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Life After Impact: The Concussion Recovery Podcast
Life After Impact: The Concussion Recovery Podcast. This podcast is the go-to podcast for actionable information to help people recover from concussions, brain injuries, and post-concussion syndrome. Dr. Ayla Wolf does a deep dive in discussing symptoms, testing methods, treatment options, and resources to help people troubleshoot where they feel stuck in their recovery. The podcast brings you interviews with top experts in the field of concussions and brain injuries, and introduces a functional neurological mindset to approaching complex cases.
For those feeling lost, hopeless, or abandoned let this podcast be your guide to living your best life after impact. Subscribe now and start your journey to recovery!
Life After Impact: The Concussion Recovery Podcast
The Missing Element in Concussion Prevention AND Recovery: Dr. Theo Versteegh Explains Topspin360 | E38
What if the fastest path to fewer concussions and better performance starts with how we train the neck? We sit down with physiotherapist, inventor, and researcher Dr. Theo Versteegh to unpack a novel training device that targets rapid, eccentric stabilization—the exact kind of control impact sports demand. Instead of slow, single-plane moves, his device builds rate of force development in rotational and multiplanar directions, then tracks progress with clear metrics. The results are hard to ignore: multiple teams across genders report zero head and neck injury seasons after adoption, and many go on to win their conference within three years. On the clinical side, a randomized trial in persistent post-concussion syndrome shows 70%+ symptom reduction, alongside big gains in headache and neck disability scores.
We break down why Type II fast-twitch recruitment and proprioception are the missing links in concussion prevention, balance, and visual stability. You’ll hear how a simple, two-minute, twice-weekly protocol can raise resilience without adding grind to already packed schedules, and why more isn’t better—especially for those with headaches or dizziness. We also talk safety screening, learning curves, and how the self-limiting design only spins as fast as your system can control.
The NFL granted Topspin Technologies the First and Future Innovations to Advance Athlete Health and Safety Award in 2019. The Detroit Lions took the charge, adopting this technology, and went on to win their division for the first time in 31 years. In this conversation we connect the dots between neck readiness, better awareness on the field, and fewer neck and head injuries per season.
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TopSpin360 website
Dr. Theo Versteegh LinkedIn
Neck rehab consulting for clinicians: Neck Revolution
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So we've had like m now multiple sports teams across both genders and multiple sports that after implementing training, in many cases, drop 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 Topsten 360, they've gone on to win their conference championship.
Dr. Ayla Wolf:Welcome to Life After Impact, the Concussion Recovery Podcast. I'm Dr. Ayla Wolf, and I'll 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. Theo Versteegh, thank you so much for coming on to Life After Impact. Welcome.
Dr. Theo Versteegh:Thank you so much for having me. I'm excited to be here.
Dr. Ayla Wolf: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 top spin technologies and this device that you created?
Dr. Theo Versteegh:Sure. So I'm a physiotherapist by training. I've been practicing uh predominantly or almost exclusively in sports medicine, I guess, for over 25 years now. And um uh at the last clinic I was working at, I was one of the one of two sport concussion specialists. My interest began back in 2011. And it was, uh I don't know how many of your kind of audience are hockey fans, but uh Sidney Crosby had a uh very significant concussion back in 2011 that uh ended up keeping him out for almost a year. And it uh the idea spawned where all good ideas come from, which was uh at the bar after playing wreck hockey myself. So after a few beers, when you solve all the world's problems. And uh and they're showing that uh um like the injury um uh, you know, uh the previous one that four days later he was re-injured. And myself and my um uh I guess teammate from uh from hockey, he was also my strength and addition 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, you know, you push forward, push back, and side to side. Yeah. And you know, we got talking like, oh, if his neck was stronger, his head wouldn't have flown around like it was on a bobblehead. And uh, and that kind of got us thinking about um uh just kind of neck strengthening in general, and kind of brought back to the you know, the four-way neck machine. And and with my physio background, um, I was thinking, okay, like, well, that'll strengthen it going forward, back, side to side, but it's also that kind of rotational uh impact. And further, it's also kind of that fast eccentric uh 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 muscles eccentrically, but concussions are also very fast events, so you're gonna have to kind of get kind of uh the speed of contraction involved. So you're focusing on um the fastest twitch muscle fibers, which are the type 2 X fibers or the type 2 B fibers, if you plan on when you do your training, and uh, which are three times faster than the type 2A fibers. And traditional neck strengthening, you end up focusing on that, those type 2a fibers, which are notably slower. Um 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 uh against potential head and neck injuries because we're we're quite unstable statically in that because uh 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 a lot of kind of thoughts, and it's like, well, that's a pretty tall order of training in order to uh to properly train the neck to stabilize the head in space. Um, was playing around with for a few months, just kind of different approaches and and concepts. And I just happened to have with another kind of concept I was uh uh working on, they what ended up being uh an axis on top with a with a weight, and it uh kind of swung around. And I was like, oh my God, that's this is exactly what I'm trying to achieve. And that was the inception point of what is now the Tosman 360.
