StarTalk Radio - #ICYMI - Protecting Your Dome: Concussions & Helmet Technology

Episode Date: September 13, 2018

Discover more about the latest in concussion research and helmet technology with hosts Gary O’Reilly, Chuck Nice, Dr. Samuel Browd, Co-Founder of VICIS, Richard Brandt, PhD, CEO of Sports Science, and Dr. Roger Härtl, neurosurgeon for the New York Giants. Don’t miss an episode of Playing with Science. Please subscribe to our channels on:Apple Podcasts: https://itunes.apple.com/us/podcast/playing-with-science/id1198280360 TuneIn: https://tunein.com/podcasts/Science-Podcasts/Playing-with-Science-p952100/ GooglePlay Music: https://play.google.com/music/listen?u=0#/ps/Iimke5bwpoh2nb25swchmw6kzjq SoundCloud: https://soundcloud.com/startalk_playing-with-science Stitcher: http://www.stitcher.com/podcast/startalk/playing-with-science NOTE: StarTalk All-Access subscribers can watch or listen to this entire episode commercial-free here: https://www.startalkradio.net/all-access/protecting-your-dome-concussions-helmet-technology/ Subscribe to SiriusXM Podcasts+ on Apple Podcasts to listen to new episodes ad-free and a whole week early.

I'm Gary O'Reilly and I'm Chuck Nice. This is Playing With Science. Yes, concussions and head traumas are most definitely this season's must not have thing and people are rightly concerned but is there light at the end of the tunnel? Yes, well, actually, there may well be light at the end of the tunnel as we speak because active steps have already been taken in a number of major sports to combat exactly this issue. Mild traumatic brain injuries and chronic traumatic encephalopathy are no longer marginal issues, but are now at the forefront of many minds. And today, we focus on what is being done, especially in the world of football.

Yeah. So, Dr. Samuel Brown is a neurosurgeon, as well as the co-founder and chief medical officer of VICIS, V-I-C-I-S, developing new football helmet technology that shows significant reduction in impact forces for NFL, college, and youth football. And we'll also have physicist Richard Brandt, CEO of Sports Science Football, who do a lot of helmet testing. As well as Dr. Roger Hartle, official neurosurgeon for the New York football giants. So I think what we have is a group of experts that can address why things need to happen, what is happening, where we are going to go from where we are right now. Because I think if we look backwards, we're not going to help ourselves. No, and you know what? Here's the thing. First of all, we know that we have so much more information available nowadays.

You know, there was a time I remember when I was a kid playing football and, you know, the whole idea was to ring somebody's bell, as they would say. Like, that's what you wanted to do. And now we know that, you know, that's a problem. But it's not just football. It's not just the NFL. I mean, you look at, they talk about the micro collisions from the headers in soccer, right? There you're looking at me. Yeah.

That's it. Yeah. That's the way it goes. So you've got a lot of sports that are involved in concussions, in mild traumatic traumas. But at the moment, the people that are taking the lead seem to be the NFL, who brought forward $100 million and a head health challenge, which Dr. Samuel Broward's group, Vicious, I'm not sure, we'll find out the correct pronunciation, have won for the safest helmet and is already in play with some NFL teams and players. I could have used that helmet as a child because from what I understand, I was dropped repeatedly on my head. There'll be a reason for that. All right, first joining us, and we have the privilege today dr

samuel browd attending neurosurgeon at seattle's children hospital med be patient because this is a long title list by the way medical director of the seattle children's sport concussion program director of university of washington sports health and safety institute and he serves as an unaffiliated neurologic consultant to the NFL, independent neurologic consultant to the Seattle Seahawks, and co-founder, and this is the important bit, and chief medical officer. Is it Vicious or Vicious? How do we pronounce that, sir?

Vicious. Vicious. Vicious. Wow, we were totally off. We were everywhere. We were everywhere. It was like Vices, Vicious. I was like, Vicious, man, that's an aggressive title.

That's an aggressive name. Vicious, okay. like, vicious, man. That's an aggressive title. That's an aggressive name. Vicious, okay. Especially for a helmet company, like vicious, vicious helmets. That's right. Wear a vicious helmet. So how do you get involved with this particular program? And obviously your background has led you towards it, but you've got some interesting co-founders on the board, I believe. Yeah. So, you know, I've had the great privilege of working at the Children's Hospital in Seattle, and we have a concussion program here. So I've seen a lot of the kids come through who were getting concussed and, you know, also doing the sideline work with the Seahawks and just getting

really involved in football in general. And it struck me a few years ago that, you know, the technology really hadn't caught up in terms of certainly head health and head protection. And so we started to look critically at the helmets and realized that the technology really hadn't been updated in, you know, many, many years. So we thought there was a nice opportunity to take the best engineering principles out there and really rethink what a football helmet would be and should be. Yeah, you know, the thing is,

you guys basically went down to the studs. You started from scratch. So aside from the fact that it goes on the head, what is that process? How do you start from scratch with a helmet? You know, I'm very lucky. I work at an amazing research university, and I literally called the chair of mechanical engineering and said, I'm interested in talking to you about this problem.

