Engineering Musculoskeletal Health with Spencer Lake

Spencer Lake studies musculoskeletal soft tissue mechanics to improve patient care

Shawn Ballard 04.16.2025

Image: Aimee Felter/Washington University

On the season finale of Engineering the Future, we conclude our focus on Engineering Human Health with Spencer Lake, associate professor in mechanical engineering & materials science. Lake describes his work on orthopedic soft tissues, including tendons and ligaments that let the body move. Lake’s lab works to advance our fundamental understanding of these tissues, using experimental and computational approaches to inform clinical applications and treatment strategies.

Spencer Lake: I think it's fascinating to be able to take these tools of engineering and apply them to orthopedics, to musculoskeletal tissues, to health, and really try and improve our understanding of how these tissues function, what happens when they get degenerated or damaged or injured, and how can we better inform treatment strategies to allow people to have functioning tissues.

Shawn Ballard: Hello, and welcome to Engineering in the Future, a show from the McKelvey School of Engineering at WashU. I'm your host, Shawn Ballard, science writer, engineering enthusiast, and part-time podcast host. Today I'm here with Spencer Lake, who is an associate professor of mechanical engineering & materials science. Welcome, Spencer!

SL: Thank you, happy to be here.

SB: Great to have you. So, I am really interested in talking with you on our theme, which is of course engineering human health. And you do an aspect of health that I suspect people like me, people who are generally healthy, maybe take it, you know, take for granted, right? And that is musculoskeletal health. So, things like how our joints move, how our bodies move. Can you tell me what all is contained in musculoskeletal health? And am I right about people not really thinking about this as much as they should?

SL: Yeah, no, I'm happy to talk about that. So musculoskeletal health would be, think about your body and how it moves. So, you can think about the bones in your skeleton, the muscles that attach and move your bones, and then any of the connective tissues that support that. So tendons and ligaments and there's capsule, there's meniscus, there's inner vertebral disc. So all these tissues that together give us locomotion, like the ability to move and the ability to, you know, lift things and those kinds of actions.

So when everything's working fine, people don't think about it as much, right? But when those things get injured or start breaking down with aging or other things, then it becomes more of a concern, of course. So a lot of the work we do on the musculoskeletal system is we talk more about being quality of life type things, right? So you can function and get along, even if you have a musculoskeletal injury a lot of times, as opposed to like a heart attack or something that's more life-threatening. But we really try and help understand these conditions better so people can have a better quality of life. And as the population continues to age, it's going to be more and more of an issue with the aging population needing to maintain that high quality of life.

SB: What are the big issues with those kinds of things? You mentioned aging, does that stuff just wear out over time or what do you see in that area that's sort of the big problems?

SL: Yeah, so yeah, a couple of different things. So depending on the tissue, the issues can be slightly different, but aging pretty much affects all these tissues. So, you know, people's bones get more porous with age, so more like could have fractures, so osteoporosis is a main condition there. The breakdown of cartilage, cartilage lines your joints and provides that lubrication and that cushioning between your joints. So, you know, as people age, they'll have cartilage breakdown and have painful joints. And that could be in their knees or their hips, it could be in their hands, you know, you can get arthritis in your hands, things like that.

A lot of the tissues that my lab studies are kind of the connective bands between bones, which would be ligaments, or the bands that connect muscle to bone, which would be tendons. And so, everyone's familiar with some of those injuries. You hear about an athlete tearing their ACL, which is a ligament in the knee, or maybe an older person who has degeneration in the rotator cuff and has a rotator cuff tear, which is a tendon tear. So, these things can develop with age, they can also be traumatic injuries from sports, or even just, you know, a slip and a fall, you know, dislocation of the elbow or something like that. So, these are injuries that, or degeneration that, will affect a large portion of population at some point in their life, either from a traumatic injury or just later on with aging.

SB: Okay. So, yeah, that seems like something that like pretty much everyone at some point, right, has done something to injure those kinds of tissues you're talking about. And so, those are the orthopedic soft tissues, is that right, that your lab specializes in. And so, you've kind of told me what that means, how that fits into musculoskeletal health. Can you tell me about your pathway into getting into studying these things, right? This is something that will affect basically everyone. I'm going to say everyone. I can't imagine anyone making it through life without having something in this category. How did you get interested in this specifically?

