Sideline Saliva Testing for Concussions: The Future of Decision-Making in Sport | Andrew Cordssen-David (HeadFirst CEO)

This conversation is with Andrew Cordssen-David, CEO and co-founder of HeadFirst and a former semi-professional hockey player. Driven by his own experience with concussions, Andrew is working to transform how these injuries are detected and managed through the development of a rapid, saliva-based screening tool designed to help physicians make better sideline decisions. 

We Discuss: 

• Andrew’s hockey career and personal concussion history 
• Current diagnostic tests for concussion 
• Athletes hide concussion symptoms 
• Concussion pathophysiology 
• Saliva biomarkers of concussion 
• Best case use for point of care saliva testing 
• Bringing the product to market in North America 
• Advice for athletes dealing with a concussion 

HEADFIRST 

Episode Show Notes:  

• Connect with Andrew - LinkedIn 
• Sport Awareness Concussion Tool 
• Parachute Concussion Resources 
• Concussion Awareness Training Tool 

Connect with me: @casswarbeck  

Audio editing and processing by Wyatt Pavlik

Theme music by Ievgen Poltavskyi from Pixabay

 *Please appreciate that any information discussed is not intended to be a substitute for professional medical advice, always seek the opinion of a physician or qualified healthcare provider.*

Transcript

SPEAKER_03 0:03

This is the Here All Day podcast. I'm Dr. Cassie Barbeck, the sports medicine physician and combat sports athlete. This podcast is all about sharing conversations that break down the science of sports medicine, recovery, training, and fund-based nutrition to help you perform at your best, stay healthy, and show up all day. This conversation is with Andrew Quartz and David, former semi-professional hockey player and CEO and co-founder of Headfirst, a company focused on transforming how we detect and manage concussions through rapid saliva-based screening. As a sports medicine physician, concussion care is honestly one of the most challenging areas I've had to learn to navigate. Despite how common these injuries are, in the absence of clear neurological signs or obvious abnormalities on screening tests, we really still rely heavily on subjective symptom reporting to make the diagnosis. And unfortunately, the research suggests that up to 60% of concussions may be missed during initial sideline screening. It's a space where the stakes are high, but objective tools remain limited. Andrew brings a unique perspective to this problem, combining a background in biotechnology with lived experience as a high-level hockey player. Through his own experiences with concussions, he saw firsthand the gaps in how these injuries are recognized, assessed, and managed, particularly in the moments that matter most on the sidelines and in real time. Through Headfirst, Andrew and his team are developing a rapid, saliva-based diagnostic tool designed to detect biomarkers associated with concussion, with the goal of providing clinicians and athletic therapists with faster, more objective information to guide sideline decisions and improve athlete safety. This is a conversation about the reality of concussions in sport, the limitations of current assessment, and what it might look like to move forward with an objective, performance-informed approach to brain health. I was really excited to have this conversation and I hope you enjoy it just as much. Andrew, welcome to the podcast. I'm so glad we were able to make this happen. We were just chatting kind of before we started recording here about how busy you are. So thanks for squeezing me into your crazy life right now.

SPEAKER_00 2:06

No, absolutely. Thank you very much for having me.

SPEAKER_03 2:08

Awesome. Um, okay, so so much, obviously, I want to chat to you about. Um, you're doing a lot of exciting things these days. Uh, but maybe to lay the foundation, it would be helpful to start this conversation. I'd love to hear a little bit about your own hockey career. So your own background, your own experience as an athlete, and then maybe we can go from there. So, what where did you play hockey? What level did you play? All those things.

SPEAKER_00 2:29

No, absolutely. Sounds great. And that's that's a really interesting question. And I actually don't really get asked that a lot where I played, but I'll try to keep it as service level as possible because I played everywhere. So uh, you know, I was I was born in Canada. I was born in Montreal, but I moved down to the greater Philadelphia area when I was very young. Uh, and compared to Quebec and Montreal area, there's no outdoor ranks in the wintertime here. So, you know, I grew up in the area playing AAA hockey in the States. Um, from there, let's say when I was 14 years old or 13, I got scouted to play at a school called Shadow St. Mary's, which is in Minnesota. I went to that school for two years. Uh, and that's when my experiences with concussions happened, but we'll we'll get to that point in a little bit. Um, and then from there I went to play major junior back in Quebec, given that that's where I was born. I always wanted to play in the Quebec major junior. It was a dream of mine ever since I was very young. So I played there for uh two seasons. And then from there, I went to several different junior aid teams that were trying to build teams to go far in the playoffs. So I went from uh Bay Como, Draccar in the Quebec Major Jr. to uh the Bathurst Titan. And then from there, that was also in the Quebec Major Junior. I went to uh Surrey Eagles, Trent Goldenhawks, Georgetown Raiders, Kirkland League Gold Miners.

SPEAKER_02 3:42

Oh my goodness.

SPEAKER_00 3:43

All within the last, yeah, all within the last two years of juniors or two and a half. Um and uh not in specific order. That was just all the teams I did play for. I don't think I'm leaving any out. Uh yeah. And then from there, I just went to the University of Waterloo and played five years uh on the varsity team, but COVID took away a year. But uh yeah, I was still on the team.

SPEAKER_03 4:01

Amazing, amazing. So lots of in-depth hockey hockey experience. Uh, what position? I'm curious.

SPEAKER_00 4:07

Uh I'm a defenseman. Uh I, you know, I'm a bigger guy. I'm six foot five, two twenty five. So I played more of the shutdown D role, but I'd say for my height, I moved pretty well. Uh, and I think uh the points in my my elite prospects kind of show that as well. So uh played defenseman. I I played a little bit of forward but stuck to defense.

SPEAKER_03 4:26

Nice, nice. I uh I'll admit I I was googling in preparation for this. I I saw as well as some like your highlights, I saw you dropping the gloves a little bit out there on YouTube too.

SPEAKER_00 4:35

So yeah, yeah, that was that was back in the day when um hockeyfights.com was posting. I think they slowed that down for for not minor hockey, but anything outside of the professional leagues. Uh but yeah, that's those are fun times for sure.

SPEAKER_03 4:50

Um okay, so you alluded to it a little bit already, but um, let's um start talking about the experience you had with concussions, I guess. Um so you can start that wherever you feel we need to start, but maybe like when was your first concussion and kind of what has been your experience with concussion in hockey?

