www.SynTurf.org

No. 22 Ben Roethlisberger credits natural grass for staving off injury. January 2009.

No. 21 Turf is the culprit in NFL pro Mark Jones’s injury. December 2008.

No. 20  Washington, D.C.: Kehoe Field’s turf poses danger to student athletes. October 2008.

No. 19  A primer on turf toe. October 2008.

No. 18   Poughkeepsie, NY: Injuries are common on artificial turf. August 2008. 

No. 17   Illinois sports medicine physician explains down side of playing on turf. August 2008.

No. 16   Bill Littlefield, Getting Played: The risks to children – particularly girls – in increasing competitive sports.

No. 15   Jamaican women's u-17 soccer team doctor says turf increases injuries (July 2008).

No. 14   Connection between turf and concussions (July 2008).

No. 13   Orthopedic/sports medicine surgeon says athletes get hurt on turf as often as on grass (June 2008).

No. 12   Synthetic Turf: A Question of Ingestion (a video clip) (June 2008).

No. 11   Protecting users and public with help of informational signs at turf fields (June 2008).

No. 10   South African soccer legend cautions about artificial turf (June 2008).

No. 09   Argonauts' running back injured by turf (June 2008).

No. 08  Footwear technology to reduce injury from turf (May 2008). 

No. 07  Is turf especially cruel to female athletes? (April 2008).

No. 06  MLS urged to encourgae natural grass fields. March 2008 

No. 01  Editor's Note.

No. 02  Synthetic turf playing fields present unique dangers.

No. 03   Staph infection at Winchester High School.

No. 04  Field of nightmares. 

No. 05  San Francisco Parks Poised To Infect. February 2008. A Pictorial 

[No. 53] MLB: Turf injury reported for Mets’ Reyes. According to a news story on Mets Blog (July 1, 2010), “The Mets' worst fears about playing a series on artificial turf may have been realized last night [June 30]. Jose Reyes was a late scratch from the lineup with a stiff right side -- an injury the Mets were calling "turf related" before they beat the Marlins 6-5 at Hiram Bithorn Stadium (San Juan, Puerto Rico). Source: Mike Puma, “Reyes' scratch blamed on turf,” on Mets Blog, July 1, 2010, available at http://www.nypost.com/p/sports/mets/reyes_scratch_blamed_on_turf_qv3aqmiwILOQggdfgD6DbL .

[No. 52] Giants players weary about artificial turf at Meadowlands.  Domenik Hixon a wide receiver and return specialist for the New York Giants of the National Football League. During minicamp, on June 15, 2010, during minicamp, “Hixon crumpled to the new FieldTurf untouched on a punt return and tore the anterior cruciate ligament in his right knee,” according to eyewitness account by safety safety Antrel Rolle. “I was right there when it happened and I saw it right away,” Rolle told ESPNNewYork.com on Thursday after the Giants’ final practice of veterans’ minicamp. “And I was like, ‘Damn, it don’t look good.’ He didn't make a cut or anything. It just got caught in the turf.”

When the Giants took to the field on June 15, “some players said the turf felt soft and slippery.” “I thought it was real slippery,” wide receiver Steve Smith said. “We were all slipping and stuff. Hopefully it settles in when more people do stuff on it.” “Rolle said he couldn’t put his finger on what the turf felt like.” “I don't know what it was,” Rolle said. “My feet were burning at the bottom on the turf. I was slipping on each and every play. It just didn't feel good to me at all. I can't lie to you about that. I am not one to really complain or make excuses or anything but they should definitely look into that as far as playing on that field in the future during the season.” “Rolle said he initially thought he was the only one who felt a burning sensation in his feet.” “I thought maybe it was just me and my cleats,” Rolle said. “But everyone's feet were burning, guys had a hard time gripping, they were getting caught a lot.”  Source: Ohm Youngmisuk, “Rolle believes turf caused Hixon's injury,” on ESPN, in June 17, 2010,

available at http://sports.espn.go.com/new-york/nfl/news/story?id=5298318 .

[No. 51] Rays’ outfielder is ordered off the artificial turf. According to a news story on KFFL.com (June 6, 2010) “Tampa Bay Rays OF Carl Crawford sat out [f]or the second time in the last three games Thursday, June 10, for what manager Joe Maddon called "preventative maintenance," according to The Associated Press. Crawford pinch ran and stole a base in the ninth inning. "There's nothing wrong," Maddon said. "We just want to get him off his feet, especially on the (artificial) turf. He's always had trouble with this particular field." Source: “Carl Crawford out again Thursday,” on KFFL.com, June 6, 2010, available at http://www.kffl.com/gnews.php?id=649993 .

[No. 50] Turf Toe – A Primer. The following is from University of Wisconsin Badgers’ Sports Medicine Corner: Ryan Dean, “A look at the often-misunderstood and painful condition of turf toe,” on UWbadgers.com, June 2, 2010, available at http://www.uwbadgers.com/genrel/060210aab.html  or click here. Here are a few excerpts from the longer memo:

“What is it? Turf toe is an injury of the foot. It received its name from its association with athletes that participate on harder surfaces such as artificial turf.”

“Turf toe could keep an athlete sidelined anywhere from a few hours to an entire season depending on the severity of the injury.”

“Who’s at risk? While anyone can suffer from turf toe, athletes involved in running and/or jumping sports are at a higher risk. Athletes that run on harder surfaces such as hardwood, tracks, and artificial turf are also at higher risks because these surfaces have less give than a softer surface such as grass.”

[No. 49] Eagles safety Marlin Jackson injured on artificial turf. According to a news story in the Burlington County Times (June 2, 2010), on Tuesday, 1, 2010, during a practice session at Eagles’ indoor facility, the safety Marlin Jackson ruptured the Achilles tendon in his right leg; his 2010 NFL season ending before it begins. “Jackson was injured when he tried to change direction while defending Jeremy Maclin on a routine non-contact drill, a completion from Kevin Kolb.” “Although a couple players have suffered severe injuries during noncontact minicamps at the NovaCare - Ndukwe Kalu and Correll Buckhalter come to mind - Jackson is believed to be the first player seriously injured on the bubble's artificial turf field since the indoor facility opened in 2002.” Source: Reuben Franck, “Jackson suffers another setback,” in Burlington County Times, June 2, 2010, available at http://www.phillyburbs.com/news/news_details/article/117/2010/june/02/jackson-suffers-another-setback.html .

[No. 48] The curse of artificial turf visits A Rod’s groin. According to a news report on MLB.com (June 6, 2010), “Alex Rodriguez left the Yankees' 4-3 win over the Blue Jays on Sunday [June 6, 2010] in the ninth inning with tightness in his right groin.” “It was more the turf than anything else -- probably the 14 innings yesterday and the early game today,” Rodriguez said after the game. “It's fine now. I'll be ready to go on Tuesday.” Rodriguez said he first felt the tightness before even taking the field and that it got "a little bit" worse as the game progressed. He added that his baserunning mistake in the second inning -- when he was thrown out trying to reach second base on a single that squirted off the hands of shortstop Alex Gonzalez into left field -- had “nothing to do with” the tightness. Source: Tim Britton, “A-Rod exits with groin tightness; Third baseman expects to play for Yanks on Tuesday [June 8, 2010], on MLB.com, June 6, 2010, available at http://mlb.mlb.com/news/article.jsp?ymd=20100606&content_id=10887484&vkey=news_mlb&fext=.jsp&c_id=mlb .

Update: According to a news story on MLB.com (June 10, 2010), “Alex Rodriguez was removed from [June 10, 2010] Thursday's 4-3 loss to the Orioles after the first inning with tightness in his right groin, and he will see a team physician on Friday [June 11, 2010] in New York.” “Rodriguez has been battling tightness in his right groin since last weekend in Toronto, a situation he attributed to the artificial turf at Rogers Centre.” Source: Bryan Hoch, “A-Rod has tight groin, will visit doctor Friday,” on MLB.com, June 10, 2010, available at http://mlb.mlb.com/news/article.jsp?ymd=20100610&content_id=11041982&vkey=news_mlb&fext=.jsp&c_id=mlb .

[No. 47] Toronto, Canada: Turf field at Rogers Center claims Italian soccer star. In European soccer, the rivalry between Juventus (Turin, Italy) and Fiorentina (Florence) is legendary. On May 25, 2010, they met in a friendly at the Rogers Center in Toronto. Fiorentina won 1 to nil. The greater casualty however was the Juventus’ defender Goncalo Brandao. Accroding to news report in The Toronto Sun (May 26, 2010), he “looked to get a cleat caught as he tried to chase down Fiorentina striker Babacar Khouma. He fell awkwardly, and slammed his fists into the turf in pain. He was taken off the field on a cart.” Also playing in the match was Alessandro Del Piero, arguably one of Italy’s best-ever forwards. He said the conditions were far from ideal. “It’s not the best,” he said of the turf. “We prefer to play on a more natural terrain. Natural turf is better than synthetic surfaces.” “The stadium is beautiful, I felt very good,” said Fiorentina’s player Stevan Jovetic. “We made adjustments, We aren’t used to playing on artificial surfaces.” Source: Steven Sandor, “Artificial in many ways: Players take no chances on Rogers Centre turf in uninspiring soccer friendly,” in The Toronto Sun, May 26, 2010, available at http://www.torontosun.com/sports/soccer/2010/05/26/14090391-torsun.html

[No. 46] Earthquake’s midfielder bothered by back-to-back play on turf, gets rest time. According to an item in the Mercury News 9May 29, 2010), the “Rookie Brad Ring will start tonight [May 29] in place of central midfielder Andre Luiz, whose knee is bothering him after two games on artificial grass, in New England (May 15) and Seattle (May 22).” Source: Elliott Almond, “San Jose Earthquakes goalie Joe Cannon is having fun again,” in Mercury News, May 29, 2010, available at http://www.mercurynews.com/sports/ci_15186591

[No. 45] Per-team injury rates in the National Football League are  27% higher for games played on artificial turf surface. According to a news story on ORTHO Super Site (April 30, 2010), available at http://www.orthosupersite.com/view.aspx?rid=63790 , a recent study “associates NFL players’ lower extremity injury rates with playing surface. Per-team injury rates in the National Football League were 27% higher for games played on a specific artificial turf surface vs. games played on natural grass during the 2002 to 2008 seasons, according to a recent study, which also found 88% higher ACL injury rates and 32% higher ankle eversion sprain rates for games played on the artificial turf.” This is according to the conclusions reached by the National Football League (NFL) Injury and Safety Panel published at the 2010 Annual Meeting of the American Academy of Orthopaedic Surgeon (AAOS). The surface evaluated in the study was from FieldTurf. The study “analyzed data from the NFL Injury Surveillance System for 1,961 games played over seven seasons for a total exposure of 3,222 team games. During that time, there were 1,105 knee sprains and 1,115 ankle sprains. Investigators then calculated the experimental injury rate for the artificial turf exposure and compared it to the control injury rate, those seen on natural grass, to determine the differences in injury rates by surface. They then used various means to validate their statistical findings.” “The differences in all injury rates that [the study] identified …. were statistically significantly different for the FieldTurf surface turf vs. grass.” The lead-investigator of the study “stated in a AAOS press release that, ‘Many NFL players prefer FieldTurf because it is softer and more comfortable to land on than other playing surfaces such as natural grass, but the more that NFL players play on this surface, the more they are prone to injury.” The study is Hershman EB, Powell J, Bergfeld JA, et al., American professional football games played on FieldTurf have higher lower extremity injury rates. Paper #692 (presented at the 2010 Annual Meeting of the American Academy of Orthopaedic Surgeons. March 9-13, 2010, New Orleans). See http://www.synturf.org/health.html (Item No. 41).

[No. 44] UCLA cornerback Sermons breaks leg; turf may have been the culprit. According to a news report in The Orange County Register (April 3, 2010), “What started as an upbeat day of practice for the UCLA football team – its first of the spring with pads – ended with bad news. Cornerback Brandon Sermons broke his left leg midway through the practice session.” “Sermons’ injury occurred on the artificial turf side of the practice field. Several players have been recently injured on that side of the field as opposed to the side with the grass.” “The injury occurred when Sermons tried to make a quick cut on a pass-coverage drill. His left foot got caught either on the turf or entangled with the receiver.” “Offensive lineman Nick Ekbatani missed most of last season after suffering a knee injury on the artificial surface. Micah Kia missed the entire season after injuring his knee on the same practice surface. Defensive end Reggie Stokes tore cartilage in his right knee and missed a big part of last season.” But UCLA coach Rick Neuheisel “doesn’t think the turf is an issue.” “Teammate Aaron Hester, who broke his leg in the first game of 2009, thought Sermons’ foot got caught on the turf but figures all of that will be sorted out later. His main concern was for Sermons’ well-being.” Source: Al Balderas, “UCLA football: Sermons breaks left leg,” in The Orange County Register (April 3, 2010), available at  http://ucla.freedomblogging.com/2010/04/03/ucla-football-sermons-breaks-left-leg/13439/ .