SL: Yeah, so I was an undergraduate, and I was interested in engineering, and I had always, math had always been my favorite subject, and I liked science, and I was interested in medicine, but didn't know if I wanted to be a doctor. So, I was studying engineering and I was at the University of Utah for my undergraduate and after my first year, they developed a new degree program in biomedical engineering. So, that seems like a good fit combination of my engineering interests, but also some health and medicine.

So, I started pursuing that degree and one of my courses had a guest lecture from someone who was studying the mechanics of knee ligaments. And he came and gave a talk about how they could do experiments to study how strong the ligaments were in the knee, and then create a computational model of that. And I just thought it was the coolest thing I'd ever seen because you could take an understanding of math and you know some basic mechanics and apply it to understanding, you know how does a knee joint function, how does it move, what do the what role do the ligaments have, what happens if you injure one ligament, how does that impact the other ligaments. I just thought it was really really fascinating. So, I reached out to him and took a little bit of time, but eventually I was able to join his lab as a research assistant and started doing some of that research and you know dissecting human cadaver knees and testing some of the ligaments and testing the full joints and I just became fascinated with it and thought it was really, really neat.

And so that was you know after my second year in college, and I just have stuck with it ever since. I just think it's fascinating to be able to take these tools of engineering and apply them to orthopedics, to musculoskeletal tissues to health and really try and improve our understanding of how these tissues function, what happens when they get degenerate or damaged or injured, and how can we better inform treatment strategies to allow people to have functioning tissues and can treat them.

SB: Yeah, so when you're, you know, it seems like you're focused there through that research and then through grad school and your further studies, right, have really been oriented toward interventions in patient care, really thinking about, you know, it's not just we're studying sort of how these joints work together, but these are joints on real people, really making an impact there. How does that function as a motivation in your lab work, and how do you see that sort of playing out maybe on the clinical side in applications?

SL: Yeah, so we try and ground our – you know we do basic science research – but we try and ground it in questions that we think will eventually be able to help in the clinic. So the best thing we do for that is we collaborate closely with orthopedic surgeons and physical therapists, for example. And so we have, you know, these active clinicians on most of our research projects, and we like to meet with them and brainstorm ideas with them, get feedback from them. You know, what are you seeing with these kinds of conditions? Or, how could it inform what we're trying to study to better give you information?

And so, I think our best collaborations have been where we have these conversations directly with clinicians who are seeing the patients and giving us the information to know how should we direct our studies to best provide them what they need. So that's how we try and really stay connected there. You know at times we get off on some side tracks of some really interesting kind of you know scientific questions and the details of a particular experiment or study or whatever, but we try and always at least keep the main project focused on what could eventually help you know human health at the end of the day.

SB: Okay, can you walk me through an example of that, maybe a research project that you have going on right now or one that you're particularly excited about where you are on that sort of basic science side in the lab but see the applications or the potential applications? What does that look like in a specific case for you?

SL: Yeah, absolutely, so we have a project right now we're really excited about about elbow injury and looking at post-traumatic joint contracture. So basically after you injure your elbow. Let's say you fall and land on your arm and dislocate your elbow, which is a very common injury, typically there will be some soft tissue damage in the joint and a real common outcome is a loss of motion. So patients can end up with a really restricted motion, and the crazy thing about this injury is it's very unpredictable who will get a contracted joint and who will recover fully. And when there's been a loss of motion, some of that can be regained through physical therapy, but it's challenging and again unpredictable how patients will respond.

And so when I started at WashU about 12 years ago, I came and I met with an orthopedic surgeon and was asking for, what are some challenging questions, challenging injuries to deal with? And this was one that was brought up is we don't really know how to treat elbow injuries very well, and so this would be an area that would be really helpful to try and study. So we started looking into this and thinking how can we address some of these questions.

We realized pretty early on that we would not be able to do all the things we needed to do to understand the injury if we looked at humans because it's hard to get access to that many patients, and the injuries are quite variable. So we decided early on we'd need to develop an animal model to study this. So we spent some time identifying the best animal to use for this and settled on these Long-Evans rats, which is a species or a breed of rat that actually exhibits more human-like motion, particularly pronation/supination. Of course, they also have flexion/extension, but pronation/supination.