SPEAKER_00 5:07

Yeah, that's uh that's a good question. And I don't want to throw any teams under the bus, so I'll keep it very general uh in terms of where they were sustained and I'll stick to age ranges. But my first concussion when I was around 13 or 14 years old. Uh, I remember that I got hit, I blacked out for a second or two. I went back to the bench and I remember getting pulled and I got ran through the subjective tests that exist today, right? The very simple type of tests. And I felt like something was wrong, but it wasn't obvious, right? So I just felt a little bit off and and I vocalized that, but I passed the subjective tests. So I actually returned into the game and I was fine for the rest of the game. But later that night I had uh delayed symptoms and I had nausea and vomiting. So the next morning I went to the hospital, and actually was the next morning when the symptoms really occurred, and that's when I got diagnosed my first concussion. And once again, I was 13 or 14 years old. And, you know, as as someone of that age, it's it's it's a scary thing, right? Because you don't, it's not like you break a bone and I've had injuries, all kinds of injuries, from you know, broken knuckles to torn MCLs, ACLs, meniscus, shoulder, you name it. I've I've probably heard that part of my body, but the concussion was particularly surprising because you know, you didn't really feel that immediate symptoms right away. You felt something was wrong, but you didn't really know. It was kind of more of a scare factor. You blacked out for a little bit, but the symptoms really didn't show until around 12 hours later. So that was my first experience. And then from there, uh I was always uh I say a little bit taller and a little bit heavier uh than most of the individuals my age. So I played an age group up for a lot of my youth hockey. And then when I went to major junior, I really filled up that role of defensive defenseman. Uh, I just by nature played a very uh aggressive game. I was very intense. I loved it. It's just the way that I played my best was when I was fully, you know, into the game. Um, and then from there in my junior career, I suffered multiple concussions. I'd say at least another two that were documented. And I'd say another handful that are questionable. But because of the subjectivity of the sideline assessments, that's all the doctors really had to use to be able to diagnose it or not. And, you know, around right now, 50% of concussions go undetected per the CDC. And it's it's possible that I did have concussions when maybe they slid under the radar. So um, yeah, it's been a long road with concussions. My most recent one uh that I don't know if it was a concussion or not was actually uh during my university uh career. Um, so it's been around three years, concussion-free, I guess. Um, but yeah, I've had a lot of experience with concussion, with the different tests, different rehabilitation methods, uh, some that work better than others. Uh, but yeah, several throughout the career.

SPEAKER_03 7:45

Yeah, wow. Um, thank you for sharing your experience. Um that's like I guess hearing it now, it's like the fact you blacked out and then went back into a hockey game. That's alarming. And I I know concussion, we've learned a lot. Um it was like several years ago. So we've learned a lot since then. And I like to think most sport med doctors or trainers wouldn't send a player back out now. But you're so right. There's so much subjectivity to the testing, especially when there's not like a big, bad red flag. Like we don't have those like objective findings, and then we rely so much on what the players tell us. Um, do you remember some of the subjective testing that they put you through, like during your career? Like I'm assuming it was like remember these numbers or months backwards, those types of things.

SPEAKER_00 8:27

Yeah, absolutely. And just to step back to the last question, too. Uh, that first concussion was over 15 years ago, right? So everything that we know about concussion now, all the awareness that's been coming out in the last decade, that has definitely improved the way we, you know, diagnose and treat concussions. But when I was younger, it was just like you got your bell rung, right? That was just the standard back then. So uh, but anyway, so yeah, um, in terms of the testing that we went through, very similar. So, what's your name? Where were you born? Where are you from? Where do you live? How much time was left on the score clock? Uh, to the best of your ability, it was the time that was left, what period was it in? Um, yeah, the the months of the year backwards, there were some balance tests as well. Um, so walk in a straight line with your eyes open and then do it again with your eyes closed forward and backwards on a straight line. Uh trying to think of the other, it was probably mainly the scat test because they've been around for a while and there's been different revisions of it. And now that I think about it, it was really memory. Uh, so cognitive function overall, um, some visual tests, so fall of the finger, right? Um, and then a little bit of balance was thrown in there as well. So that was probably the earliest concussions. That's what I remember the most. But I'll all I remember really vividly is the weird questions they would ask about like, what's your name? I was like, well, of course I know my name, right? Things like that. That you know, depending on the situation, it's obvious or not. Um, but yeah, there's some questions where I was like, is that really something you need to ask? But uh, but yeah, a lot of a lot of those questionnaires.

SPEAKER_03 9:56

Yeah. And that's very much on what we rely on now. Like, I think we're at the SCAT six now. And it's very like we we I feel like we keep adding things, it makes the test longer. But there's it's it makes it almost more difficult to interpret because I I think there's certain things where like I think I want to hear this out that like 20% of athletes would fail certain components of it just at baseline. Like, unless we have that baseline testing, we're comparing it. And then obviously it takes time to implement. So, unless we're willing to pull the player off the ice and do a 30-minute assessment, it's it's difficult. So um, I know I rely like as much as I do my neurological stuff and the objective testing, I rely on a lot of what players tell me. So, do you feel foggy? Do you feel slowed down? I'm I'm curious if like, did you it seems like you a lot of your symptoms that you had were delayed? So some of those symptoms weren't initial or yeah, yeah, that's a good point.

SPEAKER_00 10:48

And I will say too, I didn't think about it that way when you say we've added more to these tests, and it actually complicates it to a sense. I didn't actually think about that originally, but that's a hundred percent true. The more data you have and the potentially more conflicting it is, the more difficult the decision is, right? So that's a good point. But um yeah, in terms of the symptoms and how open I was, I will be transparent because when you're in major junior and you're playing junior hockey, you're not thinking at your health at 50 years old. You're thinking about making the NHL and staying in the lineup because especially when you get to the higher levels, you know, you have all of these external stressors, right? The parents want you to do well. Uh you want to impress your coaches and your teammates, you want to be tough, right? In the sense of working through any injury. And I wasn't 100% truthful. I was in a position as a defensive defenseman where my roster spot was always in contention. I wasn't first line star defenseman. So for me, my my ultimate goal was to stay in the lineup any means possible. And I played with broken bones and torn ligaments. So for me, it wasn't anything different than that. But in reality, it's you only have one brain and you have to protect it. And there's no process of uh healing a lot of the things that can happen if you don't take it seriously the first time. So I've also seen other athletes kind of work their way around these tests as well. So for me, it was do anything you can to stay in the lineup. I wasn't fully truthful with the assessments. Uh, and you know, at the end of the day, that's on me. But as a young, let's say young adult and teenager, I didn't really know better. Right. So that was that was kind of that downfall. But yeah, 100% that uh uh the awareness has gone up. More athletes are being truthful, which is phenomenal. But there's still studies that have come out recently, even with professional athletes, saying that 80 plus percent are still saying that they're not reporting their symptoms. And that's it's a big problem.

