Don’t be a quitter, think about your teammates, play through the pain–call it sports culture: Parents, coaches and trainers are all complicit at one time or another. And it doesn’t seem to be a uniquely American phenomenon. Athletes participating at the 2016 Rio Olympics recounted many stories of training–and competing–while injured. In essence, they expressed the “no-pain-no-gain” mindset that has made them the elite athletes that they are.

But where is the line between competing with a little, or even a lot, of pain (think everything from calluses to torn ligaments to broken bones) and competing with neurological damage that could, potentially, have lifelong consequences?

Keep your head OUT of the game

A new study cited in The New York Times details the severe consequences of staying in the game after suffering a concussion–a type of traumatic brain injury. The study showed that athletes who returned to play after sustaining a concussion took twice as long to recover from their injury as those players who left the game immediately.

The numbers? 44 days for those who returned to play, 22 days for those who left the game–essentially three weeks vs. six. Recovery time is comparable to a sprain or a broken bone. But whereas a bone or sprain is generally completely healed after a month or two, concussions can leave long-term and sometimes permanent cognitive issues including memory loss and confusion, as well as concomitant sleep disturbances . Even one concussion raises the likelihood of symptoms. Multiple concussions can result in chronic traumatic encephalopathy–a disease that mimics Alzheimer’s and has been known to affect individuals as young as 25.

Worth the risk?

It begs the question: When is enough enough? Are we teaching our children to ignore their physical well-being for the outcome of a game? Are adults who are charged with the care and guidance of children unwittingly engendering a dubious prognosis? Is it really sportsmanlike-behavior to risk your brain for the game? This recent study should leave no question.

Immediate action is imperative not only for short term concerns, but also for a stable, healthy future.