Sports and Brain Injuries: Sports and the Long-Term Danger to the Brain
- Dr. Nati Blum
- Published in c14
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In recent years, evidence has been accumulating that participation in certain sports increases the risk of developing degenerative brain diseases such as CTE (chronic traumatic encephalopathy), dementia, and Alzheimer's. • Dr. Nati Blum, CEO of the EMDA Association, wrote about the heavy price that popular sports can take on the minds of athletes.
Popular sports can take a heavy toll on athletes' brains. In recent years, evidence has been accumulating that participation in certain sports increases the risk of developing degenerative brain diseases such as CTE (chronic traumatic encephalopathy), dementia, and Alzheimer's.
At the top of the list are sports where head injuries are common. From rugby to boxing, from soccer and ice hockey to American football, many competitors suffer long-term medical consequences from head injuries.
Brain injuries in martial arts
Boxing and other martial arts They are a prominent example of brain injuries due to competitive sports. Contestants suffer repeated blows to the head throughout their entire careers. It is no coincidence that the term “punch drunk syndrome” was coined in 1928 to describe older boxers who have lost their balance and cognition. Experts warn that brain injuries are a known occupational hazard in this industry – just as impaired lung function is an occupational hazard in coal mining.
Boxing legend Muhammad AliFor example, he was diagnosed with Parkinson's at the age of 42, and the symptoms of brain degeneration that accompanied him are linked by many to years of head blows in the ring. Other great boxers such as Joe Lewis וSugar Ray Robinson They suffered in their later years from symptoms of dementia and Alzheimer's – painful testimony to the toll that fighting takes on the arena.
Brain injuries in football
is also football is in the researchers' sights. This popular sport seems safer at first glance, but in fact it carries a cumulative brain danger. The main factor is kicking the ball: over the course of a career, a player makes thousands of kicks, and each such blow to the skull adds cumulative microscopic damage. A Scottish study published in 2019 found that professional soccer players developed significantly higher rates of dementia than the general population.
In fact, recent studies show that professional soccer players are at about a 50% higher risk of developing degenerative brain disease compared to a control group, and that former soccer players were 3.5 times more likely to develop dementia in old age.
A famous case is that of Jeff Estelle, a former England striker who died at the age of 59 after suffering from severe dementia. The coroner ruled that his death was caused by an “occupational disease” due to cumulative head injuries from tackles. Indeed, post-mortem examinations of several footballers’ brains have revealed signs of CTE – chronic traumatic brain injury.
A striking finding from recent studies is that soccer goalkeepers rarely suffer from the same problems – probably because they rarely hit the ball. This data strengthens the hypothesis that repeated hits are the root of the problem. In fact, Boston neurologist Dr. Anne McKee , one of the pioneers in CTE research, notes that the number of recorded concussions a player experiences is less significant for the development of the disease – what matters is the accumulation of small head blows over the years.
Brain injuries in other ball games
is also American football וRugby – Sports based on hard contact and collisions – have been linked in recent decades to cases of CTE and dementia among their players. In the US, the CTE scandal in the NFL (American Football League) exploded when dozens of former players were discovered with advanced brain damage after death, leading to huge lawsuits and changes to the league's concussion protocols.
In the UK, a recent rugby study found that 68% of the brains of rugby players who donated their bodies for the study showed signs of CTE. The researchers found that each additional year on the field further increased the risk of degenerative brain injury – an increase of about 14% in risk for each year of active play.
Head injuries in rugby and football are caused not only by direct blows, but also by the powerful shaking and rotation of the brain inside the skull during a hard tackle – a repetitive motion that causes deep damage to the nervous tissue, as one researcher describes it, "like a bowl of porridge spinning" inside the head.
Brain injuries in other sports
is also Ice hockey It is not without its dangers: The game, which involves fast skating, physical contact, and occasional fights, leads to a high incidence of concussions. Several NHL (Hockey League) players have retired or died young and have been documented with signs of CTE.
Additionally, motorsports such as car and motorcycle racing and extreme sports (e.g. skateboarding, parkour) may expose participants to serious accidents and repeated concussions. While injuries in racing are not as frequent as in contact sports, when accidents occur at high speed, the risk of traumatic head injury is significant.
Repeated falls in pursuit of adrenaline in extreme competitions can also cause cumulative damage. In these cases, a single acute concussion is enough to cause extensive damage, but a series of "minor" and subclinical concussions can also accumulate to major damage.
Mechanism of injury: repetitive trauma, degeneration, and protein accumulation
What happens to the brain as a result of these repeated blows? The presumed mechanism involves several interrelated processes. First, any blow to the head – even a relatively mild one – can cause a tiny injury to brain tissue: stretching nerve fibers, microscopic tearing of blood vessels, or the release of harmful chemicals in nerve cells.
