Exploring the Associations of Playing Surface and Lower Extremity Injuries Among National Football League Players Restricted; Files Only
Bushnell, Juliana Y. (Spring 2023)
Abstract
Introduction: Lower extremity injuries make up a large proportion of injuries experienced by football players. There is limited literature on the specific role playing surfaces have on injury rates.
Methods: We conducted analyses of the association between playing surfaces and visiting team missed-game lower extremity (LE) injury rates per team game of the 2018-2021 National Football League regular season. Our data included 2,593 LE injuries resulting in at least one missed game. We compared the IRs of playing surface as a binary, trinary, and an eight-level category (artificial turf models and natural grass types specified) variable. Finally, we used a Poisson mixed model with a log link function to estimate the association between playing surface and LE injury rates. This model was selected as our outcome is count data (# of injuries) and it allowed us to control for stadium and club-year as random effects. We ran three versions of this model with our three different surface variables.
Results: For the binary surface variable, the LE injury rate was 1.42 (95% CI 1.31-1.53) and 1.31 (95% CI 1.21-1.40) respectively. When divided into three categories (Artificial sit film, natural grass, other artificial) we found that slit-film had the highest injury rate per team game (1.49 95% CI 1.32-1.65) compared to other artificial (1.36 95% CI 1.22-1.51). When artificial and grass types are specified, A-Turf has the lowest IR (1.07 95% CI 0.69-1.45). Bermuda and Kentucky Bluegrass had an injury rate of 1.30 (95% CI 1.20-1.41) and 1.34 (95% CI 1.10-1.57) respectively. The highest injury rate was UBU/Turfnation with an IR of 2.04 (95. % CI 1.70-2.39). Our model output also showed that Artificial slit-film has the highest injury rate ratios (1.14 95% CI 0.97-1.32). The two major slit-film models, UBU/TurfNation and MomentumTurf, had the highest IRR’s for the octonary surface model ran (UBU: 1.33 95% CI .92-1.94, MT: 1.31 95% CI 0.91-2.01).
Discussion: In our data, artificial slit-film had the highest injury rates followed by other artificial models then natural grass. We recommend that artificial slit-film be prohibited as a playing surface for both competition and practice fields moving forward.
Table of Contents
Table of Contents
Background
Football
Population
NFL Demographics
Injury Reporting
Youth Leagues Through College
NFL
Injury Location
Playing Surfaces
Natural Grass
“Kentucky” Bluegrass
Ryegrass
Tall Fescue
Bermuda Grass
Artificial
Distribution of field types - NFL
Injury Rates & Turf Type
Limitations and Gaps in Literature
Manuscript
Introduction
Methods
Data Source
Measures
Exposure
Outcome
Injury Definition
Data Transformation
Analysis
Results
Model Outcome
Discussion
Appendix: Figures & Tables
Citations
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File download under embargo until 18 May 2025 | 2023-04-20 11:29:44 -0400 | File download under embargo until 18 May 2025 |
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