Journalist: Amy Stewart
Amy: Welcome to SciSection! My name is Amy Stewart, and I am the journalist for the SciSection radio show broadcasted on CFMU 93.3 FM radio station. We are here today with Dr. Theo Versteegh, a physiotherapist educated at Western University and the Chief Technology Officer at TopSpin Technologies. Thank you so much for coming on the show today!
Dr Versteegh: Thanks for having me, I’m excited to be here.
Amy: To get us started, tell us a bit about your educational and professional background.
Dr Versteegh: Sure, so I actually ended up doing all my degrees at Western, which I know in academia circles is generally frowned upon, but I did my undergrad in physiotherapy back in 1998 back when it was an undergrad degree. And then I worked and traveled for a number of years and came back to London in 2008 and I completed my master’s in science in physiotherapy in 2010 and then in 2012 I embarked on my PhD in physiotherapy at Western University and I completed that in 2016.
Amy: Awesome, thank you. So, researching you I see you did a lot of work with concussions which I’m sure is a common thing for people who play sports and are in university athletics and working as a physiotherapist and being a former university athlete, I'm you have a great understanding of the severity of concussions in sports. And it seems that you understood it so well that you created the device known as Topspin360. And what exactly is TopSpin360, what are some of the mechanics and methodology behind it and how did you come up with it?
Dr Versteegh: Sure, so the original idea and concept came from Sidney Crosby’s concussion back in 2011 that kept him out of hockey for almost a year. And watching - where all great ideas come from which was at the bar after playing rec hockey - the injury on replay I thought “if his neck was stronger, he wouldn’t have had such a bad concussion cause his head just whipped around on him”. So that got me thinking about neck strengthening and training and as you mentioned I played football at Western back in the 90s and we had back then the 4-way neck machine, which is a bit of an archaic device where you put your face in and you push it forward or you push to the right or to the left or back and as the name implies 4-way neck machine. And so that got me thinking “yes that would improve your ability to take heavy weight and push it forward or back or side to side but it wouldn’t necessarily improve the neck’s ability to absorb a sudden load that would lead to concussions”. So, with my physiotherapy training and experience it's fairly easy to appreciate that muscles respond very specifically to the type of training you expose them to, and traditional neck training involves taking a heavy weight and pushing against it, which will improve your neck’s ability to take a heavy weight and push against it, but it won’t necessarily improve its ability to quickly absorb a sudden blow to the head that can lead to a concussion. So that got me thinking “well how would you strengthen the neck in a manner more related to live action sports?”. Which kind of got me doing a few different prototypes and approaches and I finally came up with what is now the TopSpin360. So, it’s a modified football helmet with a centrally mounted axis on top and then an arm protruding from that and it’s hooked up with a couple bearings so it’s completely self-generated, it’s kind of like a hula hoop for the head and the athlete or individual puts the helmet on and then kind of using coordinate movements of the neck they get the weight spinning around their head. And so, the faster they get that weight spinning the more centripetal force is generated, the faster the muscles - the neck muscles - must respond and react to keep that weight going. So, if we’re in the science side of things, we can go deeper into the science, which because it uses centripetal force, if those who are listening remember their grade 12 physics which is: centripetal force is mass times velocity squared over r. So, what that means is as the velocity increases in speed, the force actually goes up exponentially to the factor of two because velocity’s squared. Now the key metric that we’re interested in when it comes to neck muscles and muscles in general it’s not necessarily how much force you can generate, you can appreciate again that a concussion is a very fast event so you want to know how quickly can those muscles generate force. So, this term is rate of force development and is quite simply force divided by time. So, you can appreciate that as again as you got that funny looking helmet on and you’re getting that weight spinning around your head like a hula hoop, the faster you get that small weight spinning, the force goes up exponentially but the faster it goes it takes less time per revolution so that force over time, the time value gets smaller as the force value get bigger. What happens is that causes another exponential component so as you’re spinning it at 150 rpm it’s roughly 3 lbs. of force. But if you double that to 300 rpm so you double that initial speed, that rate of force development goes up over 30 lbs. of force. So, it’s quite a dramatic relationship and it ends up being quite form what we’ve seen, it seems to be quite closely related to someone’s concussion risk and it makes sense from where the research is right now.
Amy: That’s fascinating how you combine so much physics and knowledge of physiotherapy and how just one night watching a hockey game you got an inspiration for an idea that I’m sure has helped so many people and I think could be used to help so many more. What domains have you introduced TopSpin360 into and what are your future goals for the company?
Dr Versteegh: So, we’ve started initially what with my history being in football we certainly started with football and that’s when I did my PhD training. So basically, I had this idea watching Sidney Crosby’s concussion and I thought “ok this is great I just finished my master’s, so I just go do research and find the supporting literature and go to market”. At the time back in 2011-2012 there was very little research out there that supported the role of the neck muscles in concussion mitigation, or anything related to concussions. Of course over the past decade a lot more, almost monthly or weekly research has come out to support this approach which is pretty exciting, but at the time there wasn’t enough to go to market and for me I didn’t want to release a gimmick on the market, I wanted to make sure that I didn’t make an error in my assumption somewhere along the way and so I wanted to test that and knowing how much work was involved with doing a master’s and that this was going to be larger undertake and I thought “well, I might as well get a PhD out of it that way if I made error in my assumption I can go into academia”.
Amy: That’s awesome. I saw also online that your device has been used by the Philadelphia Eagles in the NFL and that you’ve also sold some to the Mayo Clinic and I think they're doing research with hockey players?
