The defending Super Bowl champions were against the ropes after a shocking overtime loss to Todd Haley's Kansas City Chiefs.
It was their second loss in a row after a five-game winning streak. The Chiefs would win their first game at home in 11 tries, as eventually, both the Steelers and the Chiefs became two teams to qualify for the playoffs the previous season, but miss that year.
Big kickoff returns and yet another interception return kept the Chiefs in a game they didn't appear to have any business winning. To make matters worse, quarterback Ben Roethlisberger was kicked in the head as he was sacked in overtime, sustaining a concussion.
The Chiefs got a 61-yard reception from Chris Chambers to set up a Ryan Succop chip shot game-winning field goal.
Charlie Batch relieved Roethlisberger, and got hurt himself, meaning the defending champs were set to take on their rivals, the Baltimore Ravens, the following week with the possibility of giving Dennis Dixon his first career start.
A UPMC-sponsored conference Saturday in Pittsburgh highlighted the decisions made in regards to Roethlisberger, and it had nothing to do with the Steelers record at that point in the 2009 season.
The conference was open to the media, but much of the information provided there was to be held off the record - including specific testimony from Steelers fullback Will Johnson and left guard Ramon Foster - except for accounts from trainer John Norwig in regards to the concussion Roethlisberger suffered against Kansas City.
According to Norwig (and transcribed by Tribune-Review reporter Alan Robinson), "I had to go to the head coach (Mike Tomlin) and say, ‘Hey, look he's symptomatic. He can't play."
Roethlisberger would eventually change his tune Saturday before the game. He said he ran up and down the halls of their hotel, telling Norwig he felt good, and he could play. Norwig passed that information onto team neurologist Dr. Joseph Maroon, who nixed the notion of Roethlisberger playing because of a team rule that states a player who is symptomatic 24 hours before the game will not play.
Steelers president Art Rooney II agreed, and Dixon would make his first career start. The Steelers lost 20-17 in overtime, the third of what would be a five-game losing streak that would keep them out of the playoffs.
Former Steelers wide receiver Hines Ward would criticize Roethlisberger that week, suggesting a concussion is something everyone plays through. He would back off those comments later, saying how tough Roethlisberger is but noting it was the right decision.
That correct decision, Ward would admit later, according to Norwig, was also made when Ward took a hit to the helmet in a 2010 loss to New England. Ward wasn't allowed back on the field, snapping his 186 game streak of catching a pass. Ward was blanked in the loss, but Norwig said Ward told him a few days later, holding him out was the right thing to do.
Powerful statements from all involved. If anything, it paints a picture of a team that has been accused in the past of sending players back onto the field when they were knowingly symptomatic. Roethlisberger not playing in that game against Baltimore may have been the difference between winning and losing, or maybe it wasn't. Dixon player well, considering the circumstances, and his 24-yard naked booleg scored a huge touchdown in the fourth quarter. His lone interception set up the game-winning field goal in overtime, but not a bad performance overall for a third-string quarterback making his first career start in primetime on the road.