The latest advancement in concussion prevention is considered “genius” and could one day be just another piece of equipment, akin to wearing a helmet or a cup – and that’s according to a concussion expert who didn’t have anything to do with its creation.
For now, it’s known simply as “the collar,” and it is in development by Performance Sports Group, the parent company of Bauer Hockey. The collar aims to provide a solution to what’s known as “slosh theory.”
Essentially, when a blow to the head occurs, the brain moves around inside the skull because of the extra space, occupied by blood and brain fluid. Helmets cannot prevent the brain from sloshing around inside the cranium, but, according to its creators, the collar can. Blood flows out of the brain through the jugular vein, which creates that space inside the skull. The collar gently presses on the vein on each side and slows the outflow of the blood, just enough to stop the brain from shaking.
Dr. Neilank Jha, a neurosurgeon and chairman of KONKUSSION, a Toronto-based concussion management program, was not involved with the development of the collar but is a believer and vocal supporter of its claims.
“If you ask me from a conceptual point of view, it’s genius what they’ve done,” Dr. Jha said. “There’s not going to be any magic bullet in the field of concussions. This collar’s not going to prevent every single concussion from occurring. But even if this collar can prevent a significant number of concussions, as a parent myself I would say, ‘Wow, I’d rather have my son wearing the collar than not wearing the collar.’ ”
Further testing needs to be done, and the product needs approval from Health Canada and the U.S. Food and Drug Administration, but PSG said early returns are promising.
“Historically, the management of this injury has been through helmets and reducing the transfer of energy from the outside of the athlete to the head. The challenge with that has always been the brain moves inside your cranium. And that is a causation for mild-traumatic-brain injury,” said Kevin Davis, the CEO of PSG. “If the product can support the claims…our belief is that all athletes should be able to take advantage of this.”
The breakthrough for the collar came thanks to data and research about concussions in athletes who play at high altitudes. Playing at high altitudes can reduce that same space in the skull, and studies have shown a 30-percent reduction in concussions at those altitudes. The collar can actually replicate what happens at high altitudes in the brain.
“Even more research needs to be done, but it’s a step in the right direction,” Dr. Jha said. “And the preliminary data we’re seeing is very positive.”
Dr. Jha suggests a simple next step would be to take 1,000 athletes – 500 with the collar, 500 without – and document if there are fewer incidents of concussion in people with the collar.
“If the number of concussions goes down, I think overnight every parent is going to come knocking asking if they can have one,” he said. “It’s so challenging because of the hysteria around concussions, but if there was a simple solution that could help the situation I think parents would be very much into that. It will become like a helmet, another adjunct piece of equipment that is safe. You wear shoulder pads to product your shoulders, you wear the collar to protect your brain.”
There are also advancements being made in concussion diagnostics. One of the biggest obstacles in treating and recovering from concussions is the uncertainty about the injury. The severity of a concussion and decision of when to return to play are, for the most part, subjective and often left to the individual. That could soon be a thing of the past thanks to the Abbott Concussion Test. The test requires drawing a few drops of blood and running them through an already-available, portable blood-scanning system. Within about 15 minutes the test can tell you if there are proteins in the blood that are not normally found at that level. That would serve as a warning that further evaluation is needed.
“You cannot treat what you don’t know,” said Dr. Beth McQuiston, a board-certified neurologist and medical director at Abbott Diagnostics. “It’s critical to diagnose a concussion early so that people can get put on the right path to treatment and recovery. In order to do that, a really excellent way would be to have objective measurements. “There are blood tests for all different organs in the body – blood tests for the heart, blood tests for the pancreas, blood tests for the liver. As a neurologist, I say it’s about time we have blood tests for the brain.”
While professional sports leagues like the NHL turn to “concussion spotters” and independent doctors to administer traditional concussion tests, the team at Abbott aspires to have their system ready for use on the sidelines to offer more definitive results. The test is still in active development.
“The brain is tricky – the symptoms (of a concussion) can be mistaken for things like dehydration, a bad night’s sleep or a common headache,” Dr. McQuiston said. “It’s really difficult for folks trying to diagnose concussions because there is a lack of objective measurements. This would be another tool that you could use to help make an informed decision.”