Randy and the boys are watching a Broncos game when one of the players gets hit really hard, his concussion in the past and hit he's just taken are taking their toll. The NFL commissioner is asked what they are doing about the concussion problem, and as a good commissioner says nothing relevant to the question asked of him. Some classic NFL players come out on the field showing obvious signs they were concussed throughout their careers. The game is about to resume and Randy tells the boys the kickoff is the most important that they should remember when they have their next football practice. Stan tells his dad that they aren't allowed to kickoff anymore as the school says it the most dangerous play. This sets Randy off and he goes to the PTA meeting and voices his concern about the kids football program. He begins making sarcastic suggestions on changes they could invoke to make the game safer: players will wear bras, tinfoil hats and the ball is replaced with a balloon and all the players hug. A sport where safety is the number one concern; he even suggests calling it "Sarcastaball." The PTA take his suggestions seriously and he is asked if he'd like to coach the school's Sarcastaball team. He sarcastically says yes and soon he finds himself coaching the boys in this new sport. The news covers Randy's sarcastic attempt to get Sarcastaball made a new sport nationwide and because everyone is missing Randy's point he is sent to Washington to speak before Congress. Meanwhile, back in South Park the boys are finding themselves frustrated with trying to know all the rules. Only Butters seems to be able to grasp onto the Sarcastaball idea and he fires up the team for the big game. The NFL commissioner even gets on board with Sarcastaball and makes Randy the head coach of Denver's team. With Randy unavailable to be their coach the boys settle on Butters as their new coach. Butters fantasizes about what his new responsibilities will bring him and his dreams end with some creamy goo coming out.
In Denver a Sarcastaball game's score is determined by the replacement officials and Randy's team has a winning record. Worried about next week's game, he wants the players to come back the next day for practice. Back in South Park Cartman comes to Butters' home for some advice as he knows he can't be nice enough to be a good Sarcastaball player. Butters enlightens him on the creamy filling that is inside all of them, he even show's Cartman the collection of goo he's been collection in case in the future he finds himself with that feeling anymore. Cartman wonders is the goo will work on someone else and he tries some. Sports commentator Jim Rome talks Sarcastaball with Randy. Afterwards, Sharon realizes that Randy can no longer speak without be sarcastic and he asks for her help in saving him. Meanwhile the boys feel they are losing their Sarcastaball game and ask Butters for some of his goo to help them though it. Randy is getting his brain scanned, and his brain is filled with sarcasm. In a sarcastic dialog exchange Randy comes to realize that Sarcastaball might be affecting the brain.
Jim Rome does an ad for Butters' Creamy Goo, the sports drink that gives you an extra boost. The boys are in the midst of playing their Sarcastaball game, when Randy and Sharon drive onto the field. Randy tells Stan that he's taking him out of the game, he then goes over to the parents in the stands and really tries hard to unsarcastically tell them about the dangers of Sarcastaball. The boys instead tell Randy that they actually enjoy playing this non-violent sport. They suggest that Randy try some of Butters' Creamy Goo, which he does and Randy identifies it for what it really is, cum. As a result, Butters' gets grounded even though he doesn't know what sarcasm or cum is. He dad says he tell him when he's older. Jim Rome follows up with some final thoughts on it all.