Recognize to Recover Was Developed with the Help of Medical Experts and Will Provide Coaches

CHICAGO (Dec. 2, 2015) – The United States Soccer Federation today introduced a comprehensive player health and safety program called Recognize to Recover. The first-of-its-kind program aims to reduce injuries in soccer players of all ages and promote safe play by those on and around the field.

Recognize to Recover was developed with the help of medical experts and will provide coaches, players, parents and referees with information, guidance and educational materials to improve the prevention and management of injuries.

• Read more about Recognize to Recover

“Recognize to Recover will lead to better awareness and understanding of player health and safety initiatives and strengthen the role parents, players, coaches and officials play in preventing, protecting and addressing injuries,” said U.S. Soccer Chief Medical Officer George Chiampas. “While U.S. Soccer is launching the framework of Recognize to Recover today, this is just the beginning as more information around specific areas of focus will be rolled out in the coming months.”

Information about head injuries, including new guidelines regarding concussions, will be included in the program, along with other important player health and safety topics such as heat-related illness and dehydration, heart health, nutrition and injury prevention.

“As the national governing body of our sport, U.S. Soccer is committed to being the leader in lasting change that has a positive impact on the game,” said U.S. Soccer President Sunil Gulati. “We created Recognize to Recover to elevate player health and safety and bring players, coaches, parents and officials together to help ensure safe play at all levels of our sport.”

As part of Recognize to Recover, U.S. Soccer recently presented overall concussion guidelines that include rule changes that will reduce the possibility of head injuries while preserving the nature of the game. Players suspected of a concussion will be given plenty of time for evaluation by a health care professional without penalty or loss of a substitute. U.S. Soccer is also recommending that heading the ball be prohibited for children 10 and under, and to limit the activity to practice only for children ages 11 to 13.

• U.S. Soccer Concussion Guidelines

“We know that the vast majority of concussions occur when there is contact between players trying to head the ball,” said Chiampas. “Whether that is head-to-head contact, elbow-to-head or their head hitting the ground while challenging for the ball in the air; by reducing the number of those aerial challenges to head the ball, we believe we will decrease the incident of concussions.”

“While the science on head injuries is still developing, these rule changes and recommendations are based on the advice of the U.S. Soccer medical committee. As we continue to learn more, we’ll have the flexibility to adapt to the findings and make the appropriate changes.”

As part of Recognize to Recover, U.S. Soccer will be working directly with current and former players to spread the message about the importance of player health and safety. More information about those player ambassadors will be provided in the near future.

RECOGNIZE to RECOVER is U.S. Soccer’s comprehensive player health and safety program aimed at promoting safe play and reducing injuries in soccer players of all ages.

The program, which was developed with the help of medical experts, will provide coaches, players, parents and referees with information, guidance and additional educational materials to improve the prevention and management of injuries.

• U.S. Soccer Announces Recognize to Recover Player Health and Safety Program
• U.S. Soccer Chief Medical Officer and Medical Committee Member Speak In Depth About Recognize to Recover Program

Information about head injuries, including new guidelines regarding concussions, will be included in the program, but other important player health and safety topics such as heat-related illness and injury prevention will also be provided.

Beginning in January 2016, additional areas of focus will be added to the overall program.

RECOGNIZE TO RECOVER TOPICS

• Concussions and Head Injuries
• Heat-related Illness

Additional topics will be provided starting in January of 2016

CONCUSSIONS
A main component of Recognize to Recover is focused on head injuries, including concussions. U.S. Soccer has taken a lead in education, research and proposing rule changes to improve player safety for several years.

U.S. Soccer Concussion Guidelines

In December of 2015, U.S. Soccer unveiled the U.S. Soccer Concussion Initiative that provides information guidelines that will be implemented in January of 2016.

The elements contained in the initiative are intended to give U.S. Soccer Organization Members, as well as players, parents, team/club staff and coaches and referees, guidance and direction when dealing with head injuries and potential head injuries during soccer participation.

U.S. Soccer Concussion Initiative

Included in the U.S. Soccer Concussion Initiative are specific changes to rules on substitutions and heading for certain age groups. Those changes included:

• Modify substitution rules to allow players who may have suffered a concussion during games to be evaluated without penalty
• Eliminating heading for children 10 and under
• Please note that U11 is listed in the U.S. Soccer Concussion Initiative document because U11 players can be 10 years old at the beginning of the season
• Limiting the amount of heading in practice for children between the ages of 11 and 13
• Please note that U12 and U13 are listed in the U.S. Soccer Concussion Initiative document to account for players who are 11, 12 and 13 years of age participating on those teams

These are recommendations for youth members because some of the youth members joining in the initiative do not have direct authority at the local level to require the adaption of the rules. Although these are only recommendations, they are based on the advice of the U.S. Soccer medical committee, and therefore U.S. Soccer strongly urges that they be followed.

As noted in the Concussion Initiatives, U.S. Soccer has implemented these rules as requirements for players that are part of U.S. Soccer’s Youth National Teams and the Development Academy. It should be noted that Youth National Teams will continue to be bound by the substitution rules of the events in which they participate.

For more information, please refer to the frequently asked questions,which should help clarify questions regarding the new initiatives.

Concussion Management

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.