SPEAKER_03 12:32

Yeah, no, I completely agree. That was going to be my and then my next question for you is if you ever tried to hide symptoms. So thank you for volunteering that, being honest. Um, and I think again, it's just the more we talk about this, the more awareness there is around it and how important brain health is that younger athletes listening, then hopefully they report their symptoms to their doctors. But I understand the external pressures to make the team and stay in the lineup. Um, like your lineup place is never guaranteed. Um did you coming back to your the concussions that you had, did you because I think I read in some articles that you were struggling a little bit with post-concussion syndrome or you had some prolonged symptoms afterwards? Do you want to share just a little bit about kind of that experience?

SPEAKER_00 13:12

Yeah, it's I will say too, that was the most traumatic part in my experience with traumatic brain injury was the post-concussion syndrome. So throughout juniors, and I don't remember which year, I think it was my third year, towards the end of the season, I sustained a concussion. Uh, I passed the tests again, I went back into play. I didn't feel like anything was wrong. I got another hit, and it wasn't a massive hit that where I hit my head or anything like that. It was just a regular bump uh from a player that was, I was shot the puck into the zone, and they came in and they gave me a bump. And from that point, I was like, okay, something's wrong. Um, I felt pressure in the head immediately, went to the bench. I didn't finish that game. I got out completely. And that was funny enough, the last game of the season. So it actually benefited me regardless because there was no more game. So there's less uh uh incentive for me to not be truthful, right? I guess in a sense. So for me, what happened was I was a little bit of sensitive, like sensitive to light and sound, but not that much. I just noticed a subtle difference. And then for me, the biggest challenge was uh I'd have the spins when I go to bed. I'd have nausea and potentially vomiting as well. So when I would go to bed for around six months, um crazy, five or six months, I'd go to bed and I'd I'd be scared because I'd have the spins. And as a young adult, you you don't, you know, you think it's your new reality for the rest. It's a very scary thing. So that was, I think, the biggest motivating factor, first of all, to start head first was that experience. Uh and yeah, it was a very scary point in my life. Uh, we were able to do a lot of different treatments around it. Uh, we did VOMs and everything like that. It really helped me uh, I guess, restabilize myself. So with coordination, everything like that, it helped me really figure out those symptoms and overcome them. Uh and there's a few other methods as well, but yeah, it was a very scary point.

SPEAKER_03 14:56

Wild, wild. Okay. So it was kind of going through that experience that it was, okay, we need to change what we're doing here a little bit.

SPEAKER_02 15:04

Yeah.

SPEAKER_03 15:04

So so you mentioned that's when kind of the first idea of starting something like Head First came to you. Or when did kind of when did you have that first idea? Because quite a an ambitious idea.

SPEAKER_00 15:18

No, absolutely. And that's a great question. I can't pinpoint a moment in time where it was an aha moment. I always knew it was a problem. I just never thought about actually solving it because I didn't know there was a solution to it. Because especially when you're young, too, you're you're not thinking of at least I wasn't. I was focused on trying to make the NHL or play professional hockey. Um, so the idea really dawned on me when I went through. So I went to the University of Waterloo for my undergrad. I did science and business. It's not a double major, but it's uh you don't really have many elective choices. The courses are set out in science and business, and that's about it, which I loved. I love science. I was never great at it, but I loved it. So I really got fasting with the human body and how it worked. I did physiology, anatomy. Uh, didn't really go into neurology that much, but there are some uh topics in the courses that covered neurology. And then I decided at the end of my undergrad, if I don't do a master's now, the likeliness of me going back and doing a master's was unlikely. So I just decided, you know what? I I there's this one program at Waterloo I'm really passionate about. I want to do it, and it's called the Master of Business, Entrepreneurship and Technology. And what that program is at a high level, it's an MBA for startups. So you identify a problem, you validate it by talking to hundreds of people, and then you solve it. And my first idea through Embet that I was trying to build a business around was reverse logistics, which is completely not medical device related whatsoever, concussion related. But uh, what it was was, you know, COVID, a lot of these uh uh retailers they said, you can order 10 and return nine and we'll give you a full refund. But that wreaked havoc on the logistics system. But as I dug in further and did more, you know, potential interviews and things like that, it wasn't a big problem. So towards the end of the program, after I learned all these skills and actually put them to use, um I forget where I was, but it was like in a startup accelerator type event. And there was someone there that created a VR headset to assist in rehabilitation to in clinics to help healthcare professionals and medical professionals try to solve some of these symptoms uh that are uh as a result of the TBIs. And for me, I was like, wait a second, objective sideline screening still doesn't exist. I was like, it's all subjective. Even in Waterloo, like that time when I had concussions, there's this one time I went through the assessments. Once again, it was all object or subjective. So that's when it dawned on me saying, What can we build that's objective to detect concussions? And I'll know we'll get into the the how we landed on bodily fluid biomarkers, but uh that was kind of the moment. I think it was May or June of 2023, was when we first thought of the concept. And uh that's when our journey began.

SPEAKER_03 17:55

Exciting. So cool, so cool. Um, okay, yes, I want to get into kind of what the actual test is doing and all that, but maybe I realize we should take a slight step back and talk about at a high level what a concussion is. And then I think maybe that'll set the stage for kind of understanding what your test is doing. Um, most people listening to this will probably be well aware of what a concussion is, but maybe if you just want to give a broad overview in how do you define a concussion or what is a concussion, like what is going on in the brain when we get hit.

SPEAKER_00 18:26

Great question. I'll keep it very simple to leave out most of the science behind it. But at a high level, uh your brain sits in fluid inside your skull. And when you suffer a concussion, the brain hits the side of the skull and it causes a traumatic event to the brain. Um, in our sense, what we're trying to do for head first and a head first with our device is similar, and I like to use this analogy a lot. When you roll your ankle playing basketball or outside, whatever it might be, uh, within minutes there's swelling in the area because the immune system kicks in, something's wrong, there's traumatic event that happened to the body. And then from there, yeah, the immune system kicks in, biomarker levels rise as a physiological and biochemical response to an injury. And it's a very similar concept with the brain. When this event happens, what happens is the brain begins to swell. And then biomarkers actually end up leaking through our blood-brain barrier and into our bodily fluids at a higher level. And what we're trying to do ahead first is really detect those differences between, let's say, healthy concentrations of these biomarkers and then post-concussion concentrations of these biomarkers.

