When Justin Morneau was kneed in the head while sliding into second base to break up a double play against the Blue Jays last July 7, he knew right away that he was hurt. The Twins' All-Star first baseman remained on the ground for a few moments, slowly removed his helmet and eventually was helped to his feet before walking off the field with a dazed look.
He'd had a concussion earlier in his career after a beaning, so he had some idea of how serious the injury can be. He took a few days to rest, figuring he'd be back inside a week.
But in retrospect, he said, he really had no clue. He wound up missing the rest of the 2010 season, a total of 81 games, and wasn't back on the field in a full-time capacity until midway through spring training last month.
"I didn't think it was going to be that long," Morneau told Newsday this past week during the Twins' three-game series at Yankee Stadium. "It happened about five days before the All-Star Game and I was still hoping to go to the All-Star Game. Now that I look back on it, there was no chance, but I didn't think it was that bad when it happened."
Morneau's injury and others -- including concussions suffered by the Mets' Jason Bay last year and Toronto's Aaron Hill in 2008 that sidelined each of them for months -- prompted Major League Baseball to create a new seven-day disabled list last week, specifically for players who have suffered blows to the head.
That, as well as other rules and guidelines, are designed to protect a player who might feel pressure to rush back to the field before his brain is healthy enough.
Morneau, the 2006 American League MVP and a four-time All-Star, might be the most high-profile player to miss significant time dealing with a concussion. And at a time when all of the major sports are instituting policies and adapting equipment for dealing with concussions, trying to keep up with the ever-expanding science and research, Morneau has become an unofficial spokesman for awareness in his sport.
Addressing the problem
According to Major League Baseball, eight players spent time on the disabled list in 2010 with a concussion or concussion-like symptoms. That's the most since 2005.
"The most likely reason we're seeing more concussions is unquestionably greater awareness and therefore greater recognition of the injury," said Chris Nowinski, co-founder and president of the Sports Legacy Institute and a co-director of the Center for the Study of Traumatic Encephalopathy at Boston University School of Medicine.
Still, most big-leaguers step into the batter's box with more protection on their elbows or shins than on their heads.
For the most part, players continue to wear helmets that are essentially a plastic shell, with all of the padding designed for comfort and not protection. The Rawlings CoolFlo helmet, one of the most popular models in the majors, provides protection for fastballs at a speed of 70 to 75 miles per hour, according to Art Chou, Rawlings senior vice president of product. That's barely enough to ward off a Williamsport heater, never mind a big-league fastball 25 mph faster than that.
It was only two years ago that a player coming back from a concussion would be saddled with an awkward-looking helmet. Mets third baseman David Wright wore one of the first versions of the Rawlings S100 when he came back from a concussion after getting beaned by a 94-mph fastball from San Francisco's Matt Cain in 2009. That version was a bulky dome with extra protection that made him look as if he were about to topple over. Last year, Yankees backup catcher Francisco Cervelli, who has a history of concussions, wore a similar helmet.
Though no helmet can prevent concussions, the newest version of the S100, which Morneau now wears, ups the protection to withstand pitches in excess of 100 miles per hour, Chou said. More significantly, the new S100 is much slimmer than the one worn by Wright. Wright is not wearing the new S100. Neither is Bay.
"They're trying their best to protect us and allow us to go out there and do our thing while feeling comfortable," Wright said. "They're modifying it, so I would be more than willing to give it a try, but I feel comfortable with the helmet I have now. We'll stick with that for now."
Last year, the S100 was mandated in the minor leagues. The hope is that as those young players advance to the majors, they'll bring the more useful helmets with them. But even with the aggressive concussion rules enacted by MLB, players are not required to wear the newest generation of gear.
Besides Morneau, Chou guessed that there are "less than a handful" of big-leaguers who wear the S100. Most of those are doing so because they've already suffered a concussion.
"I liken it to the guys wearing the eye shields in hockey," Chou said. "The first guys wearing them were mostly for protecting some sort of injury. And then you get used to it and you start to wear it. Does it help prevent future injuries? Absolutely. But you don't really feel compelled to wear it until you feel like you're in danger."
Nowinski, who was a professional wrestler whose career was cut short by concussions, would like players to recognize that they are, in fact, in danger.
"Knowing what I know, if I were a player, I would move over to a safer helmet," he said.
There's still a social stigma about it, though. A perceived weakness, perhaps. But that appears to be changing, too.
Fellow Mets razzed Wright about his large helmet when he used it. This season, Morneau has to wear a batting helmet during all warm-ups and batting practices, but rather than ride him about it, his teammates have been more understanding.
