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Redefining Orthopedic Braces for Children, with Advanced Technology: Faizan S. Mohammad, LEG&AIRY

Alex: interviewing visionaries of healthcare innovation

Suddenly you discover your three-year-old child cannot keep balance, cannot walk or climb steps, their muscles contract uncontrollably. And you become a “patient’s parent”. What can you do?

Faizan let us into the intimate world of parenting a child with a rare condition, the strength, and happiness that turned into a startup.

You’ll hear about

  • custom-made ultra-light orthopedic devices
  • 3D scanning
  • AI technology
  • digital twins
  • the use of digital customer data for, in the future, predictive fitting
  • orthopedic braces
  • robotic actuators
  • hyperreflexia
  • meeting the right people at the right time
  • and also, about what can you learn from creating an orthopedic prosthetic device for a dog, a Dalmatian to be precise.

Faizan Mohammed a co-founder of LEG&AIRY. An entrepreneur trained in machine automation with an eye for innovation. You may meet him at the Zurich airport while his son speeds there on his wheelchair.

LEGandAIRY is a Swiss startup that uses 3D scanning and AI to manufacture custom made ultra-light orthopedic devices such as braces, cervical collars, cranial orthoses. With the aim to mobilise children with motor difficulties.

Reach out to them via https://legandairy.com

Timestamps:
0:00 Faizan S. Mohammed and LEG&AIRY
2:36 What does LEG&AIRY mean
4:59 A Family Faced with Child's Neurological Disease
15:41 Custom Orthopedic Braces: Traditional and Digital
18:47 Creating Custom Orthopedic Braces and Prosthetics
21:17 Meeting a Co-Founder
26:14 Creating Orthopedic Devices with Digital Twins
31:26 Startup's Vision: from a Speck of Hope to Leader of Orthopedic Braces
37:55 Advancing Robotic Technology in Medical Devices
44:52 Customer-centricity, WhatsApp, and Multilingualism
48:14 Expanding and Unlocking Scale with AI, Smartphones, Flagship Centers
59:26 Follow LEG&AIRY, follow X-Health.show, Disclaimer



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The information in this podcast is for informational purposes only and should not be considered medical advice. If you have any medical questions, please consult your healthcare practitioner. The opinions on the show are Alex's or her guests. The podcast does not make any responsibility or warranties about guests statements or credibility. While the podcast makes every effort to ensure that the information shared is accurate, please let us know if you have any comments, suggestions or corrections.

Faizan S. Mohammad, LEG&AIRY:

But we knew we were onto something that the world needs.

Alex, X-Health.show:

Hi, I'm Alex and welcome to the X-Health. s how, where I talk to visionaries behind the latest innovations in healthcare. For the eXtra health of the future. We're in Büro Züri, a co-working space on a busy high street in Zurich, where startups can rent a desk or a room hold your breath for free. My guest today is Faizan Mohammad, a co-founder of LEG&aImp;A;mp;ap;am;ampampY;amRp;aImp;Aamp;mp;ap;am;ampamp;aIpAamp entrepreneur trained in machine automation with an eye for innovation. You may meet him at the Suri Airport while his son speeds down his wheelchair. Legendary is a Swiss startup that uses 3D scanning and AI to manufacture custom-made ultra-light orthopedic devices, such as braces, cervical collars, cranial orthoses, with the aim to mobilize children with mortal difficulties. You'll hear today about supporting children with neuromuscular diseases, helmet therapy for premature infants, ankle foot orthoses, full robotic suit, returning customers, scaling custom-made products. But first a personal story, faizan. I was thinking what's behind founding Legendary? Was it frustration, helplessness, or was it something else?

Faizan S. Mohammad, LEG&AIRY:

I think it was all of the above. I think it usually started when my own son got diagnosed with rare neurothopedic symptoms. We had a period of about a year where he gradually lost some of his mobility and was required to be using a wheelchair.

Alex, X-Health.show:

How old? How old he was at this time.

Faizan S. Mohammad, LEG&AIRY:

He was four and that was the time when he received his first wheelchair. It was also the time when we decided to do something about it. That's actually the story behind founding the company Legendary. It was difficult, you know. It was quite difficult because I didn't know what to do. I didn't know where to start. There was this little opportunity. I got to know my now co-founder, timu, and he is a trained orthopedic technician and specialized in building orthopedic devices that help stabilize and also mobilize certain body parts, especially on the limbs, legs and arms.

Alex, X-Health.show:

Let's disclose maybe first what's behind Legendary. What's Legendary means we spell it as L-E-G and ARI.

Faizan S. Mohammad, LEG&AIRY:

A-I-R-Y-A yes, yes, Leg and ARI Legendary or Leisurey, it is a vision and a promise to help our patients, users, customers and their families, and supporting people around them, to come back into the reality of their lives, having their legs firmly rooted in the ground. And ARI, as in lightweight, easy, fresh and new. Have a fresh sense of lightness back into their lives, Not be weighed down by the challenges or maybe even some sort of the fate that they might be facing in their personal health journeys. Have that lift a bit with our products.

Alex, X-Health.show:

So Legendary stays in opposition to what you experienced.

Faizan S. Mohammad, LEG&AIRY:

Yeah, exactly, we were weighed down. We were at our psychological limits at that time, not knowing where to go, and out of that frustration, we founded that name. And that name was obviously an interesting epiphany or a discovery, because at that time it was 2019, we were figuring out a brand name and we hired a really strong brand designer who worked with us on that project and we selected Legendary from about 320 different logos and brand names and it was a process of about six months and quite intense, you know, going back and forth. What do we want? How do we want to deliver our promise? How do we actually fulfill our promise and how do we keep fulfilling our promise after the fact, Once a customer receives our device, what does that mean? All of that is accompanied or encompassed in this name. Everything at our company and everything with our customer experience or employee experience, internal or shareholder experience should be Legendary.