I think there's an opportunity around football helmets to do something different. You know, originally football helmets were designed for catastrophic injuries, skull fractures, bleeding in the brain. They were never really intended to address concussion, which we think come from rotational forces. And so we sat down with Per Reinhold, Dr. Reinhold, and we started to think around how would we engineer and try to address this particular problem. And I think we have this great luxury of starting completely from scratch and moving forward and trying to build into the helmet all of the things that we would want to see if we're leveraging the best science, the best medicine, the best engineering. If you've got 100% perfection as your aim,

how close do you think the Zero One, the helmet you're actually holding, has got to addressing that? It's important. I always say that there's never going to be a technology that 100% eliminates the risk of concussion or head injury. But what we've really tried to do is understand the type of forces that we want to mitigate and design around that. And so as we've gone through and built the helmet and started to do all of the bench reduction in the forces that are transmitted through the helmet to the head form. So we're hopeful that that's going to have a meaningful effect in terms of reducing the risk of injury. And so these are things that we're looking at long-term to be able to study. When you talk about the rotational forces, can you just explain for anybody who may not know what that is when you say rotational forces of where you believe concussions come from?

And when I say for somebody who may not understand, I'm talking about me. So a lot of people think that the injuries are coming just from a straight hit to say the front of the helmet for example and a lot of the injuries are occurring because somebody gets hit on the side and what's happening inside the skull is that there's sort of a rotational force that happening where there's forces that are put down toward the center of the brain and we think that those are areas that are more likely to lead to concussion. So as we design the helmet, if you look at the internal structure of this thing, it has columns and the columns are able to not just bend, but they can move in different directions. And the idea there is that not only can it absorb this linear force, but it can also

take what we call these shear forces where you get hit from the side. Columns can move and then some of that energy and this is one of the really novel and unique things about this is the design of this helmet that layer that you've just described where did you go for what did you go to rather for your inspiration well again dr reinhold's a very brilliant mechanical engineer and to be honest he tied back into history a bit. You know, we started to look at the properties of columns and how they can move and compress. And we were looking for a very specific type of force curve to reduce the energy that you see in football.

And so through many, many iterations and experiments in the early days, we came up with an idealized structure. So how many of the columns there are, how they're spaced, how easy it is to compress them or not, is all part of the magic of the way this helmet is designed and works. So I remember there was big talk years ago about this water helmet. I don't know if you remember that. Like apparently there was, you know, the idea was to absorb and distribute the force of the impact. How is this different? I mean, I know that's what you're doing. You're absorbing and distributing the force of the impact so that it doesn't reach the brain. That's really what you're doing. It's kind of like the way a shock absorber picks up the bumps in your car. You're still getting the bumps, you just don't feel them. But what is the difference between that and the padding of

the foam padding on the inside of a helmet or like like remember the water helmet? What's the difference there? So when you look at all the different materials that go into the helmet, what we're trying to look at is what the force curves look like. So you take and you impact this helmet. How many G-forces do you see that spike up from the head form that's inside for the bench test? And so as we look at different materials and you look at water for example when water is compressed it actually can cause a very high g-force versus foam materials and then different foams also have different properties and so where you really want to go

is to try and take best structures you can to redistribute the force. And so in the helmet, for example, in the Vices 01, there's a column structure that mitigates a lot of the force, but there's also padding inside that's used to fit the helmet, but that also affords energy absorption. So there's a lot of science that, fortunately, the engineers are quite brilliant at figuring out, and we've tried to really optimize around the forces that we see in football in particular. With all of what's going on inside the helmet, are you now looking at it being gigantic?

Is it constrained by dimensions of size and weight that you have to work to or can you do whatever you wish almost? Actually, that's a great idea. Let's just give players giant helmets. Everybody can walk around looking like they're in the Mardi Gras parade and we don't have to worry about it. Just big giant helmets running around on the field. I'm sorry. I'm sorry, Todd. Well, you know, it's funny because I laugh about it because in the early days, you know, we were thinking about the helmet and, you know, you have kind of some nerdy guys, a neurosurgeon and a mechanical engineer.

