Sports Medicine

Concussion Guidelines

As the science of evaluating and managing concussions has advanced, key findings emphasize the need for education of players, their families, coaches, medical staffs and the public at large on the signs and symptoms of concussion. There is also a critical need for early identification and proper management of a concussion.

The goal of the U.S. Soccer Concussion Management Program is to provide state-of-the-art education, evaluation and management of concussions among Development Academy and National Teams players. The program includes pre-injury baseline testing with comprehensive post-injury follow-up evaluations and return to play protocols.

At the core of the program is a network of sports neuropsychologists who will serve as referral sources for post-injury evaluations and provide team medical staff with important information about a player's post-injury neurocognitive status.

For information regarding U.S. Soccer Development Academy concussion evaluation and management protocols, please refer to the Concussion Guidelines section on the Sports Medicine page.

Concussion Defined

Concussion is a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. Several common features that incorporate:

Concussion may be caused either by a direct blow to the head, face, neck, or elsewhere on the body with an "impulsive" force transmitted to the head.
Concussion typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously.
Concussion may result in neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than structural injury.
Concussion results in a graded set of clinical syndromes that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course.
Concussion is typically associated with grossly normal structural neuroimaging studies.

Development Academy Concussion Testing and Management Process

ImPact is the Concussion Management Program that the U.S. Soccer Federation uses for all of the National Teams and the Development Academy
- Baseline all athletes before the start of the first game of the season
- Baseline test can be administered at www.impacttestonline.com/customercenter

Establish a relationship with a sports physician and neuropsychologist (see www.sportsneuropsychologysociety.com/find-a-sports-neuropsychologist) trained in the evaluation and management of concussion.
Review U.S. Soccer Development Academy Concussion Management and Protocol
Emergency assessment and stabilization of the athlete
Evaluate athlete on field
- Immediately remove athlete from participation if concussion is suspected

Transport athlete (if needed)
- Ambulance
- Car
Sideline/Post-Game Evaluation
- U.S. Soccer Development Academy Concussion Modified SCAT2 Form - symptoms assessment should be completed by the athlete.

Graded return to play - From U.S. Soccer Development Academy Concussion Management and Protocol
- Step 1

Consult Neuropsychologist and Physician
ImPACT Concussion Post Injury Test (after symptom free for 24-48 hours)
- See Development Academy ImPact Post-Injury Testing Instructions

If the player is judged to be neurocognitively at baseline (as per consultation with neuropsychologist) and the player is symptom free at rest for a minimum of 24-48 hours begin graded return to player under the direction of a healthcare professional. If the player has not returned to baseline, follow instructions from the doctor.
Graded Return to Play
- Steps 2-4
- Steps 5-7

Consult healthcare professional for final clearance
Return To Play
Symptom tracking via the U.S. Soccer Development Academy Daily Symptoms Checklist should be done until the player has returned to full contact play.

U.S. Soccer Development Academy Insurance Coverage

Every Academy player and coach is covered by secondary insurance for Academy related injuries. If you are a parent or administrator, please read the policy and filing instructions below. Teams are responsible for assisting parents in filing claims with the U.S. Soccer Development Academy. Additional questions can be sent to damedical@ussoccer.org.

2018-2019 DA Insurance Filing Instructions
2018-2019 DA Participant Accident Form
2018-2019 DA Insurance FAQs

U.S. Soccer Heat Guidelines

A reference for coaches, referees, and players for training in warmer climates. Additionally, the guidelines serve as a guide for game play, hydration breaks, and participant safety during extreme temperature conditions. More information on the guidelines can be found here.

U.S. Soccer Cold Weather Guidelines

A reference for coaches, referees, and players for training in colder climates. Additionally, the guidelines serve as a guide for game play and participation safety during extreme temperature conditions. More information on the guidelines can be found here.

Recognize to Recover is aimed at promoting safe play and reducing injuries in soccer players of all ages. The first-of-its-kind, the program was developed with the help of medical experts to provide coaches, players, parents and referees with information, guidance and additional educational materials to improve the prevention and management of injuries. For more information on R2R, please click visit www.recognizetorecover.org.