Transcript

Dr. Theo Versteegh  00:00

So we've had, like now, multiple sports teams across both genders and multiple sports that, after implementing training, in many cases, dropped down to zero head and neck injury seasons the following year. But also, pretty excitingly, is so far in in I think, every case, within three years of adopting Topspin360 they've gone on to win their conference championship.

Dr. Ayla Wolf  00:29

Welcome to Life after impact, the concussion recovery Podcast. I'm Dr Ayla Wolf, and I will be hosting today's episode, where we help you navigate the often confusing, frustrating and overwhelming journey of concussion and brain injury recovery. This podcast is your go to resource for actionable information, whether you're dealing with a recent concussion, struggling with post concussion syndrome, or just feeling stuck in your healing process. In each episode, we dive deep into the symptoms, testing treatments and neurological insights that can help you move forward with clarity and confidence. We bring you leading experts in the world of brain health, functional neurology and rehabilitation to share their wisdom and strategies. So if you're feeling lost, hopeless or like no one understands what you're going through, know that you are not alone. This podcast can be your guide and partner in recovery, helping you build a better life after impact.

Dr. Ayla Wolf  01:30

Dr, Theo Versteegh, thank you so much for coming on to life after impact. Welcome. Thank you so much for having me. I'm excited to be here. Yeah, I'm so excited to learn more about this device that you created in the world of concussions, I think you're one of the few people who's really doing things to try to prevent them in the first place. So why don't you tell us a little bit about your background and kind of how you started Topspin technologies and this device that you created.

Dr. Theo Versteegh  01:59

Sure. So I'm a physiotherapist by training. I've been practicing predominantly, or almost exclusively, in sports medicine, I guess, for over 25 years now. And at the last clinic I was working at, I was one of the one or two sport concussion specialists. My interest began back in 2011 and it was, I don't know how many of your kind of audience are hockey fans, but Sidney Crosby had a very significant concussion back in 2011 that ended up keeping him out for almost a year. And it the idea spawned where all good ideas come from, which was at the bar after playing wreck hockey myself, so after a few beers, when you solve all the world's problems and and they were showing that, like the injury, you know, the previous one, that four days later, he was re injured, and myself and my teammate from from hockey. He was also my strength and conditioning coach back when I played football in university, and we got chatting, and that hit, it was quite noticeable how his head just whipped around like it wasn't even attached to his body. And certainly, back when I played football, we had the, you know, somewhat archaic, but the four-way neck machine. So, you know, you push forward, push back and side to side. And, you know, we got talking like, oh, His neck was stronger. His head wouldn't have flown around, like it was on a bobble head and, and that kind of got us thinking about just kind of neck strengthening in general. And kind of brought back to the, you know, the four way neck machine. And with my physio background, I was thinking, okay, like, Well, that'll strengthen it going forward, back, side to side. But it's also that kind of rotational impact. And further, it's also kind of that fast eccentric load, so where the muscles are contracting, but they're getting longer, so they're absorbing the load, they're not generating the load. And it's a very different type of contraction that you you can't really get with doing a traditional four way neck machine. And so it got me thinking, you know, as a as a physiotherapist, and kind of key components of, if you were to train the neck to protect and stabilize the head in space, what would that look like? And again, the the key thing is to strengthen the the muscles eccentrically. But concussions are also very fast events, so you're going to have to kind of get kind of a the speed of contraction involved. So you're focusing on the fastest twitch muscle fibers, which are the type 2x fibers, or the type 2b fibers, if you depending on when you do training, and which are three times faster than the type two a fibers. And traditional neck strengthening, you end up focusing on that those type two a fibers, which are notably slower.

And also, you know, the neck is an incredibly complex neuromuscular system, and it doesn't just move the head. In single planes of motion, kind of forward, back, side to side, like it is. We are constantly, you know, if you're playing sports, your head's on a swivel, and it's that rotational direction that's really key for stabilizing and protecting against potential head and neck injuries, because we're quite unstable, statically in that because we don't have any structural stability to prevent rotation, because it's such a key movement that we've got to be able to do very quickly, and we can't have it restricted at the same time, it ends up being very prone to injury for that exact reason, because you either have mobility or you have stability. So with that kind of a lot of kind of thoughts, and it's like, wow, that's a pretty tall order of training in order to to properly train the neck, to stabilize a head in space. Was playing around with for a few months, just kind of different approaches and concepts. And I just happened to have with another kind of concept. I was working on a what ended up being an axis on top with a with a weight, and it kind of swung around, and I was like, Oh my God, that's this is exactly what I'm trying to to achieve. And that was the inception point of what is now the top spin 360 Gotcha.

Dr. Ayla Wolf  06:15

Well, everything you just said makes so much sense about differentiating between fast twitch fibers and slow twitch, and obviously in in sports, and, you know, I did a lot of martial arts, and I have a very long, thin neck that I probably lacked the needed strength. And so when I got punched in the face, I mean, there was a ton of rotational forces, and those are coming at you very quickly. Nobody's punching you in slow motion. Absolutely, it makes sense that you need to train something and to actually strengthen those fast twitch muscles versus just those machines that people go through, where it is a slow, controlled motion that maybe isn't the exact replica of what you need when you're in a sport like boxing or martial arts or football or

Dr. Theo Versteegh  06:58

Absolutely, because these are like ballistic, high impact movements and training slowly, isotonically, in a single direction, it doesn't translate. I mean this, you know, for the strength and conditioning coaches in your audience, it's the said principle so specific adaptations to impose demand. Just as in order to train for to be a world leader in 100 yard dash. You don't train by running marathons. Yeah, yeah, exactly mimic that in some capacity. And the other thing is, it has to be safe, you know, when you're doing it. Theoretically you could, you know, like, just do lighter and lighter punches and just kind of build up the strength of the punch. But what if, you know the person's fatigued, and you go to that next load you're causing the injury that you're trying to prevent. Yeah.

