Safety of artificial turf needs further study

The feel and smell of natural turf has been a big part of the pleasure derived from outdoor sports. Increasingly over the past 50 years, that aspect of sports participation has been replaced with various artificial materials. Today, the safety of those materials has come into question.

The original Astroturf field consisted of nylon strands woven into a carpet and was designed for an indoor stadium like the Houston Astrodome. A subsequent version was made up of a tighter weave and more compact surface. These forms resulted in injuries from impact with a firm surface and friction burns.

This led to the current generation of artificial turf fields consisting of longer, softer synthetic strands filled with granulated recycled rubber. These fields now provide a softer surface with improved traction for cleated footwear.

Despite these innovations, an increase in the frequency of lower extremity injuries can be related to the change from natural to artificial surface. Among these injuries are turf toe, a painful condition that results from injury to the ligaments supporting the great toe. An increase in anterior cruciate ligament knee injuries is also believed to be related to the change in playing surface.

“The evidence suggests that synthetic turf increases the chance for injury, and at best the more natural the surface the less increase in injury — especially for the football player,” reports Dr. Stephanie Mazerolle, Assistant Professor of Kinesiology at the University of Connecticut. “I think when considering playing surface, natural surfaces (i.e. grass) may offer a more favorable environment when it comes to the safety of the student-athlete.”

More recently, ESPN’s “Outside the Lines” and others have called for further investigation into anecdotal reports of increased cases of cancer in athletes who have high exposure to the so-called “crumb rubber” fields. Soccer goalies are particularly vulnerable given their exposure to the rubber particles especially when playing indoors. The principal forms of reported cancers are blood related such as leukemia and lymphoma.

Despite the economic advantages of artificial turf, more investigation regarding safety must be carried out.  

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at

Education is key to preventing concussions

Eleven high school students died in 2015 while playing football. Seven of those players lost their lives to brain injuries. The question now facing parents, physicians, athletes and coaches is whether more can be done to avoid severe brain injuries. Potential solutions may be centered on education, legislation and rule changes.

In 2009, the state of Washington approved the Lystedt Law. It is named for Zachery Lystedt, a 13-year-old junior high school football player who suffered permanent brain damage after being allowed to return to a game shortly after a concussion. Since then, all 50 states have passed some variation of this law requiring that a player suspected of having suffered a concussion must be removed from a contest and not allowed to return until cleared in writing from a medical professional.

These laws typically require all scholastic coaches to complete an education program that addresses the signs of concussion. Unfortunately, these laws only address coaches at the high school or higher level.

Ironically, despite best efforts at education, the most vulnerable brains are at the youth level where there are approximately 3 million football players, 3 million soccer players and another 500,000 hockey players. This also is the level where there are the least experienced coaches and often no athletic trainers.

Rule changes at every level have been met with resistance from traditionalists. Interestingly, many professional coaches and former players believe that contact is not necessary to teach the necessary skills to advance in these sports.

Recent studies looking at the effectiveness of these laws have demonstrated increased reporting of concussions but no firm direct correlation with the educational efforts associated with them.

“As a pediatric neurologist, I am acutely aware of the importance of physical activity and sports for the developing brain and body,” said Dr. Meeryo Choe, a pediatric sports neurologist and assistant professor at UCLA Mattel Children’s Hospital. “Playing a team sport can teach children about teamwork, responsibility and sportsmanship. As children progress through years of participation, they may also learn leadership skills in a unique way. Participation in sports should always begin with education on not only the rules of the game, but how to play the game safely, no matter the sport.”

The remedy for any public health problem is education and concussion is no exception.  

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at