And yeah, if you made the helmet bigger, that's probably better for force absorption. But as you know, we're talking about young guys out playing and the mirror test is very very important and I can go talk to them and say you know safety safety safety but number one through ten on their list is often how cool does this thing look and do I look vicious and fierce and ready to go play so early days we knew that we had to make a helmet that was going to look like a football helmet have the same general you know size requirements and then also weight and so as we went through the design of this helmet, we did a large project around industrial design and talked to many, many players and coaches and everybody else to kind of get a feel for what a helmet should be. And so if you look at the size of this helmet, it's the same as other helmets that are currently worn by players.

It's the same as other helmets that are currently worn by players. The weight of this current helmet is right down the middle in terms of how much it weighs. And the aesthetic of it, while it's really modern and very cool looking, it doesn't look hugely different than a helmet. And it definitely doesn't look like a bobblehead for somebody to wear this thing. No, actually, it's a really cool-looking helmet. For those of you who don't watch us on StarTalkAllAccess.com, to give you an idea of what the helmet looks like, think of a fighter pilot's helmet with the visor down.

That's kind of what this helmet looks like. So the doc is holding it up on the screen right now. So for those of you who are. Try and post that on social. Yeah, it's really, it's actually a little ominous looking to be on. Like if you were to wear this helmet, it's a little scary looking, you know. What do you want on the front? Hello Kitty. Well, to be honest, I wouldn't mind.

I wouldn't mind a little Hello Kitty. As a matter of fact, you show me an NFL player with a Hello Kitty on the front of his helmet. He's my new hero. Oh, for heaven's sake. Let's get back to reality. Yeah. You won the NFL head health challenge and congratulations, sir, to you and everybody on your team. How then did you find pick up in terms of the NFL itself, college and high school players? Yeah. So, you know, initially we spent a lot of energy reaching out to teams and players across all levels. So that goes from the NFL to NCAA to even high school programs to, again, learn from them and understand what they would want in a helmet and where there have been problems with helmets in the past for them.

And so we really tried to establish good relationships and partnerships, if you will, with the different teams as we were developing this thing. And there were many contributions, you know, throughout the NFL and college and other places that went into the ultimate design. And so we really wanted to listen and have these guys as partners so that when we went back, they understood what we had done, why we had done it, and they could advocate to their players that they should at least take a look at wearing this helmet. And so we were very fortunate. I think, you know, the Seahawks locally here have been amazing in their staff, giving us advice. And I think it's paid off. You know, this year, every single NFL team will have players in our helmet.

We're going to have somewhere over 130 NCAA teams wearing the helmet. There are teams like Notre Dame that have gone to almost full roster adoption, as well as Baylor. full roster adoption as well as Baylor. And so we're starting to see people paying attention and recognizing that they want to look for the latest and greatest in the best technology out there. Congratulations, by the way. That's incredible. Just as a point of interest, the NFL head health challenge was kind of like a, call it a contest, if you will, right, for people to come up with solutions to concussion mitigation, correct? Correct, yeah. As we know, technology produces an awful lot of solutions without knowing it for a number of other problems. But I have this reoccurring question in my head,

and I can't get rid of it, and I apologize in advance. If woodpeckers don't get headaches, do we look to nature for our solution? Yes, woodpeckers don't get headaches, do we look to nature for our solution? Yes. Woodpeckers don't get headaches, but they do get hangovers. And believe me, I've done a lot of drinking with woodpeckers. Thank you for that. All right. Do you look to nature for answers like that?

I mean, Gary, I've got to tell you, that's actually kind of brilliant because I'm thinking now of all these animals like rams. Actually, they do that. Rams, deer with antlers. Deer with the antlers. So is there a way to look to nature for some answers? You know, it's actually a great question, and people have started to do that. And the animals that you've mentioned in particular, woodpeckers, rams, things like this.

You mentioned in particular woodpeckers, rams, things like this. There are a couple of companies that are out there that are looking at neck collars or other things that compress the jugulars to increase the amount of blood that's in the brain. So there's maybe not as much sloshing that's going on as an example. I tend to kind of take a step back and go, those things are very interesting and they may be relevant in the future. But the practicality is where I always get hung up because you've got to be able to not just have a good technology, but you've got to be able to bring it to the field and make it such that the players are going to want to wear this technology. Because, again, often we're talking about young people and especially at the elite athlete level, they're very ingrained in what they've done in the past. And so it's not just the technology, it's making sure the technology fits into the game. And so, you know, for us, that's been a big, big component of the way we've

