Revolutionizing the Future of Orthopedics — Teddy Hodges, BRACEUNDER (Medium)
Health Transformer Teddy Hodges, co-founder and CEO of BRACEUNDER, discusses his company’s cutting edge technology in the restorative and therapeutic treatment of orthopedic injury and the impact BRACEUNDER holds for the future of orthopedic medicine.
Key takeaways from this episode of StartUp Health NOW can be found here.
Steven Krein: [00:02] Welcome to StartUp Health NOW. The weekly show celebrating the Health Transformers and change makers, reimagining medicine. My name is Steven Krein, and on today’s episode, we have Teddy Hodges, the co‑founder and CEO of BRACEUNDER.
Music Intro: [00:15]
Steven: [00:15] Teddy, great to have you on StartUp Health NOW.
Teddy Hodges: [00:55] Thank you for having me.
Steven: [00:56] You’ve got an interesting background, interesting company, I want to take a step back so the listeners can understand a little bit about you, and why you started the company. Take us back, where did you grow up and what are you doing?
Teddy: [01:09] I’m from Denver, Colorado. By the time I graduated high school, I had five knee surgeries, when I went to the University of Oregon to start the cold, humid weather was a bit rough for me, so I took a little bit off the beaten path route and went to Bali, Indonesia to study yoga.
[01:24] When I came back, after nine weeks there, was not ready to go do the college grind again, I’ve always had a Pre‑Med mindset, anatomy is my favorite subject, so I studied massage therapy in Boulder.
[01:36] When I finished that, after 9 months, 10 months, I was blessed with the opportunity to work with a couple of pro‑athletes, got to see the whole training circuit, the eating, how they trained, what their mindsets were and realized how important the mindset was.
[01:50] From there, I’d say, I had the opportunity to do my eighth surgery, I was doing the surgeries in Vail, Colorado, and I just said, “You know what, why am I doing this? This makes no sense, I’m just causing more damage, so I’m going to go live in a warm, humid climate.”
[02:06] The opposite of where I started, I had eight friends in South Carolina so I went down there, got a job in a physiotherapy clinic and chiropractic clinic, got in‑state tuition and started the journey into Pre‑Med at the University of South Carolina.
[02:21] While I was there, that’s where BRACEUNDER started.
Steven: [02:25] You gave me your background, you layered in your knee surgeries, and all of the things related to, I know, what BRACEUNDER is doing now.
[02:35] As you went through your journey, what was it that even interested you in even thinking about entrepreneurship and doing something as bold as BRACEUNDER?
Teddy: [02:46] I think it’s in my blood. My dad’s an entrepreneur and having a massage therapy business really ingrained some of those self‑reliant tendencies that the entrepreneur world cultivates.
[02:58] I think it’s a combination of all those things, just innate plus what I was surrounded with and what I got to experience watching my dad’s companies and working for him since I was 12 years old.
Steven: [03:14] What was the moment where you had the, “A‑ha,” to create BRACEUNDER?
Teddy: [03:20] I was walking around campus, my first semester at University of South Carolina, and it’s a lot of walking, a lot of concrete, I was using a cane to walk around and it’s just…
Steven: [03:28] That must have worked well at school, walking round with a cane.
Teddy: [03:32] Actually no, picking up chicks with a cane is not easy.
[03:34] [laughter]
Teddy: [03:34] I didn’t want to use the cane, and I wanted to blend in, I went back to, “Well, maybe I should use a knee brace.” Got a couple of knee braces, and lived with the incredible pain points, the knee brace fall down your leg, they’re uncomfortable.
[03:51] About a month after I was wearing a knee brace, my roommate looks at my leg and he goes, “Dude, I can see the brace embedded in your leg.”
[03:58] It’s like a Saturday, I said, “I haven’t worn the brace since Thursday on campus, what are you talking about?” Sure enough, I looked in the mirror, and that knee brace was embedded in my leg, the muscles were growing around where the brace was sitting.
[04:11] I realized this is an issue, this is a problem for me, my grandmother taught me to sew when I was like 13 years old, and I got a pair of compression shorts that I had and I sewed some Velcro on the bottom of the compression shorts, so that I could take my knee‑brace and stop it from sliding down.
[04:26] Then I started playing with memory foam, and different padding so that I could have this buffer, an interface in between my body…
Steven: [04:33] Between the brace and your body.
Teddy: [04:35] Exactly. While keeping it in place. Started playing with that, then…
Steven: [04:38] How many years ago is this?
Teddy: [04:39] Had to have been 2012. I started monkeying around with the sewing machine and trying to fix the problems I had.
[04:47] Then my roommate at the time ‑‑ he had a lot of legal connections, his whole family is full of lawyers ‑‑ I came home from general chemistry class after learning about Einstein and all the thermodynamic properties, and how these guys discovered the quantum universe without having any type of real ability to see it.
