As the football season gets underway every season, two things are certain: There will be some headline-grabbing concussions, and we’ll hear the National Football League (NFL) tell us that player health and safety remain a top priority.

The contrast between appearances and that claim is striking. Few fans could forget Miami Dolphins quarterback Tua Tagovailoa stumbling on the field after a huge hit, being cleared to play and then sustaining another scary injury a few days later. The scene of a wobbly player being escorted off the field after a head impact is all too familiar on high school fields, in college stadiums, and, of course, in the NFL. Yet we hear claims that the game has gotten safer, as the NFL regularly reports progress in the fight against concussions, citing new rules and equipment, greater awareness, improvements in its concussion protocol, and continued research into the issue.

Can we be confident that all of these efforts are making a difference? As we’ll see, the answer may well be no.