Dr. Ayla Wolf:Gotcha. 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. Yeah, 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 absolutely, because these are like ballistic, high-impact movements and training slowly, isotonically in a single direction, it doesn't translate.
Dr. Theo Versteegh:I mean, this uh, you know, for the strength and additioning coaches in your audience, it's the the said principle. So specific adaptations to impose demand. Um, just as in order to train for to be a world leader in 100-yard dash, you don't train by running marathons.
Dr. Ayla Wolf:Yeah, yeah, exactly.
Dr. Theo Versteegh: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.
Dr. Ayla Wolf:Yeah. 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. Uh, what types of movements are they doing? I saw a little video of you folding some laundry, I think, and using it while you're folding laundry, multitasking at its best.
Dr. Theo Versteegh:Exactly. So it's got a essentially mounted axis, and uh it, you know, as everything does these days, it has a an app. So you turn the uh the helmet on and you pair it with the app and it brings it to the the training page. And so you know, I'm just gonna do uh demonstration, I'll kind of walk you through what I'm doing for those who are listening. But essentially it's a centrally mounted axis on the apex of the helmet with a 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 at just merely counts the revolutions and it also calculates out the centripetal force that's generated, which is mass times velocity squared over r. But it we're not just interested in the force, we want to know the rate of force development. So how quickly can that neck generating multiplanar stabilizing force? And that's really kind of the metric that we wanna that we wanna know and quantify is is how good is the neck at stabilizing the 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 uh 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 multiplanar dynamic neck strength and stability.
Dr. Ayla Wolf: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.
Dr. Theo Versteegh:Yeah. It's it is funny. So we've had like now multiple sports teams across both genders and multiple sports that after implementing training, in many cases drop 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 Topspin 360, they've gone on to win their conference championship.
Dr. Ayla Wolf:Okay, so you're not just preventing concussions, but somehow you're improving sports performance.
Dr. Theo Versteegh:It yeah, and it is like, and we've been doing uh so looking at the actual statistics. Because that was um uh, you know, I I I did my PhD research in the multiplane dynamic neck training. So uh, you know, 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-Topspin and post-Topspin, the the number of wins and then the the increase in championship. There's a three and a half fold increased likelihood of winning a championship after implementing Topspin compared to before.
Dr. Ayla Wolf:Well, that's a motivator for uh a team to adopt this technology. And how much time are people spending actually using the device, like per day or per week?
Dr. Theo Versteegh:Yeah, so it's that's the other thing is I'm very fond of the minimum effective dose and uh 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 uh quite dramatic and substantial improvements. Specifically, the outcome measure we've been doing is multiplanar static neck strength. So we do just look at uh 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:Wow. And so you're talking four minutes a week.
Dr. Theo Versteegh:Yeah.
Dr. Ayla Wolf:Wow. And so that's obviously very doable. And that also makes me think that clinically, you you know, you have a lot of people going into physical therapy clinics, all kinds of clinics that are doing different uh 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, all people are already coming in twice a week. You just add two minutes to their uh session, and you could have astronomical results in terms of neck strength and stability and preventing future concussions.
Dr. Theo Versteegh:That's right. Yeah, and it's uh it's proving very effective at treating those who are clinically symptomatic with concussion, um, you know, uh headaches, dizziness, um, uh post-traumatic migraine, stuff like that. We've got a a study that the data collection is done, the analysis done, we're 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, you know, 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 sport-blade concussion who's still suffering with headaches, you know, four weeks later.
Speaker 2:Yeah.
Dr. Theo Versteegh:And uh 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 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, the thing's just whipping around them.
