There is a growing trend within local councils to convert sports grounds from natural grass to artificial turf. The financial case seems straightforward: grass field maintenance is expensive, and turf fields are less prone to weather-related cancellations, something that’s happened frequently in recent years given the amount of rain and resultant field damage.
But there’s a common assumption tangled up in this shift: that artificial turf is harder on the knees. It’s an intuitive fear, and one that comes up often in conversations about switching surfaces. The research tells a more specific, and more useful, story.
What the Research Actually Shows
A 2023 systematic review by Gould and colleagues, published in the American Journal of Sports Medicine, examined the available evidence comparing injury rates on artificial turf and natural grass, broken down by body region and level of competition. The findings don’t support the common assumption:
- Foot and ankle: Injury risk is genuinely higher on artificial turf, consistent across all levels of participation.
- Knee: Injury rates were broadly similar between artificial turf and natural grass.
- Hip: No meaningful difference between the two surfaces.
In other words, if you’re worried about your knees on turf, the evidence doesn’t back that up. If you’re not thinking about your ankles, the evidence suggests you probably should be.
Why the Ankle Bears the Brunt
The mechanism comes down to what happens when a stud loses traction. Artificial turf is quite slippery underfoot and typically requires longer studs, similar to how players choose longer studs on wet, soggy natural grass to compensate for reduced grip.
The difference is in what happens next. On natural grass, when traction runs out, the studs either dig in and support the player, or the boot slips freely through the surface and the player falls. On artificial turf, the studs can continue digging deeper until they catch in the underlay, creating a sudden, sharp torque through the ankle rather than a clean slip. That short, sharp torque, rather than a controlled fall, is where a lot of these injuries occur. A player is often better off if the boot slips through and they go down, than if the foot stays fixed while the body keeps rotating.
Is the Financial Case as Clear as It Looks?
If turf genuinely increases foot and ankle injury risk, it’s worth asking who ends up absorbing that cost. Whether it’s out-of-pocket medical care or increased insurance premiums, injury costs don’t disappear just because field maintenance costs go down. It’s a fair question whether switching to turf is actually a net financial win, or whether it simply shifts the cost from the council’s maintenance budget to the individual player.
How BeFit Can Help
If you’re managing a foot or ankle injury from playing on artificial turf, our Sports Physiotherapy team can help with assessment, treatment and a Return to Sport plan tailored to your situation. A running assessment can also help identify individual risk factors if you’re regularly training or competing on artificial surfaces.
Book an appointment at BeFit Training Physiotherapy — no referral needed.
Edgecliff: (02) 9327 7749 | Coogee: (02) 7205 2805 | befittrainingphysio.com/book-now
References
Gould HP, Lostetter SJ, Samuelson ER, Guyton GP. Lower Extremity Injury Rates on Artificial Turf Versus Natural Grass Playing Surfaces: A Systematic Review. Am J Sports Med. 2023.
Australian Physiotherapy Association. Clinical guidelines. physiotherapy.asn.au.
