No difference in sudden-onset injury risk between artificial turf and natural grass for Finnish female elite-level footballers: A five-season study.

Purpose: Evidence on injury incidence on artificial turf for female footballers is conflicting. Some studies have found no difference in injury rates, while others have suggested increased knee injury risk. The aim of this study was to compare match injury incidences between artificial turf and natural grass in the Finnish female premier division of football.

Methods: All teams in the Finnish female premier division of football were invited to participate in a five-season prospective cohort study, and eight to ten teams took part depending on the season. Injuries were reported by players in weekly questionnaires and categorised by anatomical region, recurrence, contact, severity, and playing position. Individual match exposure was tabled, and incidences per 1000 h of match exposure and incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated for both surface types.

Results: A total of 517 league matches (401 on artificial turf and 116 on natural grass) were played during the five-season follow-up. In that time, 237 sudden-onset injuries (184 on artificial turf and 53 on natural grass) were reported. The overall injury incidence rate was 19.6/1000 match hours on artificial turf and 19.3/1000 match hours on natural grass (IRR 1.0, 95% CI 0.7-1.4). No statistical difference was observed for risk in knee injuries or other subcategories.

Conclusions: This study found no evidence of a difference in match injury risk between artificial turf and natural grass for elite level female footballers. Research with modern non-filler surfaces will be needed as pitches containing microplastic pollution are banned in the European Union.

Level of evidence: Level II.