Samuel R. Browd, MD, PhD, FACS, FAANS, FAAP
Professor of Neurological Surgery at the University of Washington; Pediatric Neurosurgeon at Seattle Children’s Hospital; Medical Director of the Seattle Children’s Sports Concussion Program; and Director of the UW Medicine Sports Health and Safety Institute.
Ironically, a decade ago concussion wasn’t part of our world as neurosurgeons. I trained from 2000-2007 at the University of Utah, and I don’t remember managing concussions, seeing it in the clinic, or reading much about it in neurosurgery textbooks. Fast-forward to 2018; neurosurgery has taken a leadership role in managing traumatic brain injuries (TBI) and advancing research and clinical care for youth and adults with concussions. This work included major efforts including:
- Significant legislative efforts such as the enactment of strict return-to-play laws in all 50 states — known as the Zackery Lystedt Laws — protect young athletes from returning to play too soon after a concussion;
- Leadership by neurosurgery within the National Football League (NFL) leading to fundamental changes in concussion management with widespread acceptance across all levels of play; and
- Innovation for sports safety across the spectrum of protective equipment and concussion diagnostics.
Running the concussion program at Seattle Children’s Hospital and working as an unaffiliated neurotrauma consultant for the NFL in Seattle opened my eyes a few years ago to the lack of innovation in the helmet industry. While much energy in 2013 was focused on sensors to “diagnose” concussion, it seemed like there was an opportunity to improve safety at the time of exposure on the field and during practice.
Working with two amazing colleagues — Dr. Per Reinhall, chair of mechanical engineering at the University of Washington, and Dave Marver, a seasoned med tech executive — we began an exploratory and inventive process to redesign the football helmet specifically to address rotational forces which the literature suggests is the most likely culprit causing concussive injuries during helmeted sports participation.
With no preconceived idea of what a helmet should be, we began testing concepts arriving at a columnar structure that slowed and redistributed the impact forces, significantly lowering the impact g-forces seen during laboratory testing. At that point, we knew we were onto something important and very different in helmet technology. While we knew the technology was sound, we also realized that we needed input about how to design a helmet that young people would wear. The “mirror” test is very real, and many technologies fail to be adopted due to lack of use; being practical and cool we realized was very important. We talked to players, coaches, team doctors, athletic trainers and equipment managers. All of these individuals contributed ideas and suggestions, many of which made their way into the final design. Safety for our youth was paramount in everyone’s mind.
Fast forward to today and the technology has now been spun-out of the University of Washington by our company VICIS. Independent testing by the NFL and Virginia Tech ranked the VICIS ZERO1 helmet first in force reduction in 2018. Within two seasons, thousands of players have worn the helmet across all levels of play. Legends of the sport are supporting our work, wearing the helmet and advocating for advanced safety technologies, including local hometown favorite Russell Wilson. The team at VICIS was honored by Time Magazine as one of the “Best Inventions of the Year in 2017,” and numerous articles have been published on our work and the mission to make sports safer through engineering and medicine.
The core technology is now being looked at for implementation in a variety of other helmeted sports, and we are introducing a new youth football helmet designed specifically for kids, something that as a pediatric neurosurgeon has been my focus from the first call to Dr. Reinhall and Mr. Marver in the spring of 2013.
The military is also evaluating VICIS technology to protect our warfighters from impact forces, a mission our engineers are tackling with great resolve and pride.
As I look back on the experience, I think there are several lessons learned. Neurosurgery is on the front line treating complex medical problems. Often the solution to those problems are before us, and it takes that initial push to engage colleagues who bring a different skill set than our own to make an idea become real. The experience of working with people committed and passionate about improving sports safety has been one of the most amazing experiences of my career. I’m hopeful we can write the next chapter on sports concussion mitigation and advance the safety of participation for youth and adults alike. No doubt, neurosurgery will continue to lead the way in protecting our smallest and most vulnerable pediatric patients.
Editor’s Note: We encourage everyone to join the conversation online by using the hashtag #PedsNeurosurgery.