There is an unspoken question lurking behind the NFL domestic violence cover-up saga that has emerged over the last month. It is whether the brutality of the game, particularly head injuries, plays a role in the prevalence of players committing acts of violence against women. The NFL has a vested interest in not having this discussion. On head injuries, as the title of the award-winning book said so clearly, it remains “a league of denial.” If, in the name of public relations, the owners won’t have a discussion about the connection between their sport and horrific post-concussive syndromes like ALS and early-onset dementia, are they really going to talk about links between head injuries and domestic violence? The sports media are largely in denial about this topic as well, as there was not one question in Roger Goodell’s instantly infamous Friday press conference about whether the league would investigate whether brain injuries could be the bridge between the violence at work and the violence at home.

Yet many domestic violence advocates are also—understandably—not thrilled with this line of discussion. Partner abuse occurs in all walks of life, all professions and among all income groups, and post-concussive syndromes are almost always not a part of those stories. Additionally, to blame it on concussions seems to be excusing domestic violence and denying the fact that NFL players have agency and choice before becoming abusers. This resistance is very understandable. But attempting to explore and explain the shockingly high rates of domestic violence in the NFL is not the same as excusing it.

So is there a connection? As my friend Ruth, who is a DV counselor, says, “When it comes to domestic violence, it is extremely difficult to generalize across the board, in the NFL or otherwise.” In other words, every case is distinct, reflecting the interpersonal relationships of the parties involved. But there are factors that appear to show themselves in the football cases with alarming regularity. Some of these factors are high rates of stress, a culture of entitlement for sports stars that predates their life in the NFL, and an inability to turn off the violence of the game once the pads are off. This is when we see the most toxic part of the sport’s hyper-masculinist culture poison the relationships between the men who play the game—as well as the men who own teams—and the women in their lives. But among many players, this question of the role of head injuries still lingers in the background.

Dan Diamond over at Forbes is one of the few journalists I have seen explore these links in detail. In one piece, he cites a “disturbing new report” that shows “3 in 10 NFL players suffer from at least moderate brain disease.” Diamond then details many examples of former players who were found in their autopsies to have the repetitive post-concussive syndromes known as CTE, and were also arrested at some point or another for domestic violence. He writes:

The key issue is whether suffering repeated head trauma lowers a person’s self-control. And while many pro football players haven’t been diagnosed with concussions in the NFL, nearly all of them have been playing football since they were young and suffered repetitive, frequent blows that can add up over time. And researchers know that those concussions can change a person. Even a pillar of the community.

This connects anecdotally with much of my own research. Over the last two months, I have spoken with three different women whose husbands are or were NFL players. All three are domestic violence survivors. In one case, the marriage was mended and endures to this day. In one case, it ended in divorce. In one case it ended with the suicide of the player in question. Yet that is where the differences ended. The similarities were stunning. In all three cases, the violence was precipitated either by migraine headaches or self-medicating—drugs or alcohol—to manage migraines. In all three cases, the survivors spoke about their NFL husbands becoming disoriented or light-sensitive, easily frustrated and quick to anger in ways that did not exist earlier in the relationship. In all three cases, they spoke about bizarre looks on their husbands’ faces when they committed the abuse, from a chillingly peaceful calm to quizzical smiles. Whatever the look, they spoke of being in the presence of someone they “did not recognize.”

I also spoke with Matt Chaney, a former college football player and author of the book Spiral of Denial: Muscle Doping in American Football, about whether he believed there was a causal link between concussions and domestic violencw. He e-mailed me back the following.I can’t speak as medical authority on any link but as a journalist and academic who’s read and filed tens of thousand documents on football hazards from violence to drugs, and one who’s interviewed a thousand people, along with being a former college player who has knowledge of countless athletes and their relationships, I believe football brain injuries lead many players to violence they wouldn’t otherwise have committed, ranging from domestic cases to random acts.… I think brain injuries, after studying the topic as we all have in recent years, now explains much about the perplexing cases of violence and other irrational behavior among football players I’ve known. And while I thought I abhorred street fighting, before college football, I found myself nearly involved with or nearly instigating such trouble on more than one occasion while I was in full-contact activity, fall and spring practices, banging my head. If I didn’t have headache after a college contact session, I didn’t think I’d done anything.”

This question, of course, has profound implications well beyond the sport. It is about the choice families make whether to let their children play tackle football. It is about the health and safety of women in relationships with NFL players, and whether recognizing warning signs of CTE can create opportunities for intervention before abuse takes place. It is about the degree to which the league’s very violence bears some complicity in their abuse. This is a difficult question, one Roger Goodell is loathe to discuss. That is exactly why we need to keep asking it.