U.S. Soccer Federation releases new player safety initiative called R2R

The U.S. Soccer Federation officially unveiled a series of player health and safety initiatives on Wednesday aimed at reducing injuries for players of all ages and promoting safe play on and around the field -- and preventing concussions was a major part of the equation.

The program -- which the USSF is calling Recognize to Recover, or R2R -- targets a number of areas including heat-related illness and dehydration, heart health, nutrition and injury prevention. The initiative also includes programs to educate referees, coaches, parents and players on a range of health related topics.

"Obviously the health and safety of our players is extremely important to U.S. Soccer, and as our sport grows significantly year over year, it is as important as ever to make sure our players, at all skill levels and all genders are safe as they play the sport that each of us loves," said USSF chief medical officer Dr. George Chiampas on a conference call with reporters.

He later added, "We feel that by elevating player health and safety above the game, and bringing all of our health and safety efforts into this one, powerful program, we believe that R2R will be a leader in this area, and allow deeper understanding of player health and safety, and the role parents, players, coaches and officials play in protecting our youth athletes and pro athletes across the country."

But the main focus of the program surrounds the prevention and treatment of concussions. The USSF settled a class action lawsuit filed last month that alleged negligence on the part of FIFA, the USSF, and the American Youth Soccer Organization in the treatment of head injuries.

The USSF is mandating that qualified medical personnel be present for all games involving youth national teams and clubs participating in the USSF Development Academy and that a return to play protocol is followed at that level. Substitution rules will be altered at the DA level, with a substitution made in response to head injury not counting against the team's allowable number of substitutions per game. (In international tournaments, U.S. youth national teams will have to abide by the rules set down in those competitions, as opposed to these guidelines.)

Perhaps the most contentious area of the program surrounds the age groups at which heading will be allowed and taught. The USSF is recommending that at U11 and below, players not engage in heading during games or practice. The USSF is also recommending that players at the U12 and U13 age groups "be limited to a maximum of 30 minutes per week with no more that 15-20 headers per player, per week.

Yet Chiampas stressed that "heading -- purposeful heading -- in and of itself, does not cause concussions."

Dr. Margot Putukian, a member of the USSF's Medical Committee, and the director of athletic medicine at Princeton University, added that there was little in the way of data as it related to head injuries at younger age groups.

So why make the change? Dr. Putukian indicated that heading accounted for "a fair number of these injuries, about 50-60 percent." Therefore the elimination of heading at younger age groups would lead to a reduction in the number of head injuries and stress more skill and technique.

"It was a matter of trying to look at common sense, knowing that the aerial challenge happens to be one of the culprits," said Dr. Putukian.

Dr. Chiampas admitted that the USSF is taking a better safe than sorry approach in this instance. He said, "How can we maintain the integrity of the game based on the literature we have currently, but then at the same time decrease those aerial challenges where we know injuries can and do occur?

"This is a big, bold step for soccer in the U.S., and the decision to make these changes for the safety of our players is of the utmost importance.

"You can never ignore research, and we have that adaptability to adjust it comes forward."