[No. 43] American Academy of Orthopaedic Surgeons: “Artificial Turf Injuries Still More Likely in NFL.” An article on MedPage Today (March 15, 2010) reported on Hershman E, et al “American professional football games played on FieldTurf have higher lower extremity injury rates” (AAOS 2010; Abstract 692), a paper that was submitted  at the annual meeting of the American Academy of Orthopaedic Surgeons in New Orleans in March 2010 (see Item No. 41 below). According to Todd Neale, “AAOS: Artificial Turf Injuries Still More Likely in NFL,” on MedPage Today, March 15, 2010, reviewed by Zalman S. Agus, MD; Emeritus Professor University of Pennsylvania School of Medicine and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner – available at  http://www.medpagetoday.com/MeetingCoverage/AAOS/19020 -- The Hershman Study found that “Players were 27% more likely to sustain a lower extremity injury when the game was played on artificial FieldTurf instead of the real thing (P<0.01), according to Elliott Hershman, MD, of Lenox Hill Hospital in New York City. More specifically, there was an 88% increased risk of an injury to the anterior cruciate ligament and a 32% increased risk of an eversion ankle sprain when playing on FieldTurf (P<0.01 for both). Hershman is chair of the NFL's Injury and Safety Panel. Hershman and his colleagues analyzed data from the NFL Injury Surveillance System for the 2002 to 2008 seasons. An injury had to involve removal of the player from the game or loss of at least one participation day to be included in the study. The rate of lower extremity injuries was significantly higher for games played on FieldTurf -- 1.79 versus 1.40 injuries per team-game. Hershman acknowledged that the analysis was unable to control for other possibly contributing factors, such as the players' footwear.”

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[No. 42] Wayland, Mass.: More injuries on artificial turf. The following item is from http://groups.yahoo.com/group/waylandvotersnetwork/message/415 . It was posted on the site by Tom Sciacca on March 21, 2010. Mr. Tom Sciacca is the author of “The Thermal Physics of Artificial Turf,” http://www.synturf.org/sciaccaheatstudy.html (January 1, 2008). He is a retired electrical engineer, whose professional work included design of computerized data acquisition systems used for precision temperature measurements, using thermal physics extensively in his circuit and systems design work. He holds a patent for a novel home heating system. A graduate of Massachusetts Institute of Technology, he is a former conservation commissioner for the Town of Wayland, Mass.

Subject: WVN # 342: Wayland turf type linked to pro football injuries

Dear Wayland Voter,

The kind of artificial surface used on Wayland's high school playing field has been implicated in excess National Football League injuries.

Also in this newsletter: The town's website has won an award for making government information available to the public.

TURF INJURIES

On March 12 the Associated Press reported an NFL study showing higher rates of leg injuries on FieldTurf, the brand used on Wayland's field, than on grass fields. The rate of anterior cruciate ligament (ACL) injuries was 88 percent higher , the study said. Ankle sprains were 32 percent higher.

Dr. Elliot Hershman, a Jets team orthopedist, noted that the NFL research may not apply to lower levels of football or to other sports.

But data from the Wayland High School athletic department shows a large number of knee, leg, and ankle injuries after the turf field was installed. In fact, an ACL injury occurred on Sept.19, 2007, only four days after the field was first opened. The injured student took more than a year and surgery to recover. Another student received an ACL injury later in that same short season. Both occurred while playing football.

The following spring, lower limb injuries included two ankle sprains and two quadriceps strains. These all occurred while playing lacrosse. Both boys and girls were injured.

In the fall of 2008 there were two ACL injuries. One was during football practice and the other from girls' soccer. In addition, a field hockey goalie suffered a medial collateral ligament strain. There were three ankle injuries, one a fracture. Also, a soccer player suffered a hip strain and another child suffered a back injury.

The spring of 2009 saw many fewer injuries, including only one ankle sprain. And the fall brought only one ankle sprain and one knee contusion.

But 2009 also brought seven concussions. This is a type of injury that turf field manufacturers and proponents often claim is less common on turf fields, compensating, they say, for any increase in leg injuries. In all, there were 13 concussions on the turf field in the 2-1/2 year period from fall of 2007 through fall of 2009. Concussions have been in the news lately as causing lifelong damage, including possible early onset dementia.

ACL injuries have also made the news recently, as possibly causing early onset of arthritis. "People who tear their ACL have a 50 to 75 percent chance of developing severe osteoarthritis in 10 to 20 years", says Dr. John Hardin, the chief science officer of the Arthritis Foundation, quoted in the Boston Globe. "Even though the orthopedic surgery is very effective in getting you back to playing your sport, it doesn't change your odds of developing severe osteoarthritis and we really don't know why."

Researchers have measured much higher stresses on a player's legs on artificial turf than on natural grass. As a player pivots, the plastic strands simulating grass "grab" his foot. Natural grass, on the other hand, tears and allows scraping of the underlying soil, absorbing energy in the process. The same tearing and scraping that protects players also leads to higher maintenance costs for natural grass; such costs are part of the rationale for conversion to artificial turf.

A number of other injuries were documented on the Wayland field during the period, including thumb fractures, neck strain, wrist fracture, an apparent episode of fainting, and a stroke. Very high temperatures, over 160 degrees Fahrenheit, have been measured on the field. Such temperatures could have led directly or indirectly to some of these injuries by affecting coordination or consciousness.

A request for comparable data from the period before the installation of the turf field resulted in only three seasons worth of information. In those three seasons only one ACL injury occurred. Seven lower body injuries were recorded. That compares to 18 lower body injuries on the turf field over five seasons. It is unclear if the number and types of games played per season pre- and post-turf were comparable.

There were six concussions in the three pre-turf seasons.

Outgoing Selectman Michael Tichnor cited Wayland's "first turf field" as one of the accomplishments of his six years as a selectman. Tichnor was the most prominent proponent of the field, pushing the Board of Selectmen to support the construction and fund part of the nearly $1 million cost with Community Preservation funds, which was later judged illegal in a court case involving a similar project in Newton. Department of Environmental Protection orders resulting from appeals to the turf field proposal resulted in over $100,000 of required drainage work charged to the water department, never reported to taxpayers but included in water fees.

When the plans to build the field were being debated in front of the DEP, Town Administrator Fred Turkington argued that completing the turf field was necessary to protect children's safety.

SynTurf.org Note: It is reasonable to conclude that turf fields are injuring players, tots and titans alike. Lawsuits over injuries are already a part of the picture. They may well increase, on individual basis. But the road to greater product safety will probably be the same as battle over tobacco products, asbestos and automobiles – class action suits. Some of the people hurt on turf will suffer much of their lives as a result of these injuries. Often a simple public records request is all that a person needs to obtain the injury records for the school fields. On lawsuits visit this sites page http://www.synturf.org/lawsuits.html and also check out Brian J. Duff, “Game Plan for a Successful Product Liability Action against Manufacturers of Artificial Turf,” in 5 Seton Hall Journal of  Sports Law, vol. 5, 223-251 (1995), discussed in http://www.synturf.org/beckhamslament.html .

[No. 41] NFL Injury and Safety Panel: “Injuries are more common on artificial turf.” According to a  news story by the Associate Press (March 11, 2010), “An NFL panel found that certain serious knee and ankle injuries happen more often in games played on the most popular brand of artificial turf than on grass. The league’s Injury and Safety Panel is presenting its study Friday [March 12, 2010] at the annual meeting of the American Academy of Orthopaedic Surgeons in New Orleans.” “The report examined the 2002-08 NFL seasons, comparing games played on grass to those on FieldTurf. It found that the rate of anterior cruciate ligament injuries was 88 percent higher in FieldTurf games — a conclusion the manufacturer of the synthetic field hotly disputes.” “The panel has presented its findings to league owners, the NFL Players Association and companies that make artificial turf. The study has been submitted for publication.” “The panel started to notice a higher rate of injuries on the new turf in evaluating the data the NFL compiles each season, Once enough games had been played on the newer surfaces to do a scientific analysis, the panel found that ACL injuries and a more serious type of ankle sprain occurred at a higher rate that is statistically significant.” “The rate for the ankle sprains was 32 percent higher on FieldTurf than on grass. MCL injuries and a less serious type of ankle sprain also happened more frequently, but the difference was not statistically significant.” “FieldTurf president Eric Daliere argues that the panel's methods are faulty and cites research by Montana State professor Michael Meyers that has been published in The American Journal of Sports Medicine. Meyers' work, though, has only looked at high school and college football, and not the NFL. FieldTurf paid for Meyers’ recent study that found lower overall injury rates for college games played on the surface.” Source: Rachel Cohen and Barry Wilner, “NFL panel finds some injuries more common on turf,” Associated Press, March 11, 2010, available at http://www.google.com/hostednews/ap/article/ALeqM5hDn9hI92kotimLtxmGJrb2lcSCzgD9ECT5HG0 . Click here for pdf version.

For the NFL Player Association surveys of playing surfaces, see

http://www.synturf.org/health.html (Item No. 24); http://www.synturf.org/playersview.html  (Item Nos. 5, 14 and 24)

For studies on biomechanics of artificial turf and conclusion directly opposite Dr. Myers’ conclusions, see http://www.synturf.org/health.html (Item Nos. 28, 31, 38).

SynTurf.org Note: Playing surface are no different than floors of factories – they are the environment where the workers (players) toil, labor. The obsession with installing these plastic and crumb-rubber/sand infill playing surfaces lies entirely with management (owners) who ultimately reap the pecuniary gain from engendering the health and careers of the players. The same can be said of the municipalities and schools that promote play on these surfaces. The question then is whether players of all ages are worth real grass.

[No. 40] More on concussions: The turf factor. SynTurf.org, Newton, Mass. February 21, 2010. The Februaury 14, 2010, edition of CBSSports.com carried an article by Matt Rybaltowski, entitled “Young player helps turn trauma into action on concussions.” It is available http://www.cbssports.com/nfl/story/12928497/young-player-helps-turn-trauma-into-action-on-concussions . It is a long and well research piece on concussion among football players of all ages – and what is being done at all levels – government to research – to understand the phenomenon and prevent it from getting worse, hoping to reduce the risk of an injury that can leave athletes cognitively challenged and physically debilitated. Here are a few excerpts from the article:

Although the frequency of catastrophic football-related injuries resulting in major cognitive impairment, paralysis or even death has declined drastically over the past several decades, concussions in youth football still remain a serious concern. As players become bigger and the game has become faster, coaches on the whole still lack the requisite education to properly deal with a concussed athlete. At the same time, a dearth of on-site certified athletic trainers and poor funding in youth football has helped create an environment so violent that Houston Texans tackle Chester Pitts promises to find a less harmful sport for his three-year-old son Champ.

[Dr. Dawn Comstock, an associate professor at The Center For Injury Research and Policy at Ohio State University's Nationwide Children's Hospital] said the misreporting of concussions is a two-pronged issue that she attributes to the lack of awareness among some parents, coaches and athletes in combination with the culture of machismo prevalent among teenagers in the sport for decades. With potential college scholarships on the line and pride at stake, often the last thing a youth football player wants to do is leave a game. It might explain why Comstock's research found that 15.8 percent of high school players returned to a game last season after experiencing a concussion that resulted in a loss of consciousness.

One factor commonly ignored when evaluating concussion rates in football is the surface of play. Tom Bainter, the coach of Bothell High School just outside Seattle, said there were six concussions in his program in 2005, the last season before the school tore up a worn artificial turf field. The worst occurred when a freshman linebacker lowered his shoulder during a hit and slammed his head against the turf, experiencing a “double hit,” as his helmet bounced back up. The linebacker missed several weeks of school and needed to be escorted through the hallways to locate his classes when he first returned. Bothell has not had a player experience a concussion since.

Don Bollinger, president of Construction Services at ATG Sports, an athletic surfacing manufacturer that has installed turf fields on the high school and collegiate level since 1980, said there is a direct relationship between concussions and the amount of sand underneath a turf field. He said most of the surfaces constructed by his company contain an all-rubber infill that unlike sand does not compact and provides a softer surface.

The company, he said, strives to create a surface safer than natural grass. Playing surfaces, he added, are given a G-Max rating that tests its softness, or the amount of shock your brain receives when it hits the ground. Artificial turf fields with high contents of sand will produce G-Max ratings in excess of 200, comparable to the amount of force your head experiences when hitting a dashboard during a car accident. While there are still hundreds of artificial fields on the high school level that contain sand underneath, surfaces with all-rubber infill are considered much safer, Bollinger said.