Alex, X-Health.show:

Like that, and you started that journey as a patient's parent. How was that journey for you? How did that start? As you say, you were waiting for the diagnosis for a year, so I can imagine that was very difficult. And then it comes a diagnosis which might have been a bit more difficult to take, and then, yeah, what was it for you?

Faizan S. Mohammad, LEG&AIRY:

Yeah, you know, we're still waiting on the diagnosis. Oh, wow, no, it's a super rare thing. There are some ideas what it could be, but you know, no confirmation. So, yeah, it was super hard. Obviously it was not easy, and you know, and we didn't really get any help. So we were left. You know, we went to a regular device manufacturing place and you know, and the frustration was already at 100% and once we received the device and it didn't fit, the frustration overshot and that's when I decided that okay, there's something, there's got to be something. And you know, we didn't, as I said before, we didn't know what to do.

Alex, X-Health.show:

What were the symptoms? Because I can imagine there was something worrying at the beginning, like when your son was what three?

Faizan S. Mohammad, LEG&AIRY:

Yeah, three, three, h4. Yeah, I mean, the symptoms are a magnitude of. You know, a drop feet is one of the medical symptoms. There is certain levels of spasticity. This is when the muscles contract uncontrollably, and also some sort of hyperflexia and varying degrees of muscle tone, and all of them combined made it difficult for him to keep his stability when walking or climbing up steps. And you know, and continuously you know, with him growing and gaining thankfully gaining weight along the way, it became increasingly difficult at that time and that was that these are the symptoms behind it.

Faizan S. Mohammad, LEG&AIRY:

The origin of those symptoms is yet to be defined, but we know for a fact that there is something neurological, it is coming from the central nervous system and a way to work around. That is extreme physical therapy to rebuild. I mean, obviously you have children, you know they have to be. You know naturally they just run around all day, jump and climb and break their arms and legs and things. So that was not happening for him anymore and we had to find a way to externally force these movements. And that's when obviously, orthopedic devices and mobilizing and rehabilitation devices come in play, where they take away some of that instability and stabilize to a certain degree so that the muscles can be trained specifically in that place. I mean focused, specifically trained for that muscle group.

Alex, X-Health.show:

So you went to doctors and then you know, someone recommended one of the casts that you described at the beginning.

Faizan S. Mohammad, LEG&AIRY:

Yes, you know it works in a way that you know you go to a doctor can be any kind of doctor specializing in neuromuscular symptoms, neuro orthopedic symptoms. Usually those are orthopedic doctors, neurologists, maybe even metabolism doctors, and also of all sorts surgeons, and they, you know, they see, either you know you get an orthopedic brace or there's a surgery needed, or we do nothing. So there's a very degree of, or even more, and I'm not a doctor, I don't know what to what to propose, but and the process that follows, you get, you get that prescription, you take that prescription and go to one of those selected or certified stores or centers to receive your either pre manufactured brace that gets then fitted to your, to your body part, or a new one gets created for you specifically as a custom made, tailor made usually. And that's when it's crucial to figure out a way to fit them perfectly to the body and that's where we unfortunately had a very bad experience in the market.

Alex, X-Health.show:

How did your life change after you know you started noticing that you started basically trying to treat your son's disease.

Faizan S. Mohammad, LEG&AIRY:

You know our life changed. Personally, you start to rethink what your future might look like as a in our position and it's not easy, you know. You do. You know the university hospital was quite generous. We, we received some sort of psychological support during that time. This is something they offered us, very appreciated and and and we learned. We learned to see this fate not with sadness or receive this fate not with sadness, but more, in a way, with gratitude, and it's not always easy. But our life has changed in a way that we see disabilities in a different way now than we did before.

Faizan S. Mohammad, LEG&AIRY:

Being affected yourself or indirectly affected yourself changes your perspective on life and the things that really matter in life. You know we decided, however bad our journey might get with our kid, or, you know, whatever the diseases or the symptoms might do, we will always be, or try to always be, happy. Or you know it's a choice and you can either be sad or you can either be happy, and we picked the latter because you know you just live better and you know nowadays you know we try to spend as much time together as a family. You know, currently, with the warm weather out, I don't know the most important thing for us and our kid is to hang out in the basement or go, go out with the, with the tram you know the street cars and hang out in the city, or or then maybe go for an ice cream and then come back home, and this is kind of this is what we do in our past time after school, after work, and you know it's not much time, you know the kids come home at four or five, then you hang out for a for an hour or two, half dinner and then you put them to sleep and the next day starts quite soon again.

Faizan S. Mohammad, LEG&AIRY:

And you know, and if you're happy, you just live better. And the biggest thing that changed is how we look at medical, how we look at the whole healthcare system and and you know being through basically every department of a hospital that there is, we know that there is, we as in you know, myself, my partner, my wife, my kid we really know that the market or the, the healthcare system, isn't where it should be as a whole. The patient or the customer, however and call it nowadays the patient, in, in, at default, is usually the last one to make decisions or the last one to be able to to affect the kind of treatment they get.

Alex, X-Health.show:

So you didn't feel like an agent really.

Faizan S. Mohammad, LEG&AIRY:

No, not really. I mean, these things were happening. We were in the middle of those appointments and things were decided and obviously as a parent you decide that with the doctor, that is the right thing to do. I mean, we are not the experts. They are the experts, but we wasn't like, okay, can we look at something else Is what is out there. I mean, can we start a study or or a paper or start a research thing? It wasn't like that. So we were not in the driver's seat and obviously you are not. When you get sick, you get into the healthcare system and I can.

Alex, X-Health.show:

I can imagine you expect at least a discussion, right?

Faizan S. Mohammad, LEG&AIRY:

Yeah, and we did. You know we did have discussions as it would be wrong to say we didn't have discussions and the doctors were always available to us to speak to. You know, I remember, you know writing emails day and night. You know, and maybe I have looked at this article and they were super helpful and super appreciative and they would always answer our emails and letters and things. But it's the experience, you know. It is the experience that there is no, you know, centralized body of knowledge on rare or complex diseases and you know, everything we tried was a, was a shot in the dark. Maybe it works, maybe it doesn't. Maybe we try this medicine.

