Grass Vs Turf: Which Surface Is Safer For ACL Tears?

The NFLPA and its players have declared war calling for all playing surfaces to be grass. The NFL and Jerry Jones have defended turf fields as safe. What is the truth? As in most arguments, the reality lies somewhere in the middle.

When it comes to ACL tears so far this NFL season the difference is minor and may even favor turf (but the sample size is small). Exactly half of the 32 teams play on grass and half on turf. A study of surfaces for knee ACL tears thru the halfway point of the regular season showed:

  • 35 total ACL tears: 24 on grass and 11 on turf (but 10 were in practice which is mostly on grass)
  • 25 ACL tears in all games: 14 on grass and 11 on turf
  • 17 ACL tears in regular season games: 8 on grass and 9 on turf

The NFLPA President called for the immediate ban of a particular turf called slit film.

Seven teams play on this type of surface: the Lions, Vikings, Saints, Colts, Bengals, Giants and Jets (the final two share MetLife Stadium).

For ACL tears this season, five stadiums lead the way with three ACL tears each and only two use slit film turf (Lions and MetLife). Two of the remaining three are the grass field of the Broncos and Dolphins. The final is SoFi stadium but that turf is not slit film.

If you remove the two stadiums with two teams playing home games (doubling the exposure for injury), the three left are Detroit (turf), Denver (grass) and Miami (grass) that lead the way with three ACL tears each. At least for ACLs, the data this season is not clear cut.

NFL Players Speaking Out

George Kittle complained about playing on different types of turf instead of one unified type of artificial grass.

However, not all grass fields are the same in the NFL either, there are different types of grass used.

Bruce Irvin just complained about the poor grass field that caused slipping in Germany.

Although poor footing makes for sloppy football, it makes it safer against ACL tears.

As a former NFL head team physician, anecdotally, I do prefer grass as slightly safer for major ankle and knee injuries. However, the only way this controversy can be solved is for the NFL to share its injury data base over the last several decades so all injuries on different surfaces can be studied.

Dozens of players are now tweeting and speaking out to make all playing surfaces grass. They need to remember that converting to all natural fields was on the table at the last CBA but that point was bargained away by their union.

Written by Dr. David Chao

David Chao, MD -- known digitally as Pro Football Doc -- is an expert contributor for Outkick. Chao spent 17 seasons as the team doctor for the San Diego Chargers (1997-2013) and is part of the medical team at OASIS in San Diego where he treats and specializes in orthopedic sports injuries, working with high-profile professional athletes from the NFL, NBA, and MLB.

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