Tinnitus and Head Injury

Summer is a time for connecting with family and friends during common summer activities, whether it’s going to concerts, watching the fireworks, or attending a sports event. However, for some former players, these activities can be challenging or even unbearable due to the loud noises from the environment.

Has ringing in one or both of your ears ever held you back from attending an event or impacted your life in other negative ways? You’re not alone. It’s estimated that 15%-20% of the general population, and roughly 39% of the former players we surveyed in our latest study, experience ringing in their ears—a condition known as tinnitus.

Tinnitus is defined by hearing ringing or other noises in one or both ears. These noises may manifest as clicking, pulsing, rushing, humming, or low- or high-pitched ringing, and aren’t attributed to an external source.

Symptoms of tinnitus are common, with more cases reported in older adults. While many people experience these symptoms, they may not know that it’s a condition that can be diagnosed and treated or managed.

After learning from former NFL players about their experiences with these sounds, our researchers conducted a study to better understand the rates of tinnitus in our cohort of former NFL players.

What we measured:

Our researchers surveyed 1085 former NFL players, asking them questions like:

• In the last year, have they experienced ringing, roaring, or buzzing in their ears or head?
• Did they have any signs and symptoms of concussion while playing or practicing football, including headaches, nausea, dizziness, loss of consciousness, memory problems, disorientation, confusion, seizure, visual problems, weakness on one side of the body, and feeling unsteady on their feet, as well as symptoms of depression, anxiety and cognitive symptoms?

What we found:

• Roughly 39% of participants reported experiencing symptoms of tinnitus
• Greater concussion symptom history was associated with increased reporting of tinnitus symptoms
• Among players with tinnitus symptoms, we found strong relationships between head injury and depression, anxiety, and cognition
• The odds of reporting symptoms of tinnitus were 50% lower in players who identified as Black compared to their non-Black counterparts
  • This difference may indicate that Black players are underdiagnosed and/or underseen for this condition

Previous research on military personnel and the general population has found that a history of repeated head trauma may increase the rate of reported tinnitus. In these groups, tinnitus has been associated with diminished quality of life, including symptoms of cognitive impairment, depression, and anxiety.

Given our past research on the connection between a history of concussion symptoms and cognitive impairment, depression, and anxiety, we felt it was important to further study how these same factors may also be related to NFL players and their symptoms or diagnosis of tinnitus.

There are implications from these findings that are important for former NFL players to consider:

First, it is recommended that former players with history of concussion and traumatic brain injury request enhanced tinnitus screenings.

Second, treating tinnitus could serve as an intervention for former players who are experiencing symptoms related to a history of head injury, such as anxiety and depression.

Potential Action Steps:

If you are concerned about your hearing, are experiencing ringing or other sounds in your ears, or think you may have tinnitus, reach out to your medical care provider for testing. If you need to find a primary care provider (PCP), please visit health.gov to learn how to find a provider.

There are several ways to diagnose tinnitus. Diagnosis can include:

• A hearing exam
• A movement test to identify if symptoms intensify in different positions
• Imaging, including CT and MRI scans
• Lab tests

The above tests can identify tinnitus, as well as other conditions that may be causing symptoms related to hearing impairment. Talk to your medical provider about your symptoms to determine the best test.

Additionally, there are multiple treatments for tinnitus and other hearing conditions depending on your symptoms. These treatments include:

• Earwax removal
• Further assessment for a blood vessel condition
• Hearing aids
• Medications
• Noise suppression to minimize tinnitus symptoms
• Types of counseling to help with managing symptoms such as Tinnitus Retraining Therapy (TRT) or Cognitive Behavioral Therapy (CBT)

This condition especially if experienced by those with a history of concussion symptoms, can negatively impact mood. If you think you may be experiencing depression or anxiety, talk to your doctor about these concerns and how you can address them. If you need to speak with someone immediately, contact the NFL Life Line, (800) 506-0078.

Additional Resources

The American Tinnitus Association is an organization offering comprehensive support, credible information, and groundbreaking research on tinnitus. Visit their website to find more information about tinnitus symptoms, diagnosis, treatment, and more.

Speak to your doctor about your sleep and other health concerns. Lifestyle changes (e.g., exercise, diet) and medications can improve your health. Use our checklist designed specifically for former players to use when speaking with your healthcare provider.

NFL Life Line: This is a free, independent and confidential phone consultation service that is available to former players and their families 24 hours a day, 7 days a week. It is designed to help individuals with any mental or physical health matters that they need support on, and to connect them with the resources they need. The Life Line is run by professionals who are trained to assist individuals experiencing personal or emotional crises. Contact: (800) 506-0078.

Players Assistance & Counseling Services: This benefit provides eligible former players and their families with up to eight free counseling sessions a year for matters ranging from family/marital concerns to depression. Contact: (866) 421-8628.

NFLPA: Myths about Depression and Anxiety: This resource discusses and debunks common myths about depression and anxiety.