Faizan S. Mohammad, LEG&AIRY:

This is used for Parkinson's. Some of the symptoms match. We use the other thing and and it's frustrating because you never know what's happening there are no standards because it's so experimental that there's just no clarity in what. What do we expect? And there were many times that we started the medication and had to had to stop it only a few weeks later to see that it didn't help or even made things worse. You know some things, yeah. For example, symptoms changed in a negative way, got worse.

Alex, X-Health.show:

Like, like what, for example?

Faizan S. Mohammad, LEG&AIRY:

It's hard to say. I mean this. Obviously the hyper reflexion increased the muscle tone, you know. It reduced muscle tone because of the increase in the medical supplement to reduce muscle tone. And suddenly, you know, the the kid was not as strong anymore as they used to be, and that was when we noticed that it doesn't, maybe even lost some of his abilities, and yeah. So it's not always easy to remember these times and what we see is there is obviously room for improvement.

Faizan S. Mohammad, LEG&AIRY:

But the system as such doesn't allow, doesn't allow for creative maneuvers in certain degrees. You know saying OK, let's figure out a way to fix this. Maybe the science isn't there yet. You know we don't understand the human body like we understand things we build ourselves. You know, if a car breaks, you just go in and fix the, figure out what pieces broke me, replace it or fix it. And we haven't understood, I think as a humans we haven't understood our body at that level or have that kind of a deep understanding to be able to fix rare diseases or complex diseases. And I know we are doing big strides with with gene therapy and, you know, personalized medicine, but we're not, you know it is not not ready for mass adoption yet.

Alex, X-Health.show:

And then, yeah, was it like a spark of an idea that you wanted to improve at least part of your son's experience, or was it a process you grew up to?

Faizan S. Mohammad, LEG&AIRY:

Yeah. So we were lucky in a way that my wife's brother-in-law he's a neurologist and we had a hot wire all the time and he was our go-to person to discuss what to do next and he recommended orthopedic braces at some time. He said, okay, this will prevent further deterioration of muscle and muscle structure, muscle tendons and especially tissue that is in the limbs.

Faizan S. Mohammad, LEG&AIRY:

So the role is to stabilize right To stabilize and also to prevent the symptoms for taking overhand. If you have a drop feed, you know you want to have the foot be lifted again. Otherwise the muscles that are responsible for lifting the foot and the tendons, you know the cables within your muscles. They shorten and they shrink and once they shrink the foot remains the way it is. And don't quote me on that Work for word.

Faizan S. Mohammad, LEG&AIRY:

I think a medical doctor will be able to explain that much, much more sophisticated, but this is kind of the mechanics behind it, and it really is. I mean, you know the saying use it or lose it, and this really is true in terms of muscle. If you don't use your muscles, you lose them, and I mean they start to shrink and then it gets smaller and with symptoms like structural anatomic symptoms such as a drop feed or a change in tone in muscle, these change the way your muscles grow, especially in small children. And that's why my family member and now he's an advisor to the company recommended we look into bracing and supporting devices.

Alex, X-Health.show:

So what was wrong with them?

Faizan S. Mohammad, LEG&AIRY:

Wrong with what.

Alex, X-Health.show:

With the bracing and the the casts.

Faizan S. Mohammad, LEG&AIRY:

So traditionally, you know they are made by hand. And, as I said before, you know we went into those orthopedic stores. It was cold, it wasn't child friendly, it was, I mean, if I can say it, boring, and we had to take our entertainment plan with us. You know iPads and toys and that kind of things. And that's when you get started. You know you have a long discussion before hand with the technicians. You discuss what to do, they look at the prescription and you take it from there that they start with a hand casted leg copy.

Faizan S. Mohammad, LEG&AIRY:

So you know you really get plastered in wet plaster mass, you know, and you know it's uncomfortable for us adults. Now look at the three year old kid. How would they feel having some weird thing be wrapped around your arm or your leg? And then you know have to hold still for about half an hour or 45 minutes for it to cool down and harden out. And then you know the guy comes up with a knife and starts cutting away at this at this cost. And you're like, oh, why, why are you bringing this sharp knife? And it's not even a sharp knife, it's a scalpel. And they come out with this thing and you're like no, and some guys even come up with a saw and they start sawing away this thing and I saw medical saw.

Faizan S. Mohammad, LEG&AIRY:

it doesn't it stops, but it's still weird to see, you know the guy.

Alex, X-Health.show:

it looks scary yeah.

Faizan S. Mohammad, LEG&AIRY:

And and, and you know what becomes. You know, and at that point do you start to become hopeful that, wow, there's some, could be something out there that will help us in this journey, and but really it isn't. Because what happens then is they take that cast and they, they work on it for three weeks or four weeks and finalize it, and then they melt hot plastics on top of that, put it on top of that plaster and, and you know, or a 3d model, they create another 3d, as in digital, but a physical, three dimensional model out of that cast, that which should be a copy of your leg, and and it's all this plaster cast material. It doesn't represent anything of the skin or the body anymore, and you don't know how fast the patient is changing or growing, or or the symptoms are improving or worsening during that time.

Alex, X-Health.show:

I just wanted to say that, like, if you did that measuring like, say, just before summer so I mean after three weeks of summer the kid might have grown, I mean a couple of centimeters at least.

Faizan S. Mohammad, LEG&AIRY:

Yeah, and this is, this is a thing, and you never know. You never know what happens during that time and while they're working, while the technicians are working on the product, you receive it and it's a surprise party. It can fit. Best case scenario you take it out, it fits perfectly. Worst case scenario, and unfortunately happened to us. We received that raise by, by mail, because we felt like we don't have to go in again and they said, okay, it will fit. And it didn't fit. Not at all.

