CHICAGO (AP) — Alecko Eskandrian starred at the University of Virginia before playing for five teams during seven seasons in Major League Soccer. The All-Star forward had five documented concussions during his MLS career, leading to his retirement in 2010.

When it comes to head injuries and soccer, Eskandrian said, the sport has come a long way.

“When I was younger, growing up, that wasn't even a thing to, hey, report your concussion," he said. “It was more of like, if you felt OK, you carried through, you carried through, and there were never discussions about short-term, long-terms effects, things like that.”

The 40-year-old Eskandrian, who works for MLS in player relations and player development, shared his perspective while speaking on a panel Wednesday on the first day of a head injury summit at a downtown Chicago hotel.

The conference of scientists, medical professionals and athletic trainers and officials was organized by U.S. Soccer, Major League Soccer, the National Women’s Soccer League and the United Soccer League. It also included speakers from the Premier League, English Football Association and World Rugby.

Looking to build on the findings of the sixth International Conference on Concussion in Sport held in Amsterdam in October 2022, the summit featured presentations and discussion on the latest developments in concussion prevention, diagnosis and care.

“The amount of literature that's been published in the last two, three, four years is equal to the amount of literature that's been published in the last 20,” said Margot Putukian, the chief medical officer for MLS. “So this is a really important topic.”

The summit opened a day after the Concussion Legacy Foundation announced that four more former professional soccer players had been diagnosed with chronic traumatic encephalopathy — a degenerative brain disease that has been linked to concussions in athletes, combat veterans and others who sustained repeated head trauma.

There was little mention of CTE during the presentations and panels on Wednesday, and no researchers from the Boston University CTE Center — the brain bank that has led the research into the disease that can cause depression and other cognitive difficulties — were invited to address the conference.

Speaking during a break Wednesday, Concussion Legacy Foundation co-founder Chris Nowinski said he was looking forward to a “deeper discussion of heading” and for "a sense of urgency.”

“I don't think the level of concern for how many soccer players are being diagnosed with CTE is high enough,” Nowinski told The Associated Press. “I don't think it's what the players would want it to be, who are actually the ones out there risking CTE and could have a future (CTE) prevented if there were changes made today.”

Asked about the criticism by some CTE researchers, Putukian defended the agenda for the summit — pointing to a Thursday session that includes presentations on neurological markers for chronic degenerative disease, neurocognitive dysfunction and neurodegenerative disease in soccer.

“We've, I think, tackled and been very transparent about all the issues,” she said. “We want to hear about all the issues. We want to continue to learn from all the stakeholders that we've invited.”

The opening of the summit was filled with signs of progress in concussion research — and plenty of examples of how far there is to go. Beyond conversations about advancements in technology and a growing recognition of several different conditions as factors in diagnosis, experts also touted the importance of exercise in recovering from head injuries.

Gone are the days of resting in a dark room after sustaining a concussion.

“We're learning that exercise is medicine,” Putukian said. “Exercise makes people feel better. ... There's been an explosion of research and very clear evidence that strict rest is actually deleterious and that it early exercise is really helpful.”

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