What is a concussion?
Inside the Carolina Panthers locker room on Thursday, amid the clutter of bags being packed and prepped for the team’s first road trip of the 2017 season, an instructional poster lay on top of a rolling cart.
It had Luke Kuechly on it as an example of how to dress for the game; the literal “poster child” of the proper equipment players can wear.
The irony is that Kuechly will actually be wearing a piece of equipment Sunday against the San Francisco 49ers that is still largely foreign to the NFL.
You’ll have to squint to see it. Kuechly has worn the thin band that circles around the back of his neck, with two open ends that press slightly against either side of his jugular vein, throughout the preseason to little notice.
It’s only slightly visible in the small gap between his shoulder pads and the bottom of his helmet.
Kuechly, the first NFL player to wear this device, said repeatedly he can’t discuss it other than to confirm he has been wearing the experimental collar and will continue to do so. In fact, he hides it in his helmet when coming off the field to speak with media.
But Kuechly did tell the Observer that he hopes the device works for him.
Because it just might save his brain.
The Q Collar
The device Kuechly is wearing is called a Q Collar.
Co-invented by Dr. David Smith a little over five years ago and developed by Connecticut-based sports science company Q-30 Innovations, the Q Collar’s inspiration was drawn from the physiology of a woodpecker, which beats its head against a tree trunk several thousand times per day but does not suffer brain damage. This is because, among other advantages, a woodpecker’s tongue can put pressure on its jugular vein.
By doing so, the blood flow out of the skull cavity slows and provides a cushion for the brain on the inside of the skull.
Similarly, Smith found, as the two ends of the Q Collar press slightly on a human’s jugular vein, cerebrospinal fluid outflow is slowed, increasing the amount of fluid by between a teaspoon and a couple of ounces.
That sounds frightening, but the amount of fluid that is inside the skull and around the brain while wearing the device is about the same as if a person is lying down, according to Dr. Gregory Myer, an independent researcher of the collar.
Myer is the Director of Research and of the Human Performance Laboratory in the Sports Science division of the Cincinnati Children’s hospital.
“By putting a small ‘kink in the hose,’ you’re creating a backfill,” Myer said. “So that extra blood volume is filling that free space in the cerebral-vascular tree. ... We’re just filling up that free expandable space so the brain has less room to move inside the skull.”
When the brain does move violently upon collision and ricochets against the skull (a phenomenon unceremoniously referred to as “slosh”), both a coup (area of immediate impact) and contrecoup (ricochet area of impact opposite the initial collision) effect occurs.
That effect causes both minor and major trauma to the brain, including concussions. Studies show that repeated impacts of this nature – both minor and major – can lead to chronic traumatic encephalopathy (CTE).
Luke Kuechly, the first NFL player to wear this device, said repeatedly he can’t discuss it other than to confirm he has been wearing the experimental collar and will continue to do so.
The Q Collar aims to prevent that slosh by limiting the space within the skull that the brain has to move, and in turn protect the brain from damage.
Myer said he is reminded of Newton’s Cradle – the metal balls clicking together in a demonstration of energy transfer – when he considers how the Q Collar may provide aid to the brain. If the brain is tight inside the skull, he said, the energy passes through it entirely instead of being absorbed into the brain’s soft tissue.
The ingenuity of the collar’s design is that it is focused on internal protection via an internal method – on the brain itself and cerebrospinal fluid.
Most other products, including those on the market today, place an emphasis on exoskeletal designs – building the shell around the brain – like better helmets for football players.
“Adding more weight and more mass (around the outside) doesn’t make a lot of sense from a physics standpoint to help protect the brain on the inside,” Myer said. “(But) coming at it with the idea of providing an airbag for the brain seemed like a novel approach.”
Mike Gordon, the head athletic trainer at St. Xavier high school in Cincinnati, was approached by Myer and the children’s hospital to be a part of a study involving the Q Collar in 2015, with both hockey players (as a preliminary study) and football players.
In the study, a group of St. Xavier varsity football players wore the collars through the season. An opposing high school team participated as the control group in the study, and did not wear the collar. Forty-two total participants were evaluated.
In both the preseason and the postseason, each player’s brain function and structure were tested using an MRI technique called “diffusion tensor imaging,” or DTI, which measured the structure of the brain, and an “FMRI” (a functional MRI) that tested memory and gauged how the brain was activated as the players performed tasks.
We were blown away by the results. This was having preventative characteristics in the brain over the course of the season.
Head athletic trainer Mike Gordon, on the results of the Q Collar study at Cincinnati St. Xavier High.
The research team found that though both groups of players sustained almost identical numbers of impacts, there were significant changes in the brain structure and function of the players who did not wear the collar.
In the brains of the St. Xavier players, there were not.
“We were blown away by the results,” Gordon said. “This was having preventative characteristics in the brain over the course of the season.
“If it continues to prove, as it has with the things we’ve already done, that it works, this could be a very big change to all contact sports.”
The Q Collar is still largely in its research phase, and has not yet been approved by the FDA for sale in the United States – although a spokesman for Q30 said they are actively seeking approval.
But the device can be used in approved situations, including by a player whose recent and very public hits to the head might make any potential solution a necessity.
Kuechly is an alumnus of St. Xavier, and is aware of the program’s research with the Cincinnati Children’s Hospital. That’s how he heard of the Q Collar, which has perhaps come along at the right time for him.
Last season, Kuechly suffered his second known concussion in two years.
It happened on prime-time television during a Thursday Night Football game against the New Orleans Saints on Kuechly’s home field.
Kuechly, carted off the field in tears, was in the NFL’s concussion protocol for three games. He was then held out for three more games because of the coaching and medical staff’s concern for his long-term health, in light of continued research that has been published linking NFL players with CTE.
When Kuechly stood up at the podium in front of local and national media to discuss the concussion for the first time, he seemed outwardly unconcerned. A few months later, as the team held its mandatory minicamp, he informed reporters that he was done speaking about the subject.
“I’m not worried about that,” Kuechly said in December, when asked how he felt about the potential long-term effects of his concussions.
But wearing the Q Collar shows he might be.