[No. 39] Rugby coach: “artificial turf beats the hell out of you.” The Witter Rugby Field is located at the Memorial Stadium, on the campus of the University of California in Berkley. The coach of the Cal Rugby team (the Bears) is one Jack Clark. Following this March (2010), the field will be shut down for renovation until 2013 or 2014. According to a news story in The Daily Californian (February 9, 2010), “What many call the ‘best grass in Berkeley’ will be torn out and replaced with artificial turf to accommodate practices for football and lacrosse. ‘Playing on artificial turf beats the hell out of you,’ said Clark. ‘Even the newest generations of turf are not appropriate for rugby.’ Watching the field that you built being paved over is tough. Not being able to play at home is worse.” For more on this story, go to Gabriel Baumgaertner, “At Wit's End,” in The Daily Californian, February 9, 2010, available at http://www.dailycal.org/article/108154/at_wit_s_end .

[No. 38] Hospital for Special Surgery: Cleat/artificial turf combination most likely to result in ACL injury. Hospital for Special Surgery in New York City (www.hss.edu) is a world leader in orthopedics, ranking 2^nd in the United States. In a recent published study (January 2010), the investigators at HSS  found that “Athletes put less strain on their anterior cruciate ligament (ACL) while making a cut on a natural grass surface while wearing a cleat.” The investigators “tested the strain placed on the ACL of four different shoe-surface interactions: Astroturf/turf shoe, modern playing turf/turf shoe, modern turf/cleat, and natural grass/cleat.” Available at http://www.hss.edu/newsroom_cleat-grass-acl.asp (and here), here are an excerpt from HSS Press release (dated January 20, 2010 – Contact person: Phyllis Fisher, fisherp@)hss.edu – 2121-606-1197):

"It appears that a similar cut made on four different surfaces, the best strain profile is in grass/cleat combinations," said Mark Drakos, M.D., formerly an orthopedic fellow in the Sports Medicine and Shoulder Service at HSS. "So, there is less force occurring at your ligament for the same cut on that particular surface using this model."

He added that the study investigated noncontact injuries. "These are injuries where an athlete plants his or her foot while making a cut and blows out his or her knee," Dr. Drakos said. "The reason that I think this is so interesting is because there are still environmental factors, which have yet to be optimized. We don't know all the science behind why ACL injuries may be more common on turf than on grass. This study starts developing some of the science behind that, so that it can be looked at more closely because, at the end of the day, I think we need to optimize some of those environmental factors."

Previous studies have suggested that increased traction at the shoe-surface interface may increase the risk of sustaining an ACL injury. While the majority of studies reveal that ACL injuries are more likely to occur on artificial turf, there are some studies that have shown that injuries occur more frequently on grass fields. So, investigators have concluded that confounding factors, such as weather and footwear, must play a role in injuries. Some investigators have constructed models to test how the shoe-surface interface impacts loading conditions at the level of the foot, but no studies have investigated how the interface directly impacts the knee.

To fill this knowledge gap, investigators at HSS used a cadaveric model to test various shoe-surface interactions; they used the lower extremities (knee, foot, and ankle) from eight cadavers. One at a time, each specimen was positioned in a box-like structure, rigged to be in a standing position. The knee was positioned at a 30 degree angle, the flexion angle where the anterior cruciate ligament is most sensitive to strain. Investigators constructed an apparatus that placed weight on the leg, to simulate the weight of a body. Underneath the foot was a turf box that housed whatever turf they wanted to test and underneath the turf box, they placed a force plate that registered how much load was being placed on the shoe-surface interface. A lazy Susan was placed underneath the force plate that allowed the force plate and turf box to rotate. In this way, researchers could simulate a cut or a person pivoting in, for example, a soccer game.

"Our model looks at how forces travel up the kinetic chain, and that is something that should be looked at more closely, meaning you can't just look at the knee injuries by looking at the knee in isolation," Dr. Drakos said.

The investigators found that the natural grass/cleat combination placed a statistically lower maximum strain on the leg than any of the remaining three groups. All other combinations placed a greater amount of strain compared to the natural/grass cleat combination. The Astroturf shoe was 80.2 percent greater, modern playing turf/turf shoe was 47.5 percent greater, and the modern playing turf/cleat was 45.1 percent greater.

"As a former football player. I was always curious about why I was more sore after playing on artificial surfaces than playing on grass, and I wanted to find out the reasons behind that using a biomechanical model," Dr. Drakos said. "There are basically 200,000 ACL injuries every year in the United States alone and this [type of playing field and type of shoe] is an environmental factor which has been shown to play a role in injury, but has yet to be optimized. I think it is a scenario that deserves attention and further research."

Astroturf can be thought of as a carpet with ½ inch fibers on a 5 millimeter foam pad. The newer, modern playing turf consists of two inched fibers with a crumb rubber infill, three pounds of infill per square foot of turf. Investigators used fresh Kentucky bluegrass sod for the natural grass samples.

The study is entitled The Effect of the Shoe-Surface Interface in the Development of Anterior Cruciate Ligament Strain, by Mark C. Drakos, Howard Hillstrom, James E. Voos, Anna N. Miller, Andrew P. Kraszewski, Thomas L. Wickiewicz, Russell F. Warren, Answorth A. Allen, and Stephen J. O'Brien. It is published in the Journal of Biomechanical Engineering (J. Biomech. Eng. 132, 011003), vol. 132, issue 1 (January 2010). It is the collaborative work of Sports Medicine and Shoulder Service and the Department of Biomechanical Engineering, Hospital for Special Surgery, New York, NY 10021. Abstract is found at http://asmedl.aip.org/getabs/servlet/GetabsServlet?prog=normal&id=JBENDY000132000001011003000001&idtype=cvips&gifs=Yes&ref=no (and here). An award wining abstract is found at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2553173/  (and here).

[No. 37] Another NFL career in limbo, turf takes another toll. O’Brien Schofield is a senior at the University of Wisconsin. He is a defensive tackle. On January 25, 2010, his NFL prospects dimmed when reportedly he managed to tear his anterior cruciate ligament during practice for the Senior Bowl in Mobile, Alabama (January 30, 2010). According to e news report on Madison.com (January 25, 2010), “Schofield got his cleat caught in the artificial turf when locked in 1-on-1 drills with mammoth Massachusetts offensive tackle Vladimir Ducasse, whose leg then hit Schofield's while it was planted.” Source: “Schofield tears ACL in Senior Bowl practice,” on Madison.com, January 25, 2010, available at http://host.madison.com/sports/college/football/article_6d752568-0a2c-11df-85ee-001cc4c002e0.html .

[No. 36] Yes, turf can be an injury-causing hard surface, leading to head injury.  Last November (2009) we reported on Matt Blea’s ordeal (http://www.synturf.org/health.html (Item No. 32). As the discussion about concussions among NFL players goes on unabated, Matt Blea’s predicament serves as a constant reminder that concussion and head injuries among athletes knows no age group. Our high school athletes are equally imperiled, especially in an age where greater traction of footwear and greater mass of players combine to produce greater speeds and less forgiving collisions – player on player or player onto the playing surface. One of the selling points of artificial turf fields is that the surface is soft – perhaps so, but how long does that softness last as the crumb rubber compacts or altogether migrates off the field leaving behind a hardened surface? In a recent news item about Matt Blea, we came across this in the description of the play that sent him to the hospital with a career-ending head injury: “He doesn't remember banging his helmet on the artificial turf, or getting up and wobbling toward the sideline before collapsing. Or his father, an assistant coach, pleading with him, ‘Don't give up! Stay with us!’ Or the 2½-hour surgery at Valley Medical Center that saved his life.” For more of this news item, pleas see Tom Fitzgerald, “Teen football player upbeat after near-fatal head injury: Player suffers concussion after hitting ground,” in San Francisco Chronicle (The Herald  - Monterey County,  January 28, 2010, available at http://www.montereyherald.com/health/ci_14285120 .

[No. 35] Want to save your sports career? Get off the artificial turf. According to an article in the Chicago Sun Times, January 7, 2010, playing on grass saved the career of the outfielder Andre Dawson, former Chicago Cub, one-time Montreal Expo, one-time Boston red Sox and one-time Florida Marlin. Dawson will be enshrined July 25 in Cooperstown, N.Y. Here are experts from the article:

Dawson endured knee pain after playing 10 years on the artificial turf in Montreal. He had to deal with long hours of treatment before and after games. And he had to deal with the belittling era of collusion by baseball owners that drove him from the Expos as a free agent and into a blank contract offer handed to Cubs general manager Dallas Green in 1987. He signed for the paltry sum of $500,000.

''I was sticking my neck out,'' Dawson said Wednesday. ''They made me [a low offer] to get me to turn it down. But money wasn't the issue.''

Continuing to play was his issue. Dawson said playing on natural grass saved his career.

''Chicago, for me, gave me new life, playing on the natural surface after Montreal and being in a major market with a huge fan base that really understood the game. It allowed me to relax and enjoy the game. The game was fun again.''

Toni Ginnetti, “Andre's arrival worth the wait - Perseverance played key role in his long ride to Cooperstown,” in Chicago Sun Times, January 7, 2010, available at http://www.suntimes.com/sports/1978473,hall-of-fame-andre-dawson-010710.article .

[No. 34] KPHO (CBS): Athletes & Experts say turf can lead to real pain. According to a news report on KHPO.com (CBS 5 News, Phoenix, Arizona), January 14, 2010,  “Despite the growing popularity of artificial turf, athletes and physical therapists say the fake grass could lead to more injuries on the field.” Here is the rest of the article:

Michael Branson, a physical therapist and owner of Cor Clinic in Scottsdale, said although there are not conclusive statistics that show a distinct increase in injury rates on artificial turf, common sense says if a surface is harder it could lead to more serious injuries.

"I would think you would see more injuries" with artificial turf, said Branson, who works with injured athletes.

He frequently sees problems connected with synthetic turf, such as "turf toe," which is essentially a sprain to the toe. It can be as difficult or more to recover from than a sprained ankle.

Nevertheless, Branson also said more serious injuries, like the tearing of the ACL, could arise.

"New artificial turf fields … basically have a higher level of holding onto the foot," he said. "There is a potential for more rotation injuries on artificial turf fields versus grass."

Zoe Smith, a soccer player and sophomore student at Chaparral High School in Scottsdale, said she prefers playing on natural grass. The 16-year-old has fallen on synthetic turf many times, and she said it changes how she plays.

"In practices if I'm not wearing my sliders or something, I definitely … would hold back because … it kills to fall on turf if you fall the wrong way," Zoe said.

Branson said that, despite seeing injuries on both surfaces, he thinks that natural fields are "the way to go."

Evan Lambert, “Athletes, Experts Question Fake Grass' Safety: Artificial Turf May Look Nice, But Can Lead To Real Pain,” on KPHO.com, January 14, 2010, available at  http://www.kpho.com/health/22235392/detail.html .

[No. 33] Turf-boarding, a new form of torture! SynTurf.org, Newton, Mass. December 12, 2009. So you think you have seen it all when it comes to the testosterone-driven sadistic behavior of a coach that masquerades as character-building tough-love? The coach is Mark Mangino of Kansas University, who is no longer. In November the athletic director at the university launched an investigation and by December 3, 2009, he agreed to resign.

According to a news story on KUSposrts.com (December 2, 2009), Cory Kipp played defensive lineman under Mangino in 2002 and ’03, when “he endured significant injuries to his hand as a result of a punishment carried out by the coach — a claim backed up by multiple former players, as well as photos taken shortly after the incident.” “It must have been the worst pain I’ve ever felt,” Kipp said. Here is what went down – verbatim form

Dugan Arnett, “Ex-player accuses Mangino of mistreatment,” on KUSports.com, December 2, 2009, available at http://www2.kusports.com/news/2009/dec/02/ex-player-accuses-mangino-mistreatment/?football (or click here):

According to Kipp, who started all 13 games at nose tackle during the ’03 season, the incident transpired as follows:

At the beginning of an afternoon workout in August of ’03, Mangino told Kipp to see him after practice to undergo punishment for the player’s failure to weigh-in earlier that day.

Kipp figured the punishment would be running “cross-fields” — something he and another former player said was a typical penalty for such an infraction — but was instead told to “bear-crawl” across the AstroTurf field at Memorial Stadium on his hands and feet.

Kipp began the crawl and, after moving several yards, felt a burning sensation in his hands. On multiple occasions, Kipp said, he stopped to complain that the turf was burning his hands — according to a University of Arkansas report, artificial playing surfaces have been documented at up to 199 degrees in temperature — but was ordered by Mangino, who was walking alongside the crawling player, to keep going.

By the time Kipp had finished, the skin near the heel of his hand had been completely seared, and photos provided to the Journal-World depict blistering and a sizable area of missing skin.

As a result of the injury, Kipp said, he was forced to undergo extensive treatment on his hand by then-head football trainer Carol Jarosky throughout the next three weeks, and although he said at least two members of the coaching staff were aware of the injury, he was told to practice through it.

“It wasn’t like because my hand was burned, I took a couple days off,” Kipp said. “They made me practice.”

Each day for three weeks, he said, Jarosky — who did not immediately return a phone message seeking comment — would treat and wrap the hand before workouts, using multiple layers of padding. But in the days immediately following the injury, Kipp said, he would return to the locker room after practice with the padding soaked through in blood.

