Corey Koskie's clear head

FORT MYERS, Fla. – Corey Koskie hadn't cried, he said, since his wife suffered a miscarriage years earlier.

But months after an innocent-looking tumble backward on a baseball diamond turned into a free fall of pain and confusion brought on by postconcussion syndrome, Koskie found the tears coming without warning. The world as he had known it, as a big league ballplayer who played hard and laughed harder, like the time he filled David Ortiz's underwear with peanut butter, was coming apart, with no safety net in sight.

"My head hurt, my body was numb, I couldn't walk through a door, I couldn't go in the sun, I couldn't enjoy time with my kids, my stress level was through the roof, everybody was telling me I'm fine and I wasn't,'' Koskie said.

"It was like a hopeless injury. I felt so much pressure. I wanted to play so bad.''

It's easier to talk about now that he is back on a field at the Minnesota Twins' complex, preparing to play catch with Joe Mauer, the Twins' All-Star catcher. It has been over 2½ years since Koskie last played in a baseball game, only two months since he felt good enough to start throwing and hitting and running again. The progress has been encouraging – this past weekend, he heard from Ernie Whitt, the manager of Team Canada in the World Baseball Classic, that he would be added to Canada's 28-man roster.

For Koskie, who grew up in Anola, Manitoba (population: 196) and played third base in the big leagues for nine seasons, the first seven with the Twins, this was a big step toward reclaiming his old identity. But Koskie, who turns 36 this summer and has been without a team since the Milwaukee Brewers bought him out of his contract at the end of the 2007 season, isn't prepared to predict what the next step will be.

"We'll see how the WBC goes,'' he said.”If I want to play, we'll see how it goes.''

What happened to Koskie is a reminder of how little is still known about concussions and their aftermath, especially in baseball, where postconcussion syndrome remains uncommon relative to high-collision sports like football and hockey.

"I had one doctor who treated postconcussion syndrome,'' Koskie said, "who told me that if he ever wrote a book, he would title it, 'If I Only Had a Cast.' Another type of injury and a player is in a cast, everybody says, 'Well, he's hurt.'

"But if I would go to the ballpark and joke around with the guys a little bit, they'd say, 'What's wrong with this guy, he should be playing.' ''

Not until he found a physical therapist named John Groves doing cutting edge work with whiplash victims in the fall of 2008 did Koskie begin to improve. Groves focused less on what had happened to Koskie's head than to his neck.

"Not every whiplash patient has sensory motor problems, but we're finding that a subset does,'' said Groves, who manipulated the cervical joints and muscles at the base of Koskie's skull.

The nausea, the dizziness, the disorientation that had been present since a fateful game July 5, 2006, went away. "It was amazing,'' Koskie said.

The problems began when Koskie sprinted into the outfield from his position at third base to chase a looping fly off the bat of Felipe Lopez of the Cincinnati Reds that July day. At the last moment, he reached back awkwardly for the ball and lost his balance. The ball popped out of his glove, and into that of Brewers shortstop Bill Hall. Koskie fell on his back. His head bounced on the turf, not noticeably hard, but the impact caused his neck to whiplash, the way it might have if he'd been in a car accident.

That night, the play made all the highlight reels. Koskie remained in the game and batted one more time. Brewers manager Ned Yost, saying Koskie complained of dizziness and a little nausea, took him out of the game two innings later. No one seemed too concerned; the injury was described as a slight concussion.

Except the nausea and the dizziness didn't go away. The Brewers ran Koskie through a battery of exertion tests, during which they asked him to remember three words: elephant, table, apples. Koskie remembered only one. And the next morning, when he awakened, he said his head was killing him. The Brewers placed him on the 15-day disabled list, saying he had postconcussive syndrome.

Koskie had played ice hockey growing up in Manitoba and was a good enough goalie, some said, that he could have played professionally. He also excelled in volleyball, winning MVP honors at the Canadian nationals. He said he'd had a concussion or two in the past, but nothing that he deemed serious. The day before his fall, he'd collided with teammate David Bush while rushing out of the dugout after retrieving another bat, and while he felt dizzy, he hit a home run and joked about it afterward.