Dr. Ayla Wolf  07:45

Okay, so I've seen pictures of your device. It kind of looks like a helmet, almost, with a little boom that comes off of it, and that that boom is weighted. And so talk to me about kind of what this looks like when people are using it. What types of movements are they doing? I saw a little video of you folding some laundry while you're folding laundry. Multitasking at its best,

Dr. Theo Versteegh  08:08

it's exactly so it's got a essentially mounted access, and it, you know, as everything does use these it has a an app. So you turn the helmet on, and you pair it with the app, and it brings it to the training page. And so I'm just going to do demonstration. I'll kind of walk you through what I'm doing, for those who are listening. But essentially, it's essentially mounted access on the apex of the helmet with a small weight that is free to spin in the full 360 degrees. And once you've kind of popped the helmet on, securely fitted, you press start, and then the app just merely counts the revolutions, and also calculates out the centripetal force that's generated, which is mass times velocity squared over R. But we're not just interested in the force. We want to know, there we go, the rate of force development. So how quickly can that neck generating multi planner stabilizing force? And that's really kind of the metric that we want to that we want to know and quantify, is how good is the neck at stabilizing the head in all directions of motion. So with that, it ends up being force divided by time, which is rate of force development, so in pounds of force per second. And then the app afterwards shows you your best rate of force development in a clockwise and counterclockwise direction, in pounds of force per second. So that is, yeah, a direct measure of the next multi planar, dynamic, next strength and stability.

Dr. Ayla Wolf  09:49

Okay, awesome. So not only are you using it, but the app is tracking a lot of different metrics to be able to show improvement over time. As far as stability and. Now you're not necessarily moving your head that much, but you're moving it quickly. That's right, yeah. And then in terms of the I know you've been doing some research on this, and you've actually found some incredible outcomes in terms of sports teams that are implementing this, and by the end of their season, like there's zero concussions. Yes,

Dr. Theo Versteegh  10:19

it is so we've had, like now, multiple sports teams across both genders and multiple sports that, after implementing training, in many cases, dropped down to zero head and neck injury seasons the following year. But also, pretty excitingly, is so far in in, I think every case within three years of adopting toxin 360 they've gone on to win their conference championship.

Dr. Ayla Wolf  10:53

Okay, so you're not just preventing concussions, but somehow you're improving sports performance,

Dr. Theo Versteegh  10:58

yeah, and it like and we've been doing so looking at the actual statistics, because that was, you know, I did my PhD research, and then multi Ayla dynamic neck training, so unfortunately, I had to do a bunch of statistics, and you learn how to analyze that stuff. And, yeah, like, I mean, the results are really hard to argue, when you look at kind of pre top spin and post topsman, the number of wins and then the increase in championship, there's a three and a half fold increased likelihood of winning a championship after implementing tops compared to before.

Dr. Ayla Wolf  11:34

well that's a motivator for a team to adopt this technology. And how much time are people spending actually using the device, like per day or per week? Yeah.

Dr. Theo Versteegh  11:45

So it's that's. The other thing is, I'm very fond of the minimum effective dose and and high intensity interval training. So it's two minutes of training twice a week. Is the kind of the studies that we've done, and quite dramatic and substantial improvements. Specifically, the outcome measure we've been doing is multiplanar, static neck strength. So we do just look at flexion, extension, right, left side, flexion, right, left, rotation strength and the average improvement in all of those directions. So constant neck strength is 1% each two minute training session that they do,

Dr. Ayla Wolf  12:24

wow. And so you're talking four minutes a week, yeah, wow. And so that's obviously very doable. And that also makes me think that clinically, you know, you have a lot of people going into physical therapy clinics, all kinds of clinics that are doing different rehab and sports performance, and so that would also be very easy to implement in a clinical setting, too. If you're simply needing someone to come in, you know people are already coming in twice a week, you just add two minutes to their session and have astronomical results in terms of neck strength and stability and preventing future concussions.

Dr. Theo Versteegh  12:58

That's right, yeah, and it's it's proving very effective at treating those who are clinically symptomatic with concussion, you know, headaches, dizziness, post traumatic migraine, stuff like that. We've got a study that the data collection has done, the analysis done just in the process of writing up. It was a randomized control trial, where we took persistent post concussion syndrome for greater than four weeks post injury of 13 year olds and above. So this is if there's a high risk population that you're going to be timid about experimenting on. It'd be a 13 year old girl who suffers four blade concussion, who's still suffering with headaches, you know, four weeks later, yeah. And because the device is inherently safe, you can't get it going any faster than you are capable of getting it spinning. So whether that's whatever the limiting factor is, whether it's strength or neuromuscular control or balance or proprioception or coordination, it's a very small way it will not spin on its own. So it's kind of like a hula hoop. If someone's really good at hula hoop, it looks like they're barely moving and things is whipping around them. And do it, you're like, I can't get this thing up. What's going on here, right? And so it's, it's a similar kind of neuromuscular pattern. So it's inherently safe

Dr. Ayla Wolf  14:16

So this is a hula hoop for the head!