Dr. Ayla Wolf:Right, right.
Dr. Theo Versteegh:Can't do it. You're like, I can't get this thing up. What's going on here? Right? And so it's it's uh it's a similar kind of neuromuscular pattern. So it's inherently safe.
Dr. Ayla Wolf:So this is a hula hoop for the head. Yeah, pretty much.
Dr. Theo Versteegh:That's right. That's right. And uh, and so with this study, it was a randomized control trial and 29 in each arm, and it was at least four weeks uh 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 and you've gone to like every doctor, physiotherapist, and oh yeah, it'll be better by you know three months. So, 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 is 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-interest. So they're getting close to that danger zone, if you will. And one group got standard of care, which was referral to physiotherapy, and the other group got standard of care referral to physiotherapy and uh Topspin 360 to take home, train on it two minutes twice a week for eight weeks. Uh at the end of the eight weeks, the the main, the primary outcome measure was SCAT 5 symptom scores. Like where are you with all of these symptom profiles? And I I know you're familiar with the SCAT 5 and the symptoms. And the intervention group had over 70% reduction in their SCAT 5 symptom scores, whereas the control group actually had a 10% increase.
Dr. Ayla Wolf:Wow, that's a huge difference.
Dr. Theo Versteegh:Huge difference. Yeah.
Dr. Ayla Wolf:That's so exciting.
Dr. Theo Versteegh:Yeah, it it it's been it's been remarkable. And then the other ones we looked at was uh the neck disability index and the headache disability index. And both of those also improved dramatically, 35 and 40 percent.
Dr. Ayla Wolf: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 uh so that uh 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:Yeah. And and again, because you know, when I do it, I've I've you know done it a few times. So I can, you know, Denver's like, 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.
Dr. Ayla Wolf:Mm-hmm. Okay. And so there's a bit of a learning curve or a process of getting familiar with the device and and 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:A lot slower, yeah. I mean, um, 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, uh completely novel to a no history of head or neck injury, uh, is around five, five and a half pounds. In my experience, uh, and even with that study, the average RFD of someone who is, you know, chronic neck pain, chronic headache, dizziness, migraine sufferer, um, they're less than one pound of force.
Dr. Ayla Wolf: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: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 uh neuromuscular cervical perspective.
Dr. Ayla Wolf:Mm-hmm. Mm-hmm. 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.
Dr. Theo Versteegh:It's been, it was really exciting. So that was, I guess, back in um uh a few years ago now, like 2019. And we applied for this, you know, first and future uh innovations to advance athlete health and safety. And there's 1,100 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 uh, we got you know some prep and and all this, and we presented on the Saturday before the Super Bowl. Um, and uh, you know, Roger Goodell was there and uh Larry Fitzgerald and and the whole panel and and kind of presented to them. And in the end, we ended up uh winning. So we got uh like $50,000 and two tickets to the Super Bowl. Um yeah, and we're winners of the first and future word for innovations to advance athlete health and safety. And yeah, it um timing could have been better because uh very shortly after that, COVID hit and uh kind of shut everything down. Um but you know, now that things have opened back up, yeah. We got our kind of first NFL football team to fully adopt and train the entire team, uh, which was uh 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 exciting. 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:So wow. Okay. So you might have had something to do with that.
Dr. Theo Versteegh:It's you know, I'll tell you what, like, you know, correlation's not causation, but seems to hang out with us, uh good things happen.
Dr. Ayla Wolf:Yeah. Well, gosh, I feel like all of the teams need to be uh piling on and adopting this technology. All right 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?
Dr. Theo Versteegh:The a key thing to note, and this is um uh like an advantage of it, is it's actually 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 uh various conditions. So we do um it is a piece of exercise equipment. Uh and again, the same kind of uh qualifications, you know, consult your healthcare practitioner before embarking on it. Uh and in those cases, uh we end up um like with me as a physiotherapist and uh 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.
Dr. Ayla Wolf:Right. Got it.
Dr. Theo Versteegh:So there is um, you know, the option for that. And it's yeah, my clinical folks, although it's only part-time, I focus on the essentially five, 10, sometimes 20-year history of of chronic whiplash, chronic concussion, um, chronic dizziness, uh, headaches, migraines. And it's it is really quite remarkable the results that these long-standing uh patients will see with doing some appropriate neuromuscular training of the neck. Because in most cases, if they've done neck strengthening, it's you know, grab a theraband and kind of push it this way or that, um, or deep neck flexor and just kind of hold it there indefinitely, uh, 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 neck's 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.
