Interviewer: You mentioned a lot of the positives that have come from recognizing concussions. A lot of safeguards have been put in to place. I think there's been a lot of technology in terms of helmets. At least that I've seen. Is that an area that, as well can improve in terms of safety?
Dr. Joe Maroon: There are, there's a tremendous amount of work by many manufacturers to improve the helmet. How much can be improved?
Right now the helmet has been designed to prevent penetrating injuries. You'll never see a skull fracture from football. It's the inner lining that dissipates energy. There's a company recently that's developed a Kevlar technology. It's called Unequal. Kevlar, as you know, is used in bullet proof vests and...
Dr. Maroon: ...Why does Kevlar work? How does it stop a speeding bullet? It disperses the energy tangentially from the point of impact rather than going in. You may have material that doesn't penetrate but it doesn't dissipate the energy. This has been used in helmets with considerable success in a lot of players. It's a liner that goes in to help dissipate forces.
There's all sorts of companies now putting accelerometers in to helmets. Either on the helmet, on the head. A group in Cleveland has made a mouth piece with a triaxial accelerometer that measures forces in the XY and Z axis. So that you know not only how many hits you have but also how many G forces. The goal is like the badges radiologists wear in the X-ray department that tell you how much X-ray you've been exposed to. The simplified goal here is to know how many hits you've had. We know on an average season a high school kid will have his helmet impacted five to 700 times. That's a lot of hits.
We don't know what the cumulative effect of in quotes, sub concussion blows, are. There's a huge amount of research not just for football but the military.
It's a huge problem. The military. Fifteen to 20% of the soldiers serving in Iraq and Afghanistan come back with post-concussion syndrome and/or PTSD. We believe there's a connection to those in terms of a neuro inflammatory response that occurs in the brain when it's traumatized.