Dr. Theo Versteegh  14:19

pretty much. That's right, that's right. And and so with this study, it was a randomized control trial, and 29 in each arm, and it was at least four weeks post injury. On average, it was closer to three months post injury, which is a critical window, because at that point when you've had a concussion, you've gone to like every doctor, physiotherapist, oh yeah, it'll be better by, you know, three months, like, you know that 12 week mark, it'll be fine, but then it gets to that 12 week mark, and they're not fine, and there's a significant uptick in anxiety. Like, everyone was telling me I'd be better by now, and I'm not better. Like, what is going on? So when we looked at it, they were 72 days post injury. They're getting close to that danger zone, if you will. Ayla and one group got standard of care, which was referral to physiotherapy, and the other group got standard care, referral to physiotherapy and Topspin360 to take home train on at two minutes twice a week for eight weeks. At the end of the eight weeks, the main the primary outcome measure was scat five symptom scores. Like, where are you with all of these symptom profiles? And I know you're familiar with the scat five symptoms and the intervention group had over 70% reduction in their SCAT5 symptom scores, whereas the control group actually had a 10% increase.

Dr. Ayla Wolf  15:39

Wow, that's a huge difference.

Dr. Theo Versteegh  15:41

Huge difference.

Dr. Ayla Wolf  15:42

Yeah, that's so exciting.

Dr. Theo Versteegh  15:44

Yeah, it's been it's been remarkable. And then the other ones we looked at was the neck disability index and the headache disability index. And both of those also improved dramatically, 35 and 40%

Dr. Ayla Wolf  15:57

so you're finding that even people who actively have neck pain, are able to use this device, and it's actually improving their neck pain. And so that, because just when I watch you do it, you know, it would seem like, Oh, if someone has neck pain, that might create more neck pain, but you're actually finding the opposite,

Dr. Theo Versteegh  16:15

yeah, and again, because you know, when I do it, I've, I've done it a few times, so Whoa. And someone with neck pain looks at and they're like, there's no way I'm putting that crazy helmet on. Like, no way. And to be honest, that's actually probably a leading indicator that this will help them is when their visceral response is, oh, there's no way I'm putting that on. Okay.

Dr. Ayla Wolf  16:41

And so there's a bit of a learning curve, or a process of getting familiar with the device and how to use it, and I'm assuming, like you mentioned, you've used it a lot, so you can do it, and it looks great, like you're an expert hula Hooper, but when someone's starting out, you're finding their velocity is maybe a lot slower,

Dr. Theo Versteegh  16:59

a lot slower. Yeah. I mean, so the first time average healthy adult female puts it on is around, they'll generate around three to three and a half pounds of force per second. And average healthy adult male, first time, you know, completely novel to it, no history of head or neck injury, is around five, five and a half pounds, in my experience. And even with that study, the average RFD of someone who is, you know, chronic neck pain, chronic headache, dizziness, migraine sufferer, they're less than one pound of force.

Dr. Ayla Wolf  17:33

Okay, so you're kind of seeing what some of these initial metrics look like when people are starting out using the device, and then how that improves over time,

Dr. Theo Versteegh  17:43

yeah, yeah. And it's, it's, again, quite dramatic. And it's amazing how telling it is, like that initial value of where they are from a neuromuscular cervical perspective,

Dr. Ayla Wolf  17:59

Yeah, amazing. And then super exciting. You actually won an award from the NFL, which was an athlete Health and Safety Award. 1100 companies basically applied to get this award, and you guys won it. So a, congrats, thank you. B, tell me a little bit about, you know, what that experience was like and how that's helped you to maybe get into, you know, more just more spaces and more opportunities and more teams. And because it sounds like you've just got this incredible device that's making a huge difference in these athletes lives, it's been,

Dr. Theo Versteegh  18:31

it was really exciting. So that was, I guess, back in a few years ago now, like 2019, and we applied for this, you know, first and future innovations to advance athlete health and safety, and there's 1100 other kind of that applied for it, and we got, I guess, top five with the applications. So we were flown down to Atlanta, where the Super Bowl was that year, and we got some prep and all this, and we presented on the Saturday before the Super Bowl, and Roger Goodell was there, and Larry Fitzgerald and the whole panel and kind of presented to them. And in the end, we ended up winning. So we got like, $50,000, 2 tickets to the Super Bowl. And yeah, and we're winners of the first and future award for innovations to advance athlete health and safety. And, yeah, it timing could have been better, because very shortly after that, covid hit and kind of shut everything down. You know, now that things have opened back up, we got our kind of first NFL football team to fully adopt and train the entire team, which was the Detroit Lions a couple years ago, and they went on to have a zero head and neck injury season that year. So it was really saying, and you know, of note, they also went on to win their conference championship for the first time in over 30 years. They had the longest playoff win drought in the NFL at that time, at 31 years, the last time they won, they had Barry Sanders as their running back.

Dr. Ayla Wolf  19:53

So Wow. Okay, so you might have had something to do with that.

Dr. Theo Versteegh  19:57

It's, you know, I'll tell you what, like, you know, do. Correlation is not causation, but easy to hang out with as good things happen, yeah?