[05:11] I just started brainstorming and thinking, I got my sketchbook, I’ve always been an artist, started drawing, started writing about things that I needed through my surgical recovery and through trying to get back to sport, which is one of my challenges, I’d say “Oh, my knees not good, but I’ll keep playing.”
[05:28] I came up with these ideas, my roommate and I were watching a Bronco game, and Ray Lewis, at the time, was wearing an elbow brace, he’d come back from I think a torn bicep or something. Whole game, he’s constantly going like this, pulling it up, I saw that and I said, “That’s it, that’s the one.”
[05:47] Because I knew what I was doing for the knee could apply to the elbow…
Steven: [05:50] Watching the game gave you that kind of…
Teddy: [05:54] Made me realize there was definitely a market for this. Then, we got to invent help documents, to figure out how to file patents and do the whole process of creating this product.
[06:04] We use that to create basically our own invention booklet, or little mini business plan and we pitched our dads, to say, “Hey, we want to file a patent around this, this is what we want to do, here’s the plan.”
[06:15] That’s how everything got started.
Steven: [06:17] How do you describe BRACEUNDER today? What is BRACEUNDER?
Teddy: [06:22] BRACEUNDER is going to transform the way we prevent injuries, and how we support injuries through recovery. Prophylactic benefits plus changing the way we rehab joint injuries.
Steven: [06:33] By doing what?
Teddy: [06:34] By adding different types of resistance training or support mechanisms onto this platform compression tight. Basically, we’re creating a custom and dynamic base layer tight, that anyone, anywhere can put external attachments on top of it.
[06:54] If you have patellar tendonitis, which is the number one reason for missed time in the NBA, you can address the patellar tendonitis how it feels best for you, or the athletic trainer can take the tools he already has available, and apply it on to our tights in a more reliable and secured way.
Steven: [07:11] Where does technology enter this?
Teddy: [07:12] Technology enters because of the modular design, the straps that go on the top, there’s no technology in this, but we can attach technology on top where we need it and where we want it.
[07:24] The main use case for technology right now, when you tear your ACL 85 plus percent of ACL tears happen in what’s called a valgus event. Your knee goes inward. What happens at the tibia is some type of rotation, is it internal, external, let’s leave that debate for something else.
[07:42] We know it’s this movement, we can recreate that movement with a tension band, that measures the amount of tension we’re pulling on. Resistance training, like lifting weights, you know how much you’re bench pressing, 135 pounds, 185 pounds, whatever it is…
Steven: [07:58] I’m more than that…
Teddy: [07:58] A lot more, 225?
Steven: [08:01] Exactly. [laughs] Now, we’re talking.
Teddy: [08:03] Now, we’re talking. This resistance training we can create a standard of coming off of an ACL surgery, or preventing the ACL surgery altogether so that when we pull you into that position and we tell you to do a single‑leg squat, or a single‑leg press, or a lunge, we’re pulling you into this high‑risk knee injury position, and telling you to fix it, biomechanically adjust.
[08:26] Get your knee over your ankle so that you’re aligned while we are providing this force that we’re measuring, the athletic trainer, the physiotherapist…
Steven: [08:35] What are they using to measure?
Teddy: [08:37] What are they using to measure? It’s a low emitting Bluetooth, it communicates to an app on a tablet, you see it live.
Steven: [08:45] Sensors built into the tights, or…?
Teddy: [08:47] Not in the tights…
Steven: [08:47] I’m sorry, into the actual…what do you call them? The…
Teddy: [08:50] Tension straps.
Steven: [08:51] Tension straps.
Teddy: [08:51] Yes. We’ve got tension straps that don’t have any tech, they provide a physical force, or have the smart tech which can do more than just measure tension.
Steven: [09:00] What are the alternative right now to this?
Teddy: [09:04] Knee bracing is a very stagnant market, and they’re big, bulky braces that have a lot of pain points documented by research. They fall down, things I mentioned earlier.
[09:14] Compression sleeves, but the limitations are they’re just addressing six, seven, eight inches of your knee. When you have a knee injury you got to look at the foot, you got to look at the hip, you got to look at the back.
[09:23] We know, when an ACL tear happens, it commonly occurs with use of planting, decelerating, and then changing direction. Which also happens to have a sway of your core, we’re a whole body, there’s not a whole body approach to helping joint injuries or preventing them altogether.
Steven: [09:43] We’re living in a moment where wearables and sensors and data play a whole role in the potential possibilities now, both in prevention and treatment. What does this look like five years from now, 10 years from now? What’s the master plan?
Teddy: [10:00] I want to measure live time movements of coming off of an ACL injury or preventing them altogether, so we can identify risk factors in movement patterns that maybe you can’t pick up by just using your eye, and assist not only the wearer…
Steven: [10:15] By doing what? By having…?