Anyway, so we settled on these rats as a good model system to study this injury and found that they did in fact develop some contraction, contracture and some stiff joints, so that was very encouraging, and that was kind of our initial step. And then in the years since, we've tried to use this model to understand what tissues are involved in this injury, what's the time course for how these tissues are healing, when they're becoming fibrotic or not, what's leading to the loss of motion? All these kinds of questions. So we've done a lot of work with this model, and where we're at now is we're using this model to try and understand what are the best concepts to guide an interventional strategy to prevent contraction from developing or even perhaps recover some of that motion.

So we're looking at two main avenues: we're looking at physical therapy. And you might say, well how do you do physical therapy in rats? Well you can do physical therapy in different ways, and while it doesn't map directly to human physical therapy, we can study certain concepts that we think will map. So, when do you intervene? So the timing. How intense is the physical therapy, right? And how often do you apply it? So what's the duration? How long? These kinds of questions.

So we initially tried doing that with treadmill running with the rats, found that didn't really do much, and we found that a more active, more kind of a full-extension reaching activity is better, and so now we give them access to some running wheels where they’re able to fully extend, and anyway that's just kind of a detail, but…

SB: No, that's cool. I love this because that is the question, how do you do physical therapy with rats? And it's different kinds of wheels, I guess?

SL: Yeah, so what we're looking at now is we give them access to a running wheel and when they do the running motion you can see that they really fully extend, so when they have a contracted joint that repeated motion of reaching out like that. And then we've instrumented the running wheels, so we can keep track exactly of how much they run, how fast they run, how often they run, all these kinds of things. So we have some really good quantitative data to then try and match to what's happening in the tissues.

So physical therapy is one thing we're looking at. We're also looking at drug interventions. So we've looked a little bit in the past at some anti-fibrotic drugs. We're actually honing in now on inflammation and the immune response. So we're looking at can we modulate the inflammatory response. Some inflammation is good to help the tissues heal, but too much can lead to fibrosis and overproduction of tissue. So we're looking at how can we control that a little bit to promote better healing, and so we're doing that through a couple different drug applications.

And, then ideally we'd like to do a synergistic approach, right, so if we can optimize physical therapy, but also address some of the biological responses in some drug treatments, we think we can get an optimal treatment strategy. So if we can work that out in the animals, then we could hopefully transfer some of those concepts we've learned to the clinic and study things there.

SB: Yeah, and is, how much of that is sort of already available in humans? So when you say “anti-inflammation,” is this specialized applications of like ibuprofen or something different, something like that? And it sounds like it might be more about timing, and how those things are combined, is that right? Is that what you're finding?

SL: Yes, so what's interesting is in humans right now, yeah all these things are being used, but there's no consistent protocol for this. So every orthopedic surgeon or every physical therapist uses what they think is best, and they're doing the best they can of course, but there's no consistency. So there haven't been enough studies to identify what is the best way to approach this, and for certain types of injuries, how should it be approached for example. So we are trying to use drugs that are available clinically right, so if we figure out that this works well in a rat, then we think that would be easier to transfer or translate and use in humans for example. So we're trying to identify some overarching consistent concepts and themes that we think could be readily transferred to clinical treatment for example.

Some of the work we're doing with the drug treatment is trying to hone in a little more on specific inflammatory molecules, and that's just to help us see if we're heading in the right direction, right. But overall we're trying to stick with approaches that we think could easily be translated.

SB: I'm wondering if you have any sort of insights or something about those more common experiences of musculoskeletal injury. Any pro tips for us who have injured that funny bone a lot, are we more at risk? Are there things we should be doing? I'm thinking about, you know, news you can use on this front.

SL: Oh, that's a good question. Yeah, I think the thing that's tricky about some of these connective tissues is… So, think about somebody's maybe like sprained their ankle, so it's not a serious injury, but maybe hurt their ankle or something like that. So the thing about a lot of these tissues is many of them don't heal very well, so when you've damaged them, they can be more susceptible to follow-up injuries. That's not what people want to hear, but it's the truth. So I think the best thing you can do is just – not that you can't live your life – but be a little bit cautious and be careful.

