IELTS Reading 40: The Invisible Injury

Adapted from FIS / Zurich Concussion Consensus guidelines (2025-2026). IELTS Reading Section 3 difficulty, approximately 1,050 words. Source: https://assets.fis-ski.com/f/252177/x/fd5d1d6ed9/fisconcussionguidelines2026.pdf

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Reading Passage

A. A concussion does not look like an injury. The athlete staggers to their feet, shakes their head, and within minutes is walking, talking and — in the old way of things — ready to go back onto the field. Because no bone is broken and no wound is visible, concussions were, for most of the last century, treated as moments to shake off, and players suspected of one were often encouraged to return to the same game, sometimes in the belief that showing toughness mattered more than caution. Modern sports medicine has overturned that attitude completely. A concussion is now understood not as a knock-out but as a temporary disturbance of the brain's function, caused by a blow to the head or body that sends the brain sliding and rotating inside the skull. The signs may include headache, dizziness, blurred vision and a vague mental fog rather than loss of consciousness, and they may not show up until minutes or hours after the blow. Crucially, ordinary scans usually show nothing at all: the injury is biochemical and electrical rather than structural, which is precisely what makes it so easy to miss and so important to take seriously.

B. The deeper worry concerns not a single blow but many. A condition called chronic traumatic encephalopathy, or CTE, has been linked to years of repeated head impacts — not only diagnosed concussions but the smaller, routine knocks that occur in contact sport thousands of times over a career. Post-mortem studies of brains, often of former players in American football and boxing, have found deposits of a damaged protein called tau, tangled around small blood vessels, associated in life with memory loss, mood changes and confusion. The evidence suggests a kind of dose effect: the more years of repeated impacts, the higher the chance that such changes will be found. Yet researchers are careful not to oversimplify the picture. The disease can be confirmed only after death, similar changes have occasionally been found in people without a history of heavy contact sport, and most people who play contact sport never develop it at all. The relationship between an afternoon's collision and a decades-old disease is real but not inevitable, and it remains an open question exactly how many blows cross a line that cannot be uncrossed.

C. If the long-term picture is uncertain, the immediate management has become far clearer. The first rule is to remove any athlete suspected of a concussion from play at once, and never to let them return to the same match, however much they protest that they are fine and want to stay on. After a brief period of relative rest — usually no more than a day or two — the guidance now favours gentle light activity rather than the prolonged bed rest that was once prescribed, since early, mild movement appears to speed recovery without aggravating the injury. From there, athletes progress through a graduated, six-step return-to-play pathway agreed by international consensus: symptom-limited daily activity, light exercise such as walking or stationary cycling, sport-specific drills without contact, more complex non-contact training, full-contact practice under supervision, and only then a return to competition. Each stage requires at least twenty-four hours without symptoms, and any return of headache, dizziness or fogginess sends the athlete back to the previous step for another rest, a deliberate slowing-down that replaces the old pressure to return as quickly as possible.

D. Children and teenagers are treated with extra caution. A young brain is still developing, and it recovers more slowly from a concussion than an adult's; what looks like a mild blow to an adult may produce days or even weeks of symptoms in a schoolchild, whose reactions and balance are still maturing and whose brain is far less resilient. Guidelines therefore lengthen the pauses between stages for younger players and insist that a suspected concussion is grounds for removal from play on the spot, with a medical assessment before any return to the field. A history of one concussion also raises the risk of another, and athletes who have already suffered several — particularly three or more — with slow recoveries may, after careful medical assessment, be advised to step back from collision sport altogether. Baseline tests, taken before a season begins, allow doctors to compare a concussed player's balance, memory and reaction time against their own normal state, rather than against an average stranger's, which is especially useful in children whose symptoms are hard to put into words.

E. The challenge, for clinicians, coaches and parents, is to get the balance right. On one side lies the old culture of dismissiveness, in which a dazed player was patted on the shoulder and sent back out. On the other lies the exaggerated fear that every head knock is a sentence of dementia, a fear stoked by headlines but not fully supported by the evidence. The modern approach tries to hold both truths at once: concussions must be recognised and managed carefully, with time off and a graded return, yet most athletes recover fully and safely and go on to play, work and live without lasting harm. Individual differences matter too — some people weather repeated impacts better than others, and genetic factors appear to influence who suffers prolonged symptoms after an apparently similar blow, which is why two players who take an identical knock can recover at very different speeds. The invisible injury, in the end, cannot be seen on a scan or felt on a simple pulse check; it has to be inferred, respected and given time to heal, both after a single blow and across a whole career, by cultures that once prided themselves on never backing down.

Questions 1-4

Choose the correct heading for paragraphs B, C, D and E from the list of headings below.

List of Headings i. Why a single injury is hard to detect ii. The long-term concern: repeated impacts and CTE iii. The immediate, step-by-step return to play iv. Why young athletes need extra caution v. The history of football helmets vi. Striking the balance between fear and dismissal vii. How tau protein is used in food

1. Paragraph B: ____
2. Paragraph C: ____
3. Paragraph D: ____
4. Paragraph E: ____

Questions 5-8

Choose the correct letter, A, B, C or D.

5. Why is a concussion easy to miss? A. It always causes unconsciousness. B. Ordinary scans usually show nothing structurally wrong. C. It happens only during training. D. It causes a visible fracture.

6. What is CTE linked to? A. A single severe fall. B. Years of repeated head impacts over a career. C. Lack of sleep. D. A genetic mutation only.

7. What does current guidance recommend after a brief rest? A. Prolonged bed rest for weeks. B. Gentle light activity, not prolonged bed rest. C. An immediate return to full contact. D. No exercise until the next season.

8. Why are children treated more cautiously? A. Their developing brains recover more slowly. B. They play harder than adults. C. They cannot understand the rules. D. Their helmets are smaller.

Questions 9-13

Do the following statements agree with the claims of the writer?

Write:

• TRUE if the statement agrees with the information
• FALSE if the statement contradicts the information
• NOT GIVEN if there is no information on this

9. Athletes used to be allowed to return to the same game after a concussion.
10. CTE can be reliably diagnosed during a person's life.
11. Each stage of the return-to-play pathway requires at least 24 hours without symptoms.
12. Everyone who plays contact sport develops CTE.
13. Concussions are most common in basketball.

Questions 14-15

Complete the summary below using NO MORE THAN TWO WORDS from the passage.

A concussion is a temporary disturbance of brain (14) __________ rather than a structural injury. After a brief rest, athletes follow a graduated, six-step return-to- (15) __________ protocol.

Answers & Explanations

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