Teddy: [10:18] By wearing a strap on top of your knee, which may not even provide much of a tension, but provides enough to measure what the movement is. When you see that valgus movement, even if it’s a small one, you’d be able to see it on a graph occurring 20,30 times during your run.
[10:36] We’d be able to identify, there’s a high risk here, the more you do that movement the more loose your knee is going to become, or hyper‑mobile, lax you ACL becomes, which increases your risk of tearing that ACL.
Steven: [10:52] What do you need to happen for all this to work? What else has to happen, you got product, you’ve got some users, you’ve got how many different people using the BRACEUNDER?
Teddy: [11:03] Over 70 now.
Steven: [11:04] 70 people collecting a lot of data, what else do you need to make this work?
Teddy: [11:07] Some real champions of high caliber, innovative thinking, physiotherapist, orthopedic surgeons to understand and help us standardize these different resistance trainings for not only the knee, but other joint areas. Research and validating medicine, I think that’s crucial in medicine, having objective data to say yeah, this is working.
[11:29] This is changing your tissues, this is helping improve blood flow, but also, helping return your venous return, or getting the waste out of the joint, mitigating swelling.
Steven: [11:40] What are the most commonly used words to describe the benefits to people who wear it, or clinicians and others who have experienced the benefits of it? What’s the testimonials say?
Teddy: [11:53] I’ve never felt anything like it, and it allows me to address my situation on a day‑to‑day basis. I’ve got a knee problem, as I mentioned, and the pain…
Steven: [12:03] Are you wearing them now?
Teddy: [12:03] The way I wear this, and the way this product ‑‑ this is our second product, our first product was the interface for knee bracing ‑‑ what we found was there was such a niche already, ACL, there’s about 200,000 ACL surgeries a year in the United States. Knee bracing, the biggest issue is non‑compliance, patients don’t wear the braces.
Steven: [12:22] Because they’re uncomfortable?
Teddy: [12:24] The way they fit, they fall down your leg, and athletes say they inhibit their athletic performance. I say they inhibit my movement because it’s true. I found these patients, I found these individuals wearing the brace, and you know what I ran into?
“[12:36] Yeah that’s interesting, but I hate that brace so much I will never wear it again. I don’t care if your product makes a complete difference, I won’t wear it”
Steven: [12:48] They have now really bad experiences that have changed forever their view of or their relationship with braces.
Teddy: [12:51] Exactly. I had to catch these people before they ever wore the brace, so my niche got even smaller. Unfortunately, I had my ninth surgery last year, last summer, which was a biological knee replacement. Wearing a hard knee brace became something I couldn’t do.
[13:05] I was sitting on a plane ‑‑ and I’ll never forget this it was like being…you know that claustrophobic feeling ‑‑ sitting on a plane, we’re taking off so I can’t get up yet, and the brace had just started hurting so bad.
[13:15] I couldn’t do anything about it. With the brace, it’s like a belt, you can make one adjustment and that’s it. I’m sitting there and I’m just like, “OK, what do I do? What do I do?”
[13:24] I need support, I like compression tights, I’ve been wearing compression tights since I was 12 years old, that’s when I realized, “OK, how can I make a tight that has better benefits than the tights that are on the marker from the big sports apparel leaders, but that also provides the ability for me to create dynamic custom support systems, 3D printed braces, elastic kinesiology tape, reusable?”
[13:48] That’s how this product got started after that surgery. Once this got created, then I started sewing away making these different straps and support mechanisms. The way I’m wearing this right now prevents me from falling into that high‑risk knee injury position, that valgus event.
[14:06] It keeps me upright, it allows me to address the pain that I had behind my knee and in front of my knee, and helps me manage the scar tissue and the swelling that I’m fighting on a day‑to‑day basis.
Steven: [14:19] To the skeptic, what are you hearing? The people who…on the medical side and the clinician side, what are they saying about it, and how are you answering their biggest challenge to this being an awesome idea and a great solution?
Teddy: [14:36] My answer is try them on. Experience it, feel it, I guarantee you, you will notice a big difference and you haven’t felt anything like this as far as compression tights. That’s my answer, the skeptics, orthopedic surgeons, there’s just no validated research on our products yet.
[14:53] That’s one of our big initiatives is using a 3 Tesla MRI to document tissue changes from your skin, the dermis just below the skin, and then into the fascia, and the muscles, the tendons.
[15:07] Looking at the changes of scar tissue, looking at what happens to the different parts of your body as you’re wearing the tights, and you’re working out in them or just wearing them for recovery.
Steven: [15:21] Switching over a little bit to entrepreneurship, what’s been the most difficult thing about building this company.