Dr. Ayla Wolf  20:06

Well, gosh, I feel like all of the teams need to be piling on and adopting this technology. Now. Is this also available for just the average person who's been in a car accident has had a neck injury, concussion, like, can people purchase this device for home use? What is the distribution at the moment? The

Dr. Theo Versteegh  20:25

key thing to note, and this is, like an advantage of it, is it's actually, it's a piece of exercise equipment so similar to a treadmill, and you can use a treadmill to rehab kind of post concussion. The treadmill is not a medical device, but you can use it to treat various physicists. So we do it is a piece of exercise equipment, and again, the same kind of qualifications, you know, consult your healthcare practitioner before embarking on it. And in those cases, we end up, like with me as a physiotherapist and my PhD in it, generally, the avenue we like to take is to train healthcare practitioners how to use this device as therapeutic exercise to treat various conditions, just as you would. You know, hey, you got a treadmill. Let me show you how to do the concussion treadmill test. Right? Got it so there is the option for that, and it's, yeah, my clinical folks, although it's only part time, I focus on the essentially 510, sometimes 20 year history of chronic whiplash, chronic concussion, chronic dizziness, headaches, migraines. And it's, it is really quite remarkable, the results that these long standing patients will see with doing some appropriate neuromuscular training of the neck, because in most cases, if they done neck strengthening, it's, you know, grab a theraband and kind of push it this way or that, or deep neck flexor and just kind of hold it there indefinitely, which doesn't translate to how the neck functionally works, and in some cases, it can be detrimental in other areas of neuromuscular control. So there's evidence that that type of strengthening is detrimental to proprioception, which is really key of what the next role is with the body, so the neck has the most proprioceptive fibers in the entire body, and that's not a waste of resources, because, because we walk on two feet, we need to know exactly where our head is in minute detail in order for us to not constantly be tripping and falling on our face. Right? Yeah, absolutely.

Dr. Ayla Wolf  22:41

And so right now you're hoping to essentially, kind of get this device into more clinical spaces in addition to, like, sports teams and and then have people access it that way.

Dr. Theo Versteegh  22:54

Yeah, yeah, exactly. I mean, there are, as I mentioned, the, you know, people can it is a piece of exercise equipment, but, yeah, it's best because it's so novel and unique. Like, it's not something, oh, I get it. You put on, you do this as it's not intuitive at all. Like, there's, there's literally nothing that you can compare to. Oh, it's just like doing this. Nope, it's, it's not like anything. So that's one thing that we've learned is because the steep learning curve for from a rehab capacity, you know, again, the ones that we can help the most are also the ones that are most apprehensive about using it. So it requires just kind of, you know, guidance and just proper assessment, clinical assessment, and, you know, prescription on how you'd use this piece of exercise equipment, just as any other kind of therapeutic exercise applied, right?

Dr. Ayla Wolf  23:42

Since many people fall into the trap of thinking more is better, and you're saying you only need to do this two minutes twice a week, then that's also kind of important that maybe people aren't taking it and then doing it for 20 minutes every day.

Dr. Theo Versteegh  23:56

Yeah, exactly. Well, the two minutes I get 1% then I'll do it like 20 minutes, and then I'll get 10% Yeah, no, it's not gonna work that way. You know, it's, it's funny how, like, we're talking about this, and it seems common sense, but like, that is kind of what you run into with it. So it's like, yeah, you do have to be careful on how it's, how it's implemented,

Dr. Ayla Wolf  24:17

yeah, exactly. And, I mean, I've fallen into that trap when those Vibram Five Finger like running shoes came out, you know, over a decade ago, they're like, Okay, you know, only go for like, maybe half a mile. I popped those things on and went for like, a five mile trail run and gave myself Achilles tendinitis, absolutely.

Dr. Theo Versteegh  24:36

Yeah. Oh, barefoot running, that's what you got to do.

Dr. Ayla Wolf  24:40

Yeah, exactly. Let's go barefoot, run through the woods for five miles.

Dr. Theo Versteegh  24:41

Like, how much different is it from running with shoes? I know how to run.

Dr. Ayla Wolf  24:49

So I could totally see myself popping this helmet on being like, All right, let's go right 10 minutes.

Dr. Theo Versteegh  24:53

 Yeah, yeah. It's, yeah, that's exactly the precaution. Yeah. Yeah, yeah, because it's exercise, and if you overdo the exercise, you're gonna, you're gonna pay the price. You know, like your body will get better, but it's, you know, the late onset muscle soreness is, and especially in the neck, with someone who suffers from headaches or migraines, if you go aggressively at it, it'll be like, Oh, that triggered my migraine. Yeah. No kidding. Like this is targeting the exact area that is the source of your migraines. And you've just trained it quite aggressively, so yeah, at the same time, it's also confirmatory that this is what this is targeting the tissues that are at fault,

Dr. Ayla Wolf  25:35

right, right? Yeah, your your headaches are coming from your neck.

Dr. Theo Versteegh  25:40

Absolutely. Yeah, yeah.

Dr. Ayla Wolf  25:43

So in addition to kind of seeing, okay, so you've kind of talked about people are using this device, they're actually seeing less headaches, less migraines, less dizziness, I'm assuming improved balance as one of the markers too. Have you done any studies specifically looking at balance,

Dr. Theo Versteegh  26:02

so I haven't, but there was a study that was done at Acadia University using tospen and healthy group of university students, who you always do your studies on, they did improve static, standing balance with training on tospin. And that's like it, which, again, clinically, that's what, I've seen is, because I all treat people with chronic dizziness and you know, chronic headaches, chronic migraine, the average reduction in with my clinical population with train on tossman is I use the headache disability index as a as a marker of their headache score and kind of impairment. And the average reduction in headache disability index is over 50% after the first month alone, and about 75% after the second month. Wow, that's huge. Yeah, yeah. And it's, again, kind of two minutes of training with the with that, where they kind of see me and have their home, then it's every other day, because it's, again, it's only two minutes of training and have it with them. You know, it's not like, Oh, I've gotta drive across town to put this helmet on for two minutes and drive back.

