Concussion specialist talks about Roberts' rehab and return

Among the fans in attendance at last night's game at Camden Yards was a gentleman who's practically become part of Brian Roberts' family. No one else outside of it talks to him more - almost on a daily basis - or has a better understanding of what the Orioles' second baseman has gone through since he suffered his first concussion late in the 2010 season.

Dr. Michael Collins, director of the University of Pittsburgh Medical Center Sports Medicine Concussion Program, wouldn't have missed Roberts' return to the Orioles for anything in this world. He's a New England native and a huge Red Sox fan, but that allegiance was placed on hold.

"Last night was a special night," Collins, who goes by "Mickey," said this morning while driving back to Pittsburgh. "To see him play like he did, to see him perform at that level, he really stepped up. His command on the field and the leadership he brings, it's really something. I'm not an Orioles fan, but I'm pulling for them now a little bit. This could be a special time. A pennant race. What a thing to come back to."

Roberts in field tall.jpgAnd to think, the initial goal for Collins and Roberts was to make sure the second baseman could lead a normal life again. Baseball wasn't a consideration until later, once Roberts could stand up and walk around and perform daily tasks without the room spinning and his stomach flipping.

"Baseball was so far from reality," Collins said. "It was just about him getting through the day and feeling normal again. We didn't even talk about baseball for a while. But when it became clear that he was doing better, baseball became the focus, the goal.

"Last night meant a lot to me. I've dealt with a lot of athletes, and last night was one of most special moments for me as a clinician who deals with this stuff. He's genuinely a good human being and he worked so hard to get to this point. He wanted it so badly that at times I wondered if it was putting a lot of pressure on him.

"It's hard. If you feel stress and feel those issues, it can really delay your recovery, so him getting back to playing last night was very special."

Roberts didn't jump into spring training activities. It was more like sticking his toe in the water. And the thought of trying to play in real games was chilling.

"I remember him watching his first spring training game and he was like, 'I can't imagine getting out there. I can't imagine dealing with the speed and emotion,' " Collins recalled. "His type of concussion affects the brain's ability to integrate complex environments. Baseball, being around crowds and people and just all the motion that happens in that environment, the system of the brain that was affected was that system. We had to go through this so carefully and so systematically. Just getting him back in the locker room with the guys was part of his rehab. Getting him back on the field around a bunch of other people. He had to work out on his own, solitary on the field and in the weight room with no one else there. Just running on the treadmill.

"To go from there to seeing him slide back to first base last night, go first to third, all that activity we take for granted - that's what we had to rehab for, step one to step two to step three. And we did it very carefully, systematically. Now he goes out and doesn't feel any of it anymore. He's back to being a baseball player. He can handle any environment. Day game after night, travel, walking through an airport - we take it all for granted.

"It's such a long haul for someone who goes through his type of injury. It's not like he has a cast on his head. He looks fine. People see him and don't realize what he's going through. It's a really long journey for someone who goes through this."

At least he didn't go through it alone.

"I definitely was his emotional coach through this," Collins said. "We talked a lot. We joked about it last night. I said, 'Brian, I don't want to talk to you anymore, man.' We haven't spoken as much lately. He went on his rehab assignment and he felt better there than he had all along. He was feeling great and last night was no exception. The first thing I asked was, 'How do you feel?" And he said, 'Mick, I feel great.'

"It's still a process. I'll still monitor it carefully. I anticipate him doing very well, but I'll continually monitor him and make sure he gets breaks if he needs it. But he's doing great."

Roberts has come a long way since the Orioles' annual holiday party at Dave and Buster's at Arundel Mills Mall. Roberts showed up for the December event and looked nothing like a professional athlete. He was a shell of his former self, his facial expressions unable to mask his physical condition. Even worse, they advertised it.

"I remember the Dave and Buster's thing," Collins said. "I remember thinking to myself, 'We're not ready for that again.' I cancelled the FanFest thing. I'm the one. It was me saying, 'No, Brian, we have to do this the right way.' It was hard for someone like him to go through that, someone who cares so much about the community. He knows the perception of doing that. People don't understand that's exactly the environment that made him feel horrible for a couple days. It will set you back for days if you don't do it right. That was me saying, 'No, you can't do that stuff.' And it was a challenge because there's so much educating we have to do as clinicians and doctors with this type of injury for people to understand what concussions are all about.

"I deal with a lot of high school kids. Imagine being a kid going back to school like that. It's hard for anyone - an elite athlete or a fifth-grade kid trying to get through math class.

"I always felt like we could get back to baseball. I really did. But I'd be lying if I said there weren't trying moments and times when it was more difficult than we wanted. Moments when he certainly didn't feel like he was going to make it back. Times when his wife, who's a wonderful human being, felt the same way a little bit. But I knew what he had to go through and that he had to keep his foot on the pedal softly."

Roberts has stepped into a June pennant race, with the Orioles hovering around first place rather than looking up at four teams in their division. He's never finished above .500 since reaching the majors in 2001. No concussion could make him forget all the losses and heart-wrenching disappointments, the managerial changes and the same old results.

"He's a guy who deserves to win," Collins said. "He has tried so hard to get back to playing. And honestly, in a lot of similar cases like this, there isn't a 100 percent success rate in terms of getting back to play. The work he's gone through and had to endure ... when you go through this, you feel the same symptoms as you're progressing. You're going to feel things and at first it's completely disconcerting. You're dizzy and foggy and nauseous, and you feel tired and you have headaches. That's part of the process. You feel those symptoms. It takes a strong individual to endure and get back to doing what you love. That's what we had to do. I think that's lost on a lot of people.

"A player told me once it feels like going on a roller coaster and getting your (butt) kicked. That's what you feel like."

Roberts dished out the punishment last night, going 3-for-4 with an RBI, and he'll bat leadoff and play second base again tonight. Manager Buck Showalter has no immediate plans to alter the lineup.

"He's ready," Collins said. "I feel very confident about him. I think he's going to do well. I think we laid the foundation and he has a very good foundation right now. I expect him to progress and do well from this point forward. I feel very good where he's at and where he's going."

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