Oslo Sports Trauma Research Center

Intoduction

According to a new research study published in the October issue of Scandinavian Journal of Medicine and Science in Sports, there is a higher risk of anterior cruciate ligament (ACL) injuries on high-friction floors than on low-friction floors. The study followed men and women in Norwegian team handball during seven seasons, and shows that the risk of ACL injuries was 2-3 times on artificial floor types (generally older floors with high friction) for women.

PhD-student Odd-Egil Olsen found a higher risk for ACL-injuries on older, artificial floors compared to the newer, wooden floors, but only for women

In light of the high number of ACL injuries during the previous 10-15 years, especially among female team handball players, the Oslo Sports Trauma Research Center wanted tocompare the ACL injury rate between two different floor types wooden floors (parquet, generally having lower friction) and artificial floors (many old floor types with having higher friction).AllACL injuries were recorded prospectively in Norwegian team handball during seven seasons: from the top three divisions for men and women (212 teams, 3392 players each season) during the 1989-91 seasons, from the elite divisions for men and women (24 teams, 384 players each season) during the 1993-96 seasons, and from the top three divisions for women (60 teams, 950 players each season) during the 1998-2000 seasons. All the ACL injured players answered a questionnaire, where data on which floor types was collected. We also collected floor type data about for all matches played during the same period. A total of 174 ACL injuries were recorded, 53 of these occurred in regular league matches and were included in the study. A total of 6 724 regular league matches were played during the seven seasons in question.

 The main observation of this study was that the incidence of ACL injuries for women was 2-3-fold higher on artificial floor types than on wooden floors, whereas no such association was found for men. Consequently, the ACL injury rate was higher for women than for men on artificial floors, while there was no gender difference on wooden floors. It is assumed that the increased risk results from the high friction on some artificial floors, particularly some older floor types. There is no reason to believe that modern low-friction artificial floors are associated with a higher injury risk.

To prevent non-contact ACL injuries in team handball and other ball games the data available seem to indicate that floor types, either wooden or artificial, with as low shoe-surface traction as possible should be selected. Also, shoe types that result in a safer environment, yet provide sufficient friction to allow optimal performance, must be sought.

Information about friction, cleaning and maintenance routines, limitations on the use of hand glue etc. should be given to the players and coaches. Competitive athletes should consider getting two different pairs of shoes - one for surfaces with a low friction and another for surfaces with higher friction.

The principal investigator for this study was physical therapist Odd-Egil Olsen from the Oslo Sports Trauma Research Center, with physical therapist Grethe Myklebust,  professor Roald Bahr, professor Lars Engebretsen and professor Ingar Holme.

Read more about the study here