Alex, X-Health.show:

And you can't adjust it.

Faizan S. Mohammad, LEG&AIRY:

Yeah, and that was the thing, right, when you can adjust it. The technicality is that they use a heat gun and they heat it up and start molding it by hand, and it's not precise. You change it one place, it will come back. It might change again. You keep just running after fixing the fitting and and all in all, it was an unpleasant experience because for us, we received that brand new brace, based off of a perfectly new measurement or cast, and it didn't fit. And once I once I reached out to them and they said hey, guys, it's not fitting. What's up? It turned out they use the wrong cast from a different child, so it got mixed up in the workshop and it was so frustrating because we had to wait again for four weeks to get a new one and and that all of these things led to to me, you know, and I didn't have it back then. We just had it, and then, three months later, so a guy called me and said hey, I'm working on this project. Do you want to join?

Alex, X-Health.show:

How did he find you? You speaking now about your co-founder.

Faizan S. Mohammad, LEG&AIRY:

Yeah, yeah, it was. It was. We spoke, we met for dinner and I didn't know what to do. I was interested in the topic and I was bringing in the customer side and the other guy was bringing in the technology side. So he found you through hospital, so no, we found each other through a, through a mutual friend of ours who was a 3D designer for these braces and he originally just needed help in setting up a legal entity in Switzerland to be able to sell his services to the market.

Faizan S. Mohammad, LEG&AIRY:

And you were a business advisor, you were, I was he called me up because I'm, you know, I hold an MBA, and I said, hey, you know these things, can you help me with this? And I said say no more. He said you know what is the orthopedic grace? I said, yes, my son just received one that didn't fit three months ago.

Alex, X-Health.show:

So I know exactly.

Faizan S. Mohammad, LEG&AIRY:

Yeah, I was in July or June, july or August in 2019. I remember that day fondly. I was just driving back from an appointment and I just got the call out of nowhere and and through that person, through that designer, I met with Timo, who is now my co-founder, and and that was. That was the story of it, and what's Timo's background?

Faizan S. Mohammad, LEG&AIRY:

So Timo, my co-founder, he's a Swiss certified orthopedic technician, or a CPO certified prosthesis and orthodosis the international title you know. He's been working as an orthopedic technician for the past 15 years working with the biggest clinics University Hospital, basel and Bern and Zurich. And he's he's a person you know. He's part of doctor meetings with patients, so that once a patient is, you know, meeting with a doctor, timo usually gets called and said okay, we think we might have something to discuss, do you want to be part of this meeting? And usually we say yes, and and he's there and discusses with the doctor and the patient together, figuring out the best bracing support for that individual case. He's my go to man, he's our chief product officer. He understands everything about orthopedic braces. He also understands a lot about robotic actuators. So he's always, you know, pointing at the direction of adding electronic joints that can be remote controlled in a certain degree and really, really a really good person and a good soul to be, to be working with. And you know he he's a person who designed the first brace for my son, the first legendary brace for my son, after our bad experience with the others, and I trust him ever since because he did such a wonderful job, and not just technologically but also on a human level. You know, it was the first thing coming into our appointment, right Our home was him shaking hands with my kid and doing a high five hey, this is me, and you know, introducing himself. And ever since then my son lights up when, when Timo comes by to get a new fitting or a new 3D scan. So so really, he's our he's, he's really the product man behind our, behind our innovations.

Faizan S. Mohammad, LEG&AIRY:

And we took it. You know, in the beginning we were experimenting on product design. The all three of us. We were meeting different places, in Zurich and Basel, you know, just to make it easier, because Timo lived in Basel back then I was in Zurich. Now Timo is in Zurich, but our designer is somewhere else now. So so we just kept. We just kept traveling and meeting, and it was an interesting journey and a lot of progress was made in a very short time. And we had we had prototypes and products that we used on pets, on dogs and cats.

Alex, X-Health.show:

I actually wanted to ask about Malo. Yeah, you mentioned Malo on, I think, on legendary Facebook.

Faizan S. Mohammad, LEG&AIRY:

Yeah, it's a dog, is a, is a dog and it was wonderful story because that dog had a infection in one of its paws and it would keep reinfecting, because a dog would scratch his paw on the ground and you know they had to. You know, because of the increasing and the spreading of the infection, they had to amputate that paw. And the dog was fine. I mean, obviously it was amputated and couldn't use this one leg anymore. And then the dog physiotherapist reached out to Timo, because they know another physiotherapist who worked with them and which we designed a orthopedic prosthetic device for that little dog and it had integrated soul, integrated joints, integrated silicon layers. And it was a wonderful experience because we learned a heck about anatomy and that project and also how to use digital technologies to really find a perfectly fitting or design a perfectly fitting device.

Alex, X-Health.show:

So what was the grand plan? Like the final Vision.

Faizan S. Mohammad, LEG&AIRY:

Yeah, you know, after testing our devices with pets and our process was always the same we 3D scan the body part with modern 3D, industrial-grade 3D scanners. We then look at the model in a digital format and computer-aided design, cad software I mean there are many and we compare the digital twin to the original body part, because we take measurements at different stages and once a digital twin has the same measures and that has been rectified in a way that it resembles the original body part one-to-one, we then start creating a device onto that digital twin. So we take one of our products that you see here in front of us, we take one of these and then we start fitting it to that digital twin Digitally.

Alex, X-Health.show:

We have some casts here on the table. Which one was the first one, or like what did you start with?

Faizan S. Mohammad, LEG&AIRY:

We started with this one.

Alex, X-Health.show:

Yeah, could you describe it? That's for a leg and a calf right, so a foot and a calf.