When an athlete suffers hundreds and thousands of such "small blows" over the years, the cumulative damage increases. Pathological deposits of proteins (such as tau protein) accumulate in the brain, causing nerve cells to die - a process reminiscent of diseases like Alzheimer's, only starting earlier in life.
This is how chronic traumatic encephalopathy (CTE) develops, at the peak of which the brain literally shrinks and loses volume, and function is severely impaired. Symptoms of CTE and similar degenerative diseases include memory impairment, confusion, behavioral changes, depression, movement disorders and even suicidal tendencies – sometimes decades after the athlete has retired.
Besides repeated concussions, researchers point to other risk factors that can worsen brain injury. Use of prohibited substances and stimulants For example, it may contribute to neurological damage: Studies have found that long-term use of anabolic steroids accelerates brain aging and may cause early cognitive impairment. Other substances that increase heart rate and blood pressure may create microvascular damage – damage to the delicate linings of blood vessels in the brain, which may increase the risk of stroke or dementia.
Nutrition and dehydration also come into play: Athletes in weightlifting disciplines such as boxing or MMA often dehydrate to extremes before competition. A dehydrated brain loses the protection provided by the cerebrospinal fluid buffer and may be more vulnerable to concussions. Lack of food and essential nutrients may also impair the body’s ability to repair tissue damage. Thus, a combination of factors – repeated mechanical trauma, metabolic changes, and impaired blood supply – all contribute to the cumulative degenerative process.
The public discourse on brain injuries in sports
The discourse on brain injuries in sports has gained momentum in the past decade, with more and more scientific findings and personal stories making headlines. In the USThe football scandal brought the issue of concussions to public attention: Former NFL players like Junior Seau and Aaron Hernandez, who died in tragic circumstances, were found posthumously to have brain damage typical of CTE. The league was forced to acknowledge the link between rough play and brain injury, and agreed to hundreds of millions of dollars in compensation for retired players suffering from neurological problems.
In the UK , more than 300 former football, rugby and rugby league players have filed lawsuits claiming that their cognitive impairments were caused by their careers. Stories of football stars from the 60s and 70s who won World Cups but then developed dementia in old age have caused a stir, including England's Nobby Styles , Jack Charlton and Sir Bobby Charlton , who all suffered from dementia in their later years.
These cases have sparked heated debate in the British public and parliament about the need to restrict tackling in training and at youth levels. Indeed, some football associations have recently decided to ban tackling training for children under 12, based on the principle of "precaution".
The response of the scientific and medical community
The scientific and health community has also responded to the wake-up call. The World Health Organization (WHO) recently declared concussions in sports a public health problem that requires increased awareness. The WHO has joined FIFA in a global campaign called "Suspect and Protect," with the aim of educating players and coaches to recognize signs of concussion and treat them appropriately.
At the same time, leading medical journals began publishing more studies on the link between sports and brain injury. The Lancet published disturbing data on professional soccer players and the prevalence of dementia in 2023, and the New England Journal of Medicine presented similar findings even earlier.
Health authorities such as the Mayo Clinic and the NINDS (National Institute of Neurological Disorders and Stroke) have published recent reviews that confirm: CTE is a degenerative disease associated with repeated exposure to concussions, especially in contact sports athletes. It can only be diagnosed with certainty through post-mortem tissue examination, but the appearance of symptoms years after retirement is suspicious when the background is a career full of head injuries.
Responsibility, Prevention, and Support: Don't Neglect the Brain
In light of the findings, there is a growing demand for greater responsibility from sports organizations, coaches, and athletes themselves. Some sports have already updated the rules of the game and training to reduce head injuries. For example, limits on the number of exchanges of blows in boxing training, protocols for gradual return to the field after concussion, and the use of better protective equipment (such as improved helmets in football and hockey).
But experts emphasize that the first step is awareness : Players and fans must understand that a "healthy head for victories" is just as important as any trophy, and that an injury that is not underestimated today may save years of brain health in the future. The message is clear: the love of sports should not come at the expense of health. With adjustments and adherence to safety rules, it is possible to enjoy the game - without losing your head.
If you know of a former athlete, family member, or friend who is showing worrying signs of cognitive decline, confusion, personality changes, or memory problems, it is important to encourage them to seek medical help. Early diagnosis can help manage treatment and improve quality of life.
Additionally, in Israel, there is an assistance and support line for families of dementia and Alzheimer's patients operated by the EMDA Association (the Association for Dementia, Alzheimer's and Similar Diseases). The line is staffed by professionals and can be contacted free of charge for advice and guidance by calling *8889.
The author's ode
Dr. Nati Blum She is the CEO of EMDA and holds a PhD in psychology from the University of Sacramento. Her doctoral thesis focused on face-to-face group therapy versus virtual group therapy. In her role at EMDA, she harnesses her professional and managerial experience to lead efforts to improve the quality of life of those dealing with dementia, promote their rights, and raise public awareness of the phenomenon in Israel.