Q-Collar jugular compression device to protect from brain injuries in sports šŸ¤Æ

Hi friends,

Just found a strange device. With this they are applying pressure on the jugulars from the outside. This is supposed to create a jugular compression and accumulation of CSF to prevent the brain from moving.

I thought that sounds super healthy - get me two these instantly! :wink:

And then I thought when they are selling this as health support it is counterargument against recognizing jugular outflow disturbances as harmful condition.

That do you think?

Iā€™ve heard that abundant CSF accumulation also occurs after a good brain concussionā€¦

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Hey Dude,
This is Merl from the modsupport team.
Iā€™m in Australia and although CTE from repeated concussions has been identified, itā€™s only recently that itā€™s been (semi) accepted. Itā€™s my understanding that the sports clubā€™s insurers were the cause of it even being considered. These sports are ā€˜Manā€™ sports. Men are tough and a sports/football injury is a badge of honour. So, no one complains and no recognition was given. Now, we have people with complex brain injuries from repeated concussions making claims against insurers. That made them act.

Our bodies arenā€™t built for collisions, we donā€™t have hard shells or armour. Everything is exposed or thinly protected, but to be increasing CSF pressure to cushion the brain could have itā€™s own negative impacts.

I have issues with CSF and when my pressures within the skull varyā€¦WOWā€¦I get some wicked effects. I do understand the theory behind it, but the brain needs to have a balance of blood, CSF and brain matter. So, in increasing the CSF pressure something has to give. Itā€™s not the amount of brain matter that fluctuates, so it must be the blood, when does a lack of cerebral flow become risky? Our systems can handle some variation but too high or too low for too long and there can be serious consequences.

Just my 10cents worth
Merl from the Modsupport Team

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I am not sure I buy this but time will tell. This is based on imaging study of brain injury pre & post but NOT brain fluid volume measurements to explain the mechanism of protection they hypothesize. Not sure compressing IJVs on upright position increases intercranial pressure significantly (small increases but not significant enough). So I have more questions than answers.

  1. The study wrongly assumes that all drainage are done by the Jugular Veins. It is widely known that on upright position (which players will be unless they are playing football while swimming), Jugular Veins collapse and drainage is partially done by deep collateral veins which I believe this devices canā€™t compress from the neck area. So this calls into question the amount of brain fluid volume that is restricted while wearing it. This study (Internal jugular vein blood flow in the upright position during external compression and increased central venous pressure: an ultrasound study in healthy volunteers | SpringerLink) concludes ā€œCompression of the internal jugular veins or an increase in intrathoracic pressure does not reduce venous drainage but actually may increase intracranial venous volumeā€. This means the pressure increases within the veins but does have little to no effect of drainage.

  2. The FDA approval document clearly states that the device has not been proven to prevent concussion or serious brain injury (which is the main reason for wearing it to begin with)

  3. Even if we assume this induces temporary intercranial pressure, there are a lot of studies linking ICP to brain damage in the long term (Increased Intracranial Pressure - StatPearls - NCBI Bookshelf).

LIMITATIONS
ā€¢ The Q-Collar has not been demonstrated to prevent long-term cognitive function deficits,
and the ultimate impact on clinical outcomes has not been evaluated.
ā€¢ The use of imaging studies as a future indicator of brain injury has not been validated.
ā€¢ Data do not demonstrate that the device can prevent concussion or serious brain injury.
ā€¢ The Q-Collar should not be worn if it interferes with other existing protective equipment.
ā€¢ Wearers of the device should not depend on the device to protect them from all harmful
effects of head impacts.

BENEFIT-RISK DETERMINATION
The risks of the external compression device for internal jugular vein compression are based on
data collected in the clinical studies described above. Although no adverse events or serious
adverse events (e.g., syncope, loss of consciousness, etc.) were reported during the studies, based
on products with a similar mechanism of action and other clinical knowledge, there are probable
risks to patient health without adequate mitigations in place:
ā€¢ Small amounts of excessive pressure to the muscles surrounding the IJV could disrupt the
flow of oxygenated blood through the arteries to the brain leading to syncope.
ā€¢ Use error could cause injury to the user including excessive head impacts caused by a
false sense of protection, use of the device by athletes who should not wear the device, or
interference with existing protective equipment (e.g., helmet). .
Source FDA Approval : https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN200017.pdf

I also agree with the assessment of New York Times writer below.

Concerns About Q-Collar Not Approved By FDA To Prevent Concussion ā€” Concussion Alliance).

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Who needs a badge of honor from playing an aggressive sport at the cost of permanent brain or body injury?! The human body wasnā€™t built to do some of the things we demand of it, and the price paid can be very high even for amateur athletes. Unfortunately, many realize that too late.

@TheDude - I love your ā€œtongue-in-cheekā€ comment. Anyone on our forum whoā€™s had IJV compression will likely shudder at the suggestion that IJV compression is brain protective. :scream: Thatā€™s about as far from the truth as you can get. Though the theory of having extra blood in the brain to act as a cushion sounds plausible, it just doesnā€™t make sense. As @Merl noted

@KoolDude - Great analysis & backing up of your opinions w/ other research article links. The Limitations & Benefits-Risk Determination really say it allā€¦thereā€™s no evidence that this device helps, & it may harm instead.

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