Faizan S. Mohammad, LEG&AIRY:

Yeah, this is a so-called ankle foot orthosis. This is made using a digital design of a brace that we, you know, we have in our company. We have a design team that designs new products, and then we have operational designers that fit the products to the body part and we use software to simplify the fitting process. So I don't want to say it, but it's truly AI-based procedures and methods that manipulate those models. And this brace that you can see here is used to rectify a few symptoms of the leg. It resembles something like a shoe. First of all, it rectifies a drop foot. The second thing it rectifies are certain varying degrees of flat foot. You know the flat feet, club feet, the kind of issues with the foot itself and also it helps rectify a symptom called varus, varus or O legs. You know you have people who have X legs and O legs Right and it helps rectify these symptoms.

Alex, X-Health.show:

You can walk in it right how I can see it's pretty light, it's not heavy. How flexible it is.

Faizan S. Mohammad, LEG&AIRY:

So we can add flexibility at the places that need it. So in the forefoot we have a flexible spring mechanism. That spring mechanism has two functions. First of all it allows for flexing of the foot, but also the spring recoils energy back to give you kind of a kinetic rebound of the foot so that you don't get to stay stuck on the ground and keep it dynamic. And obviously we have certain flexibilities at the places where we need to fit it to the body, especially on the calves, where sometimes the leg is a bit thicker, depending on the water saving in the body, or thinner in the morning. And that's a product we started with. That's one of the most requested products from us and we're really happy we can supply that.

Alex, X-Health.show:

I can imagine you tested it on your son.

Faizan S. Mohammad, LEG&AIRY:

Oh, yes, yes, yes.

Alex, X-Health.show:

And it did fit.

Faizan S. Mohammad, LEG&AIRY:

It fitted like a charm. We were super surprised because it was our first test. It fitted perfectly and the only thing we had to do is I think we had to reprint it once to fix a bug we had inside the design, but that's a design he has been wearing ever since 2020, actually.

Alex, X-Health.show:

And how long does it take to print it from the measurement to shipping?

Faizan S. Mohammad, LEG&AIRY:

For us we call it the legendary perpetual care cycle, and it takes one to two weeks max from first contact to fitting the device together with the patient.

Alex, X-Health.show:

So it's not from the measurement, it's from like hello, can you help me? Will they unpack? Yeah?

Faizan S. Mohammad, LEG&AIRY:

It always depends, obviously, on the availability of the patient. But to simplify it a bit, let's call it from the first measurement we have with the patient takes about two weeks to receive the fitted device, and we don't ship it. We usually bring it or meet with the patient at the clinic or at the rehab center to test it on, try it on.

Alex, X-Health.show:

This episode is brought to you by the Ex-Holes show and me. So, if you like this podcast, be generous, hit, follow, leave a review that will help me invite more such amazing guests for you, thank you. So what did you want when you founded the company? What was your goal? Well, I can imagine one you wanted device that fits.

Faizan S. Mohammad, LEG&AIRY:

You know it's such a good question. It's hard to remember what we really wanted because for me personally, it was kind of a speck of hope to be able to help someone really close to me. And throughout that journey and the company, we didn't have a final view on what the company would do when we created this thing, but we knew we were onto something that the world needs. And when you get into that field you start to see your customer group, you start to see actually how many people around the globe rely on these devices every day. I mean some are. I mean the most obvious ones are those with the chronic disease of some sort, maybe rare, maybe known. But then you start looking at the other things that, okay, someone just hurt their brain, their ankle. They suddenly need that too, and it's not as sophisticated as the ones we're making right now. And then you suddenly start to get a feeling for the market and the vision starts to form itself saying okay, so we are, the division was to be the leading company for orthopedic bracing in the world. And suddenly your whole perspective and you transform yourself and you transform your ideas in a much, much bigger scope and suddenly start to look at volume in a completely different way and I think the purpose of the company is given.

Faizan S. Mohammad, LEG&AIRY:

Legendary now creates the best build designs and manufactures the best orthopedic devices in the world and, yeah, we can say that because we believe in that and we will believe something else if we are shown to believe something else.

Faizan S. Mohammad, LEG&AIRY:

But right now we have a above average customer retention rate and, as we spoke before, the customers are in touch with us every day to ask us questions. We plan the follow up fitting and the you know it's a second fitting, a third fitting and the fourth fitting and we can do that so easily because we have to measurements digitally. So the second 3D scan, say in a year from now, is just a small delta from the previous scan. So we see exactly how the limb is changing over time. And you know, if you can call it a vision or one of the perspectives of our business model could be that we could do predictive fitting, saying, okay, we believe that your leg, based on a million of data that we have in our database, believe that the leg will be rectified in about three years and this is data that we can use to predict something.

Alex, X-Health.show:

This is what I was thinking that you will be sitting on a lot of useful data of human limbs, and not only limbs, as I can see. You know the other braces here. Could you say what else do we have here and also who are your customers? Maybe you know through what we have here.

Faizan S. Mohammad, LEG&AIRY:

So you know, we started with leg bracing, obviously for personal reasons, but then we started receiving requests for other products, for example, neck stabilization.

Faizan S. Mohammad, LEG&AIRY:

So that's the thing you see here, which looks like a colier Almost, looks like almost, looks like a piece of art that is worn around the neck, and the limits, that there are no limits to what we can do at the moment. So you know, the customers in our case currently are patients with chronic diseases who need a fitted device. What you see here on the table is a selection of some of our best products. It's one of them is the leg brace we spoke about. The other one is like a neck brace that is used in a, for example, in a car accident, you have neck problems, your neck stiffness, you wear this, or after a neck accident and you need stabilization, you wear one of these neck braces. The third thing you see on the table is a helmet that is used with symptoms like plagiosephaly, which is a, you know, when children are born with an asymmetrical head, technically, you just you fit the helmet into their head and wait for the head to grow into that helmet.

Alex, X-Health.show:

It's a cute one. It's a pink one with stars.

Faizan S. Mohammad, LEG&AIRY:

Yeah, it was a patient request. I report stars.

Alex, X-Health.show:

Okay.

