Adductor-Related Groin Injury During NCAA Football Games On Artificial And Natural Grass Surfaces

Groin injuries, while uncommon, can be detrimental to an athlete's health, performance, and wellness. While prior studies comparing the rate of musculoskeletal injuries on artificial turf versus natural grass have resulted in equivocal findings, few studies have specifically compared the occurrence of groin injuries between the two playing surfaces. PURPOSE: To quantify the incidence and etiology of groin trauma during game-related college football across artificial and natural grass surfaces. METHODS: Athletes from 41 universities were evaluated over 16 seasons (2006-21) across all Football Bowl Subdivision conferences. Outcomes of interest included injury severity, injury classification, injury category, primary type of injury, injury mechanism and situation, player position, skill position, cleat design, field conditions, environmental conditions, imaging and surgical procedures, and turf age. Injury incidence rates were calculated using injuries per 10 games = [(number of injuries ÷ number of games) x 10]. RESULTS: Of the 2243 games documented, 1061 (47.3%) were played on heavyweight artificial turf (≥9.0 lbs/ft2) infill systems, with 1182 games (52.7%) on natural grass. In sum, of 9360 total injuries, 111 (1.2%) adductor-related groin injuries were recorded with 48 (43.2%) occurring on artificial turf, and 63 (56.8%) on natural grass. MANOVAs indicated no significant surface effect by injury severity, (F2,108 = 0.511; P = .602), injury classification (F2,108 = 0.377; P = .687), injury category (F1,109 = 0.850; P = .430), primary type of injury (F4,106 = 0.293; P = .830), injury mechanism (F11,99 = 0.641; P = .776) or situation (F7,103 = 1.355; P = .212), player position (F2,108 = 0.144; P = .866), skill position (F7,103 = 0.511; P = .846), cleat design (F4,106 = 2.910; P > .050), field conditions (F2,108 = 2.869; P = .061), temperature (F2,108 = 4.278; P > .050), imaging and surgical procedures (F2,108 = 0.415; P = .662), or turf age (F3,107 = 1.873; P = .139). Cases occurred most frequently as minor muscle strains (87%), and during defensive play (41%) and non-contact sprinting (39%). CONCLUSIONS: Regarding adductor-related groin trauma, findings indicate that heavyweight artificial turf is as safe as natural grass. However, the results of this study are generalizable only to this level of competition.