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 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.

USSF Development Academy Concussion Testing and Management Process

  • ImPact is the Concussion Management Program that the US 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
    • Instructions for the Baseline testing administration under Development Academy ImPact Baseline Testing Instructions
  • 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 US 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
    • US Soccer Development Academy Concussion Modified SCAT2 Form – symptoms assessment should be completed by the athlete
  • Graded Return to Play – From US 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 US Soccer Development Academy Daily Symptoms Checklist should be done until the player has returned to full contact play.