Navigating the Landscape of Mild Traumatic Brain Injuries in Sports

While mTBI’s are low risk as one-time events, their repeated occurrence can have potentially debilitating repercussions over the long term and can lead to such conditions as chronic traumatic encephalopathy (CTE), a pronounced deterioration of the brain.

By Simon Posner |

I lie motionless on the lacrosse field. “Nik… Nik… are you ok?” A teammate frantically yells, as he begins to shake my body and examine me. I attempt to respond, but forget what to say. All of my thoughts seem too distracted by tiny stars lighting up around me. I can see his lips moving, but I can’t seem to understand what he’s saying. 

A never-ending fire alarm is now ringing in my ears. Dazed and confused, I wince before shrugging my shoulders. A few seconds pass, which seem like hours of soundless commotion, arguing, and pointless evaluations. My mind slips in-and-out of nonsensical thoughts, but I can’t seem to get over the tiny stars that circle around a cloud of blurry-faced… friends?


“I think he got his bell rung there, Jac,” a teammate laughs, eyeing me up head-to-toe. “I’d take him back to the bench and get him some water, he’ll be good to go for the second half.” She nods and gives a faint smile to my teammates as we stagger back to the bench. “Hear that Nik? You’ll be back for the second half!” (Dean 2019, 22).


In the above vignette, Nik has suffered a concussion, a condition known as mild traumatic brain injury (mTBI). Symptoms include visual disturbances like seeing stars, dizziness, confusion, ringing in the ears, those Nik displays above. In contrast to a severe concussion – traumatic brain injury (TBI), which one might incur in, say, a car accident, Nik’s mTBI will likely not have long term health consequences. Assuming the innocuousness of Nik’s mTBI, his coach, Jac, makes the call to have Nik sit out the rest of the half and jump back into the game after the intermission. Nik is a tough athlete, and he can play through the momentary pain.

While mTBI’s are low risk as one-time events, their repeated occurrence can have potentially debilitating repercussions over the long term and can lead to such conditions as chronic traumatic encephalopathy (CTE), a pronounced deterioration of the brain. There has been much headway regarding mTBI awareness over the last three decades – athletes, coaches, medical staff, and parents are generally better informed and trained about the dangers and prevalence of concussions, but there remain many challenges to constructively approach the issue (see Malcolm 2020; Ventresca and McDonald 2020). Medical staff often lack standardized tools to assess the occurrence of a concussion, while coaches and parents lack specific detection and recovery protocols for afflicted athletes. But athletes themselves, like Nik from above, have a complex landscape to navigate when it comes to reporting these kinds of injuries.

Athletes face both internal and external pressures that encourage them to conform to a specific identity. Common among athletes, especially male athletes in contact sports, is the normalized notion of playing through pain and adopting a warrior-like approach to competitive play. These factors encourage athletes to avoid reporting head injuries, especially if they themselves assess that they can continue to play (see Zanin 2018; Zanin et al 2020).

Additionally, athletes face indirect pressure from coaches, who face their own pressures to train the best athletes and forge a winning team. Coaches, often inadvertently, perceive athletes who play through pain and injury as more motivated and stronger team players. As such, coaches will be more inclined to put these athletes on the field while those that more willingly report mTBI’s run the risk of spending more time on the bench. For athletes considering professional sports, reporting a concussion could erode their larger aspirations (see Kroshus et al 2015).

Furthermore, athletes face pressure from their parents from childhood through college. For many parents, sports are approached as a means to build social networks and develop community belonging, which often supersedes the risks of mTBI. Also, while parents today may have generalized knowledge about concussions, they tend to defer to the judgement of coaches (see McGlynn et al 2020; Turner et al 2017).

Put together, the systemic pressures athletes face from themselves and from their entourage incite them to avoid reporting concussions and to neglect the necessary measures to fully heal. And while there have been campaigns to inform and train athletes, coaches, parents, and medical staff about the effects and ways to prevent concussions, more is needed to effectively, accurately, and quickly detect mTBI’s when they occur and interrupt their repetitive occurrence.


Dean, Nikolaus. 2019. “‘Just Act Normal’: Concussion and the (Re)Negotiation of Athletic Identity.” Sociology of Sport Journal 36: 22–31.

Kroshus, Emily, Bernice Garnett, Matt Hawrilenko, Christine Baugh, and Jerel Calzo. 2015. “Concussion Under-Reporting and Pressure from Coaches, Teammates, Fans, and Parents.” Soc Sci Med 134: 66–75.

Malcolm, Dominic. 2020. The Concussion Crisis in Sport. New York, NY: Routledge.

McGlynn, Joseph, Rebecca Boneau, and Brian Richardson. 2020. “‘It Might Also Be Good for Your Brain’: Cognitive and Social Benefits That Motivate Parents to Permit Youth Tackle Football.” Journal of Sports and Social Issues 44 (3): 261–82.

Turner, Robert, Jeffery Lucas, Lewis Margolis, and Brian Corwell. 2017. “A Preliminary Study of Youth Sport Concussions: Parents’ Health Literacy and Knowledge of Return-to-Play Protocol Criteria.” Brain Injury 31 (8): 1124–30.

Ventresca, Matt, and Mary McDonald, eds. 2020. Sociocultural Examinations of Sports Concussions. New York, NY: Routledge.

Zanin, Alaina. 2018. “Structuring Body Work: Control and Agency in Athlete Injury Discourse.” Journal of Applied Communication Research 46 (3): 267–90.

Zanin, Alaina, Jessica Kamrath, Scott Ruston, Karlee Posteher, and Steven Corman. 2020. “Labeling Avoidance in Healthcare Decision-Making: How Stakeholders Make Sense of Concussion Events through Sports Narratives.” Health Communication 35 (8): 935–45.