Bumping the arm or something like that, the funny bone, that's a nerve, you're hitting the nerve right, and so it kind of sends a funny thing there. So that's not going to be such a repeated issue, but something like you know a joint dislocation or a sprain or something like that, obviously if you have those kinds of injuries you want to take it easy, allow those tissues to recover a little bit, then try not repeat those injuries, right, because they can be problematic over time.

You want to listen to your body. I've heard to some of our collaborators say that you want to listen to your body. You know if you feel like you're getting a little sore in certain things, definitely take it easy. We do see that repetitive injuries, for example for tendon injuries, repetitive use injury is a very common way to injure a tendon, for example. So, you know rotator cuff is something I studied a lot in grad school, and we continue to study too, but you can tear your rotator cuff not from even high forces but just repetitive motions. So, you think about someone who's doing like assembly line work or someone who's in a really consistent repetitive motion.

Of course, we see injuries a lot in the arm of like baseball pitchers or softball players, right, where a lot of throwing motion. Those aren't necessarily traumatic events, but they're repetitive motions, right, and those can lead to injuries over time, so I think you do want to be smart about limiting yourself a little bit. We've seen, in the literature we've seen a lot of increase of arm injuries in young baseball and softball players, and so there's been increased guidelines for example to like limit pitch counts for pitchers or whatever to try and limit the repetitive motion there.

Anyway, that's a roundabout way of saying like I do think we should be smart about you know kind of listening to our bodies and in terms of not trying to overdo it because you do need to allow these tissues time to recover.

SB: Okay. Something about your work that I'm also interested in, in addition to this, like, it's useful. It seems like, oh, this is something that happens to everyone. You are also taking what I think is a really interesting approach in combining these kind of experimental and computational approaches, right, like you mentioned sort of the rats on the treadmill, but in your earlier work like looking at models of knees. How is that combined approach still coming through in your lab?

SL: Yeah, so models have a really important role in biomechanics and trying to understand these different things. They can be used in a number of different ways, and I'll maybe I'll just mention like two ways that that we've done this. One way you can use a model is to, if you know some information about let's say a certain tissue, but you want to be able to predict how it might respond in different environments or in your different conditions, that's kind of what we were doing years ago with the knee model, right, is trying to understand, we learned something about the physical system, but then can we make additional predictions beyond what we can study experimentally? It can be a very valuable tool to do that, and people can do models in all kinds of different ways. There's different at the tissue level or the whole joint level or things like that, but those can be very useful and very powerful.

Something we're doing more recently, that we're using in our elbow project as well, is using some machine learning type models.

SB: Very hot button right now!

SL: Yes, and what we're trying to do with that really is dig deeper into the data than we can do on our own with our own natural eyes, so we're doing a lot of image analysis, for example. So, for example, we can get a histology section, which is like a cut through the joint, and look at the tissues. And we can stain it for different things, and we can analyze that with our own eyes right, or some simple analysis, image analysis, and we can learn some things about the tissues. But we're trying to get deeper than that, and try and identify, you know, are there other aspects of these images, and a whole collection of images across many samples, are there aspects of what we're seeing buried within there that we could tease out that'll give us much more knowledge and much more information?

Then we're also getting medical images, so we're getting MRI, magnetic resonance images, of our elbows – in this case the rats, of these rat elbows – and again we're saying, we can see some things there, but could we dig a little bit deeper and perhaps extract more meaning and more valuable information from these than we could on our own? So we're working with Bek Kamilov in computer science here at WashU and his team, and we're we're developing basically protocols to analyze both our MRI images, our MR images and our histological images, and try and extract that information and eventually try and combine them together. So in that way we think we can get so much more valuable information out of these biomedical images that can then inform kind of our scientific questions.

So again, there's kind of different ways you can look at that. The models like I mentioned about like the knee, for example, is one way of thinking about getting a deeper understanding of the biomechanics. Or, you know machine learning type algorithms that you can really dig into a whole variety of things, but in this case we're trying to extract more meaningful information from our images.

SB: Okay, what kinds of maybe like patterns across those images or different kinds of images are you seeing specifically? Maybe just something I can kind of hold on to about that?

