5 THINGS TO KNOW ABOUT TURF BURNS

Rocco Monto, MD

Nantucket Cottage Hospital

We all know that injuries suck, but the undefeated King of Pain in soccer is the turf burn. We deep dive into understanding turf burns and the recommended methods of prevention, protection, and treatment.

1. Raspberry time

Field injuries are more common than you might think. Turf burns bleed, hurt, and can get dangerously infected (a.k.a. “turf burn infections”). Because most players play through these injuries, they often go unreported. But with the explosive global growth of soccer combined with generally poor field conditions and an increasing number of synthetic surfaces, skin burns and injuries are increasing in number and severity.

A Dutch study reported that 84% of professional soccer players sustained at least one major turf burn during the season, with goalkeepers at the highest risk. Several outbreaks of antibiotic-resistant staph infections in athletic teams have also been directly linked to turf burns.

2. The first cut is the deepest

Turf burns are not really thermal (burn) injuries. The combination of violent mechanical shearing of the skin and frictional abrasion can lead to large areas of superficial skin injury, which we all know are extremely painful and can take weeks to heal.

A new study examined severe turf burns and found that they were more similar to skin grafts and bikers’ road rash than to a heat or chemical burn. The same study found that less abrasive damage was seen during soccer slide tackles on wet natural grass than on dry grass or synthetic turf.

3. The grass is always greener

There is little doubt that most soccer players perceive that artificial turf is more threatening than natural grass. No shocker there. A group of international female soccer players felt so strongly that they filed suit against FIFA and the Canadian Soccer Association prior to the 2015 World World Cup to halt the use of synthetic turf during the tournament (the suit was later dropped). But current research on newer 3rd and 4th generation (Field Turf, etc) surfaces has not confirmed this belief. However, the conflicting data showing otherwise comparable injury rates between natural and synthetic turf fields still confirms that skin abrasion rates are higher on artificial grass surfaces.

Despite lingering health concerns, the high cost of maintaining high-grade natural grass fields has driven many communities around the country to convert to artificial surfaces. There are now over 14,000 synthetic sports fields in play in the US alone with a 10% increase per year.

4. You’ll never walk alone

We all know that soccer fields are not the most sterile places on earth. All types of bacteria and other nasty contaminants populate our pitches. The bigger problem with skin abrasions is that they provide sudden exposure of subcutaneous blood vessels to millions of these opportunistic bacteria. In one study, 42% of players harbored staph bacteria. Yikes!

Worse yet, antibiotic-resistant bacteria can live for weeks on both natural and synthetic fields as well and will happily colonize your crusty old gear. Because up to 10% of these abrasions will become infected if untreated, players need to become more proactive in treating turf burns. The old adage of “leave it alone and let the air get at it” not only delays healing but can also lead to increased scarring and re-injury.

Want a better approach? Gently scrub the area clean with a disinfectant (chlorehexidine=GOOD, hydrogen peroxide=BAD) and then keep it clean, moist, and covered using Tegaderm or hydrogel. This can trim healing time from 3 weeks down to as little as 7-10 days. Oh, yeah, and no sharing towels in the locker room or using a communal whirlpool.

5. Less is more

Soccer players need to start borrowing tactics from our road rash-plagued bike racing cousins. We need to start covering ourselves with modern, breathable and next-generation contact padding, which, fortunately, has ignited growing interest in an effort to protect our largest organ. Field maintenance, although expensive, also needs to become a priority. Both natural and artificial turf fields should be irrigated to control radiant temperatures and decrease abrasive risk.

First published on Storelli.com

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