Asked to examine the photos for his opinion on the severity of the damage, Birmingham, Ala.-based dermatologist Conway Huang confirmed the injury was either frictional or heat-related.

If heat-related, Huang wrote in an e-mail to the Journal-World, it was consistent with second-degree burns.

Since allegations arose two weeks ago that Mangino had regularly verbally and physically abused players, however, the coach has contended that he has done nothing inappropriate in his running of the program.

During his weekly radio show Nov. 19, for instance, he lashed out at former players and parents who had spoken out against him, insisting their allegations were an attempt at “15 minutes of fame.” Asked following Saturday’s 41-39 season-ending loss to Missouri whether he’d be willing to tone down his approach if implored to do so by university administrators, meanwhile, he responded, “You’re coming with the assumption that it needs toned down. How I coach is how I coach. Ninety-nine percent of the kids here appreciate it.”

Three other players contacted by the Journal-World confirmed the incident, including Sid Bachmann, a defensive tackle on the ’02 and ’03 Kansas teams, and former fullback Austine Nwabuisi.

“The thing was, that day, it was so hot on the field,” Bachmann said. “... We were running cross-fields, and it was so hot that the bottom of my feet were burning. I could feel the bottom of my feet — through my socks and my cleats, they were burning.”

Despite the severity of the incident, Kipp said an apology — or any sign of remorse on the part of Mangino — would have been enough to move on without any hard feelings.

“If he said that he was sorry, and he didn’t realize (the turf) was that hot, then I would have accepted his apology and that would have been that,” Kipp said. “But I never got that.”

What’s more, during a team meeting later that season, Kipp says Mangino brought the incident up in front of coaches and players — a story confirmed by Bachmann.

After pointing out a tackle that Kipp had missed during the previous week’s game, Mangino allegedly threatened to burn the player’s other hand if he ever missed a tackle again.

“I looked at some of the assistant coaches when (Mangino) said that, and they just had their heads down,” Bachmann said. “Our (defensive line) coach had his head down and he was just shaking his head.”

At the urging of his roommate, meanwhile, Kipp took photos of the damage following the incident and strongly considered approaching athletic director Lew Perkins before deciding against it due to fear of retribution — namely, worries over a potential decrease in playing time or the revocation of his scholarship.

Kipp, who now lives in California, said he was prompted to come forward after hearing Mangino’s denials of earlier allegations involving his mistreatment of players.

“I’m doing this,” Kipp said, “because I’ve got proof how horrible a coach he is.”

SynTurf.org Note: Surely, the coach was wrong to do what he did to Kipp and others. What is more appalling and hardly ever addressed in our sports culture is the players’ reluctance to complain in a timely fashion. This needs to stop – we should be educating our athletes in differences between discipline and abuse, and how tolerating abuse a hero does not make – it is the coward who dares not speak truth to power wherever and whenever. As parents we have the burden of raising children who expect respect and will not stand for mistreatment.    

[No. 32] Fractured skull, concussion, turf toe and broken foot – on artificial turf. The world of professional football is presently focused on the effect of concussions on the long term health and quality of players’ life. One often hears about the weight of the athletes, strength, speed and other factors that contribute to the ferocity of the hits and spills and collisions. Nobody is focusing, as yet, on the contribution that the artificial turf fields may be making to the collisions that produce injury, concussions or otherwise. Traction, which allows players to cut and reverse course, also helps with acceleration, greater speed. You need not be a rocket scientist just yet to figure that given the same mass and greater acceleration always produces greater force.

According to a news item in San Jose Mercury News (November 11, 2009), “Matt [Blea], 16, a football player for San Jose High Academy, remained in critical condition Friday night [Nov. 11, 2009] at Valley Medical Center. His skull was fractured Thanksgiving Day while he competed in the annual ‘Big Bone’ Game against Lincoln High School.” Here are a few excerpts from the report by Mark Purdy, “Fear of injury nags all parents of prep athletes,” in San Jose Mercury News (November 11, 2009), available at http://www.mercurynews.com/breaking-news/ci_13883441 (the url has a link to the video of the injury-producing hit):

“A new study, done by the University of Michigan, has reignited the head trauma issue. The study found that former NFL players are far more prone to brain diseases and damage than the general population. That's understandable. At the NFL level, the players are so huge, so fast. The physics of their collisions are frightening. But can it be just as bad for teenagers with smaller bodies and slower feet?

Matt Blea’s parents must have felt the same way Thursday. On video, the hit against him shows up as a hard blow, but not devastating. It happens on a pass play. Matt is running downfield as a receiver. He turns and looks back for the ball. A player from Lincoln steps in front of Matt and makes an interception.” “Then, less than a second later, another player from Lincoln smacks Matt solidly in the left shoulder as he is still looking upfield. The blindside hit knocks Matt off his feet. He falls backward. His shoulders hit the turf along with the back of his helmet, which bounces with a snap off the artificial grass. Matt rises to one knee, stands, wobbles a few steps to the sideline and then collapses. Then the awfulness begins. Ending with an ambulance ride.”

Ryan Wolfe plays football for the University of Nevada at Las Vegas. According to a news report in Las Vegas Review Journal (November 21, 2009), “Wolfe’s final season came to a close Friday [Nov. 18, 2009] after it was determined he broke a bone in his left foot during Wednesday’s practice at Rebel Park. He is expected to have surgery sometime next week and begin a rehabilitation program that will last eight to 12 weeks, after which he will be on crutches for up to six weeks, according to UNLV.” According to Rebels coach Mike Sanford, while working on his punt returns, “Wolfe fielded a punt and caught his foot in a seam in the artificial turf at the team's on-campus practice facility.” Source: Jeff Wolf, “Wolfe’s UNLV career ended by broken foot,” in Las Vegas Review-Journal, November 21, 2009, available at http://www.lvrj.com/sports/wolfes-unlv-career-ended-by-broken-foot-70690597.html .

According to a news report by 11 Alive News (November 30, 2009), an NBC affiliate in the Atlanta area, the Falcons’ Quarterback Matt Ryan would be sidelined for Sunday’s game [Dec. 6, 2009] against the Philadelphia Eagles. Ryan is reportedly suffering from an injury that is not uncommon among professional and college athletes: turf toe.” “It is usually caused by jamming the toe (this is because shoes often stick in artificial turf and cause a painful stubbing).” “[I]t hurts! The injured can have stiffness swelling and pain at the bottom of the big toe or the base.” For more of this story, go to Chris Sweigart and Fred Kalil, “Matt Ryan’s ‘Turf Toe’ Explained,” on 11 Alive, November 30, 2009, available at http://www.11alive.com/news/national/story.aspx?storyid=138221&catid=5 .

[No. 32] Turf Toe: A Q & A with Michael Hartman, M.D. Michael Hartman, M.D. is a physician with Ferrell-Duncan Clinic, Orthopaedic Surgery and Sports Medicine, in  Springfield, Missouri. Recently, Jennifer Adamson, News-Leader (November 2, 2009) conducted a Q & A with Hartman about how Turf toe can affect football, soccer players. Available at http://www.news-leader.com/article/20091102/LIFE04/911020304/Turf+toe+can+affect+football++soccer+players , here is the text of the Q & A:

Q: What is turf toe?

A: Turf toe is a painful condition at the base of the big toe, located at the ball of the foot. It involves a sprain of the big toe metatarsophalangeal joint.

Q: What causes the condition?

A: The condition is caused by forced hyperextension (or bending back) of the big toe. This forced hyperextension leads to varying degrees of disruption of the soft tissues on the undersurface of the joint.

Q: Who gets turf toe?

A: Turf toe typically occurs in sports that require planting of the foot, such as football or soccer. It commonly occurs in the running back who has another player land on the planted foot, causing the big toe to bend back excessively. The name "turf toe" comes from the fact that the injury is especially common among athletes who play on hard, artificial turf.

Q: What symptoms might patients experience?

A: The athlete may experience pain, swelling, discomfort and painful movement at the base of the big toe. In addition, the athlete may report increased pain with any attempt to push off with the involved foot.

Q: When should a doctor be seen?

A: Any athlete with suspected turf toe should be evaluated by a physician. X-rays of the big toe should be obtained to rule out a fracture or joint dislocation.

Q: How is turf toe treated?

A: Treatment depends on the severity of the injury. All injuries are initially treated with ice, compression, elevation and anti-inflammatory medications. Mild injuries may be treated by taping the big toe and/or placing a rigid orthotic into the insole of the shoe. Moderate to severe injuries may also require a period of activity restriction, use of crutches and not bearing weight on the affected foot. Surgery is rarely necessary for the acute turf toe injury.

Q: How long does recovery take?

A: With a mild injury, the athlete may be able to return to play after a brief period of rest and taping of the big toe. For a moderate injury, it is usually necessary to refrain from athletic participation for two to three weeks. With severe injuries, the athlete may be unable to return to sports for the remainder of the season. A severe injury may take up to six weeks to recover and return to play.

Q: Can anything be done to prevent turf toe?

A: Athletes who wear lightweight, flexible shoes and play on hard playing surfaces are at risk of developing turf toe. In addition, athletes who have stiffness in the big toe joint may be predisposed to injury. Wearing shoes with a stiff sole or insert, playing sports on natural grass, and increasing the flexibility of the big toe joint may reduce the frequency and magnitude of this potentially career-ending injury.

[No. 31] Hospital for Special  Surgery (New York City) Study: Artificial turf surface produces most strain in ACL. SynTurf.org, Newton, Mass. October 11, 2009. This past August we reported ona study entitled The effects of various infills, fibre structures, and shoe designs on generating rotational traction on an artificial surface, which found that the highest torques were associated with the cryogenic SBR infill. This infill consists of fine crumb rubber particles capable of packing into a dense structure thought to increase a cleated shoe’s resistance to rotation. The lowest torques were associated with the extruded infill, a larger rounded cylindrical particle made of TPE, incapable of packing as tight as the cryogenically processed infill. it is generally accepted that excessive rotational friction results in high forces being transmitted to vulnerable anatomic structures which may then precipitate ankle and knee injuries. See  http://www.synturf.org/health.htm (Item No. 28).

Now comes study that highlights with greater precision the relationship between shoe-surface interface and ACL strains. Entitled The Effect of the Shoe–Surface Interface in the Development of Anterior Cruciate Ligament Strain, the study is the work of medical practitioners at New York City’s Hospital for Special Surgery: Mark C. Drakos (MD),  Howard Hillstrom (PhD), James E. Voos (MD), Anna N. Miller(MD), Andrew P. Kraszewski(BS), Thomas L. Wickiewicz (MD), Russell F. Warren (MD), Answorth A. Allen (MD), and Stephen J. O’Brien(MD, MBA). The study is published in the Hospital for Special Surgery Journal, 2008 September; 4(2): 188–190, and is available at http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2553173&tool=pmcentrez or

here.

The following is an excerpt from the study:

Introduction: The shoe–surface interface has been implicated as a possible risk factor for anterior cruciate ligament (ACL) injuries; however, the relationship between ACL strain and the shoe–surface interface has yet to be quantified. The purpose of this study is to develop a biomechanical cadaveric model to evaluate the effect of various shoe–surface interfaces on ACL strain. We hypothesize that there will be a significant difference in ACL strain between different shoe–surface combinations when a standardized rotational moment (a simulated cutting movement) is applied to an axially loaded lower extremity.

Results: The preliminary trials confirmed a linear relationship between strain and both the moment and the axial force for our testing configuration. The average Lachman examination produced a strain of 4.33 (SD±1.72). In the experimental trials, the average maximum strain was 3.90, 3.19, 3.14, and 2.16 for groups I–IV, respectively. Group IV had significantly less maximum strain (p<0.05) than each of the other groups.

Conclusion: This model can reproducibly create a detectable strain in the anteromedial bundle of the ACL in response to a given axial load and internal rotation moment. Within the elastic range of the stress–strain curve, the amount of strain in the ACL appears to be affected by the shoe–surface interface. Specifically, the natural grass and cleat combination produced less strain in the ACL than the Field Turf–cleat, FieldTurf–turf shoe, and Astroturf–turf shoe combinations for a given axial load and moment.

