There was a time in the not-too-distant past when the United States would win games by defending aggressively, getting great goalkeeping and being opportunistic in attack. It was an approach that tended to drive opponents -- Mexico in particular -- to distraction, and the complaints afterward became utterly predictable.

"We played the better soccer," was the standard reply, to which the U.S. would respond with a massive shrug of the shoulders and point to the result and the three points in the standings or the tournament bracket that saw the Americans move on, and basically say, "Who cares?"

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So Sunday's World Cup qualifier was a bit of a role reversal. It was Canada that bit and scratched and clawed its way through the match, and took its opportunities with a ruthless efficiency. And when it was over, and Canada had claimed a 2-0 victory that all but clinches the Reds' qualification to Qatar, it was U.S. manager Gregg Berhalter who was left to bemoan how the U.S. lost a game that in some respects his side dominated.

"I think it was an entire team effort that was outstanding," he said. "We asked them to be dominant. We asked them to embrace the conditions, embrace the physicality and I think we did that and more. It's hard for me to remember a performance away from home this dominant without getting a result. So the result hurts. The performance doesn't hurt. I'm proud of the guys, proud of the way they competed."

Berhalter then insisted that while the narrow width of the field -- 70 yards officially -- wasn't an excuse, he proceeded to bring it up multiple times.

"Don't take this the wrong way," he said. "But also that we're playing on a very narrow field -- it probably has the width of Yankee Stadium -- and we're playing on a very poor field turf. So that also translates into some difficulties in processing and creating chances. But that's not an excuse. We still want to be better in front of goal."

Berhalter's statements might have been accurate, but they obscured the bigger picture. Ultimately, in World Cup qualifying, the results are all that really matter.

This line of thinking also overlooks a long-standing truism about the sport, that being that goals -- especially early ones -- change games. That Cyle Larin's seventh-minute opener was down to a cascade of mistakes can't sit well with the visitors. Matt Turner's goal kick hung up in the air and was headed forward by defender Kamal Miller with nary a challenge from Gyasi Zardes. With Miles Robinson and Chris Richards slow to sense the danger, Larin played a one-two with Jonathan David, and thanks to Richards' slip, had a clear look at goal and rifled his shot past Turner.

Once Canada jumped on top, the game was played on its terms. Canada could play physically, and focus on defending. If Christian Pulisic found a bit of daylight, foul him and then dare someone else to beat you.

So even as the U.S. was effective with its press, and dominated possession by a nearly 63-37% margin, on a certain level, it didn't really matter. Once the U.S. got close to the Canada goal, the hosts could dirty up the game, aesthetics be damned. All that mattered for Canada was its effectiveness, and even if one or two players got beat, there was always someone else to cover and break up the play. Canada could control the game by not having the ball.

Credit Canada for playing to its strengths, not the least of which are forwards Larin and Jonathan David, either of whom can win a match on his own. Canada is deservedly top of the CONCACAF World Cup qualifying standings, and has taken eight out of a possible 12 points against the U.S. and Mexico, the presumed "giants" of CONCACAF. It can safely be said that the duopoly is now a triopoly.

Canada's approach was aided by the U.S. team's biggest pain point: The U.S. attack has gone stale, and lacks aggression. The times when the U.S. got behind the Canadian defense were rare. So it goes when a team sets up in a low block. But there were opportunities in transition, and too often the U.S. seemed content to play safe. Rather than drive at the Canada defense, the U.S. was content to pass square or backward. Given the ferocity with which Canada defended, that opportunity would quickly disappear, with the home side settling into its base defense.

"One of the talks at halftime was when we win the ball in good positions, can we get forward?" Berhalter said. "And some of it had to do with maybe the passing angle to a teammate that they thought it was too risky of a pass. But we're certainly in positions at times where we could have been more aggressive in offensive transition, and we didn't capitalize on it."

That speaks to a lack of confidence. Pulisic's level of self-belief looks to be at a low ebb, and no one else in the starting XI could pick up the slack. Weston McKennie had a 43rd-minute header from a set piece touched onto the crossbar by Canada keeper Milan Borjan, but that was as close as the U.S. got. Matters did improve when Berhalter brought on the likes of Ricardo Pepi and Paul Arriola, a sense of urgency finally being injected into the U.S. attack.

It wasn't enough, and Canada put the game away in stoppage time through Sam Adekugbe's dart. But the play of the substitutes ought to guide Berhalter's thinking ahead of Wednesday's home game against reeling Honduras. Pepi has to start, pure and simple. His mobility and the forcefulness of his runs were a notable improvement over Gyasi Zardes. At minimum, Arriola should be in contention to get on the field sooner than the 14 minutes he garnered on Sunday.

Pulisic's situation is trickier to handle. He's clearly the most talented and dynamic attacker on the team. There is a strong impulse to let him try to play his way out of the funk that he's currently in. But is there a point where he should be pulled if he continues to struggle? Berhalter did precisely that against El Salvador, albeit when the U.S. was ahead. It would amount to a tough call indeed, though for now, sending him back out seems the right choice.

The U.S. side is beginning to fray in other ways as well. Tyler Adams hobbled off with a hamstring injury, putting his participation against Honduras in doubt. Defender Chris Richards sustained a foot injury, though Walker Zimmerman, who is also nursing a hamstring injury, is primed to return to the starting lineup.

It's makes for a less-than-ideal run-in to World Cup qualifying. The final fixture window is comprised of away games at Mexico and Costa Rica sandwiched around a home match against Panama. Given the U.S. struggles at both of those away venues, the hope had been to wrap things up prior to then. Panama's 3-2 win against Jamaica on Sunday has dashed those hopes. While the Canaleros are in fourth place, they trail the U.S. by a solitary point.

The loss to Canada means the U.S. has been drawn back to the chasing pack. It makes Wednesday's match a must-win. The U.S. attack will need to heat up to make that happen.