Collier: As we evolve, our sports must evolve, too

We are now viewing football through a new prism of risk ...

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Have the wise guys posted an over/under on how many penalty flags will litter the lawn this afternoon inside Ralph Wilson Stadium?

I'd put it at 15, but I'm not a professional.

In a typical Steelers game, there are 12 penalties, same as last year, but after The Great Yellow Squall of 2010 hit Pittsburgh last week, when 21 enforced penalties measured 218 yards, the notion that we're finally looking at a different type of theater was pretty firmly established.

Few in the audience approved, and between the time James Harrison was flagged for falling hurtfully upon the passer and the time I left Heinz Field that day, I heard the phrase "ruining the game" at least 10 times, including from some of the most respected and experienced pro football scholars on hand.

This is where we are: With an epidemic of concussions blazing through schoolboy football (22,000 a year in Pennsylvania alone), and a leap forward in the clinical understanding of chronic traumatic encephalopathy (the likely scientific answer to questions like "What killed Mike Webster, Terry Long, Andre Waters, et al.?"), we are now viewing football through a new prism of risk. Which is why I wanted to talk this week with Dr. Micky Collins, who walks on both sides of that prism.

"When I'm sitting on my couch watching football, I'm torn," said Collins, assistant director of UPMC's sports concussion syndrome. "I'm a football fan since I'm 4 years old. I love watching it. It's medieval in its way. You can't see the faces. There's a warrior mentality. The violence is seductive in some ways.

"We're all at a point where we all have different feelings on this issue and we struggle with it, as fans, as players, as officials, as health professions, as administrators. It really does bring about a lot of mixed emotions. Make no mistake, there are problems out there. Everyone thinks of concussion as the boogie man, but if you understand the basic facts of this injury and that we've created tools that can effectively measure the effects, we can manage these guys very well the great majority of the time."

When Hines Ward's head banged off the coconuts of two New England Patriots simultaneously the night of Nov. 14, Ward left the field against his will, and stayed on the sideline, even more against his will. But even Ward, the toughest guy on this or probably any Steelers team since 1998, is acutely aware of what Collins is aware of and of what we've all come to be pretty confident in -- that the Steelers treat these situations with great skill and caution, and that if you even suspected you'd been concussed, you could be in few better places in the world than in the care of this team's medical staff.

But ...

"The medical care the Steelers provide is light years ahead of what a 15-year-old kid might expect," said Collins, who sees some 3,000 concussed kids a year. "I mean I get referrals from all over the world. I see some really sick stuff. Whether it's because of naivete or not having the right tools in place, there's just a tremendous variability in outcomes, possibly because of a constitutional risk in some players. Something people don't understand is -- and we've done studies looking at how high school kids and pro athletes recover -- the adolescent brain is the most vulnerable brain there is to concussion."

Today and Monday in the Post-Gazette, the sometimes tragic implications of that very truth are again delivered in a relentlessly compelling series by Chuck Finder. In installment after too-often-heartbreaking installment, we've found that the number of medical professionals and research organizations devoted to concussions and brain trauma continues to expand both in number and in sophistication. But a similar claim probably could have been made in the summer of 1970, and as I remember football practice at still another time of perceived leading-edge health care, players weren't allowed to have water. I'm pointing that out only because of the possibility that a lot about football, a lot about medicine and even more about our attitudes about both will still have to change before we get through this difficult transition.

I would have thought that the precautionary and protective advances that would point the game to where it has to be would come from the bottom up rather than the top down. At the NFL level, there is so much money riding on the theater of violence that change would come slowly, even grudgingly. But where 15-year-old brains are involved, among the nearly 8 million high school athletes in America, or even 10-year-old brains among the 280,000 Pop Warner footballers (about 16,000 of whom will be concussed annually), I figured the urgency would be far greater.

Not so fast.

Collins told Finder for Monday's coverage that "doctor shopping is certainly something that happens a lot. What's amazing is that when a parent hears what's going on and [the child] can't go back to play, they still take their kid [elsewhere] to be cleared. That's a little bit scary."

That is, in fact, its own pathology.

It's been 30 years since Jack Lambert complained that they ought to put skirts on quarterbacks, and what's become of the NFL in the interim doesn't exactly conform to any definition of ruin. The game still does not face ruination. The way we enjoy it might take a hit, maybe even helmet-to-helmet, but we'll get over it. There was a time, after all, when boxers didn't wear gloves. There was a time when hockey goalies didn't wear masks. But cultures evolve and, eventually, their games must evolve with them.

Gene Collier: .


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