no significant difference in rates of season-ending lower-extremity injury between artificial and natural turf. Any perceived difference in injury rates could possibly be attributed to the increased amount of play on artificial surfaces and anecdotal evidence related to high profile cases. While there is no significant difference in incidence, surfaces should continue to be monitored and regulated for traits such as hardness, and player preferences should be considered for qualities that are not quantifiable.