Dr. Ayla Wolf:Right. Yeah, absolutely. 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 uh and then have people access it that way.
Dr. Theo Versteegh:Yeah, yeah, exactly. I mean, there are uh as I mentioned, the you know, people can um uh it is a piece of exercise equipment, but yeah, it it's best because it's so novel and unique, like it's not something, oh, I get it. You put it on and you do this. It's 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 um because of 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 it requires just kind of you know guidance and and just proper assessment, clinical assessment and and um you know prescription on on how you'd use this piece of exercise equipment, just as any other kind of therapeutic exercise applied can pop.
Dr. Ayla Wolf:Right. Since uh many people fall into the trap of thinking more is better, uh, 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:Yeah, exactly. Well, the two minutes I get one percent, then I'll do it like 20 minutes and then I'll get 10%. And it's like, yeah, no, it's not gonna work that way, you know? And it's 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 um with it. So it's like, yeah, you do have to be careful on how it's uh how it's implemented.
Dr. Ayla Wolf:Yeah, exactly. And I mean, I've fallen uh 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 tendonitis.
Dr. Theo Versteegh:Absolutely. Yeah, yeah. Oh, barefoot running, that's what you got to do.
Dr. Ayla Wolf:Um, exactly. Let's go barefoot run through the woods for five miles.
Dr. Theo Versteegh:Like you know how much different is it from running with shoes? I know how to run.
Dr. Ayla Wolf:So I could totally see myself popping this helmet on and being like, all right, let's go. Ten minutes. Let's put it down.
Dr. Theo Versteegh:Yeah, yeah. It's uh yeah, that's exactly the precaution.
unknown:Yeah.
Dr. Theo Versteegh:Because it is something, you know, it's exercise. And if you overdo the exercise, you're gonna, you're gonna pay the price, you know? Like the 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. Um, 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 drained 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:Right, right. Yeah. Your your headaches are coming from your neck.
Speaker 2:Absolutely. Yeah, yeah. Yeah.
Dr. Ayla Wolf:And uh 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. Um, I'm assuming improved balance as one of the markers too. Have you done any studies specifically look looking at balance?
Dr. Theo Versteegh:So I haven't, but there was a study that was done at Acadia University using Tospin and in a healthy group of university students who you know you always do your studies on, uh, they did improve static standing balance with training on Topspin. And that's like it which again, clinically, that's what 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 uh with train on tospin is I use the headache disability index as a as a marker of their uh headache score and kind of uh impairment. And the average reduction in headache disability index is over 50% after the first month alone and about 75% after the second month.
Dr. Ayla Wolf:Wow, that's huge.
Dr. Theo Versteegh: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 helmet, then it's um every other day, because it's again, it's only two minutes of training and uh if they have it with them. You know, it's not like oh, I've got to drive across town to put this helmet on for two minutes and drive back.
Dr. Ayla Wolf:Yeah, yeah. And are there anybody uh 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:Yeah. So basically anyone who is um like I guess acutely unstable neck. So uh, you know, if it's if it's immediately after uh a whiplash and you haven't had that kind of you know ruled out and cleared, uh if you've got any active fractures at the point. And then the the one screening test we recommend is uh it's the uh Spurling's compression test. Um so essentially you put you know about five pounds of force through the spine, uh through the head and the neck. And if they can't tolerate that, uh 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 uh you know, or acupuncture would like just to settle that system down until it can tolerate a bit of uh compression load.
Dr. Ayla Wolf:Okay. Gotcha. And then uh in terms of like ligament laxity, you mentioned whiplash. So if somebody does have a lot of cervical instability, a lot of ligament laxity, um, can this be helpful? Do they have to like do certain things prior to working up to it?