tried to advance the Vysis technology, make sure it looks cool, it fits into sort of the workday for these guys. And it has this advantage in terms of safety. Quick question because we've got to wrap up. But when you look at the big manufacturers that are out there, is this something where you share information with them or do you work with them? If they were to come to you and say, hey, you know, we want to we want in on this? How does that work? Yeah, I think as a community, we all want to be able to work together to see, you know, these safety advancements, you know, move forward. I think one of the things that's been very striking to me as we got into this is just how kind of antiquated and old school you know the helmet manufacturers in the space had been they didn't really have to change a lot because they weren't being forced to and

that's been one of the things that's been very fun for me in particular with this uh effort that we've had with vices is that we've really been a forcing function to say all right we're going to completely disrupt this industry come in and rethink it start start from scratch, do something different. And it's been good because we've been seeing the other companies respond and start to advance their science and engineering as well. And so I think there's a lot of opportunity for the community as a whole, both on the science and engineering side to come together to continue to advance what we're doing. Because at the end of the day, for me, I want to see kids able to go out and play sports safely. I want them to be able to pick what they want to do, whether that's football, hockey, lacrosse,

whatever it may be that's a helmeted sport, biking, get out there and go to town, but be able to be safe. And as a parent of young kids i want to make sure that i feel good letting my kids out playing these games so i think all of us in this space are after the same goal and you know working together and uh just continuing to push the envelope is going to be really important very cool doctor before we before we go we must go to a break. Would it be fair to call you and your team at Vysis pioneers in this area? Yeah, I think so. Good. And disruptors. I like that because, you know, it's one of these things where, you know, it took sort of a nerdy, you know, brain surgeon and a nerdy mechanical engineer to come into, you know, football and go, hey hey like you guys could do something a little bit

different here or a lot different and really make an important change and so I'm really excited it's been a phenomenal opportunity to uh you know take neurosurgery knowledge that I've acquired over you know lifetime of training and really bring it bring it forward with the the engineers and do something that we hope is going to be just really, really important. Well, you guys are the living embodiment of our show's tagline, which is where geeks and jocks collide. So good job. Yeah, man.

Way to go. Way to bring it to life. Way to bring it to life. Dr. Samuel Broward and the good people of Vysis and the Zero One Helmet, which you will be seeing this season in NFL more than you thought before. Oh, wait.

No. Wait. Yes. No. Doc, here's the thing. Before we let you go, I just had a brilliant idea. If you save the size of your head. No, no, no, no.

Here's the deal. It's a little helmet that you put on your big toe when you go to sleep so that you will never stub your toe in the middle of the night. You really need to go now. Doc, you've got to go for your own safety. Hey, hey, that one's free, doc. That one's free. Yeah, yeah. In invisible ink. Doctor, we've got to let you go. It's been a pleasure. Thank you, sir. Dr. Samuel Broward and the good people of Vysis. Thank you, guys. You're welcome over in Seattle, Washington.

We're going to take that break. Coming up next, we'll get into helmet testing and the physics of collisions. Ouch. And that will all be with the CEO of Sports Science Physicist, Richard Brand. Stay with us. Welcome back to Playing With Science. We're talking about concussions and helmic technology.

It's giving me a headache. I'm sorry. You give me a headache. That's enough of our problems. Joining us in the studio now to discuss the physics of collisions is CEO of Sports Science physicist Richard Brandt. Richard, welcome to the show, sir. Thank you for being here.

Can you give us a breakdown on, because with impacts, with concussions, there's all different types. It's not one simple thing happening when you have a collision, when you have an impact that can bring a concussion. Yeah, that's right. I mean, in American football, the typical collisions that cause concussions could be at 20 miles an hour, very fast. And this can lead to head accelerations as much as 100 Gs, 100 times the acceleration of gravity. Enormous forces, 500, 600 pounds typically on the head, and torques torques too from the rotations that are induced. So it's a dangerous sport. And at that level, it's estimated that the probability of concussion is maybe 70% at that kind of speed with a direct impact. That's insanely high.

It's insanely high. Insanely high. And there's plenty of evidence that this is happening. And, you know, of course, the issue is, and I assume we'll discuss that, what to do about it. And I have some ideas about that. But it's a serious problem. And the game is violent. And they're addressing this.

The NFL is trying to address it by limiting the types of impacts that are allowed. And most recently, they want the players to not strike opponents when their helmet is bent downwards. This has been very controversial because the players claim that's the only way they know how to play you know they helmet to helmet yeah helmet to helmet helmet to shoulder shoulder to back or to any any vulnerable part well that's the i mean that's how you're taught as i don't know if they're still teaching this but the way you were taught uh was head down drive through so you put your head down and you drive through the tackle. That's how it's historically been, and that's what they want to stop.