[No. 30] Seahawks WR back after ACL injury on artificial turf. According to a news report in Seattle Times (Septemebr 13, 2009), the Seattle Seahawks wide receiver Nate Burleson “suffered a season-ending injury when he tore the anterior cruciate ligament in his left knee on a rain-slicked, synthetic field in Buffalo during a 34-10 loss [last season].” Source: Percy Allen, “Nate Burleson shows he's back after knee injury,” in Seattle Times, September 13, 2009, available at http://seattletimes.nwsource.com/html/seahawks/2009860310_hawkside14.html

[No. 29] Honolulu, Hawaii: An epidemic of cuts and scrapes from the artificial turf field at UH. SynTurf.org, Newton, Mass. September 13, 2009. The following story would typically get filed under “Maintenance/Replacement” because of the physical condition of the artificial turf field. It is the effect of the worn out artificial turf field at University of Hawaii on the athletes that has landed this story on the “Health” page. The story is Stephen Tsai, “Warriors stinging from stadium FieldTurf cuts,” in The Honolulu Advertiser, September 8, 2009, available at http://sports.honoluluadvertiser.com/article/20090908/SPORTS0201/909080338&template=UHSports/Warriors+stinging+from+stadium+FieldTurf+cuts or click here. The following is a reprint of the story:

There is a 36-day break between last Friday's season opener and the Hawai'i football team's next home game.

That might be enough time for the FieldTurf-induced scrapes to heal.

Several Warriors noticed that the 6-year-old FieldTurf, installed in 2003 as part of the requirements for keeping the Pro Bowl in Hawai'i, no longer offers a soft cushion. The "blades" are worn down, and the paint coating, several Warriors noticed, provides a rough surface.

"It's not very forgiving," said UH quarterback Greg Alexander, his left shin covered with salami-colored abrasions. "It feels like you're playing on concrete sometimes."

Cornerback Jeramy Bryant did not work out Sunday because of a "deep incision" on his right leg caused after he slid on the FieldTurf. He said the cut might require a couple of stitches.

Left slotback Greg Salas' right forearms also were marked with cuts.

"The turf is hard," Salas said. "It hurts when you get tackled on it. ... It was that way last year. I've always had scabs (from turf burns). They never go away because I always rip them off in games when I get tackled."

On the plus side, the turf offers good traction, helping increase a player's speed. The downside, defensive end Paipai Falemalu said, is the FieldTurf feels like "carpet. It doesn't give too much."

Falemalu's knees were covered with abrasions.

UH head coach Greg McMackin said he noticed there were more reports of turf-related cuts.

"I don't know if it's just worn down," McMackin said. "It does seem a little thinner than last year. I have no answers."

Regardless of the condition, Alexander said: "You can't do anything about it now. It's football. You can't complain. If you fall down, you're going to get scraped. Whatever. You have to keep playing and not worry about it."

McMackin said he was told a new artificial turf will be installed next year.

"I know (stadium manager) Scott Chan and his staff do a great job, and they've got plans in the future," McMackin said. "Both teams have to play on it. Nobody has an advantage."

[No. 28] MSU Study: Infill and fiber spacing in artificial turf fields are factors in lower extremity injuries. SynTurf.org, Newton, Mass. August 9, 2009. A little known research paper by a group of biomechanical researchers at Michigan State University may have found the answer to why professional athletes disdain playing on artificial turf fields, with so many of them in NFL annual surveys believing that artificial turf fields injures them more than natural grass.

The purpose of this study was to investigate the role of infill material and fibre structure on the rotational traction associated with American football shoes on infill-based artificial surfaces. A mobile testing apparatus with a compliant ankle was used to apply rotations and measure the torque produced at the football shoe–surface interface.

The research study is by Mark R.Villwock, Eric G. Meyer, John W. Powell, Amy J. Fouty, and Roger C. Haut and it is entitled “Football playing Surface components may affect lower extremity injury risk.” The study was presented at the 2008 North American Conference on Biomechanics, August 5-9, Ann Arbor, MI (http://www.x-cdtech.com/nacob/Session5.html ). Funded by a grant from the NFL Charities Foundation, the study was published as The effects of various infills, fibre structures, and shoe designs on generating rotational traction on an artificial surface, Journal Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology, Vol. 223, No. 1 (2009), pp. 11-19.

Full text: http://journals.pepublishing.com/content/g51027g43j450472/ 

Abstract: http://www.x-cdtech.com/nacob/Abstracts/37.pdf or click here.

Here are some excerpts from the study:

Injuries to the lower extremity are among the most frequent injuries in all levels of sports and often account for more than 50% of reported injuries (Fernandez et al., 2007). While translational friction is necessary for high-level performance during any athletic contest, it is generally accepted that excessive rotational friction results in high forces being transmitted to vulnerable anatomic structures which may then precipitate ankle and knee injuries.

In the current study a mobile testing apparatus was developed to measure the torque produced at the shoe/surface interface on sixteen surface systems. It was hypothesized that the size and structure of the infill would affect the rotational resistance of cleated shoes.

Infill material, fibre structure, and shoe design were all found to significantly affect rotational traction. The cryogenically processed styrene–butadiene rubber (SBR) infill yielded significantly higher peak torques than the ambient ground SBR and extruded thermoplastic elastomer (TPE) infills. An artificial surface with a nylon root zone yielded significantly lower peak torques than similar fibre surfaces without a nylon root zone. The size of infill particles and the presence of a nylon root zone may influence the compactness of the infill layer. These features may act to alter the amount of cleat contact with the infill, thereby influencing rotational traction. The amount of cleat contact with the surface may also be determined by the shoe design.

Peak torques were significantly affected by playing surface…. FieldTurf and the native soil natural grass system produced significantly different torques than all other surfaces. This was in agreement with the trend in a comparable study performed by Livesay et al (2006). In the … analyses, all three infills were found to be

significantly different from one another. The highest torques were associated with the cryogenic SBR infill. This infill consisted of fine crumb rubber particles capable of packing into a dense structure thought to increase a cleated shoe’s resistance to rotation. The lowest torques were associated with the extruded infill, a larger rounded cylindrical particle made of TPE, incapable of packing as tight as the cryogenically processed infill. The open structure of the extruded infill layer was thought to reduce the frictional resistance.

Generation of excessive torque at the shoesurface interface was a factor of both the infill particle size and fiber spacing. The peak torques measured in the current study exceed injury levels based on cadaveric studies (Hirsch and Lewis, 1965). However, muscle stiffness has been shown to protect the lower extremity at similar torques

(Shoemaker, 1988). Future studies using a more biofidelic ankle may help establish relationships between shoe-surface interfaces and the potential for ankle injury.

Additionally, epidemiological studies of shoe and surface injury rates will be important for validating the injury risk potential of various shoe-surface interfaces.

SynTurf.org Note: We are grateful to Christiaan Arends for pointing us to this significant find. SynTurf.org’s sense is that, in time, this study and like of it, as well a ground swell of complaint by the players’ associations, will debunk yet another myth spun by the purveyors of artificial turf fields that this surface is safer to play on than natural grass. In a variety of postings on this site, we have relayed analyses that point to the conclusion that prolonged play on artificial turf fields is likely to produce career ending injuries among the youth and young adult players, prematurely. In the process of obtaining information about this study, SynTurf.org, also learned that an artificial turf manufacturer had threatened one of the researchers of the above study with a lawsuit in order to quash the publication of the above study. We hope it to be not so.

[No. 27] Red Sox rest up Lowell in advance of play on turf. “And on the 51st day of the season, he’ll rest,” wrote the Boston Herald (May 26, 2009) about Mike Lowell, the Red Sox third basemen, who has started in the 44 of the first 45 season’s games so far but not without aches and pains. Against Minnesota Twins [on May 26], therefore, he did not play. “Now seems like the smart time to take a break. The Sox are in the middle of an unusual stretch that will have them play seven straight games on artificial turf, which can wear down even the healthiest bodies. So tonight, finally, Lowell rests.” Source: Sean McAdam, “Veteran 3B’s contributions pleasant surprise: Mike Lowell earns a day off,” in The Boston Herald, May 26, 2009, available at

http://www.bostonherald.com/sports/columnists/view/2009_05_26_Mike_Lowell_earns_a_day_off:_Veteran_3B_s_contributions_pleasant_surprise/srvc=home&position=also

[No. 26] Ouch: Those pesky crumb rubber bits that injure!  This about one Forrest Smithkors, a programming director for a radio show, with some decent soccer creds. So recently did decided to try out for the Kansas City Wizards. This is a part of his narrative from the first day of tryouts: “At the end of the first game I started to feel some pain in the ball of my foot. I assumed I had some of the pellets from the synthetic grass in my sock that were scraping my foot. It got worse and by the end of my 3rd game I removed my shoe to find out I was developing blisters on both of my feet. During my 2 hour break I picked up some medical supplies and bandaged my foot as much as possible but it was just too painful to play to my full ability.” Source: “Local DJ trys out for the Kansas City Wizards,” in Topeka-Capital Journal, March 10, 2009, available at http://www.cjonline.com/interact/blog/david_streeter/2009-03-10/local_dj_trys_out_for_the_kansas_city_wizards .

[No. 25] Chronic traumatic encephalopathy in football players: Is there a connection to playing on artificial turf? On Wednesday, January 29, 2009, a team of researchers unveiled the results of the study of chronic traumatic encephalopathy (CTE) among Pop Warner and National Football league players. The disease is caused by multiple head injuries and afflicts individuals similarly to early-onset Alzheimer’s. In reporting on the story, The Boston Globe wrote, “In a discovery that is bound to reverberate through the nation's youth football community, clinical researchers reported yesterday that the brain of a recently deceased 18-year-old high school football player showed the earliest signs of an incurable debilitating disease caused by the kind of repetitive head trauma he experienced on the field. The discovery could provide new clues as to how much of a threat concussions are to athletes, including players from Pop Warner to the National Football League and those engaged in other contact sports, according to researchers at Boston University School of Medicine's Center for the Study of Traumatic Encephalopathy.” For more on this story, see Bob Hohler, “Warning sign on youth football head trauma: Player had hint of brain disease,” in The Boston Globe, January 28, 2009, available at http://www.boston.com/news/health/articles/2009/01/28/warning_sign_on_youth_football_head_trauma/ .

SynTurf.org Note: SynTurf.org contacted the Boston Globe reporter, Bob Hohler with this inquiry: “[D]id any of the researchers with whom you spoke about this (or written work) indicate if the type of the playing surface leads to greater incidence of concussions? I am raising this because artificial turf fields provide greater traction and torque to players who then end up on high-speed collisions. As you know, not all concussions suffered in the field of play comes from contact with the ground.” Hohler replied, “The playing surface came up with former NFL guys who played on that horrible artificial turf that seemed to be little more than a rug on top of concrete. That was about it.” SynTurf.org rejoined, “That would have been a legitimate concern because of the hard fall. The speed of play/force of collision in the new turf fields is just as critical as it would have been then.”

Maybe the time has come for leagues and schools, too, to start keeping records of injuries in reference to artificial turf fields. In a sports-crazed world with all of it love of stats, why this one has escaped scrutiny for this long?

[No. 24] Survey: NFL players prefer natural grass. On January 29, 2009, the National Football league Player Association released its 2008 Playing Surface Survey. http://www.nflplayers.com/user/video.aspx?pid=825&aid=0&sh=0&type=v. According to news stories, “NFL players overwhelming prefer grass to artificial turf, with 71.7 percent voting for a natural surface.” See, for example, Associated Press, “Top turf in NFL? Cards best, Steelers worst,” in The Evening Sun (Hanover PA), January 29, 2009.

SynTurf.org Note: Maybe the time has come for leagues and schools, too, to start keeping records of injuries in reference to artificial turf fields. In a sports-crazed world with all of it love of stats, why this one has escaped scrutiny for this long?

[No. 23] The “sticky turf” syndrome can cause severe ankle injury. SynTurf.org, Newton, Mass. January 11, 2009. One of the favorite charades put on by the proponents of artificial turf fields is to have a student athlete or parent to come up to the podium (in a cast and crutches if at all coincidental) and blame their ankle or knee injury on the school’s bad, bad and ill-maintained natural grass fields. A few weeks ago I was watching a legislator in a city near Boston rise in the well of the Aldermanic chamber and suggest that he was voting for artificial turf fields at a local high school because some years ago he twisted his ankle on those fields. Poor, baby! Well, here is a little story about the injury suffered by one Jon Cooper, Oklahoma University’s center and the All-Big 12 offensive lineman of the year. Cooper hurt his ankle in 2005 during a goal-line play when his foot was stuck on the artificial turf in Lubbock, Texas, and another player rolled on top of the ankle from the other side. He broke both ankle bones and tore every ligament. Ever since he has been trying get to 100%. In 2009 he was at 85 percent.[1] Gee, Mr. Alderman, I guess you made out better than Cooper, eh? Of all the lame excuses to vote for artificial turf!