Though it's easy for trainers and players to recognize serious concussions such as Morneau's, it's the ones that occur in more subtle ways and are not as debilitating that can be the most dangerous.
Veteran catcher Mike Matheny's career ended in early 2006 from the slow drip of foul balls hitting his mask. Yankees designated hitter Jorge Posada, a catcher until this season, said he can't count the number of minor, undiagnosed concussions he's had in his career.
"We know a lot more about what's going on," Posada said. "Before, you thought it was part of the game. You got a ringer or something like that and you felt like it was part of the game. You got a foul tip and obviously you're going to feel a little dizzy and you got back in there. Now we know that that dizziness or those stars that you see, that's part of the concussion."
Posada missed one game in September 2010 with what the team called concussion-like symptoms but insisted was not a concussion. This past week, Posada smiled at that naive suggestion. "It was a concussion," he said.
He's tried to educate himself in recent years, reading articles about Matheny, other players with concussions in baseball and other sports, and medical journals. That puts him ahead of most, who are just now learning the dangers of concussions through the MLB initiative and what other sports are doing.
Posada said he's concerned about the long-term effects that catching for 16 years in the majors will have on him.
"I'm thinking about my family first," he said. "I just hope that there's nothing there. They talk about ALS and all that stuff [stemming from concussions]. I hope that's not the case.
"It's serious stuff. I have two little kids, and that's who I think about."
Dust it off
It wasn't until the 1960s, about 100 years after the sport was born, that batting helmets started to become the norm.
Even the Iron Horse had his share of concussions.
"There are amazing stories of baseball players returning to play," Nowinski said. "Lou Gehrig had at least four concussions that were [reported] in the newspapers, including one where he was knocked unconscious for a minute at home plate by a beanball and then took first and played the game. It's certainly a significant brain injury and we know that continuing to play after suffering a concussion can lead to significant problems."
That dust-yourself-off mentality of Gehrig's time isn't so very ancient. Twins manager Ron Gardenhire, an infielder for the Mets in the early 1980s, recalled two instances when he was knocked unconscious in minor-league games.
"I was back playing by the next day," he said. "It wasn't really thought about. You had a concussion, you stepped right back in there. I'm sure many, many players have those same stories. They got beat up a little bit and jumped right back in there with really no knowledge of what you could do to yourself."
That knowledge has come out only recently. When Ryan Church of the Mets suffered his second concussion in 2008, concussion awareness was so limited that he flew with the team from Atlanta to Denver, with the long flight worsening his condition. Nevertheless, he pinch hit in two games against the Rockies.
"Anyone who played before the last two or three years was very likely to go back into a game with a concussion," Nowinski said. "The guidelines allowed for it."
Because of their dealings with Morneau last year, the Twins are one of the most concussion-aware teams in baseball. Even though they were fighting for a playoff berth, general manager Bill Smith and Gardenhire never pushed Morneau to return before he was asymptomatic.
"I think we saw as rough a situation as you're going to see with Justin," Gardenhire said. "Baseball is trying to protect guys more and more, and that's the right thing to do. Give yourself a little time here by putting them on that seven-day DL and all those things. It gives you a little time to evaluate and make sure you do the right thing for the player. That's an important step in baseball."
Morneau is in agreement: "They have policies in place now that take it out of the hands of the players and out of the hands of the manager and the coaching staff and it puts it in the people's hands who are qualified, the doctors' hands. I think that's a great step."
The unknown lurks
Morneau said he is feeling fine and that the headaches are behind him. He started out slowly, getting one hit in his first 10 at-bats and was hitting .217 going into yesterday's game against the A's.
Still, his concussion issue is not over. Perhaps it never will be. At 6-4, 235 pounds, Morneau appears to be indestructible. But the brain doesn't know about size and strength.
"It's not a shut case," said Gardenhire, who checks with the slugger daily for updates. "It's an ongoing thing."
Concussions continue to show up in the sport, from foul tips off catchers' masks to running into walls in the outfield to, like Morneau, breaking up a double play and taking a kick to the head.
Morneau has said there were times between last July's injury and his return last week when he wondered if he would be able to play baseball again. When the Twins opened the season April 1, he wore a T-shirt that read: "Play every game as if it's your last."
That's quite a change from the time of the collision, when he thought he'd shake it off and get back in the lineup.
"We said we were going to take a few days, take the All-Star break and see where we're at," Morneau said of the plan immediately after the injury. "It's one of those things where you never know. The most frustrating part of it is the unknown."
That also appears to be the part MLB is trying to conquer.