And it's a question of to what extent the officials will enforce that and to what extent the players will try to get alternative methods of achieving their goals. And you begin to change the game. Yes, you begin to change the game. of achieving their goals. And you begin to change the game. Yes, you begin to change the game. So if, and if we go down the road of if we cannot do that because it takes away the intrinsic part of the game that attracts so many players and spectators,

how does then science and technology come to the rescue and save the day? But how does it bring forward things that will help? So we talk about helmet technology and thoughts and areas that you've been working on that you feel have made progress and can still make progress. I believe with better helmets, the occurrence of concussions can be greatly reduced.

People are starting to do this. Helmets hadn't changed since the inception of the game. Well, they started with leather helmets. I was going to say, yeah, aside from the big leather hat. But now there's been some progress, but not nearly enough. And I think the main reason for this is there's just not enough money that is dedicated to the development of better helmets. I think with enough creativity, enough understanding of the science involved, enough trial and error, you could greatly reduce

the occurrence of concussions. I know you were doing work with baseball bats. Are you doing anything with helmets as well? Yeah. To test what I've just said, me and a partner, in a few months' time, put together a helmet that we thought would lead to an improvement. It's not a complete prototype. We didn't have enough money to do that. of a helmet and subjected it to impacts and measured the accelerations from these impacts on the head of a dummy. You don't have to talk about me like that. Sorry. No, it wasn't personal.

Well, go ahead. Continue. And we measured the forces transmitted through the helmet onto the dummy skull, which would be transmitted onto the human head in a real-life situation. And so with very little time and almost no funding, we had a 25% improvement in the protective capabilities over what existed at the time on the market. What I mean by that is for a given impact, a given hit on the helmet, the given speed, the given mass, the actual exerted force or acceleration on the skull of a player or dummy wearing that helmet would be at least 25% less than any helmet that's out there.

And this was just in its infancy. We didn't optimize for the best equipment, the best computer simulations, the best materials to use. The key to having a better helmet is to dissipate the impact energy into thermal energy, into heat. Interesting. The more of the impact energy that goes into heat, the less energy will be transmitted through the helmet onto the skull of the player, and the less will be the force applied on the helmet by that impact. and the less will be the force applied on the helmet by that impact. So now you've said that.

My minuscule brain is starting to work slowly. How do I get energy from an impact and superconduct it through the body of the helmet and not shoot flames out as heat, but to convert it into heat and therefore allow it to dissipate through that, is that technology available? Oh, sure. Sure. In silicon chips with the conductivity of? No, in elastic materials that are heavily damped. factory or a machine shop and there's a lot of vibrations going on, it's desirable to dampen

those vibrations because of the noise they create and because it affects the work you're doing. And eventually it'll bring down the building. So there's material that they use, sorbethane as an example, that is highly damped. So that when you have an impact on it or a vibration, it does turn a lot of that energy into heat. The trouble with that is it's heavy, heavy material. So the issue is can you make a helmet that isn't really too heavy that absorbs that kind of heat? Because the more weight you've got, the less chance I've got of running 20 miles an hour.

But you've got less chance of being able to do your job, which is being very quick. Because we're dealing with some of the most elite athletes on the planet within NFL. Are there any other ways? Does it get so hot? Are we talking ridiculously hot temperatures?

Can I cook an egg on my helmet? Not right away. Part of the problem, which you've recognized, is how to dissipate the heat that you've created, the heat that you've taken as energy from the impact. And so you just can't have a complete layer of damp elastic material in the helmet because then it will just absorb the heat and after a few impacts it will get uncomfortably hot so you have to have holes in it so that the heat can be conducted away in principle there are other ways you uh to conduct the heat away you could even

have a stream of uh of uh some cold material involved involved that will stay cold enough during the game to do the trick. You can have a fan mechanism in it. There are various things you can do, but largely it's a question of geometry. If the geometry of this damped elastic material that's inserted into the helmet is chosen appropriately, then the heat would be dissipated away without rising the temperature

to an uncomfortable level. Chuck was saying that you've worked on other things in other sports. Oh, sure, yeah. Tennis rackets? Yes. So, and baseball bats. I'm just thinking there's a point of percussion

of which you will lose, you can dampen a tennis racket down. Exactly, yeah, yeah. And a similar thing with a baseball bat. Are you able to borrow from those and introduce them into the helmet situation or is it just not viable? So the helmet issue is much more complicated. I mean, you could put a little absorptive material on a tennis racket and get rid of unwanted vibrations. For a baseball bat, you could put absorptive material in the handle so you don't get a sting. That's less important now with carbon fiber bats. But when they were aluminum, titanium, then the sting was an issue,

as well as the sound. But for the helmet, it's a more complicated problem because you're protecting a large area and trying to protect the object, the brain, that's extremely sensitive to accelerations. In an impact, the impacting bodies collide. So in terms of elasticity, they compress against one another, and then they decompress and go apart. During that compression, some of the energy from the impact is stored as elastic energy in the spring. That energy goes right back into the head of the player. But some of the energy, if the spring is damped, goes into heat. Okay. And that then would be dissipated, and that would result not only in less energy transferred to the head of the player, but it would reduce the force that's actually applied onto the helmet. Wow.

