It's no secret that young athletes often lie or understate their concussion symptoms to achieve their maximum playing time. To non-athletes, this may sound irresponsible, but there are several valid reasons as to why a player wouldn't want to disclose the true depth of their pain. Many high school level athletes are looking to be scouted for scholarships, and if this player comes from a low-income family, the playing time they have is their ticket to an education. Athletes currently playing in college have scholarships riding on their time participating in their sport, and many of them are trying to make careers of their game. Being labeled as concussed several times would be bad for their brand and/or hurt their chances of getting drafted. A major reason is that many young people just don't think their injuries are that serious. They don't report pain because they assume it'll go away soon enough, or that a small level of pain is typical after a head injury (Archambault 2023) .
Much of concussion diagnoses rely on these self-reported symptoms. Physicians do not currently have an objective method of testing for concussion, which is where Dr. Krizman's research becomes relevant. I was privileged to attend a seminar where Dr. Krizman presented research done to synthesize a reliable approach to concussion diagnosis that is clinically adoptable. The researchers tested the validity of speech-evoked frequency-following responses (FRRs) as a biological indication of traumatic brain injuries in children (Kraus et al., 2016). This test measures neural responses in the auditory midbrain, a region that may reflect damage beyond the auditory system. This method is inexpensive, non-invasive, and objective in diagnosing concussions. The most important findings of this research were that FFRs have potential to be used in the clinical setting, and that the negative cognitive effects detected by the FFRs were still detected after patients reported physical symptoms to improve. This implies that the damage sustained from concussions is persistent even if the patient truly does feel improvement.
These findings beg the question, what are the long-term effects of living with an untreated concussion? What can develop after multiple untreated impacts to the head? One of the most talked about conditions relevant to this discussion is CTE, chronic traumatic encephalopathy. This condition is a brain disease that is thought to be caused by repeated head traumas, which often occur in intense contact sports. It is marked by the buildup of a protein called p-tau in neurons around blood vessels in the sulci of the brain (Mayo Clinic, 2023); this damage is distinct from damage caused by aging or Alzheimer's. Similar to concussions, the negative effects are not being felt by athletes in real time and cannot be diagnosed objectively. In fact, CTE can only be diagnosed posthumously. People can live full lives without ever realizing that this condition was the cause of neurological issues they might be suffering from.
I first learned about this degenerative disease in 2024 after watching a docu-series about Aaron Hernandez, a young NFL player who was charged with murder. After his death, his brain was autopsied and was found to be severely damaged by CTE. The series explored the idea that Hernandez's severe neural degeneration is what caused him to engage in allegedly uncharacteristic violent behavior. This case, in tandem with others, led researchers to ask if there are any early symptoms of CTE. People who were confirmed to have CTE at autopsy were reported to have cognitive, behavioral, mood, and movement changes, but there are no confirmed early symptoms prior to diagnosis.
This question drove the research done by Morgane et al. at Boston University. These scientists studied what actually happens in the brains of athletes who experienced repeated head injuries (RHIs) before they develop CTE. They found that brain damage starts earlier than previously thought, not just after the p-tau protein builds up in the sulci. CTE is defined by the p-tau buildup, but it was found that neuron loss and inflammation occurred before tau even appeared (Morgane et al., 2025). The findings suggest that even non-concussive head traumas can cause the symptoms associated with CTE. With this research and further study, scientists may be able to develop early biomarkers and treatments that may be able to stop the progressions of these injuries.
So, while methods to diagnose and therapies to treat are still in development, what can athletes do to limit the frequencies of head traumas?
Prevention strategies must begin with the regulations and rules that are in place for these heavy contact sports. Coaches can limit the amount of time spent tackling during practices, and they can also work to change tackling techniques. There can be ways to play the game well while keeping the players safe from long-term injury. Helmet and equipment standards can be improved as well and strictly enforced by sports officials. Youth sports teams must also be educated on what concussions are, how symptoms feel different to regular ailments, and when to speak up. Athletes must be informed of the consequences of not speaking up or understating their injuries. Proper education is important for timely intervention.
Awareness can lead to early recognition and proper management of head injuries, which will reduce the risk of long-term damage (IU Health, 2025). A combination of these things in addition to the work being done by researchers and scientists will put a good step forward in reliable concussion diagnosis and improved safety of athletes from degenerative brain disease.
References:
“How Athletes Can Prevent Head Injuries and Concussions in Sports.” IU Health, Indiana University Health, 19 Mar. 2025, iuhealth.org/thrive/how-athletes-can-prevent-head-injuries-and-concussions-in-sports.
Mayo Clinic. “Chronic Traumatic Encephalopathy - Symptoms and Causes.” Mayo Clinic, Mayo Clinic, 18 Nov. 2023, www.mayoclinic.org/diseases-conditions/chronic-traumatic-encephalopathy/symptoms-causes/syc-20370921
Morgane, Butler, et al. “Repeated Head Trauma Causes Neuron Loss and Inflammation in Young Athletes.” Nature, 17 Sept. 2025, pp. 1–10, www.nature.com/articles/s41586-025-09534-6, https://doi.org/10.1038/s41586-025-09534-6.
NIH. “Effects of Repeated Head Trauma in Young Athletes.” National Institutes of Health (NIH), 19 Nov. 2025, www.nih.gov/news-events/nih-research-matters/effects-repeated-head-trauma-young-athletes.
Smith, Dana G. “Many Minor Hits Can Damage an Athlete’s Brain, Studies Find.” The New York Times, 17 Sept. 2025, www.nytimes.com/2025/09/17/well/mind/brain-damage-sports.html.
W. Tad Archambault, and Dave Ellemberg. “Hard-Headed Decisions: Intrapersonal Factors Underlying Concussion Reporting in University Athletes.” Neurotrauma Reports, vol. 4, no. 1, 1 Aug. 2023, pp. 533–542, https://doi.org/10.1089/neur.2023.0030.
Kraus, Nina, et al. “Auditory Biological Marker of Concussion in Children.” Scientific Reports, vol. 6, no. 1, Dec. 2016, www.nature.com/articles/srep39009, https://doi.org/10.1038/srep39009.
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