The shaky science behind NFL safety gear

What this episode is about

The QC collar is a $200 neck device designed to protect athletes from concussions by applying compression to the jugular vein, which increases blood volume in the brain. Backed by research that suggests preventing brain movement can reduce injuries, this innovative solution shifts the focus from external protection to manipulating internal blood flow to create a more stable environment for the brain within the skull.

Key takeaways

• Forget external helmets; science suggests protecting the brain may require internal adjustments—who knew jugular compression could be a game changer?
• The QC collar claims to mimic woodpecker physiology, but not all nature-inspired innovations are rooted in solid science. Just ask the experts!
• Concussions: a $200 solution leaning heavily on questionable data—how do we sort fact from fiction in sports safety?
• Duplicate data in research? Not a mere mistake—it's a red flag! Trustworthy science requires more than just a shiny gadget.
• The altitude effect on concussions? Turns out, not all elevations are created equal—in research or in life.

Who speaks in this episode?

• James Smoliga (Guest) · 4 min speaking
• Moo Yang (Guest) · 3 min speaking
• Johnny Townsen (Guest) · 4 min speaking
• Greg Meyer · 1 min speaking
• David Smith · 1 min speaking

What is discussed, and when

1. 0:00 – 3:00: James Smoliga, QC Collar, Q30, Tus University School of Medicine
2. 3:00 – 6:00: Mu Yang, James Smoliga, QC Collar
3. 6:00 – 9:00: David Smith
4. 12:00 – 14:55: FDA

Notable quotes from "The shaky science behind NFL safety gear"

• It's called the QC collar. Cucolor is this $200 device worn around the neck that applies compression to the jugular vein, which in turn increases blood volume in the brain. And it's this.

  about QC Collar · at 0:49

• There's no evidence that woodpeckers actually utilize this mechanism to protect their brains. I'm James Smoliga and I am a professor at Tus University School of Medicine within…

  about James Smoliga · at 2:35

• Most recently he's been working with Mu Yang a behavioral neuroscientist from Columbia University.

  about Mu Yang · at 4:07

• And David Smith, the devices inventor, told us upon hearing this idea, I looked into wellstudied non-endangered species that had omohyoid ligaments that could be.

  about David Smith · at 7:31

• Scientific credentials and obviously boost its sales is to have FDA authorize its product. This happened for Q30, the company that makes QCollar in 2021. This surprised James…

  about Q30 · at 10:31

• The FDA is saying that the data they looked at doesn't show that the QC color prevents concussion, but even more that the clinical meaningfulness of the kind of brain imaging the company was doing.

  about FDA · at 11:29

Who and what is mentioned in this episode?

People

• James Smoliga — Person · Referenced expert / primary critic · 2 mentions · first at 2:39
  Sports injury prevention researcher who challenges the scientific basis and published evidence behind the Q-Collar, including the woodpecker mechanism claim and data integrity concerns.
• Mu Yang — Person · Referenced expert / collaborator (data sleuth) · 2 mentions · first at 4:07
  Behavioral neuroscientist who reviews Q-Collar papers and identifies apparent duplicated tables/data across two different studies, escalating concerns about reliability.
• David Smith — Person · Referenced inventor / respondent · 1 mention · first at 7:31
  Identified as the device inventor who responds to BMJ inquiries, emphasizing disclosure of inventorship and stating he did not handle subjects or data.

Books & papers

• Lancet — Book · Referenced work · 2 mentions
  A medical journal referenced in the discussion about woodpeckers and brain protection mechanisms.
  Woodpeckers have been extensively studied including since the 1970s. there's a paper published in the Lanc set about how do woodpeckers protect their brain and there's been a…

Companies & orgs

• Q30 — Company · Business focus · 1 mention · first at 2:10
  The company that manufactures the QC Collar, involved in developing devices to reduce brain movement.
• FDA — Company · Regulatory body · 1 mention · first at 12:01
  The U.S. Food and Drug Administration, which authorized the QC Collar but expressed reservations about its effectiveness.
• Tus University School of Medicine — Company · Academic institution · 1 mention · first at 2:41
  The institution where James Smoliga, a professor critiquing the QC Collar, is employed.
  There's no evidence that woodpeckers actually utilize this mechanism to protect their brains. I'm James Smoliga and I am a professor at Tus University School of Medicine within…

Products & tech

• QC Collar — Product · Business focus · 2 mentions · first at 0:49
  A device claiming to help protect the brain from sports-related impacts by applying compression to the jugular vein.