One thing to realize that I think isn't generally realized, if you apply a force on a helmet, no helmet can reduce that force. Whatever is applied on the helmet is transmitted to the brain of, or to the skull at least, of the player. What a good helmet can do, though, is actually reduce the force that's actually applied onto the outer helmet. And that's where this thermal energy dissipation comes in. Let me ask you this.

How come no one has ever thought about, about like thickening the skull of the player? And by that, I mean artificially. So you would wear kind of like a skull cap, you know, or some type of layer in between the helmet and the player himself. I mean, one could say that that would just be part of the helmet. But what I'm talking about is kind of like a liner.

Like when you wear certain gloves, you put like a liner on, and then you put the glove on so you can handle really hot material. Something like that. I mean, does that make sense? No. Okay, good. No, because as I said, any force that's transmitted onto that liner is going to go through. It's still going to go through. You cannot reduce a force that's applied onto that liner is going to go through. It's still going to go through. You cannot reduce a force that's applied to it.

So really what you need to do, it's really about dissipation. It's about spreading that force out. Yes, spreading it out over a larger area so that reduces the local force application and absorbing the energy into heat so that the actual applied force is diminished. Is there any way you can then, through the helmet, transfer that through more of the body? Yes, I think that could be done.

That would be a way of having the heat that's produced dissipated without increasing the temperature too much. No more need for seat warmers when you're playing at Soldier's Field. You know what I mean? Exactly. That would be an added benefit. Yeah, when you're in the frozen tundra of Green Bay, it's just like, I got my helmet to keep me warm. Now, the truth is, though, that the impacts occur separated by several minutes or longer.

So there's plenty of time for the heat produced in a given impact to dissipate. It's not as if you're constantly getting banged in the head. What's the contact time for something that could possibly, potentially end in a concussion? The contact time is about a tenth of a second. The longer the contact time, the better, because it spreads the force out over a longer time. It could be a twentieth of a second, half of a tenth of a second.

Short contact. And then what sort of time after that are you looking for trying to transfer that energy into heat? Well, it happens during the impact. Yeah, so it's all part and parcel of that time. Yes, it all happens together. That's right. I believe I have a solution for this, and I'm just going to go out and say it.

You'll be rich. Here it is. Bubble wrap. Bubble wrap. Okay. This is Richard Brent. Thank you. For the CEO of Sports Science here in New York. It's been a pleasure talking with you. Dr. Roger Hartle, the official neurosurgeon of the New York Giants. Yep, he'll be our guest next. Don't go away. We'll be right back. Welcome back to Playing With Science.

Of course, we're looking at concussions and the new helmet technology in football. And up next, Dr. Roger Hartle, the official neurosurgeon for the New York Giants. So who better to discuss what goes on, actually goes on, in a player's brain during a collision. And of course, you got to talk to him. Unfortunately, I wasn't available. We did a pre-tape for this.

And so I'm really interested to hear what he had to say. And you will not be disappointed. It's fabulous insight into what goes on. Cool. Let's check it out. We are joined by Professor Roger Hartle from the Weill Cornell Brain and Spinal Center in New York. Welcome to Planet Science. Thank you for having me.

It's a great pleasure. Thank you kindly. Can you just describe what is actually going on when a player suffers a traumatic blow to the head in terms of how the brain reacts? Yeah, I think this is a very good question. What happens is that a mechanical impact on the head, but it doesn't always have to be the head. It could also be an impact on the body that is somewhat translated to the head. It seems to have an impact on the balance in the brain of electrolytes and neurotransmitters and especially potassium and

calcium. And there seems to be a breakdown, a temporary breakdown of the membranes in the brain that contain a certain balance between those electrolytes. And that imbalance can trigger electrophysiological changes that can result in a temporary loss of consciousness and then over time even in more significant changes such as injuries to the axons and even to cell death. It's interesting it's not just a physical impact. It's a chemical impact that combines the two. So if we're looking at how we address concussions,

because there's a full-on impact, but you can still get a concussion from a glancing blow. How do they change the whole way the brain is reacting from the two different types? Yeah, the mechanical impact is just the initial reason why these chemical changes happen. The problem is not always the initial impact. The problem sometimes is really what the brain is trying to do and trying to accomplish by repairing itself. And the problem is that these imbalances, these chemical imbalances that are being triggered by the mechanical impact have to be repaired. And the brain is trying to do that

by using a lot of energy to restore the balance. And that can lead to an energy crisis in the brain and that's why players or individuals any individual who has who have a concussion or a head injury are very vulnerable sometimes for hours sometimes even for days after the initial injury and that vulnerability is really caused by the the brain's attempt to repair and restore hemostasis in the brain. Amazing. The brain is reacting immediately. It's not gone into a shutdown and then a reboot. It reacts immediately. That's incredible. But I shouldn't be surprised.