Teddy: [15:21] I have red hard, so patience is…
[15:23] [laughter]
Teddy: [15:26] I think that, especially in healthcare, just stepping back and focusing on, “What can I do today? Where can I take action today?” Then really making sure where I’m taking action is building value in some way and where my time needs to be utilized.
Steven: [15:41] What’s been the biggest surprise that you’ve had? In terms of something you didn’t know or didn’t expect that actually turned out the way you didn’t expect it.
Teddy: [15:45] Somebody once told me along this journey that the most important thing you can do is making authentic connections. It’s not about networking for the sake of networking, it’s about making connections and learned the story of what’s in the person you’re having a conversation with mind. What are they thinking, what do they need?
[16:06] When I started making those types of relationships, that’s where the connections to NBA, NFL, elite pro‑athlete trainers, elite pro‑athletes started happening. Not when I was trying for it, but when I was truly trying to make an entrepreneurial connection that helped them and helped me, and built a friendship when I can all these people and just have a conversation and talk.
Steven: [16:30] Tell me about your team, all in one place, remote, backgrounds…?
Teddy: [16:35] Very remote, diverse, all over. Biomedical engineer, a finance guy in Texas, an elite physiotherapist who works with a lot of pro‑athletes who’s given us incredible help in terms of developing the product, and validating some of the use cases. Finding some sales guys now, it’s…
Steven: [16:57] Who do you sell to?
Teddy: [16:58] Right now, we’re not selling, so we’re a Class 1 medical device, 510(k) exempt, our focus is to continue getting high‑level validation and users as we’re raising capital.
Steven: [17:11] Who would you love, who might be listening to this, to call you or reach out to you and find out how to work with you or wear the tights, buy the tights or prescribe the tights?
Teddy: [17:18] Mark Cuban. [laughs] Yeah, definitely, I think that…
Steven: [17:23] One of the investors in StartUp Health, which we’re happy to connect you with, but what kind of people besides the individual, what kind of individuals?
Teddy: [17:31] Strategically, right now, I think a Chief Medical Officer orthopedic surgeon or a radiologist would be a phenomenal resource as we’ve established our grant infrastructure. As I mentioned, one of the focuses is using 3 Tesla MRIs to document those changes, a radiologist would be phenomenal for that.
Steven: [17:49] Is that what’s next for you guys? Getting the validation, getting the evidence?
Teddy: [17:53] Yeah, I’d really like the evidence. There’s an argument around compression tights, do they work, are they effective, is there real medical benefit or is it purely psychological? I think that without a doubt there’s medical benefit, there’s no question in my mind. I deal with chronic pain, and I can tell you it’s my coping mechanism. It’s changed my life to wear these every day.
[18:16] Doctors need, and researchers, PhDs, they need…
Steven: [18:19] Data.
Teddy: [18:20] Exactly. Validated, researched data. Objective measurements.
Steven: [18:26] What’s on your iPhone for productivity? What are you using, software‑wise, to keep sane and actually stay organized and build BRACEUNDER?
Teddy: [18:34] Slack is phenomenal, I use Slack. Let’s see, Evernote, I really enjoy Evernote. I’m old school, I’ve got a journal, I keep a checklist, that’s really my organization, because I just like being in control of a pen and paper and doodling when I want. Books on tape are my bridge to sanity.
Steven: [18:53] What’s the last book you listened to?
Teddy: [18:54] How to Win Friends and Influence People. I go through that about two, three times a year.
Steven: [18:58] More friends this year than last year?
Teddy: [19:01] A few more.
[19:02] [laughter]
Steven: [19:04] I noticed, by the way, how you’ve interacted with the rest of the StartUp Health community, they’re Health Transformers. You’ve read the book, you use that in connecting with and spending time with the other healthcare transformers. Made friends fast, Teddy.
Teddy: [19:17] Thank you. Yeah, I just read, Shoe Dog, Phil Knight’s book.
Steven: [19:22] How was it?
Teddy: [19:23] It was unbelievable, phenomenal. What he went through to get his company off the ground, and the story from when he was Tiger shoes, to Blue Ribbon, all…it was phenomenal. It was very interesting. How he treated people, some of his employees. Yeah, worth the read. Very much so.
Steven: [19:41] Fantastic. Listen, it’s been great to get to know you a little bit, watch you start to execute, and I know it’s early, but very exciting.
[19:48] I know that across the entire community, I talked to you about the physical nature of your product, carry it around, show people, I think it’s a fascinating view into the future. Not just the apparel part of it, but the actual technology part and the data I think is going to be extraordinary.
Teddy: [20:09] I will.
Steven: [20:10] Thanks for coming on to StartUp Health NOW. I look forward to having you back.
Teddy: [20:09] Thank you for having me, StartUp Health is incredible.