Dr. Theo Versteegh:Yeah, and and no, and and the the reason it's it's very helpful in this in that like think about um you know traditional ankle sprain where um if you uh you know, grade three ATFL rupture. So all of a sudden you've lost static stability of the ankle. Uh you're not gonna get surgery on that particular ligament. It's the most common one to be kind of fully ruptured. But what you are gonna do is rehab it by not just strengthening the muscles. Like you're not gonna get there by doing green theraband inversion and eversion, 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 uh you know uh most rehab exercises, 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 a um like a foam Air ex or something like that, and then getting into some uh 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 the the ligament that would tell them when it's on stretch. So the same thing applies for the neck is if you've got ligamentous laxity, um then. Retrain the muscles around it to compensate and to essentially, yeah, compensate for that. And uh and you can bring it up back to that level.
Dr. Ayla Wolf:Incredible.
Dr. Theo Versteegh:Yeah, it's been uh it's been exciting.
Dr. Ayla Wolf:Yeah, yeah. And uh so what are you seeing next? Like, do you have uh future research you want to do? Are you just at this point kind of trying to raise awareness and get uh hopefully more teams to adopt this as a concussion prevention strategy?
Dr. Theo Versteegh:Yeah, I mean, uh ideally, certainly as uh, you know, imp increased uh injury resilience and um and even you know performance enhancement because it's also uh the neck is a uh kind of the last frontier of uh performance hands. We every everyone's got leg day and everyone does, you know, chest and back, right? But what's your neck day? You know?
Dr. Ayla Wolf:Yeah, yeah.
Dr. Theo Versteegh:And 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 uh the more dynamically stable you are, the better you're gonna 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:Yeah. Yeah. The other guy's fist.
Dr. Theo Versteegh:Yeah, yeah. Well, exactly. Yeah.
Dr. Ayla Wolf:Yeah.
Dr. Theo Versteegh:Being able to absorb that. Like that's yeah, certainly a big role in MMA or boxing because like every impact to the head is a high impact, fast you know, um 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.
Dr. Ayla Wolf:Yeah. 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 you're in a corner.
Dr. Theo Versteegh:Yeah. Uh commonly a mild headache, right? And it's like, oh man, yeah, catching the zero edge on a on like hard packed. Oh.
Dr. Ayla Wolf:Exactly. And even when you think about again, like your head, you're you're, 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 uh snowboarding, wakeboarding, all all of those, all of the sports I used to do all the time, right?
Dr. Theo Versteegh:Yeah. Oh, for sure. Yeah. And uh oh, I mean, it's interesting because uh like even for me, I've got a uh 11-year-old son who wanted to play, he was playing flag football and then he wanted to play contact football. And I said, um, yeah, that's fine, but not until you get to a safe level on on my helmet. And uh and sure enough, he did, and now he's he's playing contact. And oh, it's for me, it's it's peace of mind that like, you know what? Yeah, he 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, uh feeling like you need a dark room. And everyone's like, nope, I'm pretty solid that you'll uh you'll bounce back.
Dr. Ayla Wolf:Yeah, yeah. That's amazing. This idea of you can have peace of mind if you've got uh yourself or your kids in sports and you just want to know they're gonna be safe and protected.
Dr. Theo Versteegh:And yeah. Yeah, so that's been uh certainly a big part. But yeah, I know because you've got a a history with uh essentially martial arts and and um I mean jujitsu is certainly one where kind of learning to fall would be uh would be key, but also kickboxing, like yeah, I mean you you've got a long neck and just a beautiful little target.
Dr. Ayla Wolf:That's uh exactly. Yeah, but I have a long lever there for uh my brain to get rattled.
Speaker 2:Right?
Dr. Ayla Wolf:Yeah. Well, and in jujitsu, you know, you're getting choked out too. There's a lot of neck trauma. And uh 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 um, you know, I think jujitsu 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.
Speaker 2:Yeah, yeah.
Dr. Ayla Wolf:Gosh, well, that's amazing. Your app that is uh associated with the device is basically measuring like the velocity, the rotations, it's it's tracking people over time. So like somebody has an account that actually shows their their improvements.
Dr. Theo Versteegh:Yeah. It uh time and date stamps, all the training sessions, so you can very kind of quickly go through and you can track your progress uh over time. And and the other neat thing is that um 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 uh in relationship to that because it is kind of quite sensitive to kind of how you're feeling uh that day, your energy levels, and um, yeah. And I mean, if you've got some kind of late onset muscle soreness, it's gonna kind of slow you down a bit. Uh so it is really kind of neat to see uh people kind of progress. Generally, they do improve quite, you know, almost linearly within uh within reason, but you will see variations just on uh somewhat day-to-day on on how they're feeling.
