In the moment New York Giants star wide receiver Malik Nabers went down while grabbing his knee at MetLife Stadium in Week 4 of the 2025 NFL season, fans immediately blamed the turf. Within minutes, the long-running argument over synthetic fields and knee injuries was back at the forefront of modern football.

Across the sport, turf has become the practical choice. It’s easier to maintain, cheaper over time and holds up through cold weather and heavy use. However, players and many doctors still question its safety. The debate remains: Does turf actually increase ACL injuries, or are we conditioned to believe it does?

Dr. Sameh Elguizaoui, a sports medicine orthopedic surgeon at New York Orthopedics, sees the consequences firsthand. “ACL injuries are most often non-contact pivoting injuries,” he said. “If your foot gets stuck on the turf, which is a tougher surface, and you try to change direction or the momentum of your body, you have this kind of valgus moment, and that’s when the ACL is most at risk and pops.”

While he couldn’t cite exact statistics on the number of ACL tears on turf vs. grass, Elguizaoui said, “anecdotally, it seems as though turf produced more ACL injuries than grass.”

He added that harder surfaces also contribute to concussions, shoulder separations and turf-toe injuries. “The risk of concussion goes way up with hard surfaces,” he said. “It’s why professional soccer — the most popular sport in the world — plays on grass. FIFA requires it for World Cup venues, even at places like MetLife.”

This is where the data interests Malachy McHugh, Ph.D., director of research at the Nicholas Institute of Sports Medicine and Athletic Trauma (NISMAT). Having spent decades studying how the body reacts to different surfaces, he believes the debate is more complicated. “Historically, research has gone both directions,” McHugh said. “Some studies show a slightly higher ACL injury rate on artificial surfaces, others show no difference. The problem is that not all turf, or grass, is created equal.”

Maintenance is one of the biggest factors. “These fields age rapidly. They need annual maintenance and replacement every few years depending on use. When that doesn’t happen, friction increases — and so does injury risk,” he said.

Weather plays a role as well. “In dry, hot conditions, ACL injuries on grass go up because the surface is harder,” McHugh explained. “When it’s wet or humid, players slide more, and that can actually reduce the chance of a tear.” Recalling the early days at NISMAT, “Our doctors used to love covering [New York] Jets games on wet days at Giants Stadium. They said, ‘We never get major injuries when it’s raining.’ It was all about friction.”

While McHugh analyzes the science, Iannick Di Sanza brings the industry’s perspective. As Director of Marketing for Tarkett Sports, the parent company of FieldTurf, he is deeply involved in the process behind evaluating and designing turf systems.

“For me, the difference between the two is the consistency,” Di Sanza clarified. “Artificial turf is a consistent variable. It is always the same. You know what you’re going to get day in and day out. A natural grass field is natural, which means it has to face the elements, and it can change depending on the season and your location.”

Consistency, he said, is both the appeal and the challenge: “What we’re trying to ensure is consistency. That’s really what I feel artificial turf will deliver — you know exactly what to expect.”

But even turf requires upkeep. “We have a recommended maintenance program the client can execute, or we can do it,” he said. “We call it BARS — brushing, aerating, raking, sweeping.”

Turf technology itself has evolved far beyond the harsh carpet-like surfaces of the past. “The old-school carpets from the Astrodome, which were just a dense carpet on a pad, have changed tremendously,” Di Sanza said. “FieldTurf came in with something called infill — the black rubber pellets and sand — designed to recreate a premier natural-grass system.”

To support the safety of modern turf, he pointed to independent research. “There have been many third-party safety studies on the FieldTurf heavyweight system,” he said. “Those have shown that, compared to grass, it has been much safer for athletes.” He cited research from Idaho State University as well as collaborations with University of Calgary, Pennsylvania State University and the University of Virginia.

Regarding ACLs, however, Di Sanza stressed that injuries rarely come down to one factor. “Injuries are a very complex discussion,” he said. “They don’t happen in a vacuum. It is not only a surface or not only something else — there are so many factors that influence an injury.”

Recent NFL numbers reflect that complexity. According to ESPN’s Adam Schefter, MetLife Stadium — which installed its newest FieldTurf surface in 2023 — had one of the lowest lower-extremity injury rates in the league last season. Schefter also reported that overall there were fewer ACL injuries on turf than on grass, with virtually no difference so far this year. Jets internal data found that since the update, only three ligament or Achilles injuries occurred at MetLife, compared with 38 on grass fields across the league.

Di Sanza also made clear that FieldTurf isn’t opposed to natural grass. “We’re not saying natural grass is a bad option,” he said. “A premier natural-grass system is a great solution. But our clients often have challenges living in that reality.”

For Elguizaoui, the discussion returns to real outcomes. “Maybe the newest turf is better,” he said. “I just haven’t seen enough evidence.”

McHugh agrees that skepticism is healthy. “If you’re comparing old, worn-down grass to new FieldTurf, the difference isn’t that clear,” he said. “The real question is: what shape is the field in?”

And so the debate continues. Turf manufacturers will continue funding research, doctors will continue analyzing injuries and players will get hurt on both surfaces. As McHugh put it, “Debate forces us to collect better data. That’s how progress happens.”

Every ACL tear restarts the same conversation. At this point, the surface isn’t just where the game is played — it’s part of what defines it.