Quick Reference

This Quick Reference Guide is designed to provide a rapid point of reference for mobile users. Please note that the information provided is NOT a comprehensive overview of on-field evaluation and injury management.  Please refer to the full online Content for details, including Terms of Use.

Select the type of injury below for a quick reference on what to do.  But don’t forget the SAFE principles.

The SAFE Method™ Reminder

  • S = Story.
  • A = Appearance.
  • F = Feel.
  • E = Effort.
  • Listen for and look for Red Flags
  • Red Flag = need for professional evaluation

Quick Reference for On-field Injuries

  1. The most important thing you need to know: "RICE" stands for Rest, Ice, Compression, Elevation. It's the basic sideline management for most shoulder, arm, hand, and lower extremity injuries.
  2. Always keep the young athlete's health in mind. Do not return the athlete to play if you have any questions about the injury and management. Seek qualified medical assistance when you are in doubt, and hold the player out. Better to sit the player out for a few days than to lose the player for the season.
  1. The most important thing you need to know: For minor scrapes and cuts: clean the area, put pressure to stop bleeding, cover it, and usually the athlete may return to play in the same game or training session if the bleeding is completely stopped
  2. Deep cuts, or any bleeding that does not completely stop should be referred immediately to the local emergency room
  3. Bleeding must be completely stopped and the area covered for return to play
  1. The most important thing you need to know: Young athletes with ankle sprains often return to play too soon, and are at risk of turning a minor sprain into a major injury
  2. Beware of the following Red Flag signs of a possible significant injury: "I heard a pop", "I felt it tear", “I heard a crack”, immediate bruising or swelling, complaints of severe pain, inability to move the ankle or bear weight
  3. Truly minor injuries may return to play if the ankle is pain free, and they pass a sideline functional evaluation with normal ability to jog, sprint, cut, and jump.
  1. The most important thing you need to know: Small blisters (less than half inch) can simply be covered with a Band-Aid® and the athlete may continue playing
  2. Larger blisters can be drained, leaving skin on top in place, and covered
  3. Beware of a blister that is not in an area of contact (chest, back, arms) and refer these for physician evaluation
  1. The most important thing you need to know: your job is to suspect a concussion and then immediately remove the athlete from play, then send to a qualified physician for diagnosis, treatment, and proper return to play timing.
  2. Suspect a concussion if there has been contact (head-to-head, ball-to-head, head-to-body, ground impact, goalpost impact, etc.) and the athlete has any change in their typical behavior such as appearing confused, dazed, or off balance
  3. All athletes with a suspected concussion should be removed from play and should not be allowed to return to play until evaluated and cleared by a physician
  4. Most concussions will not have a loss of consciousness. An athlete does not need to be unconscious to have a concussion.
  5. The coach does not make a diagnosis of concussion. The coach must only suspect a concussion and then send the young athlete to a physician for proper diagnosis and treatment.
  6. A concussion properly managed from the start should allow a young athlete to return to play in a reasonably short number of days, but a mis-managed concussion can lead to a lifetime of problems (or worse).
  7. Review the downloadable materials from the US Soccer Federation and the Pocket Concussion Reference Tool for Coaches. This Pocket Reference is approved by FIFA, the IOC, and many other international sport organizations and is based on the SCAT process used by team physicians.
  1. The most important thing you need to know: Players with mild contusion to the leg or ankle are treated with RICE and may return to play if there is no pain or swelling, only mild soreness, and normal ability to jog, sprint, cut, and jump
  2. Make sure your players are actually wearing shinguards during training
  3. Watch out for contusions to the chest, abdomen, back, or testicles
  1. The most important thing you need to know: Bloody noses are common. Using a gloved hand and a gauze pad, pinch the nose to stop the bleeding. The athlete can usually return to play after the bleeding is stopped.
  2. Significant eye or nose pain should be evaluated urgently by a physician.
  3. Players with eye injuries may return to play if the vision is normal and eye movement is pain free.
  1. The most important thing you need to know: beware if the player tells you there was a "pop" or "crack" sound, there's a lot of pain, immediate swelling, and the area is really tender to gentle pressure around it. Those are signs that should alert you to a possible bone fracture.
  2. A suspected fracture should be stabilized and RICE applied.
  3. Refer the player to the local emergency department for evaluation by a physician.
  1. The most important thing you need to know: the coach should be on the lookout for unexpectedly poor performance or fatigue in hot weather- this may be the only thing you see and may be the first sign of heat illness
  2. A good hydration strategy will go a long way towards minimizing the chance of heat illness.
  3. A young athlete with suspected heat illness will typically respond to cooling and re-hydration in around 15 minutes.
  4. Beware of hot skin. This is a possible sign of heat stroke, and is a medical emergency.