Dr. Ayla Wolf: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:Exactly. Yeah, and especially and also if um like we've got uh kind of a case with um uh before a a volleyball player trained herself up to a very kind of stable level and then took a huge shot off the head. Um, you know, and everyone thought she got her hands up, it's like, oh no, that beat me right off the face. So the coach was like, okay, well, we've got test you for a concussion. I'm 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, well, what's the big deal? Two days later, when she went on her top swing, her top swin score dropped significantly. And then, like a couple days later, she was back up into her regular training uh kind of range. But it just goes to show that no, actually, her neck absorbed all of that and is gonna need kind of a couple days to 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 on that second day, her score on the toss one would have flagged her as higher risk.
Dr. Ayla Wolf:Yeah. Yeah. Um, you know, I had uh kind of I'd given myself a concussion in March of this year. But what's was interesting was that the I was bending down to unplug something and I stood back up and there was a uh 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 did something once, you might be okay, but the same thing happens shortly after, and your body's like, okay.
Dr. Theo Versteegh:Yeah, that's right. And actually, it's interesting because that's also what I think happened it with Sidney Crosby, because like when he took that impact, like, you know, oh, it was it can cost her neck injury. But you see, it's like, ooh, that was a pretty significant injury. And then he seemed to be fine. He was back in uh like four days later, and then his the next hit was into the boards. You look at it, you're like, really? That kept him out for almost a year? No. The first injury took away all his defenses, and then he's like just going around completely prone and uh and open. And that's what taking 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: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:I did know, yeah. Yeah, that was pretty exciting.
Dr. Ayla Wolf:Yeah, yeah. Um, he's incredible.
Dr. Theo Versteegh: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:Um, 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 Carrrick Institute, go back to school, get my doctorate degree where I was studying traumatic brain injuries. And so, yeah, that 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 uh trying to just get the word out there to more people who are, you know, running into roadblocks in medicine. Uh and so yeah, I've just once I've fixed my own brain, uh, 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:Yeah, no, absolutely. And it 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.
Dr. Ayla Wolf:Yeah, yeah. I mean, I worked with a uh 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, uh so important. We need I just feel like uh based on what I'm hearing, like every single sports team needs one of these helmets.
Dr. Theo Versteegh:Yeah, absolutely. I mean, it's it 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 it's a tough sell because you're like, ah, no, I think we were okay with uh, we didn't have that many you know concussions last year. They almost don't want to, you know, admit to it. It's like, oh, okay. Right. But you know, the performance enhancement side uh is uh is you know quite beneficial. So we'll probably focus on that with the uh with the Top Sun 360. Um and then you know, more with the the rehab side, um uh using therapeutic exercise to to treat and uh kind of enhance that.
Dr. Ayla Wolf:It's almost like the concussion concussion prevention is the added bonus to enhancing your performance.
Dr. Theo Versteegh:You're right. Yep, totally improved injury resilience, and you know, chances are your team's gonna win your championship. Really?
Dr. Ayla Wolf:Right, right? Yep, that makes it easier to sell right there.
Dr. Theo Versteegh:It does. Absolutely.
Dr. Ayla Wolf:Awesome.
Dr. Theo Versteegh:Uh predominantly the journey.
Dr. Ayla Wolf: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:We do. So we've got small, medium, large, and extra large. And uh like a medium and a large will generally cover about 80% of the population, and then uh extra large, obviously for the kind of larger individuals, and then uh small for you know the the either uh usually kind of petite females or the pediatric um population.
Dr. Ayla Wolf:Okay. Excellent.
Dr. Theo Versteegh:Yeah, and with sorry, with uh you asked about uh research. So we do have um like if you Google Topspin360 and the Mayo Clinic, like they're currently doing a research study looking at uh uh uh injury prevention in uh hockey players, competitive hockey players. And uh so we've got, yeah, kind of a a few other kind of studies, one in uh in Calgary looking at incorporating Topspin with uh other approaches for concussion and uh lower extremity injury risk reduction. And so far the preliminary results are quite dramatic and and encouraging for sure.
