US Youth Soccer has mandated that no player in Grade 5/6 or younger may head the ball in games or practice. Heading should be very limited in practice for grade 7/8.

RECOGNIZE

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

Changes in sleep:

• Too much sleep
• • School-age children (6-13): > 9-11 hours
  • Teenagers (14-17): > 8-10 hours
  • Younger adults (18-25): > 7-9 hours
• Difficulty falling asleep or staying asleep

RECOVER

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.

Remove
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.

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

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