SPEAKER_03 19:26

That's so fascinating. That's so crazy. Okay. Um, and I maybe goes without saying here, but uh the injury we get from a concussion, um, unless there's new science, this is not something that we could see on like a brain MRI or a CT or something like that, right? Like this inflammation and these biomarker changes that you're seeing. We we don't have yet anything else, like any imaging that can diagnose this.

SPEAKER_00 19:50

That's a great question. And there's a lot of literature where they use imaging for TBI specifically. And I know for a fact that in some boxing leagues, they do baseline scans and they do post-bite scans to see the inflammation and how things are going. And that definitely can be useful. But in the large majority of individuals, when they sustain a concussion, they would only go to get a CT scan if a medical professional uh decides that there could be some type of brain bleed, subdural hematone, whatever it might be. Um, and that's when MRIs come in useful because they can detect those bleeds and then from there they can take action immediately, which is uh that's not concussion. Now you're in severe traumatic brain injury.

SPEAKER_03 20:28

That was actually a structural problem.

SPEAKER_00 20:29

Yeah. Yes, exactly. And usually at that point, I'd not say usually. Um sometimes there's cranial damage as well. So there's impact points on the head where you can pretty much say, yes, we should get you to do a CT because the actual trauma to the skull likely caused also a damage, uh damaging event to the brain. Um, so don't quote me on the exact percentage, but I think 92% of CT scans come back negative for traumatic brain injury, uh, mild traumatic brain injury, given that they detect these bleeds and not necessarily that inflammation.

SPEAKER_03 21:00

Yeah, understood. Makes that makes sense. Um, so yeah, even more so why we need something like an objective measure that also we don't need to transport you to a hospital and do ideally. Um, explain a bit more about I guess how you settled on saliva, like you were saying. Like I'm curious what kind of the the testing process looked like or how like like I'm assuming that wasn't your first idea to test this, right? Yeah.

SPEAKER_00 21:23

Yeah, yeah, that's it, yeah, that's a good one. Um yes, 100%. When so the going back to the startup story, uh during my master's, I was, you know, the University of Waterloo is a very entrepreneurial ecosystem, and everyone wants to connect someone with somebody that they know that can help them build in this space. So early on, I connected with my co founder named Shazia Tanvier. She's a PhD in uh biotechnology, uh, has a master's degree as well. Um, she's been in the space for around 15 years, not neurology specific, but medical and environmental testing and devices. Um, but from there, when we first met, we started. Sat down, I think, for three hours just going over the concepts and what we can build objectively to screen for concussions. And we said, let's do our research, see what we find, see what options are out there, and then build a platform. So we landed on, I would say, the main areas or technologies that we could use to objectively assess concussions was visually. So eye tracking or retinal scans. The other one was bodily fluid-based biomarkers as a result of the stress that the body goes under under those events. Any type of subjective tests as well, balance or VOMS, things like that. And those are really the main three that came to mind. And also imaging and MRIs and see if we can use these images to create something else. But that kind of got shut down quickly, given that there are companies that are accelerating and improving MRIs, and it's still not really a thing. So we decided to shelf that very early. So the challenge with visual tests is that not everyone gets uh uh visual symptoms. So you when you get a concussion, because adrenaline also spikes because of the event, it's scary. You know, your body's in a fight or flight response mode. Uh, your, I think it's the sympathetic nerve system kicks in and it everything goes up and it's elevated. And you actually sometimes become more aware. So we've seen individuals go through some tests that are compared to a baseline and speed matters, right? And we found that after a potential concussion, they did it faster. So uh visual inspection was difficult to do in point of care. So we decided to take that out. Uh, EEG scans and imaging. EEG is just you need to put a headset on, some frequencies of the brain, see how it reacts, things like that, which is challenging to do in the point of care, especially when you have a sweaty athlete that just got off the ice. So we shelfed that and we really focused on these bodily fluid-based biomarkers. And we know that there was a lot of studies done in blood, uh, particularly plasma. Uh, there's a company that has a test for traumatic brain injuries on the market. It's Abbott's eye statilinity tool, and it detects two different proteins. And the device is used to rule out unnecessary CT scans. So that for us was a great indication that, okay, there might there be markers that spike in bodily fluids. And we dove deeper and deeper into literature and we found some literature around saliva biomarkers for TBI. And then from there, to not go into too much detail, we figured out where are the gaps in this research? Like what hasn't been answered yet? And then we dove into that and we created a study protocol that we executed last year where really the key missing component was getting samples at the point of care. So let's say within 15 minutes of injury, and we were able to do that along with a few other things as well. But we really started with a bunch of different options and narrowed it down to bodily fluid-based biomarkers. And we chose saliva specifically because we did a short and I guess a very small pilot study around one singular concussion biomarker that's known and that's the most extensively studied for traumatic brain injury back in late 2024, I believe. And we found that after a concussion, it was increased. So uh we kind of said, okay, that's our indication that we can detect concussions with saliva potentially. And we decided to expand that study from there.

SPEAKER_03 25:12

Fascinating. That's that's actually really cool. And I think the bonus with saliva is it's way easier to get a saliva sample than to like poke an athlete and try and get a blood sample or even in like a pinprick. So that's neat. Um, yeah, because I I feel like I've seen other companies, they they I think there was like goggles you put on and they like look at how your eyes are moving or such. And that I don't think really went anywhere as far as I know.

SPEAKER_00 25:33

But they're they're still there. And I do see a lot of these companies, they're actually used a lot in rehabilitation, which is phenomenal. It helps within the process. They're still in TBI, but it helps with recovery. So moving your eyes, uh, and there's a lot of studies that show that eye movement uh in increased amounts over time uh throughout the recovery process can greatly accelerate the time of recovery. So they're used in that context, but not really in the point of care, as you mentioned.

SPEAKER_03 25:59

Yeah, not in like helping with that diagnostic piece and that kind of gray area, because we need something where we can like quickly, it's like a clinical tool that we can help decide can this player go back on the ice, or do we actually pull them off and do like the full thing? So I I think that's that's helpful. Um, in terms of, I guess you mentioned you'd kind of done a pilot study, and where are we at in terms of the kind of the research phase of it? Um, if you can speak to any of that, if you if some of it's top secret, I understand.