Now, however, he not only was unable to play baseball, but life's daily routines were leaving him wrung out.

Koskie's knuckles were bloodied and bruised, because when he went to pick up a fork, he'd bang his hand against the side of the table. He'd walk into a Target and have to lean on a shopping cart for support, because he felt like he was about to fall. Driving unnerved him. Crowds left him disoriented. When he played with his three young sons, he'd have to stop and lie in a room, with the lights out, because the room was spinning.

"Six months after I got hurt,'' he said, "I'm feeling better but I know I'm not good yet. I'm playing catch with my oldest, who is standing 40 feet away, I go to catch the ball, and bam, it hits behind me. The doctors say, 'Corey, you haven't played catch for months, you're a little rusty.'

"I said, 'Are you kidding me? I can catch a seven-year old from 40 feet.'

"You try to explain, but the more you try to explain, the more they look at you like you're crazy.''

The Brewers sent Koskie to some of the country's foremost concussion experts, including Dr. Michael Collins, a neuropsychologist in Pittsburgh who had designed tests that measure damage done to the brain by concussions, and how a patient is recovering from postconcussion syndrome. "Those tests showed I was in the one-half percentile,'' Koskie said, "meaning that 99.5 percent of the people tested had better results than me.''

Koskie said that repeated tests showed him getting better, but his progress was confoundingly slow. He talked with hockey players who had had concussions; he spoke with Giants catcher Mike Matheny, who was forced into retirement by postconcussion syndrome.

Koskie reported to spring training in 2007, but while working out on the stationary bike, he was unable to maintain his heart rate at a certain level without becoming nauseous.

"I tried to minimize the symptoms,'' he said, "because everybody told me I was fine, but I didn't feel fine.''

The Brewers sent Koskie to another neurologist in Arizona. It was a hot day, Koskie said he had trouble finding the office and arrived late, so he was sweating and out of breath. He said he rushed to tell the doctor everything that had happened to him in the previous months.

"He said, 'I've got to stop you right there. See that book over there. Go take out that book.' The book was dog-eared at one page, which was about psychosomatic anxiety disorder. He goes, 'You walk in here, your palms are sweaty, you're speaking fast, you're sighing a lot, you're having this random numbness.'''

That doctor concluded, Koskie said, that he had "exercise-induced anxiety.'' The Brewers sent him to a psychologist. Koskie asked to be allowed to go home, to Minnesota, where he'd begun his big-league career with the Twins. The Brewers let him go.

"I can't say that I wasn't anxious at that time,'' he said. "I was anxious. I wanted to be able to play major league baseball.''

Back home, Koskie followed a program of physical therapy for a year, and didn't experience a breakthrough until seeing another concussion specialist, Dr. Robert Cantu, in Boston. Cantu referred him to Dan Dyrek, a physical therapist whose most notable patient was basketball great Larry Bird. Dyrek in turn steered Koskie to Groves, a physical therapist in St. Paul, Minn., who holds a doctorate degree from Regis University in Denver.

Groves' work with whiplash victims and the ocular-motor disturbances that can result from weakened neck muscles and joint restrictions gave him insight into Koskie's condition. Treatment began on the cervical muscles and joints at the base of his skull.

Within weeks, Koskie was working out with the University of Minnesota baseball team. A couple of weeks ago, Groves said, in a conference call with some of the doctors who had treated Koskie, the player was given the green light to play baseball again.

"I've been symptom-free for two months,'' Koskie said. "If I wasn't, I wouldn't be out here.''

As part of the physicals administered to players, Major League Baseball last season began including baseline testing for concussions.

Koskie said he has not yet spoken with any big-league clubs about a possible comeback.

"I'm taking it one step at a time,'' he said. "But you know what? To be able to walk away from the game on my terms, versus what happened to me, is a big thing for me.''