Faizan S. Mohammad, LEG&AIRY:

And the stars have two functions. One of them is obviously the optical pleasant function. It looks nice, looks cute. And the second thing is the stars are in different sizes and different places. We can use these stars to measure the growth of the head. From outside we can see how far until the helmet is filled, how soon or how far along. All we in the helmet therapy and we always, we always apply that principle. We don't add anything that is not needed. So for us, the form that we have follows the function that it needs to fulfill and if we can build it or place it around the design that is wonderful to use and pleasant to the eye, we'll do that. And the fourth product you see is a is a so-called full leg brace and it's a bit more complicated right, it's not only 3D printed.

Alex, X-Health.show:

There are also some metal joints, I'd say added.

Faizan S. Mohammad, LEG&AIRY:

So you asked me about where our company is going or what's the vision, and obviously we are. We are working towards a world where we can design and design and manufacture full body mobilization suits, and this is our first step towards it, because this is a full leg brace. It's in the realms or arenas of exo robotic applications. This is not a robotic yet, but, as you can see, we have metal joints that support the limb and the joints of the body, and it's an easy thing to replace those metal joints with robotic joints that then trigger or actuate movement from the outside and suddenly people who suffer from paralysis can take steps. And that's a big, big, big win for everybody around, because suddenly you are not tied to the wheelchair in the literal sense anymore. And I'm not stigmatizing wheelchairs here, not at all. Wheelchairs are a great invention.

Alex, X-Health.show:

Oh no, they give people freedom.

Faizan S. Mohammad, LEG&AIRY:

Exactly so. So was it? So? How was it with us? And these devices have the purpose of mobilizing a step further and saying OK. For certain sequences, it might be useful to use this device Help them stand up out of the wheelchair, reach for the pepper, the kitchen or something else, whatever it might be, or wash your hands on the sink. These are the kind of use cases that these simple devices, as you can see here, are used for. But, as I said, our vision is much bigger. We will add robotic features into our devices and we will not build the robotics ourselves, because there's enough robotic scientists and robotic implementations and prototypes out there, I had one on my show already.

Faizan S. Mohammad, LEG&AIRY:

Yeah already. So that's cool. So what we might be doing is we might supply the fitting and the you know, the fitting and the device technology and the partner bringing the electric and the robotic features to bring both together and integrate it into a, let's say, a full body actuated suit that looks good and doesn't look like the ones that are out in the market yet from a design perspective, so who are the customers and how do they find you?

Alex, X-Health.show:

Are you already able to sell the braces?

Faizan S. Mohammad, LEG&AIRY:

Yeah, we, and that's a very tough question. So we have a few different customer groups. Obviously, the one that comes to mind is humans with chronic diseases of the neuro orthopedic nature, neuromuscular nature, and there are two spectrums, or the two areas of the human spectrum where our customers are are at. So the first spectrum, where we are focused on our children, very young, two, three, four years old, who started showing your or to neurological and orthopedic symptoms, and then, in the far end of the spectrum, elderly, who suffer from diseases such as Parkinson's disease, maybe multiple sclerosis or even a stroke, that again start to show neuro orthopedic symptoms at a later age. So these are the two customer groups that we're trying to aim for, and the question on how do we reach them is usually through the medical staff. So our strategy is super simple we speak to the medical staff, we show them our products, they love them and they recommend us to the patients. Or we get presented in some trade shows and patients come by, look at the products and ask us for receiving one of our braces, and that's when the second question comes into place Are we able to sell them ourselves or not?

Faizan S. Mohammad, LEG&AIRY:

So right now we are at step one of three of the regulatory approvals. So we have got the first step done, which is receiving a manufacturing and a producing number with the certified body. That's done with the Swiss authorities. The second step will be to receive a. It's hard to say but it's in English, I don't know, but it's an industry association that we need a membership of, and to receive that membership we have to fulfill certain criteria. There has to be a treatment center that you have to set up. There has to be some sort of rooms especially these are products that are close to the body, so you need a changing room in the deck Kind of. You need the privacy. You have to provide that to the patients. And once we have that facility we will have the second step of the regulatory requirements and that's enough to be able to supply these products within Switzerland and reimburse them to the insurers. And the third step, which is aimed towards global expansion, would be also a medical device certification with European authorities or maybe also with the FDA.

Alex, X-Health.show:

What are the challenges here? Because these are highly customized devices, so it's per person. You can't or can you manufacture one kind and lots of them.

Faizan S. Mohammad, LEG&AIRY:

Yeah, so these are class one medical devices and class one medical devices are usually they are not tested that strictly because you don't mass produce them and there is no incentive to produce a hundred of these and test each one, a hundred of those, for their viability.

Faizan S. Mohammad, LEG&AIRY:

So the regulators are not stupid, so they know the kind of challenges our industry faces and they made it a bit easier for us to regulate our products. But going forward, you know, as I said about the vision with the full body robotic suit, we will add sensors because we will need to know how the body is feeling underneath the suit and if it's warm or cold or the blood pressure is high or dropping, and then we will become a class two medical device and that will need special, special certification, because then it might also not be a suit that is custom made, maybe it's a standardized suit that can grow five or 10 centimeters. And you know we are working with, talking with someone who is able to design these kind of things, and then that will need a special, individual product based regulatory approval.

Alex, X-Health.show:

We met at Zurich Impact Conference when you told me that you actually envisioned that suit for your son. So, like still, your son is the propeller for your imagination.

Faizan S. Mohammad, LEG&AIRY:

You could say that he's a force of nature, and it's obviously. You know, that's what I said before. The vision is an evolving thing, right? Or well, less so the vision, but the mission itself. It is evolving. It's not changing, but it's evolving. You know, as we learn new things, we add new products to the portfolio, because we have such a strong, you know, innovative power in our company that we can add new types of similar products into our product portfolio.