SPEAKER_00 26:26

No, no, absolutely. And then that's a great question. And and I will say that this summer, I'd say more towards the later summer, we do plan on publishing our research that we currently kind of wrapped up. Yeah, uh it's technically ongoing until November of this year, but we pretty much collected the samples that we needed for this exact study. Uh, but what we did was stepping back to the initial pilot study, what we did was we collected samples from both men's and women's uh particular sport. Uh, we had 35 or 40 control samples, and we had three post-concussion samples in which those biomarkers were elevated. From there, we said, okay, this is validation that saliva could potentially be used as a tool to detect concussions as a diagnostic medium. So we decided to 10x that study. So we worked with the University of Waterloo Athletics Department. We went across pretty much every sport that they they have, as long as the athletes were willing to participate in the study. And that includes, you know, football, rugby, uh, hockey, men's and women's. Um, and we also have um even swimming, I think, was participating, right? So we had a wide variety of sports. Um, and then from there, we collected, I don't have the exact numbers on the top of my head, but several hundred control samples, and we had dozens of concuss samples. And we also collected them at different time points after the injury to see how these biomarkers react over time. And instead of focusing on one biomarker, uh, we decided to expand that panel and we discovered several that uh that were indicated that could potentially indicate a concussion. So that's where we're at with the study. Uh from there, we want to publish the results. We're going to refine our device and our platform accordingly. And then from there, later this year, we want to launch a clinical study where we're going to be collecting, we're targeting around a thousand control samples with hopefully around a hundred concuss samples. We'll be quantifying levels of different biomarkers, and we'll also be running them through our platform and then analyzing, okay, compared to let's say the FDA or Health Canada's definition of a concussion, which is on the GCS scale, how effective is our device in picking up these traumatic brain injuries? And that's that's our next steps.

SPEAKER_03 28:30

Okay, okay, very cool. Um, a couple of just like kind of small questions here, I guess. Um, how fast, like does it take time for these biomarkers to get into the saliva? Like, so let's say someone gets hit and um they cite sustain a concussion. Do we have to wait a certain, or maybe you I don't know, do you know this yet? Do you have to wait 15 minutes, 30 minutes, or is it pretty quick that you'll start to see these markers in the saliva?

SPEAKER_00 28:53

That's a good question. And also just jumping back to the research side of this, too. Uh University of Waterloo is one of our partners. We also have several other research initiatives, but that's kind of the large one there. But um, yeah, the others that we were assessing a bunch of different markers and different time points as you were discussing there. But uh, in terms of biomarkers, it is important to say that not all biomarkers are created equal. And it's it's I guess a terrible but great answer at the same time because we know that some spike uh seconds after an injury. Uh, and if you think of a regular bell curve, with let's say the half-life of the biomarker being at the top point, the climax of that bell curve. Uh, we're not trying to detect that. We're trying to detect from a control sample where on that increase can we say officially does this individual have a traumatic brain injury or mild traumatic brain injury? So that's what we're trying to say. And we found that some markers, depending on different factors, are very effective in the early, uh, let's say, parts of a concussion. And some are useful potentially in return to play protocol as well. So determining when the has healed from a concussion, right? So some of these biomarkers we know get elevated, they go back to baseline, but then some of them become downregulated as a result of the immune, the immune system kicking in. So uh very interesting findings, and we'll be publishing more and we can talk about which ones and how and why and and all the physiology behind it as well over the summer. But uh yeah, that's at a high level what we found through the through some of the data.

SPEAKER_03 30:18

Okay. Like roughly how many biomarkers are you measuring? Like it it's there's multiple. Are we talking like five, like 20? Like how many?

SPEAKER_00 30:27

We started our platform with one, knowing that we most likely would have needed more, because if you think about any type of diagnostic tool, the more markers or biomarkers you have on a panel, the more of the, let's say, the full painting that you can you can show, right? So uh we started with one. We built the platform off that one marker. From there, we decided to add more that were commonly found in literature. And then through our research, I think combined in all our research initiatives, we assessed around 131, I guess, overall central nervous system biomarkers, some that are specific to traumatic brain injury and specific to the leakage of the blood brain barrier, and some that are associated with, let's say, neuroinflammation, uh, axon damage, neuronal damage, uh, and a few other things as well. So, not all around that blood brain barrier leakage. It's really around the entire, or you know, the whole process of a concussion and how it occurs and all the physiological responses as a result.

SPEAKER_03 31:26

Wow. It's very exciting, very complex. It's like the more you ask, the more you like it get down the rabbit hole. It's crazy. Um, do you because I one thing I was kind of wondering, because the tests are difficult because they it depending on where you set that threshold for abnormal or normal, like let's say that you set the threshold too low, then potentially that you are going to classify some athletes as having a concussion that might not have a concussion. Alternatively, if you set it too high, we're going to be missing some athletes. So I'm sure that's a very hard thing to navigate and knowing like where to set it. But is that something that you guys have given some thought to?

SPEAKER_00 32:01

Absolutely. So, what we've done and with our studies, as I mentioned, we have several hundred control samples across multiple studies, and we're assessing the baseline levels. And for men and women, relatively for adults at least, they fall within pretty much the same range from what we've seen with the markers we've tested, at least the top dozen of interest for us. Yeah, it's a great question in terms of the actual threshold itself. Uh, what we like to call it in the regulatory type space and med-device space is a cutoff value. So when you hit that cutoff, then above that is traumatic brain injury or potentially. And it's also important to note that you know, we're not trying to replace all the existing tests that are out there because at the end of the day, some of them work better than others for certain people, right? So sometimes a subjective test will work for one individual because they have symptoms and it's obvious. And sometimes it doesn't, right? So what we're trying to really do with our device is not replace the system, is to add the first objective sideline screening tool to help make that more informed decision. Right. So um, so yeah, setting that clinical cutoff is difficult. We have uh some neurologists and uh sports medicine professionals that are on our uh advisory board that have been helping kind of figure out, okay, what should we target at what levels and why, and what's out there already that we can find that helps kind of relate to our research. So uh, so yeah, it's um it's a process, but we're making it through.

SPEAKER_03 33:24

Yeah, no, that's very complicated. But I yeah, it's just yeah, lots of questions, but I'm excited to kind of see where you guys end up going with this. Um what I guess in in a perfect world, what would you how do you see like the role of this test fitting into like the sideline assessment then? So let's say we bring the athlete off. I'm assuming like like as a sport med doctor, I'm still going to like do a quick neurological screen. Like I'm still looking out for those things. But then is that something like we would pull out the saliva test on like the bench? Is it like how do you imagine it fitting in?