Full transcript with timestamps

0:06 being an athlete that's played contact sports for as long as I have. Um, and you become aware of the repercussions of bashing your head into another person or, you know, concussion-l like syndromes that can come from these contact sports. Um, you're looking for ways to reduce that impact. Any other way you would do it when it comes to um, you know, soft tissue injuries? what are the preventive measures you can take? And so when QCaller came about, it was wow, here's an actual device that can help prevent concussions and um you know, seeing all the the science that was behind it, reinforcing, you know, their claims on how it can support athletes, um you know, wanted to try it.

0:45 There's a new device on the market that is claiming to help protect the brain. It's called the QC collar. Cucolor is this $200 device worn around the neck that applies compression to the jugular vein, which in turn increases blood volume in the brain. And it's this increased blood volume that the devices inventor has claimed mimics what happens in woodpeckers that helps the birds protect their brains when they peck. Conventional thinking to solve the brain injury epidemic in sports has been focused on protection from the outside.

1:18 A team of doctors came together with a different idea. to look for the solution from inside the body. They studied the evolution of animals whose very means of survival is to hit their heads. Nature reveals that the prevention of brain injury comes from the prevention of brain movement. But how to achieve this in humans? Their research indicated that by manipulating the body's blood flow, you can create a tighter fit for the brain inside the skull. They put their idea to the test in the lab. This initial study showed that jugular compression reduced torn fibers in the brain by more than 80%.

2:00 With this groundbreaking research, the innovators turned their focus to partnering with a team to develop an externally worn device that could help reduce the brain's movement safely and comfortably. Q30 and the Qaller were born. 6 years, more than 20 studies, and over 1,000 participants later, research has consistently shown the QCller helps protect the brain from sports related impacts. The BMJ was approached last year by a professor who studies sports injury prevention, who was saying that the data behind the QC color was not reliable.

2:33 The unfortunate part of that is that there's no evidence that woodpeckers actually utilize this mechanism to protect their brains. I'm James Smoliga and I am a professor at Tus University School of Medicine within the department of rehabilitation sciences. I work in the field of sports injury prevention and rehabilitation and sports performance optimization. Um the woodpeckers woodpeckers have been extensively studied including since the 1970s. Uh there's a paper published in the Lanc set about how do woodpeckers uh protect their brain and there's been a lot of work done by ornithologists and engineers uh and and physicians since then trying to figure out how woodpeckers protect their brains and basically jugular compression isn't one of those mechanisms. James first got interested in the QC collar after reading a paper co-authored by the devices inventor which stated that athletes experience less concussions at

3:24 higher altitudes and speculated that this was due to increased blood flow at higher altitudes leading to a tighter fit around the brain. I walked in my office one day and a colleague said to me, "There's a new paper that just came out that said that the risk of concussion is lower at high altitudes." And I said, "Oh, that's interesting. uh how high of the altitude and he said 600 feet above sea level. I said well no that can't be right. 600 feet above sea level isn't enough to make any physiologic difference on you know the brain. It started with the altitude paper but over the next few years James began to catalog many problems with the science underlying QOL and he's managed to get other scientists interested.

4:07 Most recently he's been working with Mu Yang a behavioral neuroscientist from Columbia University. I am a scientist at Columbia University. But the reason why I'm here is because I'm a I'm a sleuth sleuth. It's uh basically a science detective. So I I have caused over 200 papers to be retracted. James asked Moo to look at some of the QC color papers that have been published in the journal of neurot trauma. Two papers in particular caught Moo's attention. One study presented results of QC color in around 70 female high school soccer players.

