Playing surface and UK professional rugby union injury risk

Abstract

Artificial rugby union playing surface installation is increasing. This prospective cohort study aimed to examine the effect of playing surface on match injury types within 157 players of two UK professional rugby union clubs playing 209 matches (96 on artificial surfaces and 113 on grass) over three seasons. There was no difference in overall injury risk between the two playing surfaces with injury incidence on artificial 80.2 (CI 69.9-91.7) and on grass 81.9 per 1000 match-hours (CI 72.2-92.5), with an incidence rate ratio (RR) of 0.98 (CI 0.82-1.17). There was a higher rate of concussion (RR 0.52, CI 0.34 - 0.78) and chest injuries on grass (RR 0.26 CI 0.07, 0.95), and a higher rate of thigh haematoma (RR 2.25, CI 1.05-4.82) foot injuries (RR 4.12, CI 1.10, 15.40) and injury to players being tackled (RR 1.46, CI 1.00, 2.15) on artificial. Whilst there was no higher injury risk for matches played on artificial versus natural grass surfaces, the higher incidence of concussion and chest injury on grass, and the higher rate of foot injuries on artificial surfaces may be related to tackle and footwear-to-surface interface factors.

Influence of the structural components of artificial turf systems on impact attenuation in amateur football players

“…Recently, it has been suggested that artificial turf causes higher rate of foot injuries, especially midfoot and toe fractures including dislocations 46 . These type of injuries are considered overuse injuries, which were higher on World Rugby certified third generation artificial turf compared to natural grass in elite rugby players 47 .…”

“…Thus, overuse injuries and playing surface could be linked due to different traction and cushioning characteristics between surfaces 47 . Ranson, George, Rafferty, Miles and Moore 46 suggested that the highest foot injuries could be related to the greater traction, stiffness and rotational torque shown on artificial turf in comparison with natural grass. But these greater demands maybe also could occur between different artificial turf with different hardness, thickness or amount of infill, similar to this research.…”

On average, a professional rugby union player is more likely than not to sustain a concussion after 25 matches

“…Identifying concussion risk factors is an important next step. Researchers may need to take into account surface-specific match play demands (eg, tackles made and tackle technique) as grass has a greater concussion incidence than artificial surface 22. Furthermore, 50% of concussions occur in the tackle event7 and recent reports show that an upright posture by the tackler increases the risk of the tackler needing a Head Injury Assessment compared with a bent at the waist posture 23.…”

Synthetic playing surfaces increase the incidence of match injuries in an elite Rugby Union team

“…However, no statistical examination was undertaken. Two further studies have explored the differences between synthetic and natural grass playing surfaces in terms of injury risk in Rugby Union [13][14] . Despite no difference in overall injury incidence between synthetic and natural grass playing surfaces in either study [13][14] , the incidence of foot injuries on synthetic surfaces was reported as over three times that on natural grass (synthetic: 3.6 per 1000 h vs. natural grass: 0.9 per 1000 h) 14 .…”