Faizan S. Mohammad, LEG&AIRY:

And what's to hold us back from creating this full body suit? There's nothing that can stop us from building that. And we are working with great success with ETH Zurich spin offs who have developed technology that can be integrated in our braces. And you know and the question is, you know if that brace looks like that or if you know right now it looks like an orthopedic brace, but that's the ankle one, yeah, the ankle one. And what stops it from making it look like a boot that opened up, like like, clicks up, put your foot in and it closes down again? Nothing stops us from redesigning this thing into a different product Doesn't mean that we'll stop selling this. So you know, we have a business model progression going forward. No-transcript.

Faizan S. Mohammad, LEG&AIRY:

It started with my son. He is obviously a very strong force inspiring me to keep going, but not just him. We have a group of 30 or so patients that we are treating now on a regular basis and they are our fuel, and they fuel us to greater lengths, and the reason why we're in such close contact with our patients almost weekly, daily, even gives us insights into the varying experience and if our products wear better or worse. And we had patients that come back and say, oh, you know what this thing is itching somewhere and we looked at it and noticed, oh, there is some issue in the application of the product. There was no training done with the parents of that child and then we trained them into how to put that brace on and suddenly the itching was gone, the brace was fitting perfectly.

Faizan S. Mohammad, LEG&AIRY:

It was just a small training question and they never received that. The kid was wearing braces even before they met us and they always had a problem, and it wasn't the problem of the product itself, it's a problem of the application of that product. And and you know that gave us. It was just this two weeks ago they gave us an idea of creating tutorial videos on our website, saying, okay, how to put on one of these braces correctly, and that's why we stay in touch with with the customers. They give us energy, they tell us what is bothering them and they don't tell us what to do next. They tell us that's bad and we? It's our job to figure out how we can make it more delightful.

Alex, X-Health.show:

Do you have any special channels of communicating with your customers?

Faizan S. Mohammad, LEG&AIRY:

Yeah, yeah, so I don't know if I'm allowed to name it, but but we use WhatsApp so easy. I mean, they chat with us on WhatsApp. It's connected with our CRM and we know exactly where the customers are, what they're doing, what they need. They can call us on WhatsApp, they can reach out to us, they can send us photos or videos.

Alex, X-Health.show:

It sounds like a huge team behind customer service.

Faizan S. Mohammad, LEG&AIRY:

Yeah, it's, it's. It's usually it's my co founder, timo, or me handling the the WhatsApp communication. But we are now hiring, you know, support staff. We're looking for someone who is able, and in Switzerland, the challenge is to be able to speak in multiple languages or write in multiple languages.

Alex, X-Health.show:

Yes, we have German. We're in Zurich, so that's German. There's also French and Italian and obviously English, because I mean there's loads of people also speaking English, or would you add anything else?

Faizan S. Mohammad, LEG&AIRY:

Yeah, so we obviously English is a thing. We speak English with those. For example, I'm not good at French, so I try to, you know, use English. But we're looking for someone who is experiencing at least two of the national languages either Italian and German or French and German to to help us with the customer support.

Alex, X-Health.show:

And now let's, let's say that to the, you know, the rest of the world outside of Switzerland. It's not uncommon, is it?

Faizan S. Mohammad, LEG&AIRY:

It's, it's not, it is just the way it is here and it's the way things work here. And you know, we had just we. You know we're going into the French side of Switzerland actually this afternoon to the Frittadivise and and we speak French with that customers and my partner speaks French with that, and it's just the way it is. And it's the same system, the same government. You have to print the letters in three languages before they send them out.

Alex, X-Health.show:

It's been a real busy period for you and now you can actually announce like what happened.

Faizan S. Mohammad, LEG&AIRY:

So, yeah, we just signed our first investor. That's a very, very great news and we are thrilled beyond measure to to have that group as an investor to us. They are experienced in scaling companies, experienced in medical device and and smart technologies startups, so we are tapping into a extremely value I mean be of unfathomable level of expertise and and and a network that we can have access to through those investors, which we already did in the past few weeks while discussing, negotiating and running through the due diligence, and learned a lot. And learned a lot in that phase is yes, so we will close that first investor, we signed all the paperwork and we are not done raising money, so we will continue raise more money.

Alex, X-Health.show:

Yeah, the vision is big enough right.

Faizan S. Mohammad, LEG&AIRY:

The vision is big enough, but for now we know we will use that money. We have some other investors and and and foundations that are willing to help us on our journey and we will definitely place out some big news once, once we are there, and to close the round and then get in.

Alex, X-Health.show:

You mentioned investors with experience in scalability. How can you scale such customized product?

Faizan S. Mohammad, LEG&AIRY:

That's such a good question.

Faizan S. Mohammad, LEG&AIRY:

The fact that we are digital from the get go, from day one, is a big asset to us.

Faizan S. Mohammad, LEG&AIRY:

We spoke of, we touched on AI, so one of the scaling keys or unlock unlocking factors is obviously integrating intelligent technologies, things such as using iPhone scanners at home if possible, so the patients can just upload their latest, can get a fitted device and just order it right out of the legendary portal. But the second or the most important scaling factor will be legendary flagship centers where the patients can flock to and have have regular checkups and where we don't have to reach out to patients or go to the patients in their clinics or at their homes, but the patients coming into us. And this is something we might be looking into next year, once we have a good enough base of customers to understand where is the majority of our customers coming from as it may be Zurich, as it may be Basel, as it may be somewhere else in Italian part of Switzerland and Lugano or the Gino, or where are the customers that we work with, and based on that, we will do some sort of a decision, look at the data and build our first flagship facility.

Alex, X-Health.show:

We're speaking Switzerland right. You don't have plans to expand outside of Switzerland.

Faizan S. Mohammad, LEG&AIRY:

We want to expand outside of Switzerland. This is definitely one of the big topics in the next years, but we don't have any concrete plans yet. The current level of understanding is that we will be close to cities or places where there's a certain amount of population and some sort of a leading clinic in our field of interest Means orthopedic neurology, maybe even university clinics, and that's where we might be setting up our facilities, because then we can offer an integrated experience to our customers. Say you know, we can reach out to the doctors, the treating doctors or the other leading doctors, plan the bracing support for the individual patient and then supply it really close to the clinic and also have some sort of joint customer journeys where our experts can be part of the hospital journey and have hospital staff be part of the orthopedic journey with us. But it's all just rough sketches at the moment.