[No. 22] Ben Roethlisberger credits natural grass for staving off injury. According to a news article in the Pittsburgh Post-Gazette (January 5, 2009), on Monday, January 5, 2009, “Ben Roethlisberger credited the giving grass surface for saving him from a more serious injury Dec[ember] 28 when his head bounced off it after Cleveland linebackers Willie McGinest and D'Qwell Jackson knocked him to the turf late in the first half.” And so, “That artificial turf the Steelers never installed at Heinz Field might have saved them a franchise quarterback. Or at least, saved him from a bigger headache.” The report quoted Steelers quarterback as saying, “I'm glad we weren't on FieldTurf. That grass – you know, the soft Heinz Field – might've helped a little bit. That whiplash is always a pain. If you ask any position player, when they hit that ground with the whiplash, it's going to hurt like crazy.” His arms went temporarily numb. “Yeah, I couldn't feel them,” he said. “They pricked me with a pin and I couldn't feel it. When you see the doctor look at the trainer with that look, it kind of scares you a little bit.” According to the report, “Heinz Field has a DDGrassMaster surface that is grass held in place by poly fibers. The surface was installed after last season, but not before artificial turf was seriously considered, particularly after the 3-0 ‘Muck Game’ victory against the winless Dolphins on Nov. 26, 2007. The Steelers installed grass sod on top of their surface this season after their Nov. 20 game against Cincinnati.” Ed Bouchette, “Big Ben enjoys homefield grass,” in Pittsburgh Post-Gazette, January 5, 2009, available at http://www3.signonsandiego.com/stories/2009/jan/05/chargers-s6pitt/?chargers

[No. 21] Turf is the culprit in Mark Jones’s injury. The The News & Observer (Raleigh, North Carolina) reported on December 7, 2008,  “The quadriceps in Carolina Panther’s kick returner’s left leg is noticeably smaller than his right quad -- a 1 1/2-inch difference in diameter.” The atrophy suffered by Mark Jones “is a visible reminder of the gruesome injury that threatened his career last season when he was a member of the Tampa Bay Buccaneers.” “While returning a kickoff at Detroit's Ford Field on Oct. 21, 2007, a Lions defender pulled him down, yanking his body backward. His left foot got caught in the artificial turf, causing his patella tendon to rupture.” For more on this story go to Charles Chandler, “Talk about making return,” in The News & Observer, December 7, 2008, available at http://www.newsobserver.com/sports/story/1324376.html .

[No. 20] Washington, D.C.: Kehoe Field’s turf poses danger to student athletes. By Guive Mirfendereski, SynTurf.org, Newton, Mass. October 24, 2008. According to the Voice (October 23, 2008) the turf at Georgetown University’s Kehoe Field is in dismal shape and poses danger to athletes. According to Walker Loetscher, “You’ll be in the midst of a great run down the left wing, or backpedaling toward the end zone to break up a game-winning touchdown pass, when one of them sneaks out of nowhere, grabs your leg, and twists. You’ll writhe on the ground for a minute, stand up, and try to walk the injury off. No such luck. Whether it’s a sprained ankle, pulled hammy, or twisted knee, you’ve been bested again by one of those tricky Kehoe specials—the bumpy irregularities that litter Georgetown’s only recreation field for student use.” For more of the article, go to Loetscher, Nasty turf burn,” in Voice, October 23, 2008, available at http://www.georgetownvoice.com/2008-10-23/sports/nasty-turf-burn or click here.

[No. 18]  Poughkeepsie, NY: Injuries are common on artificial turf.  On August 30, 2008, the Poughkeepsie Journal quoted Chris Campilii, owner of the Center for Physical Therapy in Wappingers Falls,  as saying “Things are faster and quicker on a turf field. This leads to more injuries. The speed of the game is much quicker. You make a cut and someone hits you, your foot sticks a little bit better. You'll get much less ligament injuries on natural grass fields.” He explained the mechanics of the injuries: “[Turf surface] causes more torque on the joints and the ligaments. Thus, you will see higher-speed injuries with more frequency.” And, therefore, “You'll definitely see more injuries.”

Source: Pete Colaizzo, “Athletes quicker on surfaces, but injuries are still common,” in Poughkeepsie Journal, August 30, 2008, available at http://www.poughkeepsiejournal.com/apps/pbcs.dll/article?AID=/20080830/SPORTS/808300336 .

[No. 17] Illinois sports medicine physician explains down side of playing on turf.

Artificial field turf may have its advantages, but it's not all home runs and touchdowns. There are some downsides.

The surface is made from rubber, sand and a synthetic material that makes up the surface. As a result, turf can be hard on an athlete's skin. As athletes slide on artificial turf, their skin can sustain cuts, abrasions, or friction burns.

Dr. Geoffry Kuhlman, a sports medicine physician in Hinsdale [Illinois], said turf has more traction than natural grass. Thus, athletes playing on it may be more prone to muscle strains in their legs.

"When you're on turf, the foot doesn't rotate or slide the way it does on natural grass," Kuhlman said.

In addition, artificial turf requires periodic disinfection, as it has no natural process present to kill germs. Bacteria can grow on it.

Artificial turf also becomes hotter under the sun.

[No. 16]  Bill Littlefield, Getting Played: The risks to children – particularly girls – in increasing competitive sports. The Boston Sunday Globe, July 27, 2008, Ideas section, p. K6. A Book Review of Tom Farrey’s Game Plan: The All-American Race to Make Champions of Our Children, and  Michael Sokolove’s, Warrior Girls: Protecting Our Daughters Against the Injury Epidemic in Women’s Sports. Available on line at http://www.boston.com/ae/books/articles/2008/07/27/getting_played?mode=PF .

Bill Littlefield is the sports broadcast journalist at National Public Radio. His program is called “Only a Game.” In this book review, Littlefield also offers his own observations of the youth sports scene. In collegiate athletics, what used to be walk-ons at a time when the nation weighed less is replaced by recruitment. “As a result parents and coaches have been pushing children to specialize at younger and younger ages.”

SynTurf.org believes, the specialization of the wunderkind particularly in the suburban communities, has led to a culture that separates at an early age the “competition-minded” from “exercise-minded” and promotes the alienation of a large segment of the student population that turns away from sports (physical activity) because they are told or feel they do not or cannot measure up. Increasingly, they are relegated to Physical Education or gym classes for a few hours in a week. Who know, if this de-socialization of our youth at such an early age then does not result in depression, feeling of rejection and other disorders, including eating disorders (obesity).As more and more venues become less and less available for the “exercise-minded,” pickup games once in an unrestricted  public park too will soon become a thing of the past.

Littlefield highlights Tom Ferry’s assertion that there is “something structurally askew  with the whole setup” of youth sports in the United States, “home to the fattest children in the world,” in part because the system rewards “early bloomers, leaving the rest behind.”  

Sokolove’s point is that in this culture, the way kids play sports is not particularly good for either sex. “For the girls, though, it is all too often disastrous.” This is because for a variety of reasons, writes Littlefield, “girls suffer more knee, back, nd head injuries than men playing the same sports. At the most competitive levels of soccer and basketball, girls and women suffer anterior cruciate ligament tears about eight times as often as men do.” Sokolove writes, “What does threaten women’s sports is that far too many girls and young women are leaving the playing field broken up and in pain.” “he makes the his case with statistics, interviews, and powerful stories about women who might have been stars if their knees hand’t exploded.,” writes Littlefield of Sokolove’s work. Sokolove suggest kids play several different sports, because “specialization means more stress through repetitive motion on the same developing muscles and joints.” “he encourages parents to resist the ‘bullying’ of coaches who argue that without a full time, year-around commitment. A 10-year old athlete will fall behind her peers.”

[No. 15] Jamaica’s under-17 women’s soccer team doctor says artificial turf increases rate of injuries. According to a news story in the Jamaica Observer, “Dr Mark Sanderson, team doctor on tour with Jamaica's Under-17 women's football [soccer] team, believes any move to popularise artificial turf in football will only serve to increase the rate of injuries to players.” In a Sporting World exclusive Sanderson, a medical doctor of 14 years, said the proposed study on incidents of injuries to players on artificial turf versus natural grass, is primarily for financial reasons as football nations seek ways of slashing field maintenance costs.” Sanderson said that pitches are made from waste rubber, while pointing that on a sunny day that's 35 degrees celsius in the ambient and on the pitch it might actually be 42 degrees celsius, which can cause several serious heat-related concerns for players…. Consequently, “youth players stand to suffer the most, and overall, players will more often than not perform below optimum levels.” Sanderson also rubbished the claim that third generation turf fields are virtually like natural grass. “Remember apart from the goalkeeper the rest of the players aren't well clothed, so there still is going to be a significant risk of them having burnt injuries. It's going to make the game less attractive, because players still complain about the bounce of the ball on the hard surface. Players tend to play more cautious on artificial turf because of the frequency and severity of injuries. Fans have difficulty adapting to the glare from this type of surface, which is taking something away from the game."

[No. 14] Connection between turf and concussion in female field players: a hypothesis. SynTurf.org, Newton, Mass. July 17, 2008. A recent news story in The Boston Globe reported that female athletes suffer more head injuries than males. The article described the concussion suffered by a University of Massachusetts’ midfielder when she went up for a header and was knocked off balance by the impact of another player’s head hitting hers. The article was focused on girls experiencing concussion at rates 27% more than boys in soccer, 66% in basketball and 80% in ice hockey. See Jordana Bieze Foster, “Female athletes suffer more head injuries than males,” The Boston Globe, July 14, 2008, Health/Science section, at page A7, available at   http://www.boston.com/news/science/articles/2008/07/14/female_athletes_suffer_more_head_injuries_than_males/ .

The article did not mention the surface or speed as a contributing factor to the concussion suffered by the midfielder. Nevertheless, here is however a hypothesis about the role of turf and speed in contributing to collisions that may result in concussion.

One of the characteristics of artificial turf fields is the superior, no-skid traction that artificial turf provides to the athlete, come rain or shine. That characteristic alone contributes to running speed. In a sport lie soccer, the athlete foot speed is further warranted be cause of the faster speed by which the ball moves on the turf surface. The faster the ball speed and faster players combined to generally speed up the game. It is, therefore, a matter of reasonable inference, collisions in soccer games that are played on turf fields are often unavoidable and with harder impact. It is SynTurf.rg’s view, while the size of the arena, athleticism and type of surface in ice hockey and basketball generate speed, which need not be the case in soccer. In girls’ soccer (as well as in boys), speed can be reduced if the game is played on natural grass. This especially should be the case for youth soccer.

[No. 13] Orthopedic surgeon: Athletes get hurt on turf as often as on grass. SynTurf.org, Newton, Mass. June 26, 2008. Dr. Craig McKirgan is an orthopedic surgeon with the Center for Orthopedics & Sports Medicine (COSM) in Indiana, Pennsylvania. According to a news story in Indiana Gazette, on Monday, June 23, 2008, McKirgan’s 45-minute PowerPoint presentation to the Indiana Area School Board showed “that athletes get hurt playing on artificial turf as often as they do playing on natural grass.”  He also told the Board “that players have higher risks of contracting MRSA, a drug-resistant bacteria, from sitting in a whirlpool or sharing towels than they do from falling on artificial turf.” McKirgan said his PowerPoint presentation will be posted next week on his company's Web site, www.pacosm.com. Source: Chauncy Ross, “IASD: Prthopedic surgeon weighs in on turf issue,” in Indiana Gazette, June 24, 2008, available at http://online.indianagazette.com/index.php?option=com_content&task=view&id=30793&Itemid=52 .

[No. 11] Protecting users from heat and health hazards of turf fields. SynTurf.org, Newton, Mass. June 22, 2008. On June 19, 2008, the Centers for Disease Control and Prevention issued an advisory about lead in artificial turf fields.[1] In practice, many municipalities have taken to advising players and parents along the lines recommended by the New Jersey Department of health and Senior Services – “[to] perform aggressive hand and body washing after playing on the field, and clothing used on the field should be washed separately.”[2] The New Jersey Department of Health guidelines suggest restricting children under age 7 from using fields with high lead levels, watering down the surface to suppress dust and thoroughly washing hands, bodies and clothing after using the fields.[3] When elevated level of lead forced the closure of the turf field at the Camp Henry (Taegu, South Korea), Dr. (Maj.) Remington Nevin, of the 18th Medical Command’s preventive medicine section, stated “The field at Camp Henry does pose a potential for exposure to lead, provided that children actually ingest whatever dust might come from degradation of that field. Lead should be avoided by adults but is more likely to cause health problems if ingested by children 6 years old or younger. The primary risk is to younger children prone to hand-to-mouth activities. Parents can minimize lead exposure to children by keeping shoes off while in the home, vacuuming with a HEPA filter, cleaning off dust, washing hands and encouraging proper hygiene.”[4] Should such information be posted at the fields as well? The lead dust controversy that began in New Jersey may very well trigger a requirement by the insurance carriers to have municipalities post health signs at artificial turf fields.

The irony here is that turf facilities have a long list of installer/owner-recommended warnings about activities that could damage the carpet. Yet, so far, there has been very little movement on the part of public officials to require posting of health-related signage at artificial turf fields.

