BLUF (Bottom Line Up Front): Concussion is an internal problem, not external.
Annual speaking, Sports Related Concussion, or SRC, occurrence rated are approaching endemic levels. With an estimated range of 1.6-3.8 million per year (Broglio et al, 2014) occurring in sport and 300,000 annual visits to the Emergency Department according to the CDC (1997), many researchers and clinicians have started looking at various preventative measures. Let me assure you there are some pretty wild concepts of Concussion Prevention being discussed and not all is legitimately supported by valid, unbiased, and peer-reviewed research.
The first approach most people think about addresses that often a concussion occurs from a blunt force trauma to the head (though there are other mechanisms of injury for concussion this is the most commonly known). Along this lines of thinking many of the concussion prevention products addressed are typically based on padding the head. An example is an air bag system developed for cyclists that deploys when a fall is sensed by the system.
Another external fix for the concussion endemic is the Full 90 Soccer Headgear. The link leads to YouTube where there is a video of an NBC News on the Full 90 headgear for Soccer. The designer posed the idea and claims that it will decrease concussions by something like 50%… Dr. Cantu (we will cal him the man when it comes to Concussion research), tears the product to pieces. Aside from Dr. Cantu’s expert opinion, just listen to the video and it is ripe with inconsistency on the product preventing concussion. The video highlights Natasha Helmick, a women’s soccer player that played on the Olympic Development Team before being forced to quit the sport from a high frequency of concussions (5 after starting to wear the Full 90). Worse off… she had to drop out of college due to the long-term effects of her extensive concussion history.
But, why doesn’t this idea of throwing on padding to the head stop or decrease concussions? As I mentioned in the BLUF, concussion are an internal problem, they are caused when the brain either rotates and causes axonal torsion or from a coup-contra coup impact against the inside of the skull. The brain is not snuggly fit in the skull, there is room to move.
But, if external padding doesn’t work… then what will? Well, I mentioned in the BLUF once again that concussions are an internal problem. While we cannot go in and screw down the brain we can work externally to address the internal problem. In-fact, Q30 Technology, has developed just such a promising product, the Q-Collar. According to Myer et al (2016), the inspiration for this product came with the realization that there are less concussions occurring at higher altitudes.
“We postulated that acclimatisation to altitude may have influenced an
increased intracranial blood volume, resulting in a tighter fit of the brain within the cranium. The proposed physiological response to decreased relative ambient oxygen (thus increasing intracranial flow and volume) was speculated to have protected the athletes at higher elevations against sports-related TBI. “
The product mimics these natural outcomes by placing pressure over the jugular vein, not the artery, thereby increasing the density and viscosity of the fluids protecting the brain. The effects are less sloshing of the brain back-and-forth during impacts. This is an awesome idea when looking at the levels of G-forces experienced in sport during impacts. According to Broglio et al (2011), over an 8 year period of 4 years of starting high school football and 4 years starting college football, a player is expected to have over 8,000 head impacts, with a mean g-force of 20.9g-22.25g and a cumulative of 183,834g assaulting the brain. That’s a LOT of Gs!!!
The Q-Collar address this concern, and the research by Myer et al (2016) stated that thy found promising outcomes in animal models:
“This approach 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.”
When conducted on human models, the study found positive outcomes to decreasing these cumulative loads being placed on the brain. After an intervention of the Q-Collar being placed on 32 athlete for a season of game play, they found that the intervention group of 32 (Q-Collar Football Players), had significantly less brain diffusivity (a marker of brain injury) than the control group (30 Football Players without Q-Collar), this was found to be rather accurate with statistical measurements. They concluded that the Q-Collar may help decrease potential for injury to the brain!
Right now, you cannot get your athlete or self a Q-Collar, they are still in the research phase and have not moved to mass sales and distributions, but go check out their pages to stay abreast in their outcomes: Facebook , LinkedIn, and Website.
Here is a key take-away though, concussion cannot be prevented! What we can work on is reduction of occurrence of the injury through proper concussion education, form training, rule enforcement, rule change to protect the athletes, training on peripheral vision, and items such as the Q-Collar. Internal interventions to internal problems!
By: Jeremy D. Howard, MS, LAT, ATC, CSCS, CES, PES, ITAT
Broglio, S.P, Cantu, R.C., Gioia, G.A., Guskiewicz, K.M., Kutcher, J., Palm, M., & Valovich McLeod, T.C. (2014). National athletic trainers’ association position statement: Management of sport concussion. Journal of Athletic Training, 49(2), 245-265.
Broglio, S.P., Eckner, J.T., Martini, D., Sosnoff, J.J., Kutcher, J.S., & Randolph, C. (2011). Cumulative head impact burden in high school football. Journal of Neurotrauma, 28(10), 2069-2078.
Kelly, J. (1997). Sports-related recurrent brain injuries — United States. CDC Morbidity and Mortality Weekly Report, 46(10), 224-227. Accessed from https://www.cdc.gov/mmwr/preview/mmwrhtml/00046702.htm
Myer, G.D., Yuan, W., Foss, K. D. B., Thomas, S., Smith, D., Leach, J., Kiefer, A.W., Chris, …, & Altaye, M. (2016). Analysis of head impact exposure and brain microstructure response in a season-long application of a jugular vein compression collar: a prospective, neuroimaging investigation in American football. British Journal of Sports Medicine, 0, 1-11.