Faizan S. Mohammad, LEG&AIRY:

But what we will do is we will follow the big names in the market. Obviously and all my friends know, you know, without being an Apple fanboy we obviously want to follow some sort of a Apple store-ish concept where we have our own stores with our own geniuses sitting in the back working and tweaking on our devices and fitting them and whatever, but also laying out other products that are maybe not designed by us or maybe manufactured, but that adjacent or support or add on to our products. What comes to mind? Our specialized shoes that we can place in that store, that then can be matched with the individual brace before getting out of the store, and this is the kind of concept we're currently working on.

Alex, X-Health.show:

How did that business experience I think I'll just ask that in this, you know, very general way changed you and I can imagine from what we started also how it changed your personal perception of your experience as a patient.

Faizan S. Mohammad, LEG&AIRY:

You know, what changed is that you look at the beginning I was very impatient, you know. I wanted to have this device because I was feeling like the time is running out for me and the symptoms of my kid and everything. And now, as we progress, we learn that going slower, you know, and going really really slow on the important things in the products, let's say, the base architecture of our products and now, in a technical discussion, going slow on the features that we want to build and make sure that we cover as much ground as possible leads to better results. Even though, as a startup or a young company, you want to go fast, it doesn't always yield the same results. And what I really learned is you have to be really precise and really slow on the important aspects, not just the technology, but also the business model.

Faizan S. Mohammad, LEG&AIRY:

What's our business model? How do we plan on making money because we're spending so much time? We're getting investors in this thing and we invested ourselves into it. It has to have some sort of a return back to us. And also the importance of a brand. I think that last point was the most crucial learning that I had during the past four years five years we're working on. This is the brand, is everything. Build a wonderful brand, build a company that delivers on their promises and delights, delights the customers in what they do. And we don't overpromise, we don't underpromise, we just promise what we do and we do it well.

Alex, X-Health.show:

And this is surprisingly huge for a patient right.

Faizan S. Mohammad, LEG&AIRY:

And it is. It is. It is the thing they hope for and they hope that their symptoms will be eased or things will get better. And we try to fulfill their promise to the best of our abilities and we can say with 100% conviction that we did that in every single case that we treated so far. We have had no patient going back to their previous provider once they're working with us. So you know, we had this patient wonderful patient, really amazing and also very tragic, or not tragic, but very emotional story with the kid.

Faizan S. Mohammad, LEG&AIRY:

And you know we had a bind with a few deliveries we had to fulfill this week. And you know we made sure that we can deliver the product in time for the family to go on vacation, because summer break is starting now, actually today. And, and you know, we asked the patient, you know, would it be possible to deliver the product semi-finished, to be able to just figure out if the fitting is good enough and then finish it later on to after your vacation? And they said, yeah, relax, no worries, you can come by, we can try it on, we will take on, we will. The patient was anyway planning to take their current legendary braces to vacation because they're trained with them.

Faizan S. Mohammad, LEG&AIRY:

They know how they work and this just helped us. You know, give us just like two more hours of breathing time because we have such a high amount of demand right now and I think this is the kind of treatment we want to. You know, we extend that treatment. This road goes both ways. You know, we sometimes wait an hour for the patient to arrive, even though you know we agreed on a meeting at 3pm. They show up at 4pm.

Alex, X-Health.show:

They have their own challenges too. I can imagine.

Faizan S. Mohammad, LEG&AIRY:

Well, and because we give that kind of freedom to the patients, we are able to call in that favor sometimes, and we treat them like family and we also are treated like family back. So it is a very, very wonderful and lovely experience to be with our people, and every new person that joins our family is treated as such, greeted with open arms or open braces, and we help them. Yeah, that's what we do.

Alex, X-Health.show:

What's like in the immediate future for legendary so in the immediate future very good question.

Faizan S. Mohammad, LEG&AIRY:

We are planning on partnering with some selected clinics on certain bracing. We want to figure out if, for example, the helmet can be delivered at scale let's say, 10 helmets a second or something like that. We don't know, we have to figure out the measure, but we believe we can make 10 or 20 helmets per day or per week, I don't know and really fill up that scale. So immediately next would be to go out into the market, especially with medical experts present what we can do and what we're planning to do, and ask them for a number of referrals to learn from more patients, gather more data and also, maybe, with the money we have raised, set up our first flagship store.

Alex, X-Health.show:

Here in Zurich.

Faizan S. Mohammad, LEG&AIRY:

Either in Zurich or in Basel. We don't know yet where. We're still unsure about certain aspects of our client base. So, depending on that, might be either Basel or Zurich.

Alex, X-Health.show:

Pheasant. So thank you very much for this conversation and you guys. If you want to read more about legendary, please head to legendarycom, which is L E G A N D A I R Y dot com.

Faizan S. Mohammad, LEG&AIRY:

Correct. Thank you, alex, it was a pleasure being here.

Alex, X-Health.show:

I'm totally impressed by the audacity of researchers, then startup founders, doctors, then old reprenses or ordinary parents turned healthcare innovators, people battling the battles that no one thought before for the extra health of the future. So if you see a startup posting on LinkedIn, show them some love. Hit like, comment. It's fabulous. If you have a couple of drops more of that outreason, follow the X-Hull show, leave a review here. I'll be able to bring more of these visionaries to you. So a big thank you. You're awesome. See you next week.

Speaker:

The information in this podcast is for informational purposes only and should not be considered medical advice. If you have any medical questions, please consult your healthcare practitioner. The opinions on the show are Alex's or her guests. The podcast does not make any responsibility or warranties about guests' statements or credibility. While the podcast makes every effort to ensure that the information shared is accurate, please let us know if you have any comments, suggestions or corrections.

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