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CAROL LOLLIS

Bob Kuzmeski, left, the assistant athletic trainer at the University of Massachusetts, and Dr. Pierre Rouzier, the senior team physician, look over a patient’s x-rays in Rouzier’s office.

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CAROL LOLLIS

Dr. Pierre Rouzier, the senior team physician at the University of Massachusetts, in his office in Amherst.

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KEVIN GUTTING

UMass head coach Kevin Morris watches his defense in action against William & Mary.

AMHERST - The sports collisions that make Pierre Rouzier cringe used to make people laugh.

Big hits that left players wobbly on the football field were almost punch lines - as if the wide-eyed, dazed looks were the result of too many beers and not a potential brain injury. Slapstick humor drew laughs for decades from head injuries every time Curly or Larry took a frying pan in the forehead from Moe, or a falling anvil left Wile E. Coyote with an oversized lump while a trio of chirping birds circled his head.

Sports was not much different. While broadcasters discussed neck and back injuries in concerned whispers because of the risk of paralysis, head injuries were often another story.

It used to be that athletes were "knocked silly" or "had their bell rung." Big hits were featured in highlight packages. Now, they're part of warning videos.

A 1990s commercial for Snickers bars even lampooned a football player with a concussion. In the ad, the quarterback of a football team took a shot to the head. When he got up, he thought he was Batman. People watched and laughed.

But as study after study has shown the scary potential of long-term effects of head injuries, concussions are no longer a punch line.

"The education has changed," said Rouzier, one of two team doctors for University of Massachusetts athletes. "I don't think anyone thinks it's funny anymore to be Batman."

Lack of caution

UMass football coach Kevin Morris remembers that when he played at Williams College in the 1980s, and even early in his coaching career, an athlete who suffered a head injury would sometimes be allowed to return to the same game.

"It used to be that people would say 'you got your bell rung.' You'd feel better and go back in the game," Morris said. "Or you'd miss the rest of the game, but you'd be back in practice the next day. Now any shot to the head, we take very seriously. It's automatic that you have to go see the trainer. There's no cutting corners on that at all."

Toughness and the ability to play through pain is an honored trait, especially in contact sports. Players are praised for their ability to compete despite injuries to ankles, shoulders, knees or other parts of the body.

Convincing those same players to suspend that approach with a head injury is not easy.

"It's the same guy that plays after he hurts his arm, or tears his ACL and just puts a brace on it and plays. Those are the guys you love to have on your team," Morris said. "But you have to watch out and be careful with those guys and head injuries."

The recuperation time depends on symptoms and can vary wildly. Some players will miss just a few days of practice. While others, like former UMass softball player Jackie Teman, can miss significantly longer.

Teman, suffered two concussions between her senior year of high school and freshman year of college. Her symptoms persisted for three years.

Not always easy to diagnose

Rouzier said sometimes an athlete may mask the symptoms so it is not always easy to diagnose a concussion.

"I had a lacrosse player a couple years ago convince me he was fine," Rouzier recalled. "Afterward he came up to me with his dad and jovially said, 'Yeah, I'm sure I had a concussion in the second quarter. But I knew I could answer all the questions.'

"And his dad said, 'Yeah, he's always been like that,'" Rouzier recounted, making a pained face at the memory.

Because the severity of symptoms vary, it is difficult to know for certain if an athlete has suffered a concussion.

"Hockey players all hit their heads every game," Rouzier said. "They're tough guys and they don't complain. They think they're just a little sore and we don't hear about it after the game and the athletic trainer doesn't hear about it the next day.

"Then on Saturday they play a pretty lousy game," he added. "Afterward they say 'I don't really feel like myself. I wonder if I had a concussion?' That happens pretty commonly.

"We do a lot of education. Any time somebody takes a big hit you're always checking them and really making sure they're OK," Rouzier continued. "But if they don't complain or tell you, you don't know."

The increased emphasis on educating players and coaches has helped. Every UMass athlete, especially those in contact sports, is taught the dangers of head injuries.

"Our medical staff does an outstanding job of educating the coaches and the kids," said Morris, who attended a concussion seminar at the National Football Coaches Association Convention last year. "We've been educated, but it's still on the agenda at the convention yearly."

UMass hockey coach Don Cahoon agreed.

"There's a much greater awareness. The studies have all been presented not only to the coaches and to the people that are managing the teams, but to the players themselves," Cahoon said. "I think there's a better respect for the consequences of head injuries, although sometimes I think it gets lost in the heat of competition."

Cahoon has seen some of the consequences of brain injuries up close.

"I have a couple of personal friends that are really going through some pretty serious challenges because of head contact. One because of high school football and one from college hockey," Cahoon said. "They're suffering a little loss of memory, a little dementia. One of the guys is involved in a lot of the studies of concussions."

Both coaches said players using the proper techniques can go a long way toward preventing injuries.

"We talk about keeping everything off the head," Cahoon said. "Protect each other so we don't have the type of injuries that older generations are dealing with."

Morris said, "In blocking and tackling, you're always teaching technique and where the head placement should be. You can't lead with your head. That's paramount."

While many advances in equipment technology have been positive, some have unintended consequences.

"One of the problems in the NFL on down is that the equipment has gotten a lot lighter," Morris said. "You can run around a lot faster and deliver a bigger hit because of the speed. The impact is so much greater."

Rouzier praised the UMass coaches for respecting the medical staff's caution when it comes to head injuries and understanding that recuperation can take time.

"Every coach wants their best players playing. But our coaches have been great," said Rouzier, who added that many athletes have become allies as well. "It was harder 10 years ago. Kids are growing up knowing about concussions. Kids are growing up telling their peers you shouldn't tough it out. You should tell the doctor."

Matt Vautour can be reached at mvautour@gazettenet.com. Follow UMass coverage on Twitter at twitter.com/GazetteUMass. Get UMass coverage delivered in your Facebook news feed at http://www.facebook.com/GazetteUMassCoverage.