When Dr. Julian Bailes was the physician for the Pittsburgh Steelers, he said they were doing their best to manage concussions at that time.
“It was the standard back then if a concussion in a football player cleared and we watched them closely on the sideline, they could go back into the same game that same day. I don’t think we were bad doctors. At the time, that was the state of the art,” said Bailes, who was famously portrayed by actor Alec Baldwin in the movie Concussion.
“That’s the way it evolved,” he told the Washington Examiner.
Since 1905, presidents have tried to make their favorite sport safer for those who play the game. President Theodore Roosevelt famously called coaches and doctors to the White House that year to “reduce the elements of brutality in play.” That year, 45 young men, mostly from Ivy League colleges, died from football injuries.
Even though Roosevelt’s involvement led to the formation of the NCAA and stricter rules for the game, concussions remained a dominant problem 100 years later — so much so that President Barack Obama held a summit when he was in office on sports concussions, particularly for football players.
“Our understanding over time with brain injuries was the turn to equipment and protection in prevention. And although the football helmet does a lot of good things, it prevents a lot of serious injuries. Even though approximately four to six high school players still die every year in the U.S. playing high school football, it prevents a lot of serious injuries, skull fractures, facial injuries, and probably brain hemorrhages in most cases,” Bailes explained of the vulnerabilities athletes face. “It’s still not a perfect solution, and it doesn’t prevent concussion either.”
According to the University of Pittsburgh Medical Center Sports Medicine Concussion Program, between 1.7 million and 3 million sports and recreation-related concussions happen each year. Around 300,000 of them are football-related, and nearly half of the concussions go unreported or undetected. Two in ten high school athletes who play contact sports, including soccer and lacrosse, will suffer a concussion this year.
The fundamental problem is that the human brain is able to move inside the skull. When the head suddenly stops, or when a helmeted head suddenly stops, the brain continues to move. That can twist and tear fibers, and that’s how a concussion occurs and how horrific injuries to the brain can occur, including fatal ones.
Bailes, now the chairman of the department of neurosurgery at the NorthShore University HealthSystem and co-director of its neurological institute, has never given up his pursuit of continuing to use medicine and technology to develop safer protections for student and professional athletes’ brains.
His pursuit began ten years ago when he was at West Virginia University and Dr. David Smith brought him this concept of instead of pursuing increased external protection, why not explore how to reduce the movement of the brain inside the skull?
“That’s how the concept of limiting, or reducing somewhat, the return of blood from the brain to the heart, which is a normal physiological occurrence every second of our life, trying to reduce that so there’s a little more blood retained intracranially,” he said.
That collaboration and research were what led to the concept of having a collar that partially impedes the venous blood return to the internal jugular veins.
“We took the theory to my lab and began work on the concept in a laboratory model. And every time we tested it, it held up, the theory that if you can reduce brain movement inside the skull of a mammal, that there’s less potential for it to move and tear and get injured,” he said. “I always say it’s pretty easy to injure a rat’s or a mouse’s brain and cause them to die, but it takes a little talent to injure them and have them live, give them a concussive-type injury and to be able to quantify that, how much damage there is. So that’s what we did.”
Smith and Bailes continued their work in the lab and did larger animal model studies, and every time they analyzed it in different ways, they continued to find incredible results in the laboratory. They formed a company with investors and developed a noninvasive collar to be worn around the neck during sports activities. The collar applies light pressure to the jugular veins, slightly increasing blood volume inside the skull and reducing the brain movement that causes brain injuries.
Dubbed the Q-Collar after eight years of clinical trials and peer-reviewed medical trials in May, Q30 Innovations, a research development company formed around the medical device’s innovative head-safety solutions, submitted a request for de novo classification to the Food and Drug Administration, seeking authorization to market the Q-Collar in the United States.
The collar is C-shaped, simple, elegant, and shares the same injection-molded plastic that the popular Fitbit does. Tested over 5,000 times, it consistently applies approximately 1.5 pounds of pressure to the surface of the neck and doesn’t move or slide on the neck.
While still unavailable in the U.S., it has been used by Canadian Football League players, and Q30 Innovations is also working with the U.S. Army Medical Materiel Development Activity to study whether U.S. service members at risk of traumatic brain injury should use the collar.
A Veterans Affairs study conducted by the Mid-Atlantic Mental Illness Research, Education, and Clinical Center found that Iraq and Afghanistan veterans who suffered multiple traumatic brain injuries were about twice as likely to report suicidal thoughts than veterans who suffered one concussion or none at all.
If successful, this collar’s preventative impact won’t just protect the “Friday night lights” warriors on the high school football field. It also has the ability to protect the warriors who protect our national treasure.