SPEAKER_00 33:58

Great question. And we'll try to keep it general because we can't make claims right now. But really, what we're trying to do is complement the process that exists already and potentially help identify more concussions. So ideally, in a in a use case, uh, we don't, you know, leaving out inclusion and exclusion criteria of the individual at a high level, the athlete would sustain the traumatic brain injury event. So whether it's uh falling at home, let's say, even that can happen, or it can be on the field or on the ice when an athlete hits their head, they'll get removed from play and they would get run through the current subjective assessments. And throughout that process, um, it's important to note too that we didn't really talk about the device itself, but right now the concept is passive drool. So instead of swapping your nose or your throat, and you know, the notes with COVID and you cry and you sneeze all the time, right? We don't have to worry about that. It's a simple passive drool sample. And roughly in 30 seconds to a minute, there's enough drool in the mouth for us to be able to pull it out of the mouth. Okay. We call it our saliva pretreatment device. And then that will place four drops or five drops onto our device, which will give the reading. But when we would use our test, is after the subjective tests are done, the individual would be, you know, the individual running the test would have an idea whether they're uh concussed or not. And then with our objective test, they would provide the sample. And similar to a COVID test, um if you have a high viral load and you're very sick, usually you'll see the test line almost immediately when this, you know, the sample goes up the strip. Um, and similar in our case, within two to three minutes, you might see an indication. But the lateral flow assay standard in the world of LFAs is around 15 minutes from the sample touching the strip to the final result. So we would fit within that current sideline process, most likely after the subjective tests have been done, because we can only push physiology so far. And as you can imagine, as the brain continues to swell as a result of the event, um, it gives us more time for these markers to increase in concentration.

SPEAKER_03 35:56

Okay, fascinating. Um, do you know if other things can cause these biomarkers to increase? Like I'm sure there's something, again, on you've also thought of, but like what if we had like a like uh a cerebral infection or something like that, or meningitis? Would that do weird things to your markers?

SPEAKER_00 36:13

Absolutely. It's a great question. And and that's some that's something we don't get asked often, which is uh interesting. So uh biomarkers have sensitivity and specificity, right? So how sensitive are they to the the uh uh let's say disease or injury, and how specific are they? So specificity is uh really the the topic here where not all biomarkers that we've studied uh by design are specific to traumatic brain injury. So let's say, just for example, the interleukin family, right? Uh they're inflammatory markers. And we know that if you tear a muscle, those markers will be elevated as well, right? And it's different interleukins, because I don't know how many kinds there are, but there are a lot of different right. So uh different markers are better for different things. But uh, yeah, not all biomarkers that we've tested, because we wanted to get the biggest picture of which markers show the best results. Not all of them are specific to traumatic brain injury, but excuse me, with the research, we found, let's say, in our top dozen biomarkers, uh, we can find that some are inflammatory, some are neuronal damage, some are blood-brain barrier leakage and XYZ. We see increases from different results of the concussion. Um, so yeah, important to mention that you can't just pick a marker because it's elevated. You have to realize that it has to be a part of whatever you're trying to detect. And in our case, it's concussions.

SPEAKER_03 37:31

Yeah, no, makes sense. Um, how soon do you envision best case scenario that something like this could actually be on the market? Like if everything goes perfectly as it should be.

SPEAKER_00 37:41

If everything goes very well by 2028, we should be in the market. Okay. Uh, because we have to go through the clinical study, then clinical trials prove that it's safe and effective. And then from there, we would get granted uh FDA approval and Health Canada approval. Uh, so we're looking into 2028. Uh, I don't really believe that clinical trials and all these things will be too difficult. Uh, we're adding in a screening tool into a process that can be improved already, right? So uh we don't anticipate really any massive hurdles to overcome. But that being said, we're still early in the journey and we don't know what we don't know. Um, but uh but yeah, so far everything's been looking positive. And uh we think that 2028 timeline is is a realistic timeline for us.

SPEAKER_03 38:18

That's very exciting. And so do you think like you'd if things go well, you'd be in the United States and Canada around the same time? Like is that because I feel Canada, we always lag behind what you have in the States and it sucks.

SPEAKER_00 38:28

No, no, I should be around the same time. And um sometimes the approval process for those regulatory bodies are a bit different. Uh so when you submit your clinical trial results, sometimes it takes longer for certain uh, let's say, regions around the world to approve whatever data that you presented. Uh, and I'd say US and Canada, sometimes Canada can actually be faster. So it all depends on what we claim the device will do after we do our clinical study uh and how we frame the device itself. But uh everything that we chat about today is our intended use. It could change based on findings that we have in our clinical studies, but uh but so far we're comfortable with with with the device and its capabilities and and where we're going with it.

SPEAKER_03 39:07

Cool, very cool. Um, so I have to ask about potential cost. Do you have is that something that you've had any ability to predict or think about? Because I imagine obviously all this stuff is not cheap. And I know you've been, yeah, development, it's expensive. Um because it's a medical device, does that mean insurance could potentially cover it? Or am I like completely wrong there?

SPEAKER_00 39:29

Yeah, so so depends on the use case because insurance claims, you know, uh if a healthcare facility uses it, it's different than if an athletic department uses it, right? So for coverage itself, uh, that comes into play when we're talking about healthcare settings, um, but not necessarily in athletic settings. Uh, given that, let's say a non-medical professional screens an athlete on the sidelines and decides that they're not fit to return to play for whatever reason, TBI or otherwise, they're not making a medical diagnosis. They're making a screening decision based on symptoms and as you know, the subjective test, right? So um that's still something that's up in the air for us, depending on on the claims. But uh, but yes, insurance definitely is a possibility. In terms of the price point, I'm actually gonna Uno reverse card this back your way. What what what would you pay for something like this if you had the option? We could be a wide range, but just out of curiosity, what do you what do you expect it to be? What would you pay for it? Just give me just give me an idea. I'm curious.

SPEAKER_03 40:27

Man, I feel I'm going through my residency, so it's like I don't pay for anything. So I'm not sure. I haven't had too much privy to like the athletic budgets and all that. But like I imagine it would vary depending on the team. Like the higher, the more elite the team, I think they'd be willing to pay more. And whether that's$25,$50,$100 for a point of care test, um, I don't think would be definitely like that's not unreasonable, I wouldn't think. Because it's like you're if you can potentially clear an athlete sooner, that's like there's a lot of benefit to that from a sport organization perspective. Whereas if we're we're in a league where ah, we'll just pull him and kind of see how he does over the next few days and there's not much consequence to it, then I think there would be much less willingness to spend more than a few dollars on it, if you know what I mean. But I wish I could give you a better answer. Yeah, no, that's a great answer. And also once I have to start ordering things for my clinic, I'll be able to get back to it.