Dr. Ayla Wolf  27:06

Yeah, yeah. And are there anybody that you would say maybe isn't a good fit for this, at least at certain time points in their recovery or based on what they're dealing with?

Dr. Theo Versteegh  27:16

Yeah. So basically, anyone who is, like, I guess, acutely unstable neck. So you know, if it's, if it's immediately after a whiplash, and you haven't had that kind of, you know, ruled out and cleared if you've got any active fractures at the point. And then the the one screening test we recommend is, it's the sperlings compression test. So essentially, you put kind of about five pounds of force through the spine, through the head and the neck, and if they can't tolerate that, like the weight of the helmet system is about five pounds. So you just, you know, that's where you do some kind of manual therapy and acupuncture. Would like just to settle that system down until it can tolerate a bit of compression load.

Dr. Ayla Wolf  28:02

Okay, gotcha. And then, in terms of, like, ligament laxity, you mentioned whiplash. So if somebody does have a lot of cervical instability, a lot of ligament laxity, can this be helpful? Do they have to, like, do certain things prior to working up to it?

Dr. Theo Versteegh  28:17

Yeah, and no one. And the reason it's it's very helpful on this and that, like, think about, you know, traditional ankle sprain, where, if you, you know, grade three atfl rupture, so all of a sudden you've lost static stability of the ankle. You're not going to get surgery on that particular ligament. It's the most common one to be kind of fully ruptured. But what you are going to do is rehab it by not just strengthening the muscles like you're not going to get there by doing green theraband inversion and E version, right? You've got to dynamically train those muscles to restore the function that you've now lost statically, dynamically. So the muscles now have to compensate for that lack of structural stability with dynamic stability. So with, with, you know, most rehab exercise you'll be, you'll be doing progressively more challenging balance. So, you know, standing on one foot solid ground, then on like a Bosu, or like a foam air x, or something like that. And then getting into, you know, some like hops, two legged hops, and then single legged and you start to dynamically load those tissues in order to normalize it and to get it to compensate. And that's where, if you rehab it properly, then even though they no longer have that structural stability, that static stability, they are completely pain free, and they're able to do all of their activities from before because they've retrained the brain to get the proprioceptive inputs from the muscles no longer from that the ligament that would tell them when it's stretched. The same thing applies for the neck, is if you've got ligamentous laxity, then you. Retrain the muscles around it to compensate and to, essentially, yeah, compensate for that and, and you can bring it up back to that level, incredible. Yeah, it's been, it's been exciting.

Dr. Ayla Wolf  30:13

Yeah, yeah. And so what are you seeing next? Like, do you have future research you want to do? Are you just, at this point, kind of trying to raise awareness and get, hopefully more teams to adopt this as a concussion prevention strategy?

Dr. Theo Versteegh  30:28

Yeah. I mean, ideally, certainly, as you know, increased injury resilience and and even, you know, performance enhancement, because it's also the neck is a kind of the last frontier of performance ends. We everyone, everyone's got leg day, and everyone does, you know, chest and what's your neck day, you know, yeah, yeah. And trying to kind of bring that into the mainstream so that people appreciate that. Actually, this plays a real significant role in sport performance, because the more dynamically stable you are, the better you're going to be able to see the field and awareness of where your body is in relationship to other opponents, or, like, the ball, the puck, the whatever object that you're playing with,

Dr. Ayla Wolf  31:09

yeah, yeah, the other guy's fist, yeah, yeah.

Dr. Theo Versteegh  31:14

Well, exactly, yeah, yeah, being able to absorb that, like, that's Yeah, certainly a big role in MMA or boxing, because, like, every impact of the head is high impact, fast movement, that you've got to be able to dynamically stabilizing it. So it's the nice thing is, again, it gives you an actual metric value as to how stable, dynamically stable, your neck is. And the higher it is, the Yeah, the the more resilient you are to those impacts. Yeah.

Dr. Ayla Wolf  31:45

I mean, I remember learning how to snowboard, and when you're learning how to snowboard, you constantly are like, falling backwards and falling forwards, and then you wake up the next day and your SCMs are just on fire. And, I mean, you feel like,

Dr. Theo Versteegh  31:58

yeah, commonly, a mild headache, right? And there's like, oh man, yeah, on, like, hard packed, oh, exactly.

Dr. Ayla Wolf  32:06

And even when you think about again, like, your head, your your, you know crashing your head is going back pretty quickly. Like, those are, those are pretty high velocity whiplashes you can get when you crash snowboarding, wakeboarding, all of all of the sports I used to do all the time, right?

Dr. Theo Versteegh  32:22

Yeah, oh, for sure, yeah. And, I mean, it's interesting, because, like, even for me, I've got a 11 year old son who wanted to play, he was playing flag football, and they wanted to play contact football. And I said, Yeah, that's fine, but not until you get to a safe level on on my helmet and and sure enough, he did, and now he's playing content and, well, it's, for me, it's, it's peace of mind that, like, you know what? Yeah, he, even if he does, it's not gonna make him concussion proof. But even if he does, he'll be resilient enough that it's not gonna be like, Oh my God, you're gonna lose the next year of academic and you're gonna be, you know, feeling like you need a dark room, and everyone's like, Nope, I pretty solid that you'll you'll bounce back.

