Cohort study2025Open access

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

Immonen V, Mustakoski I, Kuitunen I, Vasankari T, Leppänen M

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 1 citation

How it was studied

Design
Cohort study (indexed by PubMed)
Studied in
People
Main outcome
Clinical events such as disease or death

Who paid for it

Funding
Independent funding
Unclassified
Tays
Nonprofit
Suomen Urheilututkimussäätiö
Nonprofit
Football Association of Finland
University or hospital
Tampere University Hospital, Wellbeing services county of Pirkanmaa

Based on 4 listed funder(s) and full-text disclosure statement.

Publication

Published
2025-08-31 · Knee Surg Sports Traumatol Arthrosc · vol. 33 · issue 11 · pp. 4070–4078
Publisher
Springer Science+Business Media
Cited
0 citations · more than 23% of similar papers · 0.0× the field average
References
24 works
Access
Open access (hybrid journal) · CC-BY
Research areas
Sports injuries and prevention · Lower Extremity Biomechanics and Pathologies · Bone fractures and treatments
Keywords
Medicine, Elite, Winter season, Orthopedic surgery, Demography, Surgery, Climatology
MeSH
humans, poaceae, athletic injuries, knee injuries, incidence, risk factors, prospective studies, soccer, adult, finland, female, young adult

5 authors

From FI

  • Ville Immonen · correspondingUniversity of Eastern Finland
  • Iida MustakoskiUrho Kaleva Kekkonen Institute; University of Jyväskylä
  • Ilari KuitunenUniversity of Eastern Finland
  • Tommi Juhani VasankariTampere University; Urho Kaleva Kekkonen Institute
  • Mari LeppänenTampere University Hospital; Tampere University; Urho Kaleva Kekkonen Institute

Abstract

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.

Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).

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