Additional Concussion Information:

• U.S. Soccer National Teams Concussion Testing and Management Process
• U.S. Soccer National Teams Concussion Management and Protocol
• U.S. Soccer National Teams Concussion SCAT3
• U.S. Soccer National Teams Concussion SCAT3 Child
• U.S. Soccer National Teams Concussion Daily Symptoms Checklist
• Concussions - "Let's Take Brain Injuries Out of Play."
• USSF-CDC A Fact Sheet for Athletes
• USSF-CDC A Fact Sheet for Coaches
• USSF-CDC A Fact Sheet for Parents
• Centers for Disease Control and Prevention's Heads Up: Concussion in Sports
• Centers for Disease Control and Prevention's Heads Up: Information for Youth and High School Sports

HEAT-RELATED ILLNESS

Heat-related illnesses, such as heat cramps and heat exhaustion can be a serious condition and potentially life-threatening.

Below is a reference for coaches, referees and players that are training in warmer climates. Additionally, the guidelines serve as a guide for match play, hydration breaks and participant safety during extreme temperature conditions.

• Heat Guidelines

Frequently Asked Questions

What was agreed to in the lawsuit?

In collaboration with the plaintiffs, the United States Soccer Federation and member defendants have agreed to:

• Improve concussion awareness and education among youth coaches, referees, parents and players
• Instill uniform concussion management and return-to-play protocols for youth players
• Modify substitution rules to allow players who may have suffered a concussion during games to be evaluated without penalty
• Prohibit heading the ball for children 10 and under and limit the activity in practice only for ages 11 to 13.

What has U.S. Soccer been doing in the past regarding concussions?

U.S. Soccer has taken a lead in education, research and proposing rule changes in the area of concussion management and protocols, and has been at the forefront of concussion prevention. Here are a few specific items:

• We have worked collaboratively with national experts in this field for many years, establishing protocols and education materials that we’ve implemented within in our National Teams, Development Academy, and Coaching and Referee programs.
• U.S. Soccer has partnered with the Centers for Disease Control and Prevention in its “Heads Up” program, which provides numerous resources including concussion education materials for parents, athletes, schools and health care providers about concussions, symptoms, management and return to play protocols.
• We have overseen baseline neurocognitive testing – a tool that assists in the diagnosis and treatment of concussions – for all our National Team players as well as the Development Academy players.
• Our trainers and doctors are educated on concussion management and return-to-play guidelines, and work with athletes before, during and after games.
• We have a Chief Medical Officer, and are pursuing additional research that will provide more information on the causes of injuries and how we can prevent them.

Are the new rules regarding substitutions, elimination of heading for U-10 and below, and limiting heading in practice for ages 11 to 13 going to be required changes?

These changes are recommended for U.S. Soccer’s youth members. Although these are only recommendations, they are based on the advice of the U.S. Soccer medical committee, and therefore U.S. Soccer strongly urges that they be followed.

On the other hand, these are requirements for players that are part of U.S. Soccer’s Youth National Teams and the Development Academy. It should be noted that Youth National Teams will continue to be bound by the substitution rules of the events in which they participate.

Why are the new rules not required for U.S. Soccer’s youth members?

For the youth members, these are framed as recommendations because some of the youth members do not have direct authority at the local level to require the adaption of the rules. But, these recommendations are based on the advice of the U.S. Soccer medical committee, and therefore U.S. Soccer strongly urges that they be followed. Organizations, leagues, clubs and teams should also be aware that each of the 50 states has passed some form of concussion education and management legislation, so they must be sure to comply with these laws in their respective states.

Did the lawsuit prompt the development of the concussion initiative?

No. Over the years, U.S. Soccer has had many measures in place designed to enhance player safety. U.S. Soccer has been working on a comprehensive player safety campaign that addresses head injuries (including concussion education, concussion management and return-to-play protocols), heat-related illness, injury prevention and much more. Work on this campaign, which will be announced soon, was started long before the lawsuit.

When will the player safety campaign be provided and what will it include?

We will share more about the player safety campaign when it is announced before the end of the year.

How was it determined that the ban on heading would apply to 10 and under? Why are the practice limitations on heading only limited to U-12 and U-13?

These limitations were based on the recommendations of the U.S. Soccer medical committee, which includes recognized experts in the field of concussions and concussion management. The science on head injuries is still developing, and the youth concussion initiative provides U.S. Soccer and the youth members with a great deal of flexibility to adapt as more is learned about these issues.

When do the substitution rule changes for the Development Academy take effect?

The new rules will take effect for the Development Academy on Jan. 1, 2016.

Who will be evaluating players suspected of having a head injury during Development Academy matches?

The rules mandate that a Health Care Professional (HCP) must be present at all Development Academy matches and will make any decisions regarding head injuries.

What do the new substitution rules specify within the Development Academy as it relates to head injuries?

If a player suffers a significant blow to the head and is removed from the game to be evaluated for a suspected concussion or head injury, that substitution will not count against a team’s total number of allowed substitutions in a Development Academy game.

If the player with the suspected head injury has received clearance from the HCP to return to the game, the player may re-enter at any stoppage of play. The evaluated player must replace the original substitute and will not count as a substitution.

The player that was temporarily substituted into the game for the player with the suspected head injury will be considered an available substitute and permitted to re-enter the game as a standard substitute per Development Academy rules.