PITTSBURGH -- Ben Roethlisberger played one of the worst games of his NFL career one week after sustaining a concussion in 2006. He is days removed from his fourth concussion in four years, an uncommonly high number even for an NFL player.
Regardless, the Pittsburgh Steelers quarterback is going through "a normal week" of preparation for a pivotal game at Baltimore on Sunday night and has every intention of playing.
"It's part of the nature of the beast of playing this game. It's a violent, physical contact sport and there's a chance you're going to get hit," Roethlisberger said Thursday. "You guys don't talk about the bruises we have all over our body. If I showed you a bruise on my shoulder and a bruise on my shin, it wouldn't get talked about as much. It's a violent sport we play."
Roethlisberger, who is having his best season statistically despite the Steelers' erratic play, is evidence of that.
The two-time Super Bowl-winning quarterback's latest concussion occurred when his head accidentally struck the knee of Chiefs linebacker Derrick Johnson while he was being tackled during Pittsburgh's 27-24 overtime loss Sunday.
The play was subsequently wiped out by a holding call.
"It just kind of felt like I got hit pretty hard. Kind of said, 'Let me catch my breath real quick,' and by that time the trainers were out there, so I didn't get a chance to get up," Roethlisberger said.
The concussion was his second resulting from a hard hit in 12 months; he also was hurt during an unimportant end-of-season game against Cleveland on Dec. 28. A third concussion occurred in Atlanta in 2006, only four months after a motorcycle crash in which he wasn't wearing a helmet left him with a concussion and numerous other injuries.
There is evidence of a cumulative effect on players who receive multiple concussions. In 2005, Kevin Guskiewicz of the University of North Carolina published a study of retired pro football players that determined players who had three or more concussions had a heightened risk of mild cognitive impairment after age 50.
Despite that, the NFL's most-sacked quarterback since 2004 isn't concerned about returning so soon because Steelers players must pass post-concussion tests before they can play again. The tests, developed by doctors and researchers based in the same sports medicine complex where the Steelers train, measure a player's memory, reaction and attention span before and after a concussion.
"I'm not worried because we have the best doctors," Roethlisberger said after going through his second full practice of the week. "If I can go out and pass thousands of these tests and show that I'm fine, then I'm not worried about it."
Both of last season's Super Bowl quarterbacks plan to play a week after getting concussions -- Kurt Warner of Arizona does, too. Only this week, NFL commissioner Roger Goodell informed teams he is examining potential rule changes to reduce head impacts.
The league also plans to urge players to wear the most technologically advanced helmets, something Roethlisberger has balked at doing in the past.
The last time Roethlisberger played so soon after getting a concussion, he threw four interceptions -- two returned for touchdowns -- during a 20-13 loss to Oakland in 2006. He appeared to anticipate sacks several times, ducking before pass rushers arrived. Former coach Bill Cowher blamed the interceptions on poor judgment, not the concussion or any hesitancy.
With the Steelers (6-4) a game behind the Bengals (7-3) in the AFC North but effectively trailing by two games with six to play because of the tiebreaker, Roethlisberger no doubt feels an urgency to play Sunday. It's also an important game for the Ravens (5-5), who might be playing for their season.
Roethlisberger probably could have picked an easier week to return, given that the Steelers-Ravens rivalry is one the NFL's most physical. Last season, the Steelers lost running back Rashard Mendenhall and guard Kendall Simmons to season-ending injuries in the first of their three games against Baltimore.
"This has been a rivalry that's been heated and well-coached, well-played since I've been here, so it's going to be no different on Sunday," said Roethlisberger, who ranks fourth with 2,867 yards passing and third with a 68.9 completion percentage.
Roethlisberger also is third with 29 sacks, and his 221 sacks since 2004 easily lead all players. Except for the Rams' Marc Bulger (205 sacks), no other quarterback is within 47 sacks.
That's a lot of cumulative wear and tear on any player, even one as relatively young as the 27-year-old Roethlisberger. Not surprisingly, the Steelers anticipate Baltimore bringing considerable pressure, despite the fact the Ravens rank only 17th with 21 sacks.
"It's the same old Baltimore, it's the same story. Everybody wants to hit the quarterback," left tackle Max Starks said. "It's our job to keep him as clean as possible and have time to make throws."