Does Turf Actually Cause More Injuries? Experts Weigh in on Aaron Rodgers Achilles Tear

Fact checked by Nick Blackmer

Key Takeaways

• Star quarterback Aaron Rodgers experienced an Achilles tendon tear during his first game of the season with the New York Jets.

• Artificial turf may be associated with a higher rate of foot, ankle, and lower leg injuries, but experts say more research is needed to fully understand the impact of playing surfaces like turf.

• Experts recommend athletes take certain precautions to reduce the risk of injuries when playing on turf, including stretching and warming up before games and practicing on turf when possible to acclimate to the surface.

Aaron Rodgers, a 39-year-old star NFL quarterback, faced a tough break when he experienced an Achilles tendon tear just four snaps into his debut with the New York Jets last week.

The Achilles tendon is the attachment between the calf muscle and the bottom of the foot which allows for the motion of pushing off. Tears typically occur when the tendon stretches while also contracting, referred to an eccentric contraction, Spencer Stein, MD, a sports orthopedic surgeon at NYU Langone Health, told Verywell.

“Looking at the video [of the play], Rodgers’ calf was stretched while he was trying to push off,” Stein said.

While excessive force on the tendon and the age of an athlete often play a role in sports-related Achilles injuries, some people suspect competing on artificial turf surfaces contribute to injury rates.

There are also those who, like Aaron Rodgers’s former teammate David Bakhtiari of the Green Bay Packers, argue that the turf surface is responsible for Rodger’s injury. Half of NFL stadiums have turf fields, including MetLife Stadium, where the Jets played the Bills last week.

NFL Players Association Executive Director Lloyd Howell is calling for the league to make the switch from turf to natural grass to protect players from unnecessary and avoidable injuries. 

“Moving all stadium fields to high-quality natural grass surfaces is the easiest decision the NFL can make. The players overwhelmingly prefer it and the data is clear that grass is simply safer than artificial turf,” Howell wrote in a Twitter post. “It is an issue that has been made near the top of the players’ list during my team visits and one I have raised with the NFL.”

Players, coaches, and administrators calling for turf is one thing. But is there research supporting claims that turf is linked to injury? The answer depends on the type of injury. Here’s what sports medicine doctors say.

Related: Achilles Tendon Tear

Is Turf Responsible For More Sports Injuries Than Grass?

Based on a review of multiple studies, in general, it appears that there may be a higher rate of foot and lower leg injuries on artificial surfaces, especially on older generation turf, Stein said.

In fact, a 2013 soccer study published in the Journal of Sports Medicine showed that artificial turf is three times more likely to cause foot and ankle injuries. Another study showed that playing football on turf made an athlete three times more likely to suffer a posterior cruciate ligament (PCL) injury compared to playing on grass.

“The exact reason is not completely clear, but it is assumed to be due to the natural differences between the surfaces,” George Eldayrie, MD, a sports medicine physician at Orlando Health Jewett Orthopedic Institute, told Verywell in an email. “The grip on turf is stronger than the grip on grass.”

This information aligns with claims from the NFL Players Association. The organization says that “artificial turf is significantly harder on the body than grass.” NFL injury data collected from 2012 to 2018 found athletes have a 28% higher rate of non-contact lower extremity injuries when playing on artificial turf. Of those non-contact injuries, players have a 32% higher rate of non-contact knee injuries on turf and a 69% higher rate of non-contact foot/ankle injuries on turf.

Related: What Is Turf Toe?

However, Stein noted that natural surfaces like grass may also pose risks, especially if they are not well-maintained.

“Grass can become lumpy or have divots, and players can get their cleats or footing caught in that,” Stein said.

Both Stein and Eldayrie believe more research is needed to understand whether or not playing on turf is actually responsible for other sports injuries.

“There appears to be a higher rate of injury when it comes to foot and ankle injuries, but most studies show no differences with respect to knee or hip injuries,” Stein said.

What About Tendon Tears?

Eldayrie said it’s logical to consider the impact of turf on an Achilles tear, since the surface doesn’t offer much give upon push-off. Grass, on the other hand, is more likely to come apart under high loads of stress.

“Grass would lead to less strain on the muscles and tendon and a lower likelihood for the forces of impact to translate into the tendons and ligaments,” Eldayrie said.

Stein said that while there is really no recorded evidence that Achilles tendon injuries happen more frequently on turf, a 2017 study found Achilles injuries were more likely to occur at the beginning of the season, as is true in Rodgers’ case.

Related: How to Safely Continue Running With Plantar Fasciitis

Can You Prevent Injury If You Play on Turf?

While there isn’t any specific gear or equipment that can help prevent injury while playing on turf, Eldayrie and Stein offered some practical safety tips:

• Stretch and warm up: If you know you are practicing or competing on turf, Stein recommends getting to the field early to warm up and stretch. There are specific exercises and movements—including jump lunges and squat jumps—that have been shown to decrease injury of the anterior cruciate ligament (ACL), especially in soccer, he said. Generally, showing up early to warm up and stretch can help players become acquainted with the surface.

• Practice on turf: Eldayrie advises to practice on turf before competition or even the week prior, especially if you’re used to playing on grass. This should help you acclimate to the different playing surface, especially if you incorporate running and cutting on the field. However, keep in mind that weather and precipitation can also impact the playing surface.

• Make adjustments as needed: While Eldayrie said wearing shoes that you’re used to is an important part of injury prevention, players should consider making small adjustments, like swapping cleats or spikes. This may mean switching to shorter studs on turf.

What This Means For You

While some research suggests turf is linked to more foot and lower leg injuries than grass, more studies are needed to confirm the link. Experts say you can reduce these risks as much as possible with proper preparation, including stretching and practicing on turf when possible.

Read the original article on Verywell Health.