Dr. Ayla Wolf  33:06

Yeah, yeah, that's amazing. This idea of you can have peace of mind if you've got yourself or your kids in sports, and you just want to know they're going to be safe and protected. And,

Dr. Theo Versteegh  33:16

yeah, certainly a big part. But yeah, no, because you've got a history with, essentially, martial arts and, and, I mean, jujitsu is certainly one where kind of learning to fall would be, would be key. But also kickboxing, like, Yeah, I mean, you've got a long neck and just a beautiful little target that's

Dr. Ayla Wolf  33:37

Exactly, yep, I have a long lever there for my brain to get rattled, right? Yeah, well, and in Jiu Jitsu, you know, you're getting choked out too. There's a lot of neck trauma, and there's, I mean, people in jujitsu generally do have very strong necks because they are often on their back, but they're holding their head up as they're moving around. And so, you know, I think jiu jitsu inherently does promote good neck strength, but to have that really quick, like you said, the fast twitch muscles also getting strengthened and being able to stabilize in the moment, I could see that as a huge benefit, too. Yeah, yeah. Gosh. Well, that's amazing. Your app that is associated with the device is basically measuring, like the velocity, the rotations. It's tracking people over time. So, like, somebody has an account that actually shows their their improvements,

Dr. Theo Versteegh  34:27

yeah, that time and date stamps all the training sessions. So you can very, kind of quickly go through and you can track your progress over time. And the other neat thing is that it'll also, like, if you are, you know, like, oh, geez, I was kind of flared up, or had a cold, or whatever. You'll you'll see your scores drop in relationship to that, because it is kind of quite sensitive to kind of how you're feeling that day, your energy levels, and, yeah, and I mean, if you've got some kind of late onset muscle soreness, it's going to kind of slow you down a bit. So it is really kind of neat to see. See people kind of progress, generally, they do improve quite, you know, almost linearly within within reason. But you will see variations just on somewhat day to day, on, on how they're feeling.

Dr. Ayla Wolf  35:13

Okay, amazing. So it's almost like a sensitive, like a heart rate variability is it can detect subtle changes in how you're feeling that day.

Dr. Theo Versteegh  35:22

Exactly, yeah, and especially, and also, if, like, we've got kind of a case with before, a volleyball player trained herself up to a very, kind of stable level and then took a huge shot off the head, you know, and everyone thought she got her hands up. Was like, Oh no, that beat me right off the face. So Coach, okay, well, we've got test you for concussion. Like, No, I'm fine. I'm fine. Took her out test for she was fine. She cleared it. She went back into the game, finished the game. Coach followed. Like, you sure you're fine? Yeah? Like, no, what's the big deal? Two days later, when she went on her tops, when her top swing score dropped significantly, and then, like, a couple days later, she was back up into a regular training kind of range. But it just goes to show that, no actually, her neck absorbed all of that and is going to need kind of a couple days to recover, then she'll be fine. Now, had she played another game on that second day and took another hit to the head. Chances are she, she would have been concussed, right? Because down that second day, her score on the toss one would have flagged her as as higher risk.

Dr. Ayla Wolf  36:31

Yeah, yeah. You know, I had kind of, I'd given myself a concussion in March of this year. But what was interesting was that the I was bending down to unplug something, and I stood back up, and there was a cabinet door that was open, and so I smacked the top of my head really hard into the cabinet door. The funny thing is that I had done the exact same thing, like either the month or two before, so I had done the exact same thing four to six weeks ago, and I was fine, but the second time I did it, it was immediately dizziness, nausea, headache, blurry vision. So, yeah, it's that idea of, like, you know, you do something once you might be okay, but the same thing happens shortly after, and your body's like, okay,

Dr. Theo Versteegh  37:16

yeah, that's right. And actually, it's interesting, because that's also what I think happened with Sidney Crosby, because, like, when he took that impact, like, you know, he was cast her neck injury, but you see, it's like, that was a pretty significant injury, and then he seemed to be fine. He was back in, like, four days later, and then his the next hit was into the boards you look at, you're like, really, that kept him up for almost a year. No, the first injury took away all his defenses, and then he's, like, just going around, completely prone and, and that's what take him out the second time. Yeah, now you're dealing with a lot of stuff. You've got to, you know, rehab, before you can get back to the game.

Dr. Ayla Wolf  37:57

Yeah, yeah. Did you know my mentor, Dr Carrick was one of the people who was very instrumental in getting Sid Crosby over that concussion and back in the game.

Dr. Theo Versteegh  37:57

I did know, yeah, yeah, that was pretty exciting.

Dr. Ayla Wolf  38:07

Yeah, yeah, he's incredible.

Dr. Theo Versteegh  38:13

And so with your because obviously you've kind of come round to focusing predominantly on on concussion and the return, and the majority of that is from your own kind of personal journey.

Dr. Ayla Wolf  38:26

I mean, initially, when I started out, I focused on fertility, yes, and so the first seven, eight years I was in practice, I was doing women's health, fertility hormones. During that time, I did rack up a lot of my own concussions. And so that's what led me to start studying Functional Neurology through the Carrick Institute, go back to school, get my doctorate degree where I was studying traumatic brain injuries, and so, yeah, that was all kind of my journey to heal my own brain and then recognize that things like herbs and supplements only really get you a certain way, and then you really need the active neuro rehab, like, that's so important. And so that really led me to trying to just get the word out there to more people who are, you know, running into roadblocks in medicine. And so, yeah, I've just once, I've fixed my own brain. And then, you know, when I got that concussion in March, because I knew what to do. 10 days later, I was pretty much symptom free again. So to say that my on my 10th concussion that I healed in 10 days, I think, is a testament to the fact that when you know what to do, and you do it right away, you can get better, and you know your brain can recover when you give it the right the right things,

Dr. Theo Versteegh  39:41

yeah, no, absolutely. And it's yeah, you're exactly right, because normally, kind of, with each subsequent concussion, there's a much higher risk of it being a prolonged process, yeah,

Dr. Ayla Wolf  39:53

yeah, yeah. I mean, I worked with a competitive half pipe snowboarder, and she said that. She had been doing that for 13 years, and she's like, Yeah, pretty much once a season, I probably get a concussion. I mean, it's just these things are so much more common, and people, I think, always hope that if they get it, they can just walk it off and be okay. But the idea that there's things that we can do to prevent them and prevent the severity of them, so important we need. I just feel like, based on what I'm hearing, like every single sports team needs one of these helmets.

