Concussion, chronic traumatic encephalopathy, and the medicalization of sport

This chapter explores the development of concussion and CTE as issues in sport, through the lens of medicalisation. It argues that medicalisation processes are evident at three distinct levels: namely at a conceptual, institutional and interactional level. Consequently we see: 1) that biomedical vocabularies have come to structure public understanding of concussion through, e.g. discussions of the power of neuroscience to identify CTE; 2) that biomedical practices are used to “manage” concussion through, e.g., the institutionalisation of diagnostic and return to play protocols; and 3) that biomedical actors have become centrally placed as the ultimate “cure” of the social problem of concussion through, e.g., and assertion of the primacy of “individual clinical judgement” in interpreting and applying concussion guidelines. The paper explores the dynamics and consequences of these processes, highlighting how the unevenness of these process with medicalisation at the conceptual level being considerably more extensive that the efficacy of treatment at the interactional level would warrant. Moreover, it suggests that the disparity between in the extent of moderation over different domains is partly responsible for the heightened level of social concern in relation to concussion and CTE. The chapter concludes with some practical reflections on the consequences of this medicalisation process, locating the enabling and constraining effects within a framework of medical ethics.