Prompted by a recent inquiry as to whether any turf field in the country has a “heat” warning about posting of heat signs at turf fields, SynTurf.org surveyed its readership for any heat or other health related posting at artificial turf fields. It would seem that there is only one such signage anywhere in the country: “Stay healthy: Wash your hands and any cuts, scrapes or burns after play,” reads the sign at South Sunset Playground, San Francisco, California.[5]

In April 2008, SynTurf.org reported on two Massachusetts towns where public health officials were considering signs at turf fields that warned about the heat effect on the fields. “On hot, sunny days, artificial turf can reach turf ground temperatures up to 20 degrees hotter than black asphalt surfaces and/or up to 50 degrees hotter than natural turf. Please be aware that direct contact with these surfaces by you, your children or pets when the temperature is elevated may lead to contact skin burns and/or heat prostration. In addition due to the increased temperature in the over all field environment during these periods, coaches, players and participants are advised to keep fluids readily available and pay close attention to staying hydrated to avoid metabolic heat stress.”[6] There has been no indication if caution overcame the unwillingness of the pols in of Wayland and Weston.    

In annals of turf heat studies, the 2002 measurements by Frank & Williams at Brigham Young University is especially a propos because the study was triggered by complaints from the football coach, who reportedly too suffered blisters on his feet. The Utah Study[7]  soon gave rise to more localized measurements and many of these from Missouri to New York City and Massachusetts have been featured on SynTurf.org.[8] When it came to ascertaining practical health tips and sound field practices, it was all the more appropriate for SynTurf.org to see how they do things at Brigham Young University.      

In a telephone conversation on June 16, 2008, Roy Peterman, director of grounds department (801-422-5410), stated there is no sign or written policy as such to warn players against elevated field temperatures. In the summer months, when the fields receive sunlight as the same angle and with equal severity of southern California, the fields are used 50 minutes at a time, with ten minutes set aside for players to rest and watering the fields. “We use an irrigation system that the supervisors can activate with the push of a button,” he said. The irrigation is necessary to keep the field temperature to below 120 degrees, he said. The university’s approach to combating the heating effect of the turf fields is helped by the fields being closed facilities, with no free play on the part of students or members of the public.    

Peterman considers the proper maintenance of the fields as a greater preoccupation. “Contaminants is a problem with turf fields. You’ve got to maintain the fields. If you have leaves, for example, pathogens is a high possibility.” Another factor in both play and promotion of pathogen is humidity. If the area is humid that is one issue; then by watering the field the humidity goes up, he said. Another problem is the compaction of the field if not maintained properly. “This, Peterman said, “can result in juries.” Already, even on a well-maintained turf field, Peterman noted, last year there were 13 more injuries on artificial turf than on natural grass fields. “The turf is tight, it grabs the cleat when making a cut, and the bounce off the turf rebounds back to the knee and shins.”      

In a municipal setting, Peterman said, “It is probably a good idea to put a sign warning about temperature and humidity,” to protect players.

[No. 10] South African soccer legend Lucas Radebe cautions about artificial turf. SynTurf.org, Newton, Mass. June 10, 2008. The Republic of South Africa is the venue for the 2010 World Cup soccer games. In an effort to meet the demand for international class playing fields, a few new pitches are being readied.

On Sunday, June 8, 2008, the South African soccer legend Lucas Radebe was at hand to mark the opening of FNB Wadley Stadium in Pietermaritzburg. The venue has South Africa’s first full sized artificial turf field.  

While there are reasons why artificial turf might make sense for the 2010 World Cup games in South Africa, Radebe, who played for and captained Leeds United in the 1998/99 season in England, nonetheless has concerns about artificial turf.  He told SuperSport "I used to train on it (artificial turf) in England during my playing days and some of the guys used to complain about their ankles or knees hurting. It does and will affect the joints if a player or a team uses it everyday. I don't see a professional team using it everyday as a training ground or for matches on a weekly basis. It definitely is good for tournaments and games now and again, but not on a regular basis."

Source: “Radebe cautions about artificial turf,” in SuperSport.co.za (South Africa), June 9, 2008, available at http://www.supersport.co.za/football/article.aspx?id=257315&headline=Radebe%20cautious%20about%20artificial%20turf .

[No. 09]  Argonauts’ running back injured by artificial turf. SynTurf.org, Newton, Mass. June 6, 2008. It is a very familiar sight at most public meetings that considers the installation of artificial turf fields – a youngsters takes the microphone and relates an episode that resulted in an ankle injury because of the deplorable conditions of the town’s natural grass field. The implication here is that artificial turf field will not cause injury or as many. This is a fallacious marketing point that the turf industry advances and the municipalities buy it with as much readiness as the notion that a turf field needs no maintenance.     

“[National Football League] trainers and physicians are looking to prevent some of the most common foot and ankle injuries among players, primarily high-ankle sprains and turf toe, an ailment involving joint tears, swelling and intense pain often linked to playing on artificial surfaces,” according to an Associated Press story that appeared in the International Herald Tribune,  on May 10, 2008. See below for details.

Next month, an NFL Injury and Safety subcommittee will see the device for the first time.

League trainers and physicians are looking to prevent some of the most common foot and ankle injuries among players, primarily high-ankle sprains and turf toe, an ailment involving joint tears, swelling and intense pain often linked to playing on artificial surfaces.

Dr. Michael Coughlin, co-chairman of the NFL subcommittee on foot and ankle injuries, contends the new playing surfaces may create more of a risk for ankle and foot injuries.

"We have some preliminary information that leads us to believe that there may be a higher injury rate on the newer infill surfaces compared to grass," Coughlin said.

Associated Press, “Research could lead to fewer turf-related injuries,” in International Herald Tribune, May 10, 2008, Sports, available at http://www.iht.com/articles/ap/2008/05/10/sports/FBN-Artificial-Turf.php.

[No. 07  ] Is artificial turf especially cruel to female athletes? SynTurf.org, Newton, Mass. April 15, 2008. In September 2007, SynTurf.org published a brief called “Beckham’s Lament”  (http://www.synturf.org/beckhamslament.html). It explored the relationship between foot fixation injuries and artificial turf. These are injuries that result from damage to ligaments and joints because of the kind of speed, stops and cuts that an athlete can achieve because of the traction of the turf.

On other pages SynTurf.org has reported also on general athletic health and the degree to which turf compromises it http://www.synturf.org/athletichealth.html. We have reported on staph infections http://www.synturf.org/staphnews.html and http://www.synturf.org/staphturfbrief.html. The daily lamentation about playing on turf is recorded at http://www.synturf.org/playersview.html, while another page reports on teams blaming turf for their performances http://www.synturf.org/miscellanea.html.

None of the athlete-related materials reported on SynTurf.org makes a distinction between male and female athletes. However, as it turns out for the most part the reporting has been from the male athletic perspective, especially professional soccer and football. That may well change, as we learn more about “Women athletes win[ning] equal time on injury list.” That is the title of an article by Judy Foreman for the Health/Science section of The Boston Globe (April 14, 2008), pages C1-C2, available at http://www.boston.com/news/health/articles/2008/04/14/women_athletes_win_equal_time_on_injury_list. The article does not discuss turf in particular, but does point out to the greater risk of injury in areas in which the female athlete is more vulnerable than a male athlete because of the difference their physiologies. SynTurf.org asks: If certain parts of the male anatomy takes a beating from playing on turf, would not playing on turf be more damaging to the same but weaker body part in a female?  

Here are excerpts from the Foreman article that should answer the question: Is Artificial Turf Especially Cruel to Female Athletes?

According to the National Federation of State High School Associations, more than 3 million high school girls play sports. “But there's a dark side to this terrific news: The more girls and women play sports, the more they, like boys and men, get hurt. And - attention athletes, coaches, and parents - they get hurt in different ways.”

Basketball is “brutal on that most vulnerable part of the female athlete's anatomy: the knees.” “And even plain old running seems to be tougher on women's legs than on men's, though it's not clear why.”

“[A]thletic activities can cause different injuries in women and girls than in men and boys. Female athletes and their coaches should pay increased attention to the anatomical differences that put girls and women at disproportionate risks for certain injuries.”

“The sports injuries that seem to disproportionately affect women include:

- Tears in the ACL, or anterior cruciate ligament, in the knee, a problem that hits basketball and soccer players especially.

- Plantar fasciitis, in which activity can cause tiny tears in heel tissue.

- Compartment syndrome in runners, in which lower leg muscles get too tight for the surrounding space, causing severe pain.

 - Shin splints in runners, in which repetitive stress can lead to pain and even fractures in the lower leg.

- Kneecap pain.

- Pain along the outside portion of the leg in the iliotibial band, between the knee and the hip, known as iliotibial band friction syndrome.”

“Women's knees are more vulnerable than men's because the "Q-angle" - the angle between the hip and the knee - is greater in women than in men. While wide hips are good for childbearing, they mean there is more stress on the knee in moves like landing from a jump and twisting. This torque can shred the ACL, a ligament that helps stabilize the knee. This is a major reason why female athletes have four times more ACL tears than men do, said Dr. George Theodore, a Red Sox team physician and sports medicine specialist at Massachusetts General Hospital.”

“Making matters worse for women's knees, especially among basketball players, is that women tend to ‘cut,’ or suddenly change direction, differently from men.” "There's more of a tendency for women to change direction on just one foot, maybe because of the width of the pelvis, while men often use two feet."

“Wider hips also mean that there may be more ‘pull’ on the kneecap, which can cause pain when running uphill. Kneecap cartilage also seems to wear down more in women than in men. And women's kneecaps slide around more from side to side, in part because women have more estrogen, which can make women's ligaments more flexible than men's.

[No. 06] MLS urged to go with natural grass. SynTurf.org, Newton, Mass. March 4, 2008. In this morning’s Boston Globe (4 March, 2008, Sports section, page D8), Frank Dell’Apa stated that the Major league Soccer should not approve artificial turf for the new stadium that will be the home of the newly approved Philadelphia soccer franchise. The stadium will in Chester, Pennsylvania. See “Soccer Notes: Opportunity is there for someone to strike” (item subtitle: Grass is greener) available at http://www.boston.com/sports/articles/2008/03/04/opportunity_is_there_for_someone_to_strike/?page=2.

Dell’Apa reported that by next season 12 of the 14 current teams will be playing on grass fields, with New York and Real Salt Lake going with natural grass, “a trend that should be encouraged,” Dell’Apa wrote. The reason for this exhortation by Dell’Apa is quite clear to the fans of SynTurf.org and other advocates seeking to limit, regulate or outright ban artificial turf fields. Here is what Dell’Apa wrote:

The exposure of young vital organs to potentially harmful substances that turf fields contain may well result in far greater health complications. On the other hand, the ill effects of pesticides and fertilizers used on natural grass fields can be replaced with organic versions of both. Types of grass now exist that grow faster and in much more adverse climates than before. Meanwhile, it should be no secret, the artificial turf fields themselves require substantial amount of bactericide and fungicide and pesticides and other treatments in order to have them kept in a decent playing condition. For more background on maintenance issues associated with artificial turf, go to  http://www.synturf.org/maintenance.html.

2003 -- A study titled “Sports Safety in Australia,” July 2003, concluded “It has been suggested that lower limb injuries, particularly in elite Australian Rules Football, are related to ground conditions and surfaces or the pace of the game. However, specific examination of these factors in community-level sport has yet to be undertaken.” In this assessment the study relied on a 2003 study by Murphy and others on risk factors for lower limb injuries, published previously in the British Journal of Sports Medicine. In that study, three factors were sited for lower limb injury in general: competition settings versus training, artificial turf versus grass or gravel, and previous injury coupled with inadequate rehabilitation. http://www.ausport.gov.au/fulltext/2004/dha/ch6.pdf. The Murphy study was cited also in “Epidemiology of Soccer Injuries in Rwanda: A Need for Physiotherapy Intervention,” a supervised masters of science thesis by Janvier Twizere, Department of Physiotherapy, University of the Western Cape, South Africa (November 2004) http://ww3.uwc.ac.za/docs/%20Library/Theses/Theses%202005%201st%20Grad/Twizere_j.pdf.  

At Michigan State University’s Spartan Stadium the artificial turf has been replaced with the new natural turf integrated modular technology. The Michigan State Spartans had decided to switch from the 8 season-old artificial turf to grass because it was worn out. The conversion was instigated at the request of coach, Bobby Williams, because he believed that natural turf cuts down on injuries. http://www.sportsvenue-technology.com/projects/greentech/.

For an article on the hazards of turf from a player's perspective, please go this site (www.syntruf.org), page called "WarpUpArticles," Article No. 1 (Beckham's Lament).

No. 03] Staph infection at Winchester High School.  http://www.boston.com/news/local/massachusetts/articles/2007/10/20/winchester_sports. The recent Staph infection (methicillin-resistant staphylococcus aureus) suffered by a member of Winchester High School [Massachusetts] football team is shedding more light on the prevalence of MRSA infections in our schools. The article repeats the common understanding that people should not share personal items used by others, wash their hands and maintain good hygiene in order to minimize the chance of getting this bacterial infection from others. Stephen Smith “Winchester sports team is checked for MRSA,” The Boston Globe, October 20, 2007, pages B1, and B5 ( The article makes no mention of the abrasions that athletes sustain when they play on artificial surfaces and how that renders them all the more susceptible to getting Staph infection when they come into contact with a person or items bearing the bacteria, possibly including the turf surface itself. The article makes it clear that the bacteria survive on open surfaces like razors, towels, drink bottles, and other things. While turf dos not cause Staph, it is capable of contributing to the contagion because the contact (impact, slide) with the turf does cause abrasions and burns on the skin and, if not treated appropriately, Staph infection can enter the body by way of the abrasion. Unlike natural grass and soil that breakdown and eliminate bacteria, the turf does not have the self-cleaning capability and must be cleansed with bactericides.

