The most promising research into concussion prevention is inspired by human yawns, woodpecker tongues and mountain-dwelling rams. The manifestation of this work is the novel Q-Collar, a device worn around the neck that works by enhancing the brain’s own physiology by lightly compressing the jugular to increase blood volume in the skull. That may help prevent the brain from moving around within the skull and thus could reduce traumatic brain injuries.
Though the technology remains under FDA review, clinical human trials are underway in the United States, and Canada recently approved commercial sales as a medical device. The Q-Collar has been licensed to sporting goods giant Bauer, which is marketing the protective gear as the NeuroShield.
Pro athletes in various leagues are recognizing its potential. Carolina Panthers linebacker Luke Kuechly is wearing one this season, and NASCAR driver Brad Keselowski recently told SportTechie that he would like to get fitted for one to wear while racing his No. 2 Ford Fusion.
“If Q-Collar does what the company believes it can do,” Keselowski said, “it will change the face of sports dramatically.”
Its genesis comes from an unlikely place: a wound care talk at an Army research lab. Dr. David Smith, an internist who owned a wound care company, gave a presentation at the Aberdeen Proving Ground that impressed an audience member, who suggested that clever minds needed to collaborate on solving the scourge of traumatic brain injury. Someone else in the room then quipped, “Gee, if somebody could just figure out how a woodpecker can smack his head against a tree and fly away without a headache, wouldn’t we have this whole problem solved?”
While most of the room laughed, Smith recalled, he was struck by the puzzle and got to work. Woodpeckers can withstand 80 million lifetime impacts at 1,200 g-force, yet 100 g’s of impact on humans typically result in a concussive force. Head-ramming sheep, meanwhile, can tolerate 500 g’s.
“Nature’s already figured this out,” Smith said. “These creatures of the forest are suffering massive blows, and yet not seemingly being phased from it.”
Engaging in the field of biomimicry, Smith studied those animals for clues. A woodpecker’s tongue attaches at the top of its beak, goes upward over each eyeball between the scalp and skull, back behind both ears before re-attaching in front as part of the vascular tree. The tongue is an omohyoid apparatus attached to the jugular, essentially meaning it depresses the vein for each woodpecker’s head blow. (Smith suggested googling for an image. “You’ll be rather stunned when you see what the anatomy of this crazy tongue is,” he said.)
“Every single animal that has a spine has an omohyoid muscle, and are you ready for this? No one knew why it was there,” he said. “No one had a clue, all these decades upon decades, and now we think we do know. When that muscle actually activates, it literally pulls straight back and collapses your jugular.
“This happens each and every time you yawn. So if you fear this technology, I would encourage you to never yawn again.”
The same mechanism is activated when a human sucks water through a straw or turns his or head to the side. The key was timing so that this could be used in protection. “It’s part of the normal physiology, but it’s not for sure that you’re going to have your jugular collapse when you go ramming your head into another player or a tree or whatever,” Smith said.
Smith then considered head-ramming sheep, who live up in the mountains, and explored the mechanics of altitude physiology. When there’s less oxygen, the body compensates by sending more blood flow to the brain. “It’s a very small amount,” he said, “but it doesn’t take much.” Incidents of concussion are lower at high altitude.
While recognizing that jugular compression is outside-the-box and a somewhat bizarre concept, Smith emphasized that the overall effect is minor and natural. He added that when a person is upright, 95 percent of his or her blood volume goes through the vertebral veins anyway. The Q-Collar technology helps create a detour for the remaining blood to redirect from the jugular to those vertebrals.
“All we’re doing is diverting that last five just so that we put a little back tension, and it just causes the veins to dilate slightly,” Smith said. “When thousands of them dilate just ever so slightly, everything locks in place. We didn’t create this physiology. Nature did. I’m just letting humans go and use the same thing all these other animals do all day long.”
Smith assembled a team with impressive C.V.’s, including co-inventor Dr. Joe Fisher, a Toronto anesthesiologist; Greg Myer, the Ph.D. sports medicine research director at Cincinnati Children’s Hospital Medical Center; and medical advisor Dr. Julian Bailes, a neurosurgeon portrayed in the movie “Concussion.”
They have conducted more than 30 studies and published as much of the research that journals have been willing to accept. Among the landmark articles evaluating its efficacy on high school hockey and football players have appeared in Frontiers in Neurology and the British Journal of Sports Medicine. A prior study noted a precipitous decline in traumatic brain injury in animal studies, reporting that the use of the Q-Collar “demonstrated an 83% reduction in amyloid precursor protein-positive axons — a widely accepted biomarker of TBI — during a 900 g impact protocol studied in animals.” The BJSM study indicated positive results in mitigating brain microstructure changes, noting that “the wearing of the device was effective to prevent diffusion changes after a full season of repetitive head impacts in high school football athletes.”
As far as personal endorsements go, both Smith and Fisher are avid cyclists who wear the Q-Collar while riding. Smith’s son wore it for two years of high school football. While contact sports such as football and hockey garner most of the attention, Smith also is exploring the technology’s application to non-sports groups such as the military.
Said Smith, “We’ve got to find a way to help people realize that there’s an answer coming and, in Canada, there’s an answer hopefully here.”