There’s a good chance you’ve heard talk of sports-related brain injuries. In the past few years, there has been a lot of news coverage of these injuries in professional football players – some of the stories have involved players displaying mental health symptoms. And some of those players have even taken their own lives. Many concerned parents and coaches understandably want to know what is happening, and how it can be prevented.

There is often some confusion when talking about head trauma. Concussions, along with other head and brain injuries, and chronic traumatic encephalopathy (CTE), often get lumped together as one issue among pro athletes. But it’s important to stress that they are all very distinct conditions.

What happens to your brain when you hit your head

When you hit your head, a flow of chemical changes occurs in response to the forces applied – the scale of these changes depends on how much your central nervous system is impacted. These chemical changes can cause an energy shortage, which can then result in certain symptoms, including a headache, amnesia, dizziness and more. These are the symptoms of a concussion. But there are also other types of head and brain injuries aside from concussions.

What we know about CTE

CTE is considered a degenerative brain disease. This means it will progressively get worse over time.

In CTE, a protein called tau forms in the brain and kills cells. As the protein does more damage, the patient or their loved ones, will start to notice the effects. A person with CTE may experience memory loss, mood swings or personality changes. They may also become more aggressive or show signs of depression or paranoia.

Diagnosing CTE is challenging. While the symptoms can be obvious, CTE cannot be confirmed until after death, when the brain can be examined closely for tau proteins. For this reason, there is no treatment or cure.

CTE is a condition that is being increasingly found in pro athletes. And because of that, people are often linking it to concussions and other head or brain injuries. The reality is, however, that CTE has not been proven to relate to or be caused by any head injuries – there is only a correlation, and the two cannot be definitively linked. Plus, studies have not expanded much outside of football players. With only this limited research, the relationship between CTE and other activities or professions isn’t known. For now, it’s important to think of CTE as a separate condition from head injuries.

CTE is not a mental illness

While there is more to learn about its impact, CTE does not operate like a mental illness.

The symptoms can mimic those of mental illness, but CTE is not a mental illness in and of itself. And it can’t be assumed that CTE causes mental illness because many symptoms do not follow just one disease. For example having the sniffles could be related to allergies, or they could come from a cold. So showing signs of depression (like fatigue or irritability) doesn’t always mean someone has depression. Rather, a person who shows these signs could have any number of different conditions.

You've probably heard about pro athletes who have taken their own life. In 2016, researchers found that among football players who were in the NFL for at least 5 seasons between 1959 and 1988, 12 died by suicide. And autopsies discovered that some of those players had CTE. That has made it seem like CTE is connected to mental illness or suicide. However, the researchers also found that the suicide rate among pro football players is actually lower than the rate for the general population. That means players are not at higher risk for suicide, as many have assumed. Instead, the misconception has stemmed from the fact that the deaths of pro athletes, especially when caused by suicide, are highly publicized.

The silver lining in the confusion between concussions and CTE

TRIA does a lot of work helping patients rehabilitate from sports injuries. But a brain injury isn’t like a broken arm that can be healed with a cast, especially because patients may not even know they have experienced damage.

More people are playing sports than ever before. Think about how many women’s sports have been added to school athletics programs. And think about how much younger kids are when they join their first team. Then, pile on the increasing demand for athletes to be bigger and stronger, and how that has translated into more time being dedicated to practices and games. It all adds up to more people putting themselves at risk for sports-related injuries, and doing it more often.

Because of this, there have actually been some positives coming out of the confusion between concussions, other head and brain injuries, and CTE. Now that the general population is more aware of CTE, there has been a gradual culture change – people have more concern for head injuries than they used to. More players are self-reporting these injuries, and more coaches are taking players out of the game after hits. Because of this increased attention, patients can be treated more quickly, before their injuries could potentially get worse.

Head injuries aren’t something to be feared – but they do need to be addressed and treated properly

Concussions, CTE and other head and brain injuries can be scary, confusing and nerve-racking for parents. But your child can still be active in sports. Here are a few key things to remember:

• There is no “safe” number of concussions. Even one incident should be evaluated.
• All ages can be at risk. A peewee flag football game can have some hard falls. And more experienced players shouldn’t just be “used to it.”
• Head injuries are not just a “guy thing.” Girls are just as likely to get injured. TRIA has actually seen an increase in the number of female athletes getting concussions.
• Parents and coaches are the first line of defense to helping out your athlete. Make sure to always pull a player from the game if you sense even a mild head injury. Then take time to observe them. If they are showing signs of a concussion, they need to be seen by a professional.

HealthPartners offers a wide range of treatment and research facilities that can help your athlete. HealthPartners Neurology works with brain and spine care. And at TRIA, there’s a comprehensive Sport Concussion Program. The goal is to provide appropriate evaluation of head injuries and return athletes to their sports or physical activity as quickly and safely as possible. A team of doctors, neuropsychologists, physical therapists and athletic trainers will work together to create a treatment plan for each patient.