Dr. Theo Versteegh  40:27

Yeah, absolutely. I mean it's, yeah. I mean, the the results that we're seeing, it's just, it's mind boggling, but it's also kind of like selling insurance, right? You know, it's just like, prevention is, is, surprisingly, it's a tough sell, because you're like, Ah, no, I think we're okay with that. We didn't have that many, you know, concussion last year. They almost don't want to, you know, admit to it. It's like, oh, okay, right. You know, the performance enhancement side is, is, you know, quite beneficial. So we'll probably focus on that with the top swim, 360 and then more, the rehab side, using therapeutic exercise to treat

Dr. Ayla Wolf  41:08

and right? It's almost like the concussion, concussion prevention is the added bonus to enhancing your performance.

Dr. Theo Versteegh  41:16

Yeah, totally improved injury resilience. And you know, chances are your team's gonna win your

Dr. Ayla Wolf  41:22

championship, really, right? Yep. That makes it easier to sell, right there.

Dr. Theo Versteegh  41:26

It does absolutely, predominantly the journey.

Dr. Ayla Wolf  41:30

Are you making these helmets in different sizes? I mean, like, I know my nephew when he was eight, needed adult helmets because he had a huge head. But that's not all kids cases. So do you have it in different sizes?

Dr. Theo Versteegh  41:43

We do. So we've got small, medium, large and extra large, and like a medium and a large will generally cover about 80% of the population. And then extra large, obviously, for the kind of larger individuals, and then small for either usually kind of petite females or the pediatric

Dr. Ayla Wolf  42:02

population. Okay, excellent. Sorry.

Dr. Theo Versteegh  42:06

With you asked about research. So we do have, like, if you Google tops, one, 360, in the Mayo Clinic, like they're currently doing a research study looking at injury prevention in hockey players, competitive hockey players. And so we've got, yeah, kind of a few other kind of studies, one in Calgary, looking at incorporating Towson with other approaches for concussion and lower extremity injury risk reduction. So far, the preliminary results are quite dramatic and encouraging, for sure.

Dr. Ayla Wolf  42:40

Yeah, that's so exciting. Well, I can't wait to stay on top of the research, see what else is coming out, and then, why don't you let people know where they can find you more information about the device, if they're interested in bringing that into their clinic or their sports team,

Dr. Theo Versteegh  42:55

sure. So with with the device, it'd be Thompson three sixty.com is is is like our website to learn more about me. For all the easiest would be on LinkedIn, so the oversteeg on LinkedIn, and then they can subscribe to my newsletter next to impossible. So we'll talk about the neck and then neck revolution comm is where I talk more about the the rehab side and like the consultancy for people who are struggling, that the nice thing that's really rewarding for me is that, because the patient population I deal with are 510, years out, in pretty much every case, when they get to me, they've seen everyone under the sun, which makes it really Easy, because if they haven't gotten better with seeing these often 20 plus practitioners, it makes me more confident that I can get them better. Because if it was anything else, the one of the other 20 practitioners would have found it and treated it, and they'd be better by now. So the it's a bit of a Yeah, kind of, I guess litmus test is is how many people they've seen for it, and the more people they've seen, the more confident I am that I can get them better, because this is the one thing that no one else is able to do right now, right, right? It's, it's been quite rewarding.

Dr. Ayla Wolf  44:16

Yeah, you've got the the missing link there, yeah, yeah. So talk a little bit more about your clinical practice. Are you seeing primarily people with post concussion syndrome? Is that kind of the basis of your patient population?

Dr. Theo Versteegh  44:30

Yeah, long standing, like I said, generally, I think the earliest the average is definitely five to eight years post injury, many cases, kind of 10 to 15 years. And the other ones you know that I find great results with are those who have specifically post traumatic headache or and or migraine, and the ones who are being treated with who get some relief. From Botox injections. And the reason being is that, for when you're doing injections, Botox injections for the treatment of headache and or migraine, where they focus on is the neck, and they end up like, it's, I mean, it's just, I hope to God, in you know, many years, people will look back and compare injecting Botox to treat migraine as leeches like in what like, literally it's they shortened it to Botox because it's botulin toxin, and they are literally injecting it to kill the nerve and the muscle, yeah.

Dr. Ayla Wolf  45:43

And then people go in indefinitely, every three months to do it. So I'm like, clearly, it's not fixing the problem. If you have to go in every three months

Dr. Theo Versteegh  45:52

because the body each time you do it, you're like, and then it's like, okay, I guess we're regrowing these again. I Why do you keep killing them? Right? And then it's like, Oh, it's coming back. Oh, we'll kill him again. What? Yeah. So I've got several cases with Yeah, three so far that actually, like in all three cases where they were years of Botox injections, they are completely off of Botox. And like to quote one, it's as if the accident never happened. And again, it's because, yeah, as opposed to, you know, killing the thing that's causing you the symptoms, because it's telling you something's wrong. Why don't you try fixing what's wrong? And, oh, wow, all of a sudden, now you don't need Botox anymore.

