A concussion can be difficult to recognize on the field. Most occur without a loss of consciousness or an obvious sign that something is wrong with a player’s brain function. They can occur at any time throughout games or practice, as a blow to the head or body from contact with the ground, the ball or another player. Working with leading physicians for more than a decade, U.S. Soccer created Recognize to Recover resources that will help coaches, players, parents and referees identify the signs and symptoms of concussion and immediately take action with the appropriate treatment.


Changes in brain functions:

  • Unaware of game (opposition colors, score of game, last play)

  • Confusion

  • Amnesia (does not recall events prior to the hit or after the hit)

  • Drastic changes in alertness

  • Does not know time, place or date

  • Slowed responses to questions or conversation

  • Decreased attention and concentration

Mental and emotional changes:

  • Depression

  • Anxiety

  • Anger

  • Irritability

  • Emotionally unstable

Physical changes:

  • Headache

  • Dizziness

  • Nausea

  • Unsteadiness/loss of balance

  • Feeling “dinged” or stunned or “dazed”

  • Seeing stars or flashing lights

  • Ringing in the ears

  • Double vision


Remove, Evaluate and Rest are key steps to treating a concussion or other head injury in soccer. When a concussion is identified quickly, it prevents the injury from getting worse, and prevents the player from staying off the field for even longer.

An athlete who experiences a blow to the head or body should immediately be removed for play and should not return to play until he/she is evaluated. When in doubt, the athlete should sit out.

Have a health care professional evaluate the athlete immediately. Do not try to judge the severity of the injury yourself.

Never rush a return to play. A return to play should only occur after an athlete has been cleared by a medical professional. If you rush the return, a player is at significantly higher risk for more problems in the future.

Mental Health



During this unprecedented time of the Coronavirus Pandemic, our lives have been disrupted. Training, playing and even watching sports is different in our current landscape. This crisis can cause negative impacts on our mental and emotional wellbeing. It is important to be aware of the impact this can have on our health so we can help ourselves. Self-care and knowledge of resources that are available are helpful in times of crisis.


Behavioral Symptoms:

Social Withdrawal, disruption of activities of daily living, decrease in sport or academic performance, substance abuse.

Cognitive Symptoms:

Suicidal thoughts, confusion/difficulty making decisions, obsessive thoughts, poor concentration, all-or-nothig thoughts, negative self talk.

Emotional/Psychological  Symptoms:

Feeling out of control, mood swings, excessive worry/fear, agitation/irritability, low self esteem, lack of motivation.

Physical/ Medical Symptoms:

Sleep difficulty, change in appetite or weight gain/loss, shaking, trembling, fatigue, weakness, GI complaints, headaches, overuse injuries. 


Any changes in mood, appearance or behavior could be an indication of a psychological concern. These behaviors can be seen in how an athlete acts, what they say or in how they relate to others.

The following are behaviors to be aware of and monitor so that they can be addressed quickly and effectively:

  • Changes in sleeping/eating habits
  • Unexplained weight loss
  • Drug or alcohol abuse
  • Gambling issues
  • Withdrawing from social contact
  • Decreased interest in activities that have been enjoyable
  • Taking up risky behaviors
  • Talking about death, dying or “going away”
  • Loss of emotion, or sudden change in emotion with-in a short period of time
  • Becoming more irritable or problems managing anger
  • Problems concentrating, focusing or remembering
  • Frequent complaints of fatigue, illness or being injured that prevent participation
  • Unexplained wounds (e.g. burns, cuts, bite marks) or efforts to conceal them


  • Demanding training schedule
  • Balancing demands of sport w/ school/social/family responsibilities
  • Developing social relationships
  • Frequent travel
  • Competitive stress
  • Injuries
  • Coach-Athlete relationship
  • Competition with teammates
  • Internal and socially encouraged pattern of toughing it out alone
  • Managing transition out of sport (e.g. out of club/ collegiate athletics, retirement)
  • Media pressure
  • Overtraining, staleness and burnout


  • Learned time management skills and
  • Strategies for prioritizing goals and important life experiences
  • Social support of teammates, coaches and staff members
  • Seeing and experiencing the world; new cultures or other perspectives from interactions with a variety of people
  • Stress relief and mood boosting benefits of physical activity
  • Overcoming obstacles
  • Positive relationships with coaches and peers centered on growth mindset
  • Working with teammates to better each other
  • Self-reliant, able to courageously face challenges and overcome obstacles
  • Applying mental and physical lessons to non-sport related issues
  • Focusing and striving to achieve a common goal/success


If you suspect someone of having any mental health related issue or if someone has brought the issue to your attention, the following guidelines can be helpful in addressing the individual and acting to get them the help they need:

  • Pull the athlete aside to speak to them in a private, non-confrontational setting
  • Do NOT accuse the individual of having a mental health disorder or issues you’ve noticed they are exhibiting
  • The first and most important step when helping someone seek the necessary resources is to assess for risk of suicidal thoughts or behaviors, non-suicidal self-injury or other harm. These warning signs are listed in the suicide section.
  • ALWAYS SEEK EMERGENCY MEDICAL HELP if the person’s life is in immediate danger. If you have reason to believe someone may be actively suicidal call the National Suicide Prevention Lifeline 1-800-273-TALK (8255) or call 911
  • Express why it is important to address these for the individual’s overall health and wellbeing
  • Be sensitive and empathetic
  • Listen opening and non-judgmentally-allow the individual to feel respected, accepted and understood
  • Give reassurance and information-mental health issues are treatable, which people can recover from with the right help.
  • Encourage appropriate help. There are many professionals who are well equipped to offer help to an individual suffering from mental health signs and symptoms.




