Does the Q (Quad Collar) collar help prevent concussions?

The Q Collar Does Not Effectively Prevent Concussions in Sports

The Q (Quad) collar has not been proven effective in preventing concussions and should not be recommended as a primary concussion prevention strategy. While some preliminary research shows potential benefits in reducing white matter changes, there is no significant evidence that the Q collar reduces actual concussion incidence rates 1.

Current Evidence on the Q Collar

Mechanism of Action

The Q collar applies gentle bilateral jugular vein compression, theoretically causing:

• Cerebral venous engorgement
• Reduced brain "slosh" during impacts
• Decreased brain movement within the skull 2

Research Findings

• Some studies show reduced white matter microstructural changes in collar-wearing athletes after a season of football 2, 3
• However, there is no significant difference in concussion incidence rates between collar and non-collar groups 1
• The collar compresses both the jugular vein and carotid artery, which may influence:
  • Sympathetic nerve activity in both men and women
  • Brain blood flow in women 4

Established Concussion Prevention Approaches

Current guidelines emphasize several evidence-based approaches to concussion prevention:

Rule Changes and Enforcement

• Rule changes and enforcement play a key role in reducing concussions 5
• The 1976 ban on spear tackling significantly reduced cervical spine injuries resulting in quadriplegia 5

Proper Technique Training

• Teaching proper tackling technique (initiating contact with the shoulder while keeping the head up) is recommended as a safer approach 5
• USA Football emphasizes keeping the head up during tackling 5

Equipment Considerations

• Sport-specific helmets have shown benefit in reducing head injuries in high-speed collision sports and sports with potential for falls onto hard surfaces 5
• However, for sports like soccer and rugby, no sport-specific helmets have demonstrated benefit in reducing head injury rates 5
• Mouthguards effectively reduce dental and orofacial injuries, but evidence for concussion prevention is largely theoretical 5, 6

Potential Risks of Protective Equipment

Behavioral Changes

• Some evidence suggests that protective equipment may actually alter playing behavior in ways that increase risk of brain injury 5
• Athletes may develop a false sense of security and engage in more dangerous play

Physiological Effects of the Q Collar

• The Q collar compresses both the jugular vein and carotid artery 4
• This compression can affect:
  • Blood pressure control during Valsalva maneuvers
  • Cerebral blood flow, particularly in women 4

Recommendations for Concussion Prevention

1. Focus on rule enforcement and proper technique training
2. Use sport-specific helmets in appropriate high-risk sports
3. Implement a stepwise return-to-play protocol after any concussion 5
4. Consider ball properties in sports like soccer (using lower-pressure balls within regulation limits) 5

Conclusion

While the Q collar shows some promising preliminary results in reducing white matter alterations, there is insufficient evidence to recommend it for concussion prevention. The current best practices for preventing concussions remain focused on rule enforcement, proper technique training, and appropriate use of established protective equipment for specific sports.