The Urgent Need to Address Concussions and Chronic Traumatic Encephalopathy in Sports

Concussions in sports continue to attract significant attention due to their immediate impact and long-term consequences. Recent cases, including high-profile class actions and young athletes engaging in highly violent activities like the 'RunIt' challenge, highlight the ongoing risks associated with head impacts. The debate persists about whether sports such as Australian rules football should eliminate head bumps, underscoring the need for safer practices.

A critical issue gaining recognition is chronic traumatic encephalopathy (CTE), a progressive brain disease linked to repeated head trauma. Former athletes sharing their struggles with cognitive decline, mental health problems, and neurodegenerative diseases have brought the dangers of CTE into public consciousness. Despite advancements in sports safety, our understanding of CTE remains incomplete, and the condition is often misunderstood.

CTE is a neurodegenerative disorder similar to dementia, Parkinson's disease, and motor neuron disease. It has been strongly associated with traumatic brain injuries and repetitive impacts, whether diagnosed as concussions or minor, non-concussive blows. Evidence suggests that the risk of developing CTE is more related to the age when athletes begin full-contact sports and the duration of their careers, rather than the number of concussions alone.

Diagnosing CTE remains challenging, as it can only be confirmed post-mortem. Symptoms observed in affected individuals include tremors similar to Parkinsonian movement issues, memory loss, difficulty in planning, impulsivity, emotional instability, substance abuse, and suicidal tendencies. Importantly, these symptoms are often mistaken for mental health issues, leading to misdiagnosis or confusion. Recent tragic cases involving athletes like Shane Tuck and Paul Green reveal that CTE can be hidden behind assumptions of psychiatric illness, emphasizing the need for awareness.

Why is there reluctance to discuss and address CTE more openly? Partly because it is an entirely preventable condition, primarily through reducing head impacts in sports. However, cultural resistance, political challenges, and societal attachments to traditional sports hinder necessary reforms. Despite some rule changes advocating safer play, progress has plateaued, and risky behaviors persist.

Efforts supported by organizations like the Concussion Legacy Foundation aim to develop and implement prevention protocols. Key strategies include limiting contact training, delaying initiation of full-contact sports for children until age 14, increasing media awareness about CTE, and encouraging health practitioners to routinely assess athletes’ head impact history. Also, families donating brains for research must be supported with clear information and resources.

Addressing these issues requires committed political will and cultural change within sports communities. Recognizing CTE, understanding its risks, and actively modifying sports practices can prevent future tragedies. Our focus should be on protecting athletes' health both now and in the future, fostering a sport environment that values safety and well-being.

Source: https://medicalxpress.com/news/2025-07-concussion-chronic-traumatic-encephalopathy.html