Environmental conditions can significantly impact player health and safety. Extreme temperatures, severe weather and the integrity of the playing field and its equipment all impact players’ ability to practice and compete safely. U.S. Soccer’s Recognize to Recover program gives players, parents, coaches and referees information and guidelines to make sure the desire to play does not cloud the decision-making process when it comes to evaluating environmental conditions to ensure the safety of those on the field.


Lightning/ Storm

  • If there is a storm on the Radar - the club will monitor closely and cancel practices if we deem the weather to be unsuitable for practice by 2:00pm. 
  • If the club does NOT cancel practice - please ensure that you are within the vicinity of practice if the weather begins to turn quickly. 

If the Heat is above >89.6°F

Scheduled hydration breaks:  Four minutes hydration break for each 30 minutes of continuous play. In a regulation 90-minute match, this would schedule the hydration break at minute 30 and 75.

Ensure players have adequate amount of water & coach to carry ice packs, extra water &. sunscreen.

Wind Chill Factor:

  • < 0F * Extreme Conditions - No Practice
  • 1-15F * High Risk for Cold Related Illness - No Practice
  • 16-24F *Moderate Risk for Cold Related Illness
  • 25-30F *Less than Ideal Conditions
  • >30F Regular Practices


Extreme heat can impact players' health and safe play. Proper hydration and knowing when you need to drink are critical, to help prevent many injuries and illnesses, from muscle cramps to heat stroke. Players should drink water before, during and after a game or practice, which means coaches should make sure there is adequate water available. U.S. Soccer’s Recognize to Recover program gives players, parents, coaches and referees information and guidelines to make sure the desire to play does not cloud the decision-making process when it comes to evaluating environmental conditions to ensure the safety of those on the field.


Thirst is a warning that your body is already in an early stage of dehydration. Drink when you are thirsty. Recognizing the signs of dehydration are important because the amount of water required will vary from player to player.

  • Dry, sticky mouth
  • Sleepiness or tiredness
  • Headache
  • Dizziness or lightheadedness
  • Rapid heartbeat
  • Rapid breathing
  • Fever
  • In the most serious cases, delirium or unconsciousness


  • Add hydration breaks
  • Shorten practice
  • Practice early or late in the day when temperatures are lower
  • Use less-strenuous training activities during practice


The effects of cold weather can impact health and safety during practices and games. The definition of “cold stress” varies across the United States, depending on how accustomed people are to cold weather. A player from Minnesota will have a much different threshold for cold than a player from Florida.

U.S. Soccer’s RECOGNIZE TO RECOVER program prepared this guide for coaches, referees and players for training or playing in colder climates. Additionally, it serves as a guide for match play and participant safety during extreme temperature conditions. The information provided is not a substitute for medical or professional care, and you should not use the information in place of a visit, consultation or the advice of your physician or other healthcare provider. For specific questions and concerns, please consult your health care provider or physician.

  • Dress for the Cold: When temperatures drop and wind increases, the body loses heat more rapidly. It is important to dress appropriately when training or playing in cold weather. This also means to not overdress.
  • Wind Chill: Pay attention to the wind chill temperature (WCT) Index. Even prolonged exposure in relatively mild temperatures can lead to frostbite. The National Weather Service wind chill chart can serve as a guide to safe play in cold weather.
  • Stay Dry: Wet and damp conditions add to the risk of injury or illness during cold weather. Players, coaches and referees should recognize these factors and use additional caution to watch for potential cold injuries.
  • Stay Hydrated: Cold weather often reduces our ability to recognize that we are becoming dehydrated. If you are thirsty you have already become dehydrated.
  • Take Action: If someone is suffering from a cold-related illness, get him or her into a warm location as soon as possible. Identify a nearby warming location before the start of training or play.



    • Use a broad spectrum, water resistant (UVA/UVB) sunscreen with an SPF of 30 or higher. Physical sunscreens with Zinc or titanium dioxide are particularly effective (4).

    • One ounce of sunscreen (two tablespoons) is typically needed to provide adequate coverage to the face, ears, neck, arms and legs (4).

    • All participants should apply sunscreen 15 minutes prior to playing soccer. Coaches and parents need to assist younger players to ensure proper application

    • Reapplication is necessary at least every two hours for prolonged outdoor exposure or with heavy perspiration (5)

    • Ultraviolet exposure occurs even on overcast days.

    • Check local UV index to assess risk. This index is listed on displayed on weather applications such as weather.com or accuweather. The potential for UV damage rises as UV index rises (5).

    • Between games and with breaks in training, seek the shade.

    • Cover up clothing, clothing with ultraviolet protective factor (UPF) >30, hats and UV-blocking sunglasses provide valuable additional protection