SL: Sure, so for example, there's an important tissue in the elbow, which is called the capsule tissue, and so it kind of wraps around the elbow joint, and the part we're looking at is the anterior capsule, which is in the little nook of your elbow. So, we focused a lot on this because we know this is involved in this contracture healing response. So, for example, what we can do is we can get these histological sections of that capsule, and then develop some algorithms for it to identify on its own, what are the sub tissues within that tissue? Or, in other words, how is that tissue changing after an injury, or during healing, or after a certain treatment? So instead of just looking at a couple cells within there, or averaging across the whole tissue, can we see like locally what's actually happening there? What changes are occurring?

So that's great if we can understand that, but that requires us taking a section out of the elbow, right, and talking about translating to humans eventually, what we'd love to be able to do is take an MRI of a patient and be able to know, how are those tissues changing in a similar way? So what we're trying to do is, can we learn how the tissue is changing from these histological sections? Is it becoming more fatty? Is it becoming more fibrotic? Is it looking more fibrous? Is it healing? Is it not healing? Those kinds of things.

If we can understand that and then correlate that to the MRI, then we now have a way to say non-invasively what's happening in that tissue. So then if I was a patient, dislocated my elbow, and came in and got an MRI, and they could say, well, when the MRI changes like this, we know that actually means that tissue is becoming fibrotic, that tissue is becoming more scarred, right, or is becoming fatty, or whatever. Then that could inform how they would treat me because they can see how my tissue is changing.

SB: Okay, so in addition to this machine learning work that you're doing on imaging, you also have a new quantitative polarization imaging technique, and I don't know what that means. Please tell me all about that and how it relates to your work with the rats and the treadmills and all that.

SL: Yeah, I'd be happy to talk about that. Yeah, this is a technique that is really fantastic, and we've been using this for a few years now. So the idea is we'd love to be able to see how tissues are organized. Okay, so tissues like a tendon or a ligament, the predominant protein in these is called collagen, and it's predominantly type 1 collagen, which are these like, you can think of like aligned fibers. Okay, so if we can see how these fibers are organized, that gives us some insight into how they will function mechanically. And then when they become disorganized, we typically see that, and when tendons become degenerate or damaged, they typically become disorganized, and so they're not as strong.

So one way that we can understand how these tissues are organized, kind of how it's put together, is through imaging. And so there's a technique called quantitative polarized light imaging, and the way it works basically is we create light of a known polarization state. So light has many properties. It has a frequency, it has a wavelength, and this is how we see it, right, but it also has a polarization to it, which is kind of the organization of the light. So most light that we see, you know coming from lights or from the sun, is unpolarized, so the waves are kind of going in all directions, and it's disorganized. But if you think about wearing like polarized sunglasses, for example, which maybe you've done before, that kind of blocks out part of the light and only gives you a certain organization of the light, so it can block out things like glare off of water or something like that.

So what we do is we create circularly polarized light, but it's light of a known polarization state. We shine that light through a thin section of tissue, and then we use a camera to capture the light on the other side of that. And the cameras we use are actually really cool. They were designed based off of a sea creature called a mantis shrimp.

SB: Oh my gosh, I've heard about these guys.

SL: Yeah, so mantis shrimp have two really interesting features to them. One is they have these barbs that they can swing out and punch, and that's how they attack their prey, so they're like a little boxer in the ocean. So they can swing out and punch, and that's how they get their prey, but the other thing that's really fascinating is they have a really sophisticated visual system. So their little eyes have the ability to sense polarization, so they can actually see polarization in light that hardly any other animals can do that, and we certainly can't.

So, some cameras were built a number of years ago based off of that idea of developing a sensor that can see the polarization state of light in real time. So, we use one of these cameras that are commercially available now, but basically it has little filters over every pixel and that allow it basically to see the polarization state of light. So, we shine that polarized light through the tissue. It gets altered by the tissue because it has a property called birefringence, which basically it alters the polarization state of the light. We have a camera that can then read that in, and then that allows us to back calculate how the tissue is organized.

Now we can do this in real time, so we can do it while we mechanically test the tissue, for example, and see dynamic changes. We recently developed a way to do this using reflected light, so we'll reflect the light off the surface of the tissue, and then we can get the same measurement. So then we could do things like take a joint and load it under certain conditions and track how the organization of the tissue changes. So this is really helpful for us because we can start describing kind of the microstructure of a tissue, how it's organized, how it's put together, how that changes dynamically, and then like I said how that might change with injury or disease.