SPEAKER_00 41:22

No, absolutely. And um, you know, it's a good point that you mentioned that it's it's important to be able to clear the athlete, but also there's a lot of studies that have been done where the sooner the concussion gets addressed, yes, faster the recovery and faster return to play. If you prolong it, and let's say it goes unreported for whatever reason and they sustain another injury in, let's say, the professional sports world, that's money out of these teams' pocket for an athlete that could be out for let's say 10 times the duration if they actually assessed it at the first place and got the actual concussion address and and gone through the you know RTP protocol. So for us, we're talking around a$30 price point. That's what we're at with now.

SPEAKER_03 42:00

Okay, that's actually better than I was expecting.

SPEAKER_00 42:02

Yeah, we don't we don't really anticipate it changing too much. Um, but yeah, at scale, we're we're looking at around$30. So still very early. It could change, but right now that's what we're looking at.

SPEAKER_03 42:13

Okay, okay. That would that'd be very exciting. And I know it's early, but it's it's hard not to get excited because I think like uh the sports world, so like something like this would be very valuable. Um, how many major organizations and sporting leagues have been approached have approached you yet or so far? It's exactly a lot of them.

SPEAKER_00 42:31

Yeah, yeah. It's it's quite amazing um the global impact of this problem given who's reached out. And I'll be transparent. There's a lot of media that we've had and we've been grateful to be a part of to help share our story and get the word out there and share a little bit about what we're building. Um, and that actually drew the attention of individuals and organizations worldwide. So we have all the way from Australia, different rugby leagues there and different clinics and healthcare facilities that deal with concussions. Uh, we have, you know, groups in Europe and South America, let's say in soccer. Uh, and then we have, in terms of the sizes of organizations, we have parents of youth athletes that are like, I don't know if my kid has a concussion. Uh, is it in market? I want to buy it now. And then we have also Olympic committees from around the world that have reached out asking about it. So it kind of just shows the scope of the problem. And doesn't matter what age you are or whatever what age the athlete is, it's a challenge across all age groups, right? So uh can't really disclose the partners for upcoming clinical studies or uh who we have, let's say, uh uh not pre-orders, but let's say expressions of interest from. But they range from small leagues, youth leagues in in North America and around the world, all the way to Olympic committees, uh uh the biggest in the business, right? So uh a lot of professional sports teams and leagues as well across various sports uh have shown interest and really, you know, we realize the impact we can have with a tool like this. That's why we're trying our best to get uh get to market as soon as we can.

SPEAKER_03 44:03

Yeah, crazy. Well, I'm gonna sign up for your email list and I'll I'll add your like head first thing into the like the show notes. So because yeah, I'm I'm definitely curious to kind of continue following this. Um uh what was I gonna ask? Here, okay. Um, a couple I know we're kind of coming up in time. I always have like just a few kind of rap, not rapid fire, but kind of some more shorter answer questions. Um, I'm curious, what's it like being an entrepreneur? How many hours a day are you working?

SPEAKER_00 44:33

That's not a short answer question. No. Um, it it sounds interesting, but but it it requires to be a special type of individual to be an entrepreneur. You have to really be obsessed with the problem that you're solving. Uh, if you're not truly passionate about it, it will fizzle out quick and you will lose interest. Um, to give you an idea to build headfirst, and I'll be very transparent here. Uh, I was very lucky uh that I was able to work a full-time job while building this company for nearly two years. Uh, I would work my regular job from nine to five, and then I would work out, eat dinner, and then work on headfirst every weekday from let's say 8 or 9 p.m. to midnight to 2 or 3 a.m. And I did that for nearly two years because if you think about it, I started this idea out of university. I was a uh broke recent graduate with student loans. And the reality was to keep myself afloat and at first afloat, we needed some type of income. So that's how we decided to get to where we are today was through non-dilutive funding, so grants and things like that. But, you know, I've seen anywhere, I'd say minimum 50, 60 hour weeks. And I've been, you know, there's some weeks, depending on deadlines and things like that, that we have to achieve within a certain time frame. Um, definitely pushing 80. Like I've been 16-hour days sometimes, and it all depends. So you have to be obsessed with the problem. It has to mean something to you. And then for me, the sacrifices that I have to do to make Headfirst successful and help push it forward, I don't second think about at all. There's no regrets from my end. Um, but uh, but yeah, it's it's a lot of hours, that's for sure.

SPEAKER_03 46:06

Yeah, thank you. Um, I was curious. I suspected you were going to say something like that, but I can't imagine. Ah, so crazy. Um okay. From a broad perspective, um, what do you think coaches need to understand about concussions? So if there's any coaches listening to this, any broad message you'd want to share with them?

SPEAKER_00 46:25

Great question. And I think that's the first time I've been asked that question. And the very short direct answer is trust your gut. If you feel like something's wrong, don't risk it. Because when you're very young, too, as you know, the body changes very rapidly. You know, you go through puberty, things change, and you're at a very susceptible time where some small types of injuries that can compound uh as you get older. Uh, it can be greatly accelerated when you're of a young age. So if there's a gut feeling, if there's any indication in your gut where something's wrong, make the decision, especially at a very young age when there might not be medical or healthcare professionals there, right? Uh, to pull the athlete and get them the treatment they need or the assessment that they truly need. Uh, because uh, if not, I've had stories and I'll share this quickly too. There's an individual that reached out to me. He's I won't say the name, but he I'd say he's in his 50s, late 40s or 50s when he was 12 years old, played hockey, sustained a hit to the head. It was a goalie. Uh uh parents and coaches said play through it. He played through to played through it. And then from there he got uh a second impact and it resulted in uh a lifetime of epilepsy. So very severe. You you should not take a second chance. So trust your gut and go from there.

SPEAKER_03 47:41

Okay, thank you. Um any advice you'd give to a young athlete dealing with a concussion? What do you wish someone had told you when you were going through all this?