4:43 The other paper was of 23 male SWAT team members, but the two papers presented the same data. I think on the second day I text Jamie and I said, "You owe me a beer." And he's like, "What?" And I showed him two tables from two papers. They contain absolutely identical data. And then if you look at the figure figure legend you see that the description of the subject are completely different.

5:15 Yeah. Essentially two different figure or two different tables with uh basically slightly different headers. The soccer study said preseason postseason. The SWAT study said pre-training post-training. The number of subjects differed within the table between groups but yet all 96 uh cells of data were exactly identical. some some cells went to three decimal points and all three decimal points were identical. Um there's no way that that was uh coincidence and since and there's the only explanation was that they copied and pasted the table, updated all the headers and all the subject numbers and changed you know everything in the columns and rows but then somehow forgot to update the most important part the actual data which is in my opinion kind of a ridiculous explanation. And the way I like to think about it is regardless of intention, we can't trust this. And you know which which one of these is is the real table?

6:11 Which image is the right image? And what else lurks beneath that we haven't noticed? If if somebody made let's call it an innocent error. If they made an innocent error for one of the key pieces of data or one of the key images, what else is is there that's also an error that we're not noticing? So regardless of intention, when we see objective evidence like this, we can't trust any of it in my opinion.

6:37 We asked the journal that published these studies, and they told us that it would publish Jaime and Moo's letter documenting their concerns as well as responses from the authors once their investigation into the data anomalies had concluded. At this point in time, they have issued an expression of concern for six papers, noting their ongoing investigation. As part of this investigative work, the BMJ approached Greg Meyer, who led the studies. Dr. Meyer told us,

7:04 "In a few cases where minor reporting errors were identified, we worked closely with the journals and issued corrections or published core agenda. Importantly, none of the raised issues altered the conclusions of the studies. No previously unreported benefits of the collar were introduced, nor were statistically significant findings changed. We remain committed to the highest standards of academic integrity and transparency and we will continue to correct any genuine errors in our published work.

7:31 And David Smith, the devices inventor, told us upon hearing this idea, I looked into wellstudied non-endangered species that had omohyoid ligaments that could be investigated. Since woodpeckers are endangered, they couldn't be studied. In response to your investigation, note that I disclosed my inventorship on the articles, and I never touched an animal nor human subject, nor did I ever touch the data. Our studies were performed at top research organizations. NFL players are always looking for an edge on the field and turn to science and technology to help them out. As Johnny Townson, who heard from the beginning, explained to me. Well, I think uh you know, helmet technology has come such a long ways. I have, you know, two actually two helmets behind me. Uh two different generations of you know, NFL style helmets. I'll show them to you real quick while we're here.

8:29 So, this was a uh this was a 2018 2019 version of the Ryell Speed helmet. Um it was what we call just a bucket. The padding was pretty old school. just has, you know, air suspension systems within it. um chin strap hasn't changed very much, but helmet technology even two years after, you know, the speed flex version came out and it has all of these different pads that help absorb, you know, the shocks of helmet to helmet contact, you know, contact with the ground and um so it's nice to know that equipment has kind of like really developed along the, you know, the time I was playing and you can notice, you know, the health effects from it as well. you know, when as an athlete, again, we're not scientists, so we don't really understand how data works. We just understand the cause and the effect. Um, and one circumstance is by trying it and making the assessment for yourself. And then the second, you know,

9:25 side of things is just blindly trusting individuals that are scientists and those that do have, you know, data to support their claims.

9:32 Scientific claims led Johnny to try the QCller to see if it might work for him. didn't notice too much of a change honestly in the effects between one run versus the other. Um but I've uh you know beyond that wore it longer and longer to see if there was some sort of you know trend I could notice in the effects and um unfortunately didn't pick up on too much. I've talked to a lot of NFL guys as well that wear them because, you know, part of my evaluation of whether or not I would continue using it was the feedback of peers that I trust and guys that have played contact sports also for a long time, but at more dangerous positions like running back, linebacker, offensive line. And um, you know, getting their feedback was important and the majority that I got from them was um, it was pretty similar to my experience. You know, didn't really notice any positive or negative effect from wearing it. Um, but they

10:22 just chose to continue wearing it because, you know, if it could potentially help, why not just wear it just in case?