So, we've done studies looking at like ligaments in the knee, like the anterior cruciate ligament, the ACL. How does the microstructure of that tissue change throughout its own tissue? And then how does that relate to grafts that are used to reconstruct a torn ACL? Because you'd like to be able to reconstruct it with a graft that has similar properties, for example. We've done similar work in the elbow looking at some prominent ligaments in the elbow and grafts they’re using to reconstruct that. So, it's a way that we're able to get combined mechanical information, but also microstructure organization, and really inform us about how these tissues are put together and how they work.

SB: Okay, yeah, and the advantage there like obviously if you know how they're structured, you know you mentioned being able to repair in a more, I guess, informed way that aligns with sort of that natural structure of the original undamaged joint?

SL: Exactly.

SB: Very cool. I had not even thought of that, and also like shout out to mantis shrimp. You've got rats, you've got mantis shrimp. You have a whole menagerie here in your work.

SL: That's right.

SB: Cool, so you've got this whole menagerie here, you're figuring out how tendons work, how to repair them in a way that makes sense. Any other exciting projects related to tendons? Other creatures we should know about perhaps?

SL: Yeah, absolutely, so we do have another ongoing project where we're using some genetically modified mice to look at tendon mechanics, and specifically we're looking at a protein called elastin. So, elastin is a protein that makes up these elastic fibers, and this is common in stretchy tissues like skin, your lungs, your blood vessels, but it's also present in tendon. And so we've been interested in this for a few years now and trying to understand where is elastin in these elastic fibers, and what is it doing in tendons. So, we've used several different genetically modified mice, either that have reduced elastin or have disrupted elastic fibers, mutated elastic fibers. We have done work with other species as well, but our work right now is focusing on these mice, and we're trying to understand how is the elastin organized in different types of tendons, and then what happens in injury.

So we're looking at like doing a partial tendon transection, for example, the Achilles tendon is what we're studying right now, and trying to see what role does elastin have in that healing response, in that recovery. We've already found some really fascinating results in how it's organized amongst the collagen that I talked about to provide some of that elastic recoil and some of that mechanical integrity of the tendon, and now we're looking to see what does that do in kind of an injured healing response. So we're really excited about this, and we'll see what happens in the next few years with it.

SB: Okay, well Spencer, you're doing a ton of stuff in the lab, right. That seems like you stay very busy there, but yet you have time to do community outreach as well. You're working with Pattonville High School, is that right?

SL: Yeah, we've had a really fantastic partnership with Pattonville High School that's been really fun. The way this came about is we were looking for a way to get kind of a longer term relationship with a local high school. We've done a lot of outreach activities over the years, you know with a group here and there, but we wanted to develop something that was a little more longer term where we could build the relationships further. So we became aware of a program at Pattonville called the biomedical science program, and basically they offer a course every year – freshman, sophomore, junior, senior – that they can take this BSP, biomedical science program, and they learn about health-related careers, biomedical science, biomedical research, things like that. And so we thought, well maybe this is a program that we could partner with. So we reached out to the administration and one of the course instructors, and they were really enthusiastic about it.

So it's probably been four or five years now that we've been working with Pattonville, and specifically with this program, and we've developed basically three aspects of this relationship, and we've been growing these over time. So the first thing we did was we brought the seniors in the program to Wash U to spend a half day here to just learn more about what is biomedical research. So they came to McKelvey and were able to visit three or four different labs, get a tour of the campus, meet with faculty and grad students, and just kind of learn about what we do here. And that was a really fantastic event.

So, we enjoyed that, then we thought, well but we're only reaching the seniors in this program. We'd like to be able to reach the whole group, all four years of high school. So we then came up with this idea that we call biomedical research showcase. And so what we do is we get volunteer PhD students from Wash U to go with us to the high school, and we do a half day event there, and we invite all the students from the biomedical science program to come. So that's about 100, 150 students. So they come, and what we do is the PhD students each set up a station, and they do a demo or an interactive exhibit or something that the students can come by and learn about the students’ research project.

