Josh Rabinowitz of Articulate Labs talks his Startup

Josh Rabinowitz of Articulate Labs talks his Startup

Where are you from originally?

I'm originally from the Metro Detroit area – Farmington Hills. Go Hawks.


What university did you go to?

I'm a proud Spartan alum from Michigan State University. Like many other college graduates of my generation, though, I'm not doing anything related to my degree in Political Theory & Constitutional Democracy.


What brought you to Austin?

My partner and co-founder, Herbie Kirn, moved to Austin from the Detroit area when his first start-up needed to have access to silcon design engineers. The choices were Austin and San Jose, and Austin looked more enjoyable. I followed shortly thereafter and began working in the political realm, then later in non-profits.


What is the idea behind your startup?

The driving force behind Articulate Labs is to integrate tried-and-true solutions from a variety of engineering fields into health-focused medical devices and technology to fulfill unmet medical needs. Our first invention to go to market is StimBrace, an adaptive, motion-sensitive muscle stimulator that may reduce pain-induced muscle inhibition in osteoarthritic knees. Here, Herbie has taken the current functional electrical stimulator and added modern digital signal processing ability and adaptive real-time algorithms from engine control to create a self-customizing, effective knee care solution.


What need does it fulfill?

StimBrace handles an unmet need for practical, non-medicinal osteoarthritic knee treatment, a need that is going to grow as the number afflicted increases to approximately 35 million in 2030. This population needs something that can compliment and compensate for current treatment options that have limited duration, poor efficacy, and/or potential drawbacks. For instance, a StimBrace user could cut back on their use of certain anti-inflammatory medications, reducing both financial expense (~$275/yr.) and risk of side effects ranging from dizziness up to gastrointestinal bleeding. The latter point is a huge issue – in 2008, over 100,000 were hospitalized for anti-inflammatory-related internal bleeding, of which over 16,000 died.

We believe StimBrace may also help postpone knee replacements. Over 700,000 knee replacements occur each year, 90% of which were related to osteoarthritis. However, many who develop knee osteoarthritis are too young to have a knee replacement. Someone who has their knee replaced at 55 will likely need another replacement at 70, if not earlier. If you can put off a knee replacement, then you've sidestepped the risks inherent with surgery at an advanced age, saved over $20,000 in the surgery alone, and potentially skipped weeks of rehabilitation and inaction.


What exactly does your product do?

Herbie has been using muscle stimulation for osteoarthritic knee rehabilitation, a direct result of a motorcycle accident six years ago in which he lost his right foot. As it turns out, studies show that quadriceps strengthening is the best prognostic indicator for knee osteoarthritis – the stronger the quadriceps muscles are, the greater the load they can distribute away from the degraded weight-bearing surfaces of the knee. If you can reduce that pressure, you can reduce the painful mechanical grinding within an osteoarthritic knee.

However, current e-stim units are only designed for use in a clinical setting, not for use while ambulant. Using his background experience as a systems design engineer, Herbie created hardware and real-time operating software that can adapt to unique motions and activities of each user. To this, he added a simple single-button user interface which prompts StimBrace to remember painful conditions. Thereafter, when StimBrace's motion sensors detects these conditions, it contracts the patient's musclature to offload the joint. The patient, rather than a pre-programmed gait sequence, determines when StimBrace becomes active and what painful motions should be precluded in the future. Now we want to help the 13.5 million people with knee osteoarthritis in the country to enjoy similar benefits.


Who is it for?

Right now, we see this device benefiting people who need non-medicinal knee osteoarthritis relief and are too young to get a knee replacement. Specifically, we're looking at people aged 55+ who need knee pain relief to stay mentally, physically, and professionally active. We're still evaluating the market to determine whether direct end user sales or physicians' prescriptions would be more attractive.

It is going to take a couple years to handle everything related to FDA approval and insurance reimbursement, so we're also looking at different populations that we could assist in the meantime. One option includes muscle rehabilitation and retraining for high-level athletes. Consider someone like Lamar Odom, the Lakers' forward who suffered a torn meniscus during NBA playoffs. If we could help someone like him with pain relief, to speed rehab by even as much as a week, it could be worth hundreds of thousands to him and to the team. (Not that they needed the help this time around)


What was the most challenging aspect of starting up a business?

It's been difficult to change my work approach from focusing on short-term problems to planning ahead and prioritizing projects over the next 18 months. With every action, I need to ask myself how this leads toward our larger goals or if this just keeps me busy. Staying busy doesn't move you forward by default, and it can actually disguise critical tasks that you are ignoring.

It's also been surprisingly difficult to work from home offices and to turn places where I would relax into places where I put my nose to the grindstone. It's good now, but it took a long time for me to figure out how to carve out time and physical space for both actions.


What is the next step for you and your startup?

Biggest priorities for this summer include completing our medical advisory board and putting in a SBIR grant proposal with the National Institute of Health to support some physician-directed trials.

We also need to track down someone who would be willing to serve as our CEO or BizDev VP. We need someone more experienced with fundraising and marketing. We have an excellent base of market and technical research as well as a relatively developed product, but need to complete a team to really get this company off the ground.


What advice do you have for entrepreneurs?

Every person you meet does something better than you and is worth learning from. Even if you feel that someone's interests or skill-set are unrelated to your work, listen and understand anyways. You never know when what you learn becomes useful in another conversation, or when someone you speak with turns out to be someone who can help you down the line. You can't pull this off, though, if you're not genuine in your interest and if you're not humble enough to acknowledge the lesson's value.


What Austin-based resource have you found to be the most helpful and why?

The friendly and helpful nature of Austinites has been extremely beneficial to us. It's not a place where people look at you and say, “If you're not helping me right now, what good are you?” It's a place where we can ask questions, take people out for coffee, network, and generally gather the knowledge we need because people are forthcoming and willing to take that time. It's also a place where we can offer our help to others in turn with no reservations. . I love this town and hope that spirit never changes.