In assessing an athlete, are there something like 31 markers for concussion? And if that is the case, how many of those markers does an athlete have to present with for you to say that's a concussion? Again, that's a very good question. And our understanding has really somewhat expanded over the years. And so far, as we really realize that there's no good definition of a concussion and therefore the diagnosis of a concussion is so difficult. We used to look at a few things and there were grading schemes that we were trying to grade the severity of a concussion. It turns out that it's not that easy. concussion, it turns out that it's not that easy. All we know right now is that it takes some type of mechanical impact and the brain and the body react to that. And then patients can display signs or symptoms and there are a host of signs. There are many more than 30. And those signs and symptoms

can be cognitive. So people can have loss of consciousness, they can have memory loss, they can be emotional, physical, obviously nausea, vomiting, headaches, and so forth are very commonly seen after concussion, or they can have much more subtle problems that can also be very significant, though, for example, sleep disturbances and so forth. So it can be emotional, cognitive, physical, or sleep patterns can be affected. So you kind of have to put all those things together with the initial impact and then have to figure out, well, did this player or did this individual really have a concussion or is there something else going on? So we really look at so many different factors, and it is sometimes a real challenge to figure out the severity and the impact of a concussion.

It's almost, once you explain it like that, I have even more admiration for the medical staff around organizations like the Giants when you've got to factor in all of those components. So if a player has what may be suspected to be a concussion, what is the protocol from taking him or her out of their business, their game, and for how long? Yeah, I think that those are very important things to talk about. And what has really evolved again over the last, you know, five to 10 years is that our, our threshold to diagnose a concussion or to at least have the suspicion that somebody has a concussion has been lowered.

And we're much more likely nowadays to assume that a player has a concussion because we look very, very carefully at a lot of these signs and symptoms. And not only that, now obviously during a game, you have the additional ability to review certain moments. You know, you can look at the videotapes, you can go back. And sometimes that becomes very important to really be able to look at the player

right at the moment of the impact or immediately afterwards. And that helps us sometimes to really make that crucial decision. Did the player have a concussion or maybe not? We have, especially at games now, we have a very, very dense network of independent or unaffiliated consultants who watch the players. So again, we're much more likely, I think, nowadays to really accurately diagnose a player at risk than we were years ago. And if that happens, usually, you know, that player is removed from the game and is very carefully examined. And that will either confirm or refute our diagnosis and then we'll make a decision. Is this really a concussion and does this warrant really removing the player from the game?

It's interesting you say that because that's the first time I heard any sporting organization, what I would call an elite organization, I'm thinking referring to the Giants, that would have a team posted to in-game identify any potential issues. So is that an initiative the Giants have taken on themselves or is that a protocol around the NFL? Well, you know, the Giants have been very proactive for many years in trying to diagnose and respond accurately to patients or players with concussions. But the NFL, as an organization over the last five to six years, has really taken this to a different level, meaning that they have invested a lot of resources in getting these

teams of specialists on the field during the game. the field during the game. We've got multiple now neurologists slash neurosurgeons who are present at every game, watch like every moment of every game. We've got ATC spotters in the booth who monitor very closely what's going on on the field. So it's quite remarkable. And I think from a professional perspective, when I'm at a game, it's pretty amazing to see the detail that really goes into assessing these players. But this has obviously evolved because of the overall increased awareness of the potential severity of concussions. severity of concussions this has evolved over the last five six years and has really resulted I think in a very remarkable improvement for us to diagnose and and then hopefully also treat and

address concussions early on how far I mean the only thing to do is take tackling out of the game and then it doesn't become football it becomes something else so I can't see that being the answer. How much further can we go with these sort of areas being addressed without changing the intrinsic value of the game of football? I think this is a fascinating topic to discuss. Life has changed. Things change all the time. Football has changed dramatically over the years and over the decades. If you look at soccer, there are tons of changes in soccer and demonstrate that this change has actually a benefit, has a positive impact on the players, on their health, on their families and so forth. I think if you can show that, then any type of rule change will be much more acceptable, not only to the players, to the organizations, but also to the individuals watching the game and the fans. So and that's kind of what we're doing.

