How Brain Injury Became ‘The Elephant In The Room’ Of Professional Sports

Stephen casper, ph.D., A noted medical historian, offers a critical examination of the rise and decline of recognition of chronic traumatic encephalopathy (CTE) in the context of professional sports. His argument revolves around a paradox: while CTE was once widely acknowledged as a significant danger to athletes, its growing recognition as a problem has led to a dangerous trend where it is increasingly dismissed or ignored, especially in contact sports like football, boxing and hockey.

THE HISTORY OF CTE AWARENESS
Casper’s analysis begins with the origins of CTE as a medical concept. The condition itself, first identified in the 1920s, was initially associated with boxers who suffered from repeated head trauma. In those early days, the condition was known as “punch-drunk syndrome,” a term that was commonly used in the medical community. As research evolved, it became clear that repetitive head trauma in various sports led to a range of cognitive and psychological symptoms, including memory loss, aggression and depression.

Left: A normal, healthy brain. Right: A brain with advanced CTE.

In the latter half of the 20th century, this growing body of evidence led to a broader understanding of CTE. The 1990s and 2000s saw some mainstream attention to the condition, particularly as athletes began to come forward with their stories. For instance, the death of former NFL players, such as Mike Webster, raised questions about the long-term impacts of repetitive head injuries. Posthumous examinations of their brains revealed patterns of degeneration that were consistent with CTE.

For a time, the presence of CTE in athletes was widely acknowledged in both academic circles and the general public. Medical professionals and former athletes began to advocate for reforms in contact sports to limit the risk of head trauma, and there was a growing consensus that something needed to be done to protect players.

THE DECLINE OF RECOGNITION IN PROFESSIONAL SPORTS
Casper argues that, despite the earlier recognition of the dangers of CTE, there has been a troubling shift in professional sports. While CTE remains a central issue in academic and medical research, the sports industry itself has begun to downplay or ignore its potential dangers. This shift can be traced to a few key factors.

THE ECONOMIC AND CULTURAL INTERESTS OF PROFESSIONAL SPORTS
At the heart of this change is the immense financial and cultural power of professional sports. In leagues like the NFL, the NHL and other contact sports organizations, the revenue generated from games, sponsorships and media deals is enormous. The idea of reforming the way the sport is played — or worse, changing the very nature of the game — may be seen as a threat to the financial model that underpins the entire industry.

The resistance to acknowledging CTE’s long-term effects can, therefore, be understood in the context of these powerful economic interests. For instance, while the NFL has faced growing scrutiny for its role in the CTE crisis, the organization has been accused of downplaying the issue, often by funding studies that cast doubt on the extent of the damage caused by head injuries. This has contributed to a culture in which the real dangers of CTE are minimized in favor of maintaining the status quo.

THE PSYCHOLOGICAL DENIAL AMONG ATHLETES
Another contributing factor, according to Casper, is the psychology of professional athletes themselves. Many athletes are deeply invested in the idea of toughness and the willingness to push through pain. In contact sports, there is a long-standing culture of “playing through the pain,” and athletes often view injury as a part of their job, rather than a potential threat to their future well-being. This mindset has led many athletes to dismiss or downplay the risks of CTE, particularly when faced with the potential of their career coming to an end due to health concerns.

Michael Lewis Webster, who died with CTE, was an American football center in the National Football League from 1974 to 1990 with the Pittsburgh Steelers and Kansas City Chiefs. He is a member of the Pro Football Hall of Fame, class of 1997.

Furthermore, there is a significant stigma surrounding mental health in the athletic world, especially among men. Admitting to problems like memory loss, depression, or aggression may be seen as a sign of weakness. The refusal to acknowledge CTE symptoms, therefore, can be understood as a form of self-preservation, as athletes try to maintain their image and identity as invulnerable competitors.

Tiaina Baul “Junior” Seau Jr., who suffers from CTE, was an American professional football linebacker who played in the National Football League, mostly with the San Diego Chargers. Known for his passionate play, he was a 6-time first-team All-Pro, 12-time Pro Bowl selection and named to the NFL 1990s All-Decade Team.

THE ROLE OF MEDICAL EXPERTS AND MEDIA
Casper also critiques the role of the media and medical experts in contributing to the marginalization of CTE. In the early 2000s, when CTE research began to gain attention, the media played an important role in spreading awareness about the condition. However, as the issue became more contentious, some media outlets began to back away from the narrative. Partly due to pressure from sports organizations, the portrayal of CTE began to shift from an established concern to a more disputed topic.
In the case of the NFL, a notable instance of this shift was the release of the movie “Concussion” in 2015, which dramatized the story of Dr. Bennet Omalu, the forensic pathologist who first discovered CTE in football players. The NFL’s response to the film and its portrayal of CTE was one of aggressive denial, leading to public confusion over the true extent of the issue. Some medical professionals also became less willing to engage with the topic of CTE directly, choosing to focus on less controversial topics or minimizing the long-term risks associated with repetitive head trauma.

THE ONGOING PROBLEM: A CALL FOR REFORMS
Despite efforts to downplay the issue, there is still significant concern about the long-term consequences of CTE for athletes. Casper’s work urges a return to a more honest, scientific discussion of the risks posed by contact sports, advocating for reforms such as rule changes to limit head trauma, better concussion protocols and greater education on long-term effects. Moreover, Casper believes the sports industry must move away from denial regarding CTE, prioritizing athletes’ health over the financial interests of leagues and teams. This shift is essential to ensuring athletes’ safety and reducing future cases of CTE.

IN CONCLUSION
Stephen Casper’s work highlights the disturbing trend of CTE’s growing invisibility in professional sports. What was once a widely acknowledged danger has now been relegated to the margins, largely ignored by powerful sports organizations, athletes and media outlets. Casper calls for a return to a serious, evidence-based discussion on CTE, one that prioritizes athletes’ health over economic and cultural forces that downplay head trauma risks. His argument serves as a critical reminder that the fight to protect athletes from CTE is not over and the risks must not be ignored in the pursuit of entertainment and profit.