A "wrap up" article on turf-related Staph infection appears on this site (www.synturf.org), at "WrapUpArticles" page, Item No. 3.

No. 04] Field of Nightmares: Can playing sports on artificial turf kill you? As the debate rages on, parents need to hear the story of one young Texas athlete who's lucky to be alive, by Patricia Kilday hart, in Texas Monthly,  Volume 34,  Isssue 5 (Austin: Texas Monthly, a Division of Emmis Publishing, LP),  May 2006), available at http://www.texasmonthly.com/preview/2006-05-01/hart.

Abstract (Summary)
Boone's doctors don't know where the MRSA originated, though they believe it entered his body through the turf burn. Westlake trainer Brad Hawkins says he knows of no MRSA cases at the school, leading him to conclude that the school's artificial turf is not contaminated. But Westlake athletic director and head football coach Derek Long acknowledges that the school once scrubbed down its field following a staph outbreak (not of the MRSA variety), in 2003.

IT HAPPENED ON THE MOST ordinary of plays. Sixteen-year-old Boone Baker, playing wide receiver on the Austin High Maroons junior varsity last October 7, sprinted a quick five yards before turning and snagging a short pass from his
quarterback sometime in the second half of a Friday night game against archrival Westlake High. Immediately after Boone caught the pass, he was tackled, hard, with his left shoulder crashing into the artificial turf of Chaparral Stadium. He remembers feeling a burning abrasion on his shoulder when he got up, but he shrugged it off and returned to the huddle.

As football games go, it was a mundane moment, with nothing to presage the medical nightmare that three months later would almost cost Boone his life and temporarily rob him of his mobility and his eyesight in one eye. On that seemingly insignificant play, this strapping, 176-pound, six-foot-two-inch teenager unknowingly joined the swelling ranks of athletes--from the National Football League to high school wrestlers--plagued by a new killer "superbug," a pernicious staph infection that mimics the flu, races through the body with lightning-quick speed, and resists normal penicillin-based antibiotics. Known as MRSA (methicillin-resistant Staphylococcus aureus ), this bacterial infection first emerged in hospitals five years ago, attacking vulnerable postoperative patients with compromised immune systems. But in the past two years, MRSA has made its deadly presence known in the community at large, with athletes being a prime target, since the bacteria thrives in steamy settings like locker rooms and enters the body through nicks, abrasions, and cuts.

But it's not just athletes who are affected; a Fort Worth woman died in February from an infection suspected to be MRSA, which she contracted during a routine pedicure. But athletes constitute a high-risk category in which MRSA
continues to show up in clusters, with disastrous consequences. In 2003 MRSA claimed the life of Ricky Lannetti, who played football for Lycoming College, in Pennsylvania, and sidelined ten football players at a Connecticut college,
hospitalizing two. That same year, the infection attacked five members of the St. Louis Rams. In Texas serious outbreaks have been reported among football teams in Denton County, Pasadena, and South Texas, where an alarming 81 cases
were reported in 2004.

Health care professionals--from the National Athletic Trainers' Association to the Texas Department of State Health Services--have begun campaigns to educate the public, and especially coaches and athletes, about how to prevent and
detect the infection. "I almost don't go to a meeting anymore that it is not a topic on the agenda," says Allen Hardin, the co-director of sports medicine at the University of Texas, where the football team has gone to single-use disposable towels in its war to combat transmission of the infection. At the University Interscholastic League, which oversees public high school athletics, a medical advisory committee is developing a poster to place in locker rooms across the state, featuring pictures of an early-stage infection, which can look as harmless as a mosquito bite, and recommending tips for locker room cleanliness.

Neither the Centers for Disease Control and Prevention nor the state health department keeps statistics on how many cases have occurred in Texas or around the country, but one CDC study suggests that MRSA may occur in as many as 25 out of every 100,000 people. Anecdotal evidence is frightening: One Austin pediatric surgeon in a four-physician practice reported to me that she and her partners averaged ten surgeries per week to drain MRSA abscesses. Officials at
Texas Children's Hospital, in Houston, say that the incidences of MRSA have more than doubled since 2003, and the new bacteria now accounts for 77 percent of otherwise healthy patients with staph infections there. Since 2002, the
hospital has lost six patients to MRSA, some of them infants. "This is not an athlete problem--it's a people problem," says Dr. Sheldon L. Kaplan, the chief of the hospital's infectious-disease clinic.

As Boone Baker's case illustrates, MRSA often starts out by disguising itself as an innocuous skin wound resembling a pimple or an ingrown hair. Immediately after the Westlake game, Boone showered and applied an antibiotic ointment to
his shoulder burn and continued to do so all weekend. But after practice the following Monday, Boone noticed that the burn had become a purplish boil and showed it to a trainer, who directed him to see a doctor. The next day, his
doctors lanced and drained the wound, cut out the pustule, took a culture, and identified the infection as MRSA. That called for a specific type of antibiotic, Septra, which, unlike penicillin-family drugs, can still knock out MRSA. Ten days later, Boone was cleared to return to football.

"I thought it was completely behind us," says Missy Baker, Boone's mom. When Boone fell ill with the flu this January, as did many other students at Austin High, the thought of a recurrence of MRSA, attacking his flu-weakened immune system, never entered her mind. Suffering nausea and a high fever, Boone lay on a couch for several days while Missy consulted his pediatrician's nurse by phone. Certain that Boone's lethargy was brought on by dehydration, Missy plied
her son with Gatorades, but nothing about his condition made her panic.

Until Thursday, January 19. Early in the day, Boone complained of excruciating back pain. He rebounded, but soon the pain returned with scarier symptoms: fast and shallow breathing, neck pain, and a sudden inability to move his legs.
Fearful that Boone had meningitis, Missy and her husband, Coalter, raced their son to an emergency room.

Life-threatening infections like Boone's could be avoided with some basic health precautions. Yet a CDC study released in February about the Rams' experience indicates that, even at the professional level, trainers have been slow to appreciate the risk of MRSA. On an average week, Rams players reported two to three "turf burns," severe abrasions where the skin is rubbed raw by high-velocity contact with artificial turf. Most of the burns were left uncovered during subsequent play. Trainers who treated the wounds on the sidelines did not have ready access to hand-washing or sanitizing materials. Players shared soap, towels, whirlpools, and workout equipment. The CDC study also determined that the infected players had a history of unusually high use of antibiotics, which could have made them more susceptible to the methicillin-resistant strain of staph. In fact, researchers believe that overuse of antibiotics in the community at large has enabled the new strain of bacteria to emerge. The CDC is advising schools that the best way to prevent MRSA is to
disinfect common areas, like whirlpools and showers; stop the practice of sharing towels and soap; and encourage frequent hand washing. Players should see trainers about every abrasion, which should be cleaned and covered
immediately.

If the prevention of MRSA is relatively simple, the treatment is anything but. When Boone arrived at Brackenridge Hospital, he was immediately placed in the intensive-care unit. For the first night, he was given fluids intravenously
while awaiting the results of blood tests to determine whether he had MRSA. By the time the infection was confirmed as MRSA, two days later, the bacteria had erupted in pustules all over his body. Doctors ordered massive doses of
antibiotics and waited for his system to respond. But it didn't. Something was blocking the antibiotics from taking effect. Boone's heart was racing at a rate that doctors compared to running a marathon at top speed. His midsection became
bloated as his kidneys and liver began to fail. "He was dying, effectively," his dad recalls.

By this time, whole teams of doctors were standing at Boone's bedside. A decision was made to conduct a full-body MRI. After a torturous five-hour session (the MRI was halted several times when Boone's temperature spiked and
sent him into uncontrollable chills), doctors found the source of his paralysis: two baseball-size abscesses around the base of his spine. On Monday, Boone underwent back surgery to drain and remove the abscesses and received another round of intensive antibiotics. He remained in the ICU, and doctors immediately began to see progress.

But Wednesday brought another scare: Upon removal of the breathing tube that had been placed down his throat during surgery, Boone said, "Mom, I can't see out of my right eye." Yet another specialist was called in, who confirmed that
the MRSA was indeed attacking his eye. For the next couple days, Boone would need to be awakened every hour so a nurse could administer three types of antibiotic eyedrops.

On Super Bowl Sunday, seventeen days after he had arrived at the hospital, Boone was allowed to have visitors. A physical therapist helped him take his first painful steps with the aid of a walker. But Boone experienced another setback when it was discovered that he had some blood clots and that a small pustule on his lung had not responded to the antibiotics. More surgery would be needed.

While Boone had fought for his life in the hospital, his illness had become a statistic in one of the ongoing issues involving MRSA: whether artificial turf can cause the infection. This is a question that affects sports at all levels and can have a major economic impact on companies that produce artificial turf. The CDC, however, is not inclined to blame turf. In its study of the St. Louis Rams outbreak, testing of the turf did not turn up evidence of contamination. "We didn't really feel it was the main mechanism for transmission," says Jeff Hageman, an epidemiologist for the CDC. Rather, Hageman said, researchers found a high incidence of infection among players with the most skin-to-skin contact.

But that has not stopped the MRSA scare from fueling the prolonged dispute between natural-turf and artificial-turf advocates. Brad Fresenburg, a University of Missouri turf grass expert, recently conducted studies of the temperature of his school's synthetic field and found an astonishing 173-degree temperature on a 98-degree day, a temperature disparity he believes contributes to bacterial proliferation. "Natural grass has a microbial system. It's self-
cleaning," Fresenburg wrote. "These synthetic fields don't have that." He suggests that synthetic turf be sprayed with a disinfectant when an infection is suspected.

Advocates for synthetic fields disagree, noting that the new generation of turf contains ground automobile tires, which include sulfur and zinc, agents that kill bacteria. "There's no evidence to support the theory that synthetic turf breeds bacteria," says Andrew McNitt, an assistant professor of soil science at Penn State University. "The majority of the data shows that the fact that there are more abrasions means the athletes have more entry points for the bacteria
to get in their bodies."

Yet the industry itself is concerned about the possibility of bacterial contamination. In November Astro Corporation unveiled a new product containing an antibacterial agent that it says will protect the turf from corrosion. Several companies have developed products to fight MRSA, including Cleveland-based Pioneer Manufacturing, which, in addition to making paint used to mark athletic fields, now sells an artificial-turf disinfectant called Titan Turf Gard. But the CDC's Hageman believes that the best way to prevent MRSA from spreading is for trainers to immediately treat and cover wounds like Boone's.

Boone's doctors don't know where the MRSA originated, though they believe it entered his body through the turf burn. Westlake trainer Brad Hawkins says he knows of no MRSA cases at the school, leading him to conclude that the School's artificial turf is not contaminated. But Westlake athletic director and head football coach Derek Long acknowledges that the school once scrubbed down its field following a staph outbreak (not of the MRSA variety), in 2003. The Bakers aren't interested in assigning blame but want parents, kids, and trainers to know what to watch for and how to avoid infections. Coalter is haunted by a doctor's comment that Boone would have died if he and Missy had waited another day to get him to the emergency room .

Shortly before Boone left the hospital, I took my son, Michael, who is a friend of Boone's, for a brief visit. Missy had prepared us to expect him to look like a prisoner of war. She wasn't exaggerating: He had lost 41 pounds. Finally, on
February 14, more than three weeks after he had been rushed to the emergency room, Boone was cleared to go home, where he remained for a couple months, staying current on his schoolwork and taking his antibiotics intravenously. His
vision has returned, but he can't return to playing sports until he finishes all his medicine--July at the earliest--and an orthopedic specialist determines that no bones have been compromised.

I dropped in to see him a few days after he got home, and though he had put on a few pounds, he still looked gaunt. He was sitting in a chair with an IV in his arm. We chatted for a few minutes, and then I asked him: "Will you play
football again?" His answer was immediate. "Oh, sure," he said, as if nothing had ever happened.

[No. 05] Picture This! SynTurf.org, Newton, Mass. February 16, 2008. What do vomit, spit, sweat and other human and animal discharge, and mold and bacterial growth look like in the fibers of artificial turf?  Wonder no more!

Courtesy of http://sfparks.googlepages.com/silvtermrsa -- here is a pictorial presentation titled San Francisco Play Fields Poised To Infect.  All photos were taken in 2008 at Silver Terrace Play Fields (San Francisco) and Garfield Soccer Field (San Francisco).