A dozen or so years ago, Dr. Cathy O'Connor, who used to help out as an athletic trainer at Amherst College, attended a conference on concussions.
One of the speakers was an NFL guru who advised the league on such matters.
"[He] sat there and denied all of the research," said O'Connor, now a general surgeon in Maine. "They had an excuse for everything. We all sat there looking at each other going, ‘Yeah, this is the problem.' "
That problem has only gotten worse.
There now are about 120 concussion lawsuits against the NFL involving approximately 3,000 former players, according to nflconcussionlitigation .com, a website that tracks such cases.
In college football, 34 percent of players have suffered one concussion during their playing days, and 20 percent have suffered multiple ones, according to the University of Pittsburgh's Brain Trauma Research Center.
O'Connor was a local pioneer in concussion prevention, helping to bring ImPACT testing -- which provides a baseline of brain activity for athletes -- to Amherst in 1997. Almost a decade later, Dr. Ellen Deibert, a concussion expert based in Pittsfield, brought the same program to Berkshire County's high schools.
Colleges such as Amherst and Williams have an advantage over high schools because the colleges have a full-time medical staff, including trainers who can diagnose concussions faster than any coach and take proper precautions.
But there still are steps colleges can take on the football field to prevent traumatic brain injuries.
Williams coach Aaron Kelton said he leaves it up to the medical staff to recognize concussions and treat them. But the Ephs are doing everything they can to limit the risk of dangerous hits to the head, from reducing the number of contact drills to teaching the proper tackling techniques.
"We only have probably two days of real contact out of our six-day week," Kelton said, adding that "practices have changed quite a bit."
"I remember when I first started coaching [in 1992], we used to take guys down to the ground all the time. We no longer do that," he said.
Amherst coach E.J. Mills takes it a step further. He said his team rarely goes "live" in practice. The Lord Jeffs also have eliminated drills that encourage contact, such as the "Oklahoma," where two players run at each other full speed.
Most importantly, Mills encourages his players to be open about head injuries and to tell trainers when they don't feel right.
"I think you have to create an environment where kids will be honest," Mills said. "I think back in the day, everybody used to say you got your bell rung. We'd come off the field and they wouldn't tell the coach you got your bell rung in fear of, ‘Oh, he's going to think less of me or this or that.' "
It's something Kelton can relate to. He said he remembers playing in the late 1980s, when players would come out of a game for just a few minutes and then go right back in.
That attitude is dangerous today.
Darren Hartwell, a senior wide receiver at Williams, said he's had trainers check to see he's OK, even if he's just had the wind knocked out of him. The Ephs have been doing ImPACT testing since 2009.
"I think we do a pretty good job of making sure nothing gets too serious," he said.
That kind of caution on behalf of players, coaches and trainers is important.
When O'Connor was at Amherst, she encouraged athletes in every sport to report when they noticed a teammate looking shaken or just not right. She said when she initiated ImPACT at Amherst, she faced some parents and players who didn't understand concussions. She occasionally still deals with people in Maine who think they're no big deal.
"The problem we still have is parents are still functioning under, ‘When I was a kid, I'm sure I had a concussion. I was fine,' " O'Connor said. " ‘Did you really? Maybe you don't remember parts of it.' "