You know, we're collecting data. So we're not just changing the rules. We're also really collecting data and we're trying to prove that whatever rule changes we implement, not we, but the NFL, the Giants and so forth, really lead to a greater safety and health of the players. So I think that's the other thing that people don't really talk about. If you can show that there's a benefit to the health, I think any type of rule change will be better accepted.

Okay. How do the players themselves react? Have they actually been proactive and come to professors and doctors and neurosurgeons like yourself and said, is there a way for us? Is there something we can do? Have they joined in this discussion, this debate? Absolutely. Individual players have, but then also the players association works very closely with the NFL. For example, they did a study comparing the helmets. You know, there are so many different types of helmets out there. And there was a study that was really supported by both organizations that looked at the quality of the helmets.

And they were able to eliminate a number of helmets that were just not good enough based on biomechanical testing. And now the players are not allowed to use those types of helmets because the understanding is that those helmets may not be safe. So there's a lot of activity going on when it comes to engineering, so equipment, education, but then also enforcement of rule changes. So those three fields together will really make football much safer. We've been speaking to a couple of people on the show, one of them, Dr. Samuel Brown, who you may know. And you're a surgeon up in Washington and has an affiliation with the Seahawks. he's involved with Vysis, the Zero One Helmet

which is the new kind of four layered helmet which has been proven under that NFL head health challenge to be the safest, do you think that is the way forward or is the solution as we've been discussing more of a

holistic challenge not just the head itself I'm a big believer in holistic approaches more of a holistic challenge, not just the head itself? Well, I'm a big believer in holistic approaches, not only for concussion, but also for spine and other health related problems. And I think that, I think it's definitely going to be holistic. The helmet alone is not going to make a difference because if you just look at the helmet you can use a helmet as a weapon we know that so uh and it so so regardless the helmet alone is important but it's not going to be the solution it has to be embedded in in the whole system approach and again that is education education of the players of the coaches of the trainers at every level, of the public. It has to be certain rule modifications or rule changes that have been implemented recently, but also over the years. And then for

sure, it has to be engineering. And that has to do with helmet safety, the mechanical safety of helmets, but also other devices that can be introduced into sports. Are all of the NFL organizations on the same page and the Giants, or are you a bit of a field leader at the moment? Well, I'm obviously a little bit biased, but I think that the Giants have a tradition of really spearheading safety, especially when it comes to concussions. It was one of the first football organizations that had a protocol in place for how to deal with concussed players. That dates back way before this was really on the radar screen of any of the major football organizations. There are publications.

We've done a number of research studies over the years looking at how can we better diagnose concussions. I mentioned in the beginning that the challenge with concussions is really how do you accurately diagnose it. We did some research on how we can use special MRI scans, for example, to hopefully better diagnose players at risk for concussion or players who had a concussion already. So I think the Giants have made a big contribution in the field and continue to do so. Thank you so much. You've joined a group of guests we've had on today's show that have shown, yes, the concussion is an issue, but that there's such positivity going towards helping diminish, not 100% solved, but address the situation in a very positive way. So, Roger Hartle, Professor Roger Hartle, thank you for your time. Thank you. It's a great pleasure. Fabulous talking to Professor Hartle, thank you for your time. Thank you. It's a great pleasure. Fabulous talking to Professor Hartle there.

Yeah. And the fact of he's looking at it holistically, he's not just saying you've got to deal with the head because that's where the brain is and that's where the issues are. Yeah. Everything is being factored in. And he said at the Giants, they've tried to lead the protocols. They've tried to lead right the protocols they've tried to understand even if you think about they have people watching every single player that's involved in a tackle and

they will then monitor for any telltale signs if they see something on a replay they will go to that player immediately and find out well listen it's very it's going in the right going in the right direction the nfl has made a lot of new rule changes, you know what I mean? But, you know, like he said, it's not just about the collision or the head. It's about all of this, you know, even like snapping of the head, you know.

What we now feel is there's, from looking at this from the outside, I understand there's such a will to do the right thing. Right. And the other thing he was saying there, we will advise, we will present information, and then the powers that be will decide on how or if they change rules. Oh, believe me, they will. I mean, you know, you're talking about this is such a big deal to the NFL. I think it's really the whole future of the league is hinged upon this issue in some way.

And I really don't think that they would look at it lightly in any way, shape, or form. I can't imagine. I mean, hopefully our listeners have had their minds challenged and are now aware that there is a lot more being done than possibly they thought was being done. We smacked you in the head with knowledge and hopefully you didn't get a concussion. Couldn't have put it better myself. That's our show. Hope you've enjoyed it and we'll catch you next time.