September usually means a handful of things: Summer’s almost gone, the kids are going back to school, the holidays will be upon us before we know it (how many holiday shopping commercials have you seen already?), and football is finally back. The return of football means many of us won’t leave our couches on Sundays — but it also means more discussion about just how dangerous the sport is.

According to ear surgeon John Leonetti, a Loyola University Medical Center doctor, retired NFL players may be at risk for more than just the effects of concussions, broken bones, and torn ligaments. According to Leonetti, they may also be at risk for permanent hearing loss and tinnitus due to repeated brain trauma.

Leonetti says there are two possible mechanisms by which repeated blows to the head could cause hearing damage: A heavy blow to the head can cause the brain to jiggle, potentially damaging the nerves that connect the brain to the inner ear; and a blow to the head can also create a shock wave powerful enough to damage the cochlea, which is responsible for sending hearing signals to the brain.

Though there has been no published study involving football players and hearing loss, Leonetti says the anecdotal evidence alone should be sufficient to convince someone to conduct a study to determine if rates of hearing damage are indeed higher. Regardless, it is important to remember that hearing loss is usually the result of repeated instances of trauma, so protecting the ears from damage means fewer health risks down the road. And the right kind of protection is the kind that fits you comfortably, creating a seal that only custom-fit hearing protection can provide.