Dr. Ayla Wolf  46:37

Yeah, yeah. I mean, I use a pulsed radio frequency kind of peripheral nerve stimulator to try to help restore health to those the greater occipital nerve, less occipital nerve, but to be able to pair that with the actual neck strengthening component, it's like, oh, now I feel like I can knock this out of the park. Yeah.

Dr. Theo Versteegh  46:55

Honestly, you would, it would completely, yeah, change and improve, like that demographic that you using that on, because where the occipital nerve comes out of, it's, it's essentially the top vertebrae comes from behind. And if you've got unstable there and you're constantly kind of hammering on it, because you don't have that dynamic movement properly with the neck, you restore that, you take that every now and then pressure off the occipital nerve. Oh, wow. Hey, their migraines have gone away.

Dr. Ayla Wolf  47:23

Yeah, yeah, yeah, no, that makes so much sense. And definitely I have the patient population where they'd probably look at that helmet and go,

Dr. Theo Versteegh  47:31

nope, yeah, yeah, it's like, Oh, perfect, yeah, yeah. I mean, yeah, I'd be happy if you want to even play around with a case study, and just do before and after, and it'll be like, you'll see the results in, like I said, after the first month, it's usually about 50% after the second much about 75% on that headache kind of population, especially those ones that have that history of Botox. Yeah.

Dr. Ayla Wolf  47:58

Well, and you know, so many clinicians who work with this patient population, if they're being super honest, will absolutely tell you that those post traumatic headaches can be so stubborn, yeah, yeah. And like you're saying, I mean, people are coming to you eight to 15 years after their concussion and still symptomatic.

Dr. Theo Versteegh  48:16

Yeah, exactly. And it, and it's still, you know, at the point of daily headaches and daily, you know, one who was she was saying that after treatment she didn't realize how much time and effort it was taking to manage her symptoms. Like, it was, like, a part time job, because, you know, like, Oh, hey, do you want to go out this Friday? It was Wednesday. It's like, I have no idea what Friday is going to be, like, like, if it was today, I'd be okay. I don't know what Thursday and Friday are going to bring. So, yeah, let's pencil that in. You know,

Dr. Ayla Wolf  48:49

yeah, yeah. No, that chronic pain, it just robs you. I mean, I I had to have a fusion on my lumbar spine, but for seven and a half years, I had daily, chronic, horrible low back pain from the age of, like, 28 to 35 and that just robbed me of some of, like, the best years of my life, where every single thing I did was painful, yeah. And so I just, I feel, you know, my heart goes out to people who have chronic pain, because it's hard to just be at ease in the world. You know, it just takes so much away from you.

Dr. Theo Versteegh  49:21

Oh, yeah, I agree. And, and the other challenging thing is that I find a lot of chronic pain kind of research and direction, specifically with with neck pain, is because, you know, until now, there haven't been effective treatment approaches for it. A lot of it has been reframing, blaming the patient in that, like, it's, you know, even with the explained pain, it's like, oh, well, you know, it's, you know, we look at it, there's nothing wrong. You turn your head here, and it causes pain is because you're like, pain fibers have been hypersensitive, and. It's not actually dangerous, but it's just telling you that it is. So we've got to retrain that, to let it learn that it's not. It's like, No, when you turn it, it hurts. It's causing pain. That's the problem. Retrain so that it doesn't cause pain when they do that anymore. And like, you know, I've got evidence that you can do that, and if you just objectively measure their multiplanar range of motion, see where that sits compared to healthy adult male or female averages, and then multiplaner static neck strength and see where that is. Treat it. Get those better. And miraculously, their symptoms improve too. So it's just you, yeah, treat the right things.

Dr. Ayla Wolf  50:41

Yeah, yeah. And that's, I think, a huge what you just mentioned about, like, patients, the last thing you want to do is make them feel guilty or blame them for their experience when they don't want this. They're not asking for this. They just want their life back. So

Dr. Theo Versteegh  50:56

Exactly, yeah. And just, you know, saying that, Oh, it's because, you know you're you've got hypersensitive pain fibers. It's like, no, there's something that's pinching that's causing the pain that like, it's not hypersensitive. It's, it's cause. That's what is there for, is to tell me when I'm doing something that's causing pain.

Dr. Ayla Wolf  51:17

Yeah, yeah. Man, well, gosh, I'm so excited for for you, for this device, for the world, to be able to have the device. So I will put all of that information in the show notes. Is there anything we haven't talked about yet that you want to share? Anything exciting that's coming up?

Dr. Theo Versteegh  51:33

I think, I think we've touched on everything that I can think of off top of my head. But yeah, I mean, it'd be like for you, if you with your target population, happy to look at doing a kind of a case study of it and see where it goes. Because it's, yeah, it is. It's really quite remarkable.

Dr. Ayla Wolf  51:54

I have so many people who I think could benefit from this so and I've been wanting to figure out, like, how do I bring a strength building component into my practice without just referring people to the clinic down the road that has the machines that do this and do that and yeah?

Dr. Theo Versteegh  52:10

So, yeah, yeah, yeah, oh yeah. We should this works. We'll talk. Okay, get you sorted.

Dr. Ayla Wolf  52:18

Love it. Love it. Okay. Well, thank you so so much for coming on the show. I can't wait to share this episode with everybody. Very, very grateful that you came with this device, but congratulations on winning that award and getting this out into the

Dr. Theo Versteegh  52:29

world. Thank you so much. Yeah, and thanks so much for having me. It's been a blast. Yes, absolutely.

Dr. Ayla Wolf  52:38

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