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Traumatic brain injury (TBI) can be caused by many things, including car accidents, sports injuries, falls, domestic violence and explosions during combat. In the past few years, research has shown American football to be a major contributor to TBI. The media has also highlighted this, especially as iconic athletes speak about their experiences and detrimental effects after they stop playing.

What exactly is traumatic brain injury? The Mayo Clinic defines TBI as an injury that occurs when an external mechanical force—such as a blow to the head—causes the brain to stop functioning normally. Brain injuries are similar in some ways to injuries to other parts of the body that cause limited use of that area. However, TBI is different because it can cause problems throughout the body, such as coma, paralysis or seizures. The potential for widespread damage is perhaps the most devastating aspect of TBI. This kind of injury can alter memory, hand-eye coordination, communication and the ability to multitask. Emotional and social behavior may change so much that a person may not seem like the person they were before the injury.

Advanced imaging techniques—think very high-powered cameras—have made it possible for doctors to see bleeding, bruising, clotting and swelling in the brain. Pairing imaging tests with a physical and neurological examination helps doctors determine the severity of the TBI. These tests measure patients on their ability to listen to and follow directions, move their limbs and form complete thoughts and sentences.

Researchers are just beginning to understand some of the molecular changes that occur following TBI. They know that certain proteins are elevated in the area surrounding the injury and in the blood for a short period after the injury. Because it’s almost impossible to predict an injury or accident that causes TBI, there is no way to prevent this spike in protein levels. However, the development of car airbags, technological advances in sports helmets and mouth guards, teaching of proper tackling techniques in football, and restricting young soccer players from heading the ball have increased our awareness about TBI risk factors and may help more people avoid sustaining these injuries. Hopefully in the future, fewer people will have to live with the challenges of TBI.

Adam Morrow, PhD, is an assistant professor of biochemistry at the Alabama College of Osteopathic Medicine.