Health Matters: Aaron Rodgers injury: Did artificial turf play a role?

Conway McLean, DPM, Journal columnist

Although relative only to the world of sports, the loss of Aaron Rodgers from the New York Jets roster for the remainder of the year (and possibly beyond?) has been called a tragedy. Three offensive plays into the season, the first game for his new team, after all the fanfare and hype, the star quarterback tears his Achilles tendon. The injury dominated the headlines for several new cycles.

The event occurred at the stadium of the Jets which, interestingly, has artificial turf. Was the surface upon which the injury took place a factor? Although a topic of concern for years, this one caused renewed interest in the subject: do artificial turfs lead to more injuries to athletes playing competitive sports? The discussion involves the livelihoods of thousands of athletes, both amateur and professional. The dollars associated with these mishaps could be in the billions if one considers the salaries of these players, and the effect on their career following one of these occurrences.

The NFL, like any investor protecting its ‘golden goose’, has sought to minimize the association, pointing out, quite accurately, it’s a violent sport. Because of the difficulty in making accurate measurements, in drawing definitive conclusions, controversy and contradiction have clouded the issues at hand. Both the NFL and the owners of the teams have many millions of dollars at stake. Pro football has been a cash cow, with profits soaring.

Asking the players themselves gives one an entirely different perspective. An overwhelming majority of semi-pro and professional athletes strongly prefer a natural grass field, knowing the costs are significantly less for artificial turf to the team/stadium owners. How dangerous are these surfaces? Apparently, it depends on who you ask.

These synthetic surfaces were first used professionally for the Houston Astrodome in the mid ’60’s. Artificial turf was rapidly adopted into the league in the 1970’s and ’80’s, because of both the reduced costs for installation and less maintenance needs. The springier surface also allowed for faster, more explosive movement, making for a more exciting product.

Since there is some disagreement by the various parties involved, an examination of the studies performed is appropriate. In a frequently cited article examining lower extremity injury rates on natural grass versus the artificial type, there was a 16% higher risk of lower extremity trauma on the synthetic surface but only for Achilles, ankle, and calf injuries. Surprisingly, there was no increased risk for knee or foot damage when compared to natural grass.

Although the media rarely covers it, artificial turf has other consequences besides orthopedic trauma. For one, the players are breathing silica sands when they’re landing on these surfaces. These extremely fine particulates, used as part of the filler, easily become airborne, especially when they have been heated. Players on artificial turf are also exposed to toxic dust and gases as field components abrade and heat up. Especially at high temperatures, artificial turf emits volatile organic compounds.

Some of the trauma associated with artificial turf isn’t of a physical nature but a thermal one. These fields become dangerously hot, causing skin injury as well as contributing to heat exhaustion. These fields can attain temperatures that are dangerous to player health. A study done by a university in Utah during the month of June revealed turf temps of 156 degrees, and this with an air temperature of 81. Despite years of discussion, the artificial turf industry has failed to make improvements.

There are additional repercussions to the use of artificial turf, specifically the risk of concussion. This seems counterintuitive to some since they assume the artificial variety is softer. Experience has shown us that as the filler material beneath the surface membrane, referred to as “infill”, ages, it becomes more tightly packed and much harder in the process.

Physicians specializing in sports medicine seem generally in agreement: a higher number of injuries, with a greater degree of severity, result from the use of artificial turf. Players are able to achieve greater velocities faster, leading to more physical stress to the structures connecting the body with the immovable object that is the earth. Because the foot is often locked in position, cleated to the turf, it’s the ankle and associated structures which must bear the greatest force.

It’s been an ongoing debate and is in no danger of dying out, not with this most recent injury. Aaron Rodgers’ season-ending injury highlights the continuing controversy over artificial turf as a playing surface. The studies are beginning to accumulate, yet little has changed in transitioning the professional football games away from artificial turf. The visiting soccer teams from Europe have the surfaces changed over to grass for their matches……then back for the next football game! That should make you think.

EDITORS NOTE: Dr. Conway McLean is a podiatric physician now practicing foot and ankle medicine in the Upper Peninsula, having assumed the practice of Dr. Ken Tabor. McLean has lectured internationally on surgery and wound care, and is board certified in both, with a sub-specialty in foot orthotic therapy. Dr. McLean welcomes questions, comments and suggestions at drcmclean@penmed.com.


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