10:30 One way a company can fortify its scientific credentials and obviously boost its sales is to have FDA authorize its product. This happened for Q30, the company that makes QCollar in 2021. This surprised James and Moo as they had seen these problems with the publicly available research on QCollar and they wondered what data the company had provided to FDA to get such an authorization. So they requested that data via a freedom of information request. What they found was that the FDA had also found numerous problems with the QCollar studies. It wasn't anywhere close to a glowing endorsement.

11:05 And so what the Freedom of Information Act uh to the FDA revealed, the documentation revealed is the FDA wasn't convinced that this act this product actually was effective at protecting the brain. And so shortly before it got authorized, there were still people in the FDA saying, "No, we don't believe that the the methods are well enough designed to show effectiveness and the data don't demonstrate effectiveness." The FDA is saying that the data they looked at doesn't show that the QC color prevents concussion, but even more that the clinical meaningfulness of the kind of brain imaging the company was doing isn't clear. Despite this reservation about the science, Jaime and Moo found that instead of rejecting the device, FDA authorized it, but required that QC color disclosed the lack of evidence around the prevention of concussion into the fine print of the product's labeling. something few people are ever

11:59 likely to notice. The FDA confirmed this in a response to the BMJ, stating that the clinical study data reviewed by the FDA supported the safety and effectiveness of this device as an aid in the protection of the brain from effects associated with repetitive subconcussive head impacts. The data do not demonstrate that the device can prevent concussion or serious brain injury. However, as you can see from this recent promotional video by the devices manufacturer, you'd never know the FDA had any doubts about the science.

12:34 Cucolor is a non-invasive device worn around the neck. It's applying a very exacting amount of pressure which allows for a back filling and there's more fluid being held in the brain so the brain can't slush or move inside the head. We reduce injury caused by repetitive subconcussive impacts. that could be what's going to minimize these longerterm health conditions, whether it's dementia, whether it's CTE. And the BMJ could not locate anywhere on the manufacturer's website the same caveats about the data that the FDA requires them to add to their manual.

13:08 And that can leave the target customer for QC color, people like Johnny Townsen, with the impression that the science on QColor is much more certain than it actually is. It turns out that if in the in the fine print essentially of the the manual, like the user guide for the product, there's a sentence. I'll read it to you. Um, data do not demonstrate that the device can prevent concussion or serious head injury.

13:37 That goes against everything that they that they claim, right? It's it's Yeah, it is. Um, it is sort of astonishing. And there's no additional sentences around it. It's just one bullet amongst a whole bunch on page I forget, you know, 10 of the 15 page manual or something like that. Um, it's pretty astonishing.

14:00 People have this perception that if they wear this $200 piece of plastic and and metal around their neck that they're brains are going to be safe and it's a quick fix. And what we know a lot of times quick fixes don't work. So, what I found really interesting about this story is that this is an area where there's this dire need for protection of the brain. People want to prevent concussions and now there's this device that everybody thinks the FDA has authorized to prevent concussions. But when you look at the fine print, that core claim around concussions actually is not proven. And it's stated there in black and white. But who's going to have the time to find the fine print? And so everybody is projecting this benefit onto the device, but when you look carefully, it's just not proven.

Questions about this episode

Who speaks in "The shaky science behind NFL safety gear"?

James Smoliga (Guest), Moo Yang (Guest), Johnny Townsen (Guest), Greg Meyer, David Smith.

What is "The shaky science behind NFL safety gear" about?

The QC collar is a $200 neck device designed to protect athletes from concussions by applying compression to the jugular vein, which increases blood volume in the brain. Backed by research that suggests preventing brain movement can reduce injuries, this innovative solution shifts the focus from external protection to manipulating internal blood flow to create a more stable environment for the…

What is mentioned in this The BMJ episode?

8 people, works and ideas are mentioned, including QC Collar, James Smoliga, Mu Yang, Q30, David Smith, FDA. Each one on this page links to its own page with every episode that mentions it.

How long is "The shaky science behind NFL safety gear"?

The episode runs 15 min; the transcript is about 2,508 words in 24 timestamped sections.

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