By Kyle Williams, GoDuke the Magazine Online

The process of recovering from an injury has proven to be among the most important periods of time in a student-athlete's collegiate career. Broken bones, sprained ligaments and other ailments are a natural occurrence within the environment of high-level sports, and finding new ways to make the rehabilitation as efficient as possible remains at the forefront of athletic training efforts.

As medical technology advances at a seemingly meteoric rate, more and more athletes are benefiting from appliances that offer a faster return to play while still ensuring a full healing process. Such is the case for Olivia Tighe, a junior on the Duke swimming & diving team who suffered a broken hand in August. Though traditional methods of casting were readily available, Tighe opted for a solution provided by a local organization with a well-documented history of aiding Blue Devil student-athletes.

In 2018, Kevin Gehsmann, Clark Bulleit and Tim Skapek – three Duke engineering students and football team walk-ons – were tasked with developing a 3D-printed brace that would protect star quarterback Daniel Jones' fractured collarbone as he aimed to get back on the field in a quicker-than-normal time frame. Working closely with the Duke medical staff, the trio conjured up a design for an anatomically fitting brace that bridged over Jones' injury and allowed him to return three weeks later, likely shedding an additional game or two that the then-NFL Draft prospect would have otherwise sat out.

Following the breakthrough, Gehsmann, Bulleit and Skapek realized the potential of their innovation and later founded PROTECT3D – a Durham-based company offering 3D-printed braces, splints and pads that are individually tailored to ensure protection, comfort and mobility. They have teamed up with numerous Division-I medical staffs around the country, and have even seen former Duke All-American and current San Francisco 49ers guard Laken Tomlinson – along with a few of his teammates – use their products.

The nascent business received further legitimacy when it won the NFL 1st and Future competition, an annual Super Bowl-week event that recognizes innovations in player health, safety and performance. The honor, presented in Miami prior to Super Bowl LIV, brought with it a $50,000 award to continue developing their technology. 

"I think that moment, just being recognized by the NFL as having the award-winning, up-and-coming technology that is going to help keep athletes healthier and safer as they take the field, gave us that validation," Gehsmann said. "That was of course right before COVID, so we had less adoption across the board on the athletic side last year. That being said, we still had folks adopt this across the country."

Even while football offered the biggest market opportunity for PROTECT3D, both with its high injury rate and the company's connections within the sport, Gehsmann and his co-founders soon discovered ways to help others across a wide range of athletics.

"Working with the athletic trainers close to us, we ended up creating a list of products that are most applicable to football, but as we got better and better at making customized products, we added more products to that portfolio," he said. "We started seeing the same wrist injuries that we make a great product for someone to return to a football game, and can tweak that product slightly for it to be great for a lacrosse player or a basketball player. The arm cast to fully immobilize a wrist and joint is something that works for everyday patients, so hopefully this is an application that gets into the hospital systems as well for us to help a larger patient population with this technology and these products."

Tighe, like any student-athlete, did not plan to have a working knowledge of cast technology prior to her hand fracture. While PROTECT3D's involvement with different sports at Duke – swimming & diving is the 10th Blue Devils athletic program they have worked with – made its way around campus conversations, Tighe recalls thinking of it as a neat project that existed outside her realm of interest.

"I had heard about them over the summer, but when this injury happened they didn't even cross my mind," she said. "One of my teammates, Will Tenpas, is also my year and over the summer he was interning with them. He explained it to me and I didn't really think much of it. It sounded cool, obviously, but it was one of those things that you just heard about. I'm not engineer, so I was just like, 'It sounds really fascinating.'"

Though she had dealt with her "fair share of injuries" growing up, Tighe always managed to get back in the water via traditional recovery methods. There was little proof of lingering effects for the former Maine High School Swimmer of the Year who continually bested her own times through two seasons at Duke. As a sophomore, her efforts culminated in a debut appearance at the ACC Championship meet, where she clocked career-best times in the 50 and 100-yard freestyle.

Then, naturally, injury struck at one of the worst possible times. It came during an athlete gathering after her return to campus in August, when she was playing a game of four-square at the Duke Quad and fell back on her outstretched left arm in an awkward position – a detail Tighe revealed in self-deprecation.

"I wish I had a really cool story about how I broke my hand – I don't," she admitted. "It was incredibly un-athletic for a Duke athlete."

The bone that fractured, little as it may seem on a skeletal diagram, can take up to 12 weeks to heal completely due to limited blood flow. Two days later, Tighe found herself in a training room, watching a plaster cast envelop her lower hand and wrist. While her teammates began preseason training regimens in the pool, she was relegated to putting on a waterproof cover – a "balloon bag," as Tighe described – that kept her from fully submerging her left arm. It appeared, at the time, that her next few months would be spent using a kickboard to swim laps while being limited to spin bikes and lower body lifting outside of the water.

Shortly after, however, Tighe was reminded of PROTECT3D by associate athletic trainer Aleah Kirsch, who presented the idea as an opportunity to work with a local company at the cutting edge of protective technology. Tighe was intrigued right away, and through Kirsch connecting with Gehsmann, she was able to quickly get scanned for an optimized device.

"I went back to the football training room and one of their interns had this really cool tablet that had an attachment on it with some sort of special camera," Tighe said. "I held my hand in the position they wanted the cast to be in and he circled around my hand a few times taking different composite images of it. Afterwards, there was a 3D rendering of my hand."