Dr Versteegh: Yeah, so basically, sorry I guess I answered your earlier question. So we started with football being my own personal background and that’s what I did my PhD research on was a group of football players at Western university and then since then we still continue to focus on football, and actually we were fortunate we won the NFL First and Future Award for innovation to advance athlete health and safety, so this was back in 2019, we ended up beating out, there’s 11 000 applicants and since we were hoping to be top five, flown down into Atlanta, went to the super bowl and on the Saturday before the Super Bowl you pitch on NFL network and Roger Goodall was there and Larry Fitzgerald and yeah and we ended up actually winning that so we got 50 000 dollars and two tickets to the super bowl so it was quite a nice nod from the NFL that we’re on the right track. So that’s certainly one key sport that we’re getting further involved with. But actually, if you look at the risk of concussion across the board, women’s sports are generally about two time the risk in sex comparable sports as the male counterparts. And the current understanding or I think the strongest hypothesis as to why that is, is women tend to have about just over half the neck strength of men. So, in that case it seems like a pretty low hanging fruit to strengthen the neck’s strength to see if we can decrease that concussion risk in women’s sports. So, we got some really exciting results in the women’s volleyball and women’s soccer. So, basically the Citadels women’s volleyball team, volleyball in the NCAA is the fourth leading cause of concussion by gender and it’s a very high-risk sport and mainly because at that D1 level these women are able to spike the ball at over 70 mph. And what happens is a lot of these concussions are from balls being beamed off people’s heads. And in 2018 the Citadels women’s volleyball team had eight head injuries or concussions on the team of about 16 to 18 players, so almost 50% rate. And so, they were desperate to find a solution to help decrease that concussion risk. So, they started, reached out to us, and they purchased a TopSpin 360 and they started training back in 2018 to 2019, and in 2019 they dropped down to zero concussions, and in 2020 they have had zero concussions, and so far, this year in 2021 they’ve had zero concussions. So, the head coach has been coaching in the NCAA for over 20 years in men’s and women’s volleyball and he’s never had a zero-concussion season and now he’s got two and a half on his hands. So pretty exciting results there. And yeah, we’ve also had just to simplify things, similar results in women’s soccer.
Amy: That’s awesome it seems like you’re making a tremendous impact in the sports field, like I can’t believe you brought it down to zero concussions. That's such a huge win. Wow. So besides designing revolutionary technology, you’ve also done a lot of physiotherapy work. What are some of the most common injuries you treat as a physiotherapist and how would you recommend preventing them?
Dr Versteegh: Yeah, so probably the most common would be ankle sprains kind of across the vast majorities of sports, maybe hockey doesn’t have that ankle sprains as much as an injury. But it’s interesting because a lot of the research on what I’m doing with TopSpin, there’s a lot of parallels in underlying physiological mechanisms there that we address through the neck that would help mitigate ankle sprains and knee injuries. So, I’d say probably the most common in sports would be ankle sprain, and then concussion would be the most common injury after that, and then third could potentially be ACL, it’s a fairly common one to get, probably the most common surgical one that we deal with. And with that again going back to concussions it’s interesting that if after someone has suffered a concussion, they’re three times more likely to suffer a lower extremity injury like an ankle sprain or a knee injury. And again, if you look at physiologically what happens with concussions a lot of times you will also sprain or strain the neck during the injury. And unless you specifically rehabilitate the neck it doesn’t come back to 100%, just as if you don’t rehabilitate your ankle afterwards it’s not going to be 100% you’re always going to have that kind of trick ankle. The problem with the concussion not addressing the neck pain and the neck sprain or strain issue, is that the upper three vertebrae of the neck have the most proprioceptive fibers in the entire body. And that’s not just a waste of resources, it's because it’s the link between our other two systems of balance; so our visual system and our inner ear. So our head kind of knows where it is in relation to space because visually you can see the horizon and your vestibular, your inner ear can feel where gravity is. That is communicated to your body through your neck, so if that proprioception or joint position awareness is off just half a degree, you going to place your foot in one place expecting the ground to be there and it's off by a degree or two when you multiply, it that ends up you roll your ankle or you blow your ACL. So, it’s quite a significant area that needs to be working at 100%, one thing I would say from an injury perspective is address the neck and proprioception of the neck, as well as there are a number of injury prevention programs out there. The FIFA 11+ is a great one, and it’s been shown to be quite effective at decreasing lower extremity risk like ankle sprain or ACL, the only issue and why there’s been lower uptake is because it generally takes about 20 minutes per session, you gotta do it like three times a week ideally, leading up to the season to get the benefits.
Amy: That is fascinating how interconnected our neck and vision and our vestibular senses are and how it can really affect injuries in lower extremities. I would have never expected them to be so interconnected like that. And I think for my last question, I would like to know what are some of the best aspects of your career and why would you encourage more students to consider physiotherapy and sports medicine as a profession?
Dr Versteegh: So, I think one of the best aspects of physiotherapy is that it’s very portable. I mean if you speak other languages it opens up the opportunity to work in a multitude of countries, so I was fortunate enough to, I’ve worked in Saudi Arabia, I’ve worked in the UK, and it really affords you quite a bit of latitude on your location of work. And certainly, if you are interested in sports, it gives you a way to maintain that close, intimate contact with the game whether you’re a team physiotherapist or even with sports injuries and in sport medicine.
Amy: That’s very cool thank you. It’s not often that science gets to help you love sports. I feel like people often see those as two very separate domains and that’s really cool how your career demonstrates how intertwined those can be. But thank you so much for joining us Dr. Versteegh! Your career in entrepreneurial sports medicine is such a great example of how diverse the scientific field is! That’s it for this week of SciSection! Make sure to check our podcasts available on global platforms for our latest interviews.