So, in this way, we reach a much larger group. It also gives the PhD students a chance to communicate about their work to a lay audience.

SB: Tough skill, yeah.

SL: Right. It's easier to talk to other PhD students. It's harder to communicate your complicated project to some high school students, you know a sophomore in high school, for example. And then we also try to do something very hands-on, so the students have that chance to interact, and then also ask the PhD students about how did you get into this? What do you like about it? Whatever. So we've done that now two times. Our third event will be next month, and we're really excited about them.

And then the third thing we've done is also partnered to give biomedical science program students a chance to come to WashU and actually do a research project. So we had one student prior to this year, and then this year we have three students who are seniors at the high school, and they're doing their senior project here with a WashU lab. So they come a couple days a week, spend a couple hours a week working directly with the faculty member, and usually like a PhD student is a mentor in the lab, and they're completing their own independent research project.

So it's been really fun over the years to kind of develop this, and we've seen now that the seniors who are in this program now have been with us for several years, so they may have come a couple times see different labs of WashU. We've come and showed things to them, and then, like I said, we have three seniors right now who are doing research projects with us. So we found this just a really satisfying way to engage with this local program but really make a meaningful impact on the students there and also give good opportunities for us here at WashU to share what we're doing.

SB: Do you have a sense of the, I guess, the long-term impacts of that would be, are you seeing these students go on to pursue studies in biomedical engineering or biomedical sciences more broadly? What are your results in that aspect of it, of inspiring the next minds?

SL: Yeah, we're really excited to see that, how it develops. We have had at least one prior student from the program who's now at WashU studying, I believe, neuroscience. And then one of the seniors who's in our lab, who's working in my lab right now, she didn't know what biomedical engineering was when she started and now she's planning on studying that in college next year. So we've seen her kind of discover what is this field and what does it mean, and now she's doing hands-on research, and then she's planning on pursuing that. So we think we'll see more of that in the future as we continue to build this relationship.

SB: I think something that will help me, and hopefully our listeners as well, is to maybe get a sense of where you're seeing engineers like you in the media. So I always love a media recommendation, and I think specifically where have you seen either people doing biomedical engineering or musculoskeletal work? Where have you seen yourself represented in the media that you thought like either, “that's really great and a great example,” or “that's terrible, that's not actually how it is. Listen to this podcast and let me tell you what's really going on.” Either way or both.

SL: Yeah, that's a great question. So, you know, where have I seen myself in the media? I don't know about that. I've been trying to think about musculoskeletal medicine or health in the media. I came up with one idea, which is you know like TV shows that are like medical type shows, like if anyone's seen House is a common TV show or a popular TV show, you know where they're trying to solve medical mysteries or things like that. And I do see our lab relating to that in some sense, in that we know there's a clinical problem, but we're trying to understand, well what are the things leading up to that? What are the things we can tease apart that lead up to that condition or that issue that we can then better inform? Not to say in any way that I am like Dr. House, but that kind of idea of trying to you know tease apart those kinds of things.

In terms of other media, I really like to read, and I've read books that maybe aren't exactly musculoskeletal, but are on topics that have informed the things we're kind of trying to do. So there's an author, Siddhartha Mukherjee, who's written some books about cancer, also about cells and then genes, but he tries to take a step back and kind of say, what is the broader history of our understanding of a cell? What is a cell? And kind of talk about that trajectory. Same thing with genes. And those kinds of books of are not exactly my area but have helped open my eyes a little bit to try and think a little bit bigger picture, right, and how we approach some of our projects.

But, you know, if there are recommendations out there of where musculoskeletal scientists are represented in other media, I'd love to hear those too.

SB: Yeah, maybe open up to the audience, like send us your suggestions. I also could only think of sort of the medical TV shows, but I also love House, so…

SL: Yeah, that's a fun one.

SB: That's a really fun one. He's so grouchy, but delightful.

SL: Yes, right.

SB: I'm glad you're not grouchy, right, that's been pleasant here, but I like to watch it on TV. So, well, thank you so much for joining me today. Those are all the questions I have for you, but this has been a delight. Someday I hope to be able to visit your lab.

SL: Come on by; we'll show you around.

SB: Perfect, thanks.

SL: Okay, thank you.