Before the cast was fully printed and given to Tighe, though, they would need to get approval from a doctor. She went to Dr. David Ruch, a hand, wrist and elbow surgeon at Duke Health, and presented what PROTECT3D had already rendered. While eager for the chance to use the product during her recovery, Tighe knew to keep her hopes in check given how relatively new the technology is.

"When we went to see Dr. Ruch, we told him about the cast and showed him half of the model that we had," she said. "He OK'd it, which was very exciting. We had set our expectation low going into it – we didn't want to get too excited because the thought of being able to have access to this was very exciting. He made a remark about how if it had been five years earlier, they wouldn't have said yes to it."

Following a slight adjustment in the cast's positioning on her hand – an inexpensive and quick process, according to Gehsmann – Tighe was set up with her state-of-the-art brace that granted more mobility, breathability and comfort than anything she'd experienced in prior injuries.

For a student-athlete like Tighe, who was craving to get back to doing what she loves, the first order of business entailed seeing how it held up in the pool.

"I got the cast right before practice one day and went right into the water," she said. "Obviously, it was less than a week out from initially breaking it, so I wasn't swimming too much at that point because it was still very tender. For the first couple weeks, I just kicked or did one-arm strokes. But just the fact that I was able to fully submerge it under the water, and that meant I could go fully under the water myself, totally changed the amount of things I was able to do in the pool."

When out of the water, Tighe's recovery was supplemented by what she could do with the cast off. Instead of working through the persistent aches and itches that come with a plaster cast – an annoyance that anyone with a broken bone knows all too well – she can remove her zip tied PROTECT3D brace whenever necessary, a feature that is useful for physical therapy, bone treatment and showering.

What the device can only do some much of, however, is temper her mental approach as she works back to full ability. Tighe has adapted to using pain as a guide, not forcing herself towards any extremes and changing what she is doing when there is any discomfort. She has also learned how to time her strokes when touching the end wall, even if that requires a half stroke to ensure that her right hand is the one reaching out.

One early aspect of Tighe's experience that she feels relieved external pressure was the blessing from the Duke coaching staff. While it would have been understandable had they preferred for her to receive a more orthodox treatment, Tighe was pleased that they were not only on board, but highly encouraging of what PROTECT3D offered.

"Dan [Colella] mentioned it to me on the deck – he was like, 'We've got to get you in one of those casts,' because they didn't want me to miss a beat," she said. "A lot of my coaches have been really good about making sure that I'm not pushing it too hard. If I do feel a little sore, there's always an option to kick. They've been very good about the situation."

The potential hesitation of doctors and coaches that Tighe prepared herself for is reminiscent of Gehsmann's early meetings with different athletic departments. As PROTECT3D was still developing its reputation, it would sometimes take peer referrals over his pitches to help convince a trainer of the product's value.

"We can describe the technology and say what we think the benefits are, and if they hear from their peers that it works really well for their athletes, that's a little bit different," Gehsmann said. "Once they are in the really tough situation of, 'How am I going to get this guy back on the field?' or 'How am I going to get this girl back in the water healthy?' and leverage our solution and toolset to use these types of products and go through that process, that's when it kind of clicks and everybody experiences how cool and impactful 3D technology can be."

In Tighe's estimation, it's hard to know how much would be lost from a conditioning or fitness standpoint had she never used the PROTECT3D brace. No matter which method of recovery she underwent, the spin bikes, running and occasional water workouts without submerging herself would have all remained an option. The ability to swim with little to no obstruction, however, is what proved most beneficial when she returned to competition.

"It's definitely a different animal," she said. "Having feel for the water is such an important part of swimming. That would've been the hardest part of coming back, is not having the feel for the water."

Tighe made her season debut on November 6 in a meet against Georgia Tech, appearing in the 100 and 200-yard freestyle as the 24th-ranked Duke women earned a 199-101 victory over the Yellow Jackets. The team is next in action on January 8, with Tighe gearing up for a stretch that she hopes finishes in mid-March. But as she continues to progress towards her top form, she has also used her experience as a guide for teammates going through a similar injury.

"One of our freshman swimmers has found himself in a cast," Tighe said. "I definitely think that my experience had been a success at the point when he had injured himself that they were like, 'Let's do it for him too.' He and I have different casts, different breaks but a similar concept and he always asks me about certain things."

With the amount of positive feedback that Gehsmann has received on the company's products – through NFL awards, stories in The Wall Street Journal and countless anecdotes of athletes making quick recoveries – it'd be almost expected for him to be numb to the success. Yet, he and his co-founders still make sure to not pass up moments where they can reflect on how extraordinary the concept of a 3D-printed brace is. The creativity that went into Tighe's device – and the ease that she experienced when using it – ultimately put it among their most memorable products to date, according to Gehsmann. 

"I think this injury and this use case was one of those situations where we actually did pause and say, 'This is awesome,'" he said. "I chatted with Olivia directly – if we're working with other schools, we rarely would have access to chat directly with an athlete, which makes it cool that it's so close to home. To hear her describe the effect that it had on her season and her recovery process, saying she didn't know if she would be back in the pool for another several weeks had it not been for this solution – I've described Olivia's use case as one of the most rewarding products that we've ever made."