"A physician kept emailing me and said he had been studying woodpeckers and figured out a way to prevent concussions," says Greg Myer, Ph.D., FACSM, certified strength and conditioning specialist, director of research and the Human Performance Laboratory at Cincinnati Children's Hospital Medical Center's Division of Sports Medicine.
His curiosity piqued, Myer agreed to meet with the physician behind the emails. It was David Smith, M.D., a clinician and inventor with a novel idea: What if we replicate the physiology of woodpeckers to protect people from brain trauma?
That was nearly four years ago. Today, Smith is a visiting research scientist at Cincinnati Children's, working with Myer on traumatic brain injury projects.
Myer has long been aware of the dangers of brain trauma for children in sports. He says while helmets are critical, they can't fully protect children from brain injuries. This is because helmets protect the skull but are unable to keep the brain from moving around inside the skull, otherwise known as "brain slosh." This is the culprit for traumatic brain injury (TBI). TBI impacts the brain's white matter and results in symptoms ranging from headaches to sleep disruption to cognitive impairment.
Facts about brain trauma
Overall, the Centers for Disease Control and Prevention (CDC) estimates that up to nearly 4 million sports- and recreation-related concussions occur every year in the United States, and children are the most affected.
However, this number underestimates the total occurrences of TBI, since concussions represent only a subset of these brain injuries. The CDC says many individuals suffering from mild or moderate TBI do not seek medical attention.
While relatively little is known about the long-term effects of these brain injuries, the World Health Organization projects that TBI will be the third-leading cause of global disease by 2020.
Inspiration from an unlikely source
So why look to the woodpecker when working for a solution to prevent brain injury? It's all in the physiology.
The bird has a long tongue that wraps around its head, compressing the jugular vein and restricting blood flow out of the skull. As a result, the brain has less room to "slosh." So Smith and his partners developed a collar that replicated this effect on humans. The collar mildly compresses the human jugular vein in a similar fashion, increasing blood volume—effectively creating an "airbag" for the brain in the skull. The collar tested well in animal studies, so Smith was eager to enlist Myer's help in testing it on humans. For Myer, this was a turning point.
"That was the ah-ha moment to say, 'Well, maybe we can mimic this approach in humans and go forward,'" he says.
Putting the collar to the test
Before testing the collar on athletes in competition, Myer conducted several safety trials at the Human Performance Lab at Cincinnati Children's. There, a team tracked a litany of metrics, including neurocognitive measures, oxygen outputs and bloodwork values—as well as reflex time, strength and power measurements. They found no adverse effects on young athletes wearing the collar.
Next, it was onto the field of play. Myer began with an initial test group of 15 high school hockey players, followed by a study of 42 varsity football players, comparing their pre-season, mid-season and post-season MRI brain scans. The findings: the groups that wore the collar throughout the season had experienced significantly less impact on brain tissue than the groups that did not wear the collar.
The quest for prevention
There's been a heightened awareness around concussions across the sports landscape in recent years, placing much of the focus on diagnosis and treatment. But Myer is quick to point out that repetitive impacts over time—without concussion—could actually be more serious than getting a concussion.
So he stresses that more research and funding should be funneled into prevention. "What I would love to see is more people coming up with solutions that are preventive and help our kids play safer," Myer says.
What's next
Testing will continue on the collar before it's approved for use in the United States. For Myer, it's a step in the right direction, one that keeps kids active and engaged in sports—not on the sidelines for fear of injury. "I'm most passionate about keeping kids playing sports and trying to reduce the risk of them playing sports," Myer says.