  1. The most important thing you need to know: Listen for the words "tear", "pull", or "pop" or a complaint of significant pain in the player's description of the injury- this often indicates a torn structure which can be a serious injury.
  2. These injuries have a high chance of recurring, so be certain the young athlete is really ready to play before returning: no pain, full movement, normal agility, normal sprinting
  3. Severe pain at rest or with the athlete's own movement should be evaluated in the emergency department for a possible hip fracture
  1. The most important thing you need to know: These common, minor injuries will usually need nothing more than ice to manage.
  2. Watch out for a severe allergic reaction to a bite or sting: any swelling around the mouth or difficulty breathing. If the player has a known allergy and has provided an EpiPen, use it! Otherwise call for emergency transport immediately.
  1. The most important thing you need to know: RICE is the basic sideline management for most knee injuries. Don't let the young athlete with a knee injury return before they are really ready; the mild injury may become much worse.
  2. The player may return to play if there is no pain, full motion of the knee, and normal ability to sprint, cut, and jump.
  3. Beware of a "pop", immediate swelling, or inability to bear weight on the leg and refer these for proper medical evaluation
  4. Beware also of a knee injury that occurs without any contact. This could be a ligament tear, bone fracture, or kneecap injury. Refer these for proper medical evaluation.
  1. The most important thing you need to know: Players with minor cuts can return to practice or play the same day, as long as the bleeding has completely stopped. It's a good idea to notify the player's parents.
  2. A player whose wires or braces have come loose needs to be evaluated by the player's orthodontist before returning to play and should strongly be advised to play with a mouth guard.
  3. Be careful with loose teeth. A dentist should evaluate a player with a loose tooth before the player can return to play. This player may need to be fitted for a mouth guard to protect the tooth from further injury during play.
  1. The most important thing you need to know: A good hydration strategy reduces the chances of muscle cramps
  2. Cramps are typically managed with stretching and massage, hydration, occasionally RICE
  3. Once the cramp resolves, the player may return to play if pain free with normal strength, agility, and speed
  1. The most important thing you need to know: Players with muscle pulls and strains are often returned to the game too soon, risking turning a minor injury into a major injury. Listen for the words "tearing", “pop”, or "pulling" from the player, often meaning there's been a muscle tear.
  2. Muscle pulls and strains have a high chance of getting worse if the player returns to play before full healing. Be cautious about return to play.
  3. The player may return to play with no pain, normal strength, normal agility and full power for sprinting, cutting, pivoting and jumping. In almost all instances, hold the player out of play at the time of injury and re-evaluate in a few days.
  1. The most important thing you need to know: These injuries demand great care and the first and foremost thoughts should be for player safety
  2. Don't manipulate the neck or back for the player; they may attempt some movement on their own. If they are reasonably comfortable they may be assisted to the sideline.
  3. Any numbness or tingling of the arms or legs associated with neck or back pain after contact is considered a serious injury. Do not move the player; call 911 for transport and evaluation.
  1. The most important thing you need to know: As with most injuries, the initial management involves RICE. The photo below shows a simple immobilization method for moderate or severe injuries.
  2. With a truly minor injury, it is possible that the player will sit on the bench for a time and then feel better. The player may return to play with no pain, full motion of the shoulder and normal strength.
  3. Do NOT attempt to "set" a broken bone or dislocation. Apply RICE and immobilize as well as you can, then have the player evaluated in the local emergency department.
  1. The most important thing you need to know: These extremely common injuries can get much worse if the young athlete is returned to play before healing. Better to sit an athlete for a few days than lose the player for the season.
  2. Watch out for these signs of a possible moderate/severe injury: complaints of a "pop" or "tear", immediate swelling, significant pain with your light touch, a sense of instability on joint movement by the player.
  3. The player can return to training when the joint is pain free, has normal motion, normal strength, good agility, and the player is able to sprint and cut with confidence.
  1. The most important thing you need to know: Wrist fractures in the 8 to 14 year-old age group are remarkably common. Be on the lookout for a wrist that is very tender or painful with light pressure.
  2. A mild injury to the wrist or hand, in which the player regains full pain-free motion after a brief period of time sitting out, can allow resumed play in the same session. Let’s re-emphasize that the wrist or hand should have full pain-free motion in order to return to play.
  3. A mild injury to the fingers can resume play by taping the injured finger to the adjacent non-injured finger.
  4. An injury you would classify as moderate should sit out; apply RICE, and have the player evaluated in the next day or two by a physician. Use some common sense and hold the player out if you are unsure about the injury.