<
>

The story behind the experimental collar worn by Luke Kuechly

CHARLOTTE, N.C. -- Many fans of Luke Kuechly remember highlight moments such as the final seconds of a 2013 win against New England when the Carolina Panthers middle linebacker kept tight end Rob Gronkowski from making the game-winning catch in the end zone.

Or emotional moments such as last year's Thursday night game against New Orleans when the 2013 NFL Defensive Player of the Year was carted off the field in tears after suffering his second concussion in two seasons.

Dr. David Smith always will remember Kuechly for something most don't see, a thin collar that wraps around the neck and applies pressure on the jugular vein to increase blood volume in the skull to create an air-bag effect.

"It's like watching your baby walking for the first time," Smith told ESPN.com.

Smith has been called the "Bird Brain Doctor" because the woodpecker -- more on that later -- was his inspiration behind what is known as the Q Collar, which was developed in conjunction with Connecticut-based Q30 Innovations. The goal of the device is to safeguard the structure of the brain and protect against mild traumatic brain injury. While the technology in the collar recently was approved for sale in Canada for $199, it hasn't been approved by the Food and Drug Administration in the United States.

Kuechly, whose high school football team in Cincinnati has used the device the past four years, is the first -- and believed to be only -- NFL player to wear the collar. He doesn't discuss it because it's still in the experimental stages.

Dr. Greg Myer, the director of Research and the Human Performance Laboratory for Sports Medicine at Cincinnati Children's Hospital, who has been testing the device for four years, also couldn't comment directly on specific players who wear the collar.

But he says imaging testing on players at St. Xavier High football, where Kuechly once starred, compared to tests on players from another team that didn't wear the collar over the past three seasons has shown "promising results."

"What we found is, when wearing the collar, the brain structure is maintained," Myer said. "But those boys that aren't wearing the collar are seeing structural changes."

Having a high-profile player such as Kuechly wear the collar will bring more attention to the device. Getting it approved by the FDA, however, is only in the preliminary stages and will prove more difficult than the process in Canada because of U.S. standards.

There are those within the world of concussion study who aren't convinced playing with the flow of blood to the brain is the way to go at all. One expert who asked not to be identified said "playing with blood vessels is really risky and could have negative consequences."

Eric Nauman, a professor of biomedical engineering and basic medical science at Purdue University, is a part of the school’s Neurotrauma Group that has conducted studies on 550 football and soccer players.

He is skeptical the Q Collar works.

"We actually did not pursue this one because we had concerns about the idea of pressing on the [jugular] vein, especially in an uncontrolled way," he said. "I would just be too nervous something bad is going to happen."

Nauman said the risk starts with the gentle pressure being applied to the jugular vein.

"If you decrease that or change the structure of the vessel because of pressure, it’s very hard to predict what’s going to happen," he said. "I just don’t know what’s going to happen if somebody is doing a bunch of sprints or high intensity activity like football and has to deal with potentially short-term transient changes on how their blood oxygenation and brain oxygenation evolves.

"I can’t say they won’t work, but we were looking at potential side effects, and it wasn’t clear to us it rose to that level."

Asked to comment on the device, NFL spokesman Brian McCarthy said, "Our office reviews any piece of equipment that is worn on game day to ensure that it would not present any issues to opposing players. Permission was granted for its use this season. Members of the NFL’s head, neck and spine committees will evaluate further the device."

St. Xavier coach Steve Specht, who works with USA Football's Heads Up program on concussion prevention, was confident enough in the device that he allowed both of his sons to wear them the past few years.

Only one of Specht's players who has worn the device has shown symptoms of a concussion, and that player had been concussed prior to wearing it.

"Why wouldn't you try something if it can help?" Specht said. "If it works, fantastic. There's some things I'm very skeptical about, but why wouldn't you try if it can put a kid in a safer position? That's my take on it."

'Bird Brain Doctor'

Smith got the initial inspiration behind the Q Collar in 2006 at a military research lab with a cadre of scientists trying to find ways to keep soldiers from bleeding out on the battlefield.

"One of the Department of Defense guys came up and put his arm around my shoulder and said, ‘Boy, that was a clever talk. Why don't clever people solve traumatic brain injury?" Smith recalled.

"And then one of the people in the audience jumped in and said, 'If somebody can figure out how a woodpecker can smack his head against a tree and fly away without a headache, then we will have solved traumatic brain injury.'"

Smith said everybody started laughing except him.

Nine months later, after researching woodpeckers and other G-force tolerant animals, Smith determined nature created internal devices to modulate and change the pressure and volume inside the cranial space to prevent concussive symptoms.

"Why wouldn't you try something if it can help? If it works, fantastic. There's some things I'm very skeptical about, but why wouldn't you try if it can put a kid in a safer position? That's my take on it." St. Xavier coach Steve Specht

He used the tongue of the woodpecker as an example.

"It's just unbelievable to see what nature evolution has done to bring the tongue up over the top of its beak, up over the top of its skull back around the back underneath its ears," Smith said. "And then it comes back around the vascular tree.

"That's what everybody missed. All of that effort just to loop the structures down against the jugulars."

The collar was developed to create the same effect.

Five years ago, Smith took his findings to Myer, who for 20 years had been researching ways to prevent concussions.

"He sounded like this crazy guy with an idea, and I had him come over on a Saturday morning at 7 a.m., and he showed up and that's how it started," Myer said. "When he explained it to me, that seemed like a reasonable approach."

The Kuechly connection

Kuechly doesn't like talking about concussions that have forced him to miss nine games the past two seasons. He said in April, "I'm not going to answer any more questions about concussions because I'm done with that."

When Boston University released in July the results of a study that revealed 110 of 111 ex-NFL players showed signs of chronic traumatic encephalopathy, or CTE, to the brain, Carolina outside linebacker Thomas Davis called it "alarming."

Kuechly simply said there's always "inherent risk to injury."

That Kuechly wears the collar that fits on his neck between his helmet and shoulder pads indicates he is taking concussions seriously enough to wear an experimental device.

Specht isn't 100 percent sure how Kuechly became aware of the device but reminded that Kuechly's younger brother, Henry, was a member of the St. Xavier team that began using the collar.

Myer said Specht's willingness to allow his sons and other players to wear the collar has been "key to our potential to even study this."

"You can't find anyone more passionate about helping make the game safe with his involvement in USA Football and the Heads Up tackling," he said. "This let us do the research independently in the right way, which makes me more confident in what we're putting out there."

Specht said neither of his sons have had symptoms of concussions while wearing the collar.

"My youngest, he's a running back/slot receiver that is constantly getting banged on," he said. "Never had any issues."

Specht admitted some kids declined to get involved in the study and some simply didn't feel comfortable having something wrapped around their neck.

"We're not trying to hide this from anybody. We're like, 'If there is something wrong with this thing, please knock us off this mountain, because we want this to be safe.'" Dr. David Smith on the Q Collar

He hopes Kuechly wearing the collar will convince others to give it a try and ultimately lead to the device being passed by the FDA for sale in the U.S.

Smith understands there are skeptics and welcomes the scrutiny.

"We're not trying to hide this from anybody," he said. "We're like, ‘If there is something wrong with this thing, please knock us off this mountain, because we want this to be safe.'"

He said it was big for Kuechly to be wearing the device.

"It's incredible," he said. "My personal view is that getting this out, and getting the knowledge out to people that these types of injuries can be helped or prevented, that is huge."