SPEAKER_00 47:53

That's another great question. Be truthful, right? Um at the end of the day, if you have any types of symptoms or feel a little bit off sometimes at a young age, you don't really, you're not aware of what concussions can do and what symptoms can happen. You know, if you break a bone and you hear your friends uh, you know, if they they tear a ligament or whatever it might be, there's instant pain and it's obvious and this concussions can be quite, you know, invisible. So if there's any events that you think of, even if it's on the field or off the field, in which you feel different, you feel something's off that's completely normal. And that means that something's wrong. Not completely normal in the sense that you're healthy, but uh completely normal that that you should move forward and say something to either your parents or your coach, whoever it may be, uh, to get uh assessed by a medical professional. Um and yeah, it's it's sometimes very difficult at a young age, especially when I had my first concussion and I was 13 or 14, I didn't really know if I felt different than I did before the event, right? It's it's difficult sometimes to really think about it. So, you know, uh there's life beyond sport. And I think a lot of athletes, especially at a young age, don't think about that. So if you have any any weird feeling, uh once again, trust your gut and and make sure you get the assessment uh from a medical professional.

SPEAKER_03 49:06

Yeah, I I agree with that. Um highly recommend. Um, I think that emphasis that there is life after sport is important, and it can seem like sport is the only thing that matters when you're young and this is your life, but uh you have a lot of years to live after your life, and it's good to have a functioning brain.

SPEAKER_00 49:22

Yeah, yeah, absolutely 100%. Yeah, it's it's tough to think as a kid. Uh definitely when you're, you know, you do the the early morning practices and then you do the team practices and you go to your games on the weekend and you carry that through university, it becomes your identity and it's hard, right? Because your whole life you've been an athlete. So the further you go, it sometimes even becomes more difficult to really think outside of sport because now you're an adult. You spent decades training at the highest level. It's tough to think about, but definitely health comes first because there's definitely life after sport.

SPEAKER_03 49:55

Um I have a couple one more question for you after this, but I always like to leave kind of the floor open here. Is there anything I should have asked you that I didn't? Is there anything, any burning desire you want to get out about your or the medical device or the saliva test or anything I didn't ask you that you need to say?

SPEAKER_00 50:18

That's a good question. Uh and it's more on like I guess the business side of things too. It's um you need to make sure you surround yourself with a good team. Um, it's just like playing on a sports team. Uh, if everyone does their job and everyone's happy, they will perform their best. And it's the same thing in the startup world. Uh, but in and you know, I'd say that's that's one thing that I realized very early on while trying to build a business is you have to have the right people. It's the same as a hockey team. The coaches, uh, if you watch the movie Miracle with Herb Brooks of Team USA, right? He said, I'm not looking for the best ones, I'm looking for the right ones. Uh, you know, the the everyone has to buy into the end goal. And it's just like uh playing on a hockey team or a soccer team. It's everyone wants to win the championship, right? And it's the same in business. Um, in terms of concussions, I think we covered everything. Uh, pathology, biomarkers, the device, passive drill, lateral flow assay. Um, yeah, I think I think we covered everything. Um good.

SPEAKER_03 51:16

I just don't want you to leave and be like, ah, I forgot to say this.

SPEAKER_00 51:19

Yeah, no, I think, yeah, I think the markers, we covered the markers, we covered the technology, uh, we covered what's out there and how we kind of use it. Um, yeah, I think that's that's it.

SPEAKER_03 51:29

We I could I could talk forever about the business side of things, but uh I'm not a businessy person, so I feel like I wouldn't navigate that as good. Um my final so my final question, I ask everyone just the same one here. Um, I've named my podcast Here All Day because showing up habitually, whether it be in sport, work, or life, is what matters. So I like to ask everyone, what does it mean to show up all day in your life?

SPEAKER_01 51:56

That's a phenomenal question.

SPEAKER_00 52:01

You know, it's it's and and everyone has a different life, everyone has different challenges, right? And and to the to that motto and that vision that you have for for your podcast, it really falls in doesn't matter what you do. Uh, there's a quote, and I don't remember where I heard it. How you do anything is how you do everything, right? I love that one. But yeah, it's really true. So every little aspect of your life, what I try to do too is I try to optimize. It's it's just a mental thing for me. It's it's you know, uh, from working out to making my bed in the morning to doing the small things that are little winds that carry me throughout the day in business and outside of business, right? Relationships, everything. So uh for me, showing up every day is not doing exactly what you want to do, but doing what you need to do. Uh, stepping outside of your comfort zone. That's something I'm very comfortable with, is being uh quote unquote the dumbest person in the room. I like to surround myself with people smarter than me because that's how I learn. And I'm very comfortable with that. So um, yeah, it's a great question. I just say uh um, even if it's hard, do hard things and uh uh show up every day and and be the best you can be.

SPEAKER_03 53:06

I like it. That was a great answer.

SPEAKER_00 53:08

Thank you. It's a tough question, but it's a it's a really valid one because you know we're trying to build a company around concussion screening, but in life in general, there are always challenges, right? And the small wins I find, if you consistently try to do small wins, even if it's as simple as making your bed in the morning, right? Uh it carries momentum throughout whatever you do. So uh so yeah, it's it's uh a great question. Great question.

SPEAKER_03 53:31

Thank you. Um okay. If anyone listening to this wants to reach out, they want to connect with you, they want to follow what Headfirst is doing, where can they find you? Where can they um make sure that they hear about when this hits the market?

SPEAKER_00 53:43

Yeah, we're we're very lucky that we have a lot of media coverage when we hit really key milestones. So keep an eye out in in media. But uh you can take a look at our website, uh www.headfirstdx.com. We also have a LinkedIn page where we post a lot of updates as well. I'd say that's pretty much the first avenue where we we post updates. Um, and then yeah, any questions, feel free to connect with me on LinkedIn or or shoot me an email through the website uh link that's there. And I can answer any questions that anybody has.

SPEAKER_03 54:11

Perfect. This is awesome. I'm so excited for everything you're doing. Um, thank you for working so hard on this. I think once this actually hits the market, it's going to change many lives. It's going to help make sport safer for everyone and help make my job as a sport medicine physician a little bit easier. So thank you.

SPEAKER_00 54:28

No, absolutely. It's my pleasure and it's a problem that I've sustained. And I want to make sure that we safeguard athlete health overall and then potentially even beyond sport as well. So perfect.

SPEAKER_03 54:37

Thank you very much, Andrew.

SPEAKER_00 54:39

Perfect. Thank you very much.

SPEAKER_03 54:42

That's it for this episode of Here All Day. If you found it valuable, the best way to support the show is to subscribe, leave a review, or share it with someone else who would enjoy it. Don't forget to check out the show notes for all the resources mentioned and links to connect. Thanks for listening, and until next time, keep training hard, eating plants, and showing up.