Dr. Ayla Wolf: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:Sure. So with uh with the device, it'd be Topspin360.com is like our website to learn more about me. Probably the easiest would be on LinkedIn. So Theo Versteegh on LinkedIn, and uh and then they can subscribe to my newsletter, Necks to Impossible. So uh uh we'll talk about the neck. And then neckrevolution.com is where I talk more about the the rehab side um and like the the consultancy for people who are struggling. The the nice thing that's really rewarding for me is that because the patient population I deal with are five, 10 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.
Dr. Ayla Wolf:Right, right.
Dr. Theo Versteegh:It's it's it's been a quite rewarding.
Dr. Ayla Wolf:Yeah, you've got the the missing link there.
Dr. Theo Versteegh:Yeah. Yeah.
Dr. Ayla Wolf:So talk a little bit more about your clinical practice. Um, are you seeing primarily people with post-concussion syndrome? Is that kind of the basis of your patient population?
Dr. Theo Versteegh:Yeah, long-standing, like I said, uh generally, I think the earliest uh the average is definitely five to eight years post-injury. Um 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 andor 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 I hope to God in you know, many years people will look back and and compare injecting Botox to treat migraine as leeches. Like in 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.
Dr. Ayla Wolf:Yeah. And then people go in indefinitely every three months to do it. So I'm like clearly the it's not fixing the problem if you have to go in every three months.
Dr. Theo Versteegh:Because the body, each time you do it, you're like, and then it's like, okay, I guess we're regrowing these again. Uh why do you keep killing them, right? And then it's like, oh, it's coming back. Oh, we'll kill them again. What? Yeah. So I've got uh several cases with um uh yeah, uh three so far that um uh it actually like in all three cases where there 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:Yeah, yeah. I mean, I use a uh 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.
Dr. Theo Versteegh:Honestly, you would, it would completely change and improve like that demographic that you're 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. Yeah.
Dr. Ayla Wolf:Yeah, yeah. No, that makes so much sense. And and definitely I have the patient population where they'd probably look at that helmet and go, nope.
Dr. Theo Versteegh:Nope, there's no way. Yeah, yeah. It's like, oh, perfect. Yeah, yeah. I mean, yeah, I'd be happy if you want to even uh play around with the uh case study and just do before and after, and it'll be like you'll see the results in, like I said, uh after the first month is usually about 50%. After the second month, it's about 75% on that headache kind of population, especially those ones that have that history of uh Botox.
Dr. Ayla Wolf:Yeah. Well, and you know, so many clinicians if 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.
Dr. Theo Versteegh:Yeah. Yeah.
Dr. Ayla Wolf: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:Yeah. Exactly. And it and it's still, you know, at the point of daily headaches and daily, you know, I had a one who was um, 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 gonna be like. Like, if it was today, I'd be okay. I don't know what Thursday and Friday are gonna bring. So yeah, let's pencil that in, you know?
Dr. Ayla Wolf: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, it, it's hard to just be at ease in the world. You know, it just takes so much away from you.
Dr. Theo Versteegh: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 um, you know, even with the explain 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. It's because your 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 multiplanar static neck strength and see where that is, treat it, get those better, and miraculously their symptoms improve too. So it's just you're yeah, treat the right things.
Dr. Ayla Wolf:Yeah, yeah. And that's I think a huge what you just mentioned about like pa patients. Um 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 exactly. Yeah, yeah.
Dr. Theo Versteegh:And just uh, 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: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. Uh 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 or anything exciting that's coming up?
Dr. Theo Versteegh:I think that I think we've uh touched on everything that I can think of uh off the top of my head. But yeah, I mean it it'd be uh like for you if you with your target population, happy to look at doing a uh 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:I have I have so many people who I think could benefit from this. So and I 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, so yeah.
Dr. Theo Versteegh:Yeah. Oh, yeah. We should uh this works. We'll talk. We'll uh get you sorted.
Dr. Ayla Wolf: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 world.
Dr. Theo Versteegh:Thank you so much. Yeah, and and thanks so much for having me. It's been a blast.
Dr. Ayla Wolf:Yes, absolutely. Medical disclaimer. This video or podcast is for general informational purposes only and does not constitute the practice of medicine or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and materials included is at the user's own risk. The content of this video or podcast is not intended to be a substitute for medical advice, diagnosis, or treatment, and consumers of this information should seek the advice of a medical professional for any and all health related issues. A link to our full medical disclaimer is available in the notes.