The Sports Physical Therapy Podcast

Hip Strength After ACL Reconstruction with Lane Bailey - Episode 10

June 07, 2022 Mike Reinold
The Sports Physical Therapy Podcast
Hip Strength After ACL Reconstruction with Lane Bailey - Episode 10
Show Notes Transcript
Everyone wants to talk about quadriceps strength after ACL reconstruction. This definitely gets all the attention due to the persistent deficits in strength that are commonly observed.

However, there are other muscles that may also be important in determining when an athlete is ready to return to sport.

In this episode of The Sports Physical Therapy Podcast, I'm joined by Lane Bailey. We'll be discussing a recent article he published on using hip abduction strength as another metric for return to play.

Full show notes: https://mikereinold.com/hip-strength-after-acl-reconstruction-with-lane-bailey

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Introduction:

On this episode of the sports physical therapy podcast. I am joined by lane Bailey. Lane is the director of research and sports medicine for the Memorial Hermann health system in Houston, Texas. In this episode, we're going to be talking about a recent article that he published. Discussing the utilization of hip abduction strength to body weight ratios and the return to sport decision-making after acl reconstruction

Mike:

Welcome back to the podcast. Everyone. I have a great episode today. I am joined by my friend lane. Bailey lane is the director of research and sports medicine for Memorial Hermann health system in Houston, Texas. And in this role, he's essentially the research guru that just pumps out more and more goldmine of research data. Right. Is that a good way to describe it?

Lane:

That's being kind, but yeah, I'll, I'll take it? Thank you.

Mike:

And I, I mean, I've known lane now for several years and I've learned a bunch from him, some from some of his presentations that I've seen, but, uh, again, very research-driven and it's very interesting to see some of the things that they're coming out with in, in Houston. So, um, I thought it would be fantastic to have lane on the show today. So lane.

Lane:

awesome. Appreciate you having me. And, uh, yeah. Happy to be here.

Mike:

awesome. All right. So the article that you just recently published, it was in the international journal of sports physical therapy, 2022. The title was utilizing hip abduction strength to bodyweight ratios in return to sport decision-making after ACL reconstruction. I thought it was a really great article. Uh, so simple. I'm looking at my notes on the article right now, and I wrote right in the sideline, so simple and then drew a heart. I don't know what that means, but. Um, but I was just like, ah, this is, this, this makes a lot of sense. And I thought it was, it was a really cool, uh, study that essentially what you showed was if you have low hip abduction strength, you're going to have lower psychological readiness scores, which I think are becoming more and more, uh, you know, something that we keep our eye on, but also just lower subjective scores on how well you think. At return to play and two years out. So, you know, very, very cool study that I wanted to dig in with you a little bit today. So why don't we start with this? What led you to starting the study? Why did you conduct it in the.

Lane:

Yeah, that's a great question. And this is really, um, it starts with. Sidebar conversations. Right? So as you mentioned, we, we do some, uh, ACL research at our institution. And Dr. Lo Walt Lowe is our chief of orthopedics and pumps out at a ton of ACL's. And so. Kind of why I'm there is to, you know, try and capture how these folks are doing and better understand how we can improve their outcomes. But it started with a sidebar conversation with him, um, and actually reading some of the work that Chris powers did out of Southern Cal, who I know many of you and listeners know about, but, um, he did a collaborative study back in 2016 that was published in, uh, a JSM, uh, with an irony. Uh, a partner is, and they looked at 600 competitive sport athletes. And they basically said, you know, if they have decreased hip BR and abduction strength, we see a significant increase and their non-contact injury risk for subsequent ACL injury, which I think all of the. work that we know about, you know, dynamic, knee valgus, and. that really bad posture that that athletes can get into when they're making cutting pivoting news. Um, we, we already do a lot of this training, I think in certain phases of rehab, but that was sort of the study that came out at that time that sort of showed and highlighted that, and they, they found that it roughly 35% of body weight was really where that threshold occurred. And so me doing gorilla math, I'm like, oh, well that's pretty close to 33. Well, I don't want to just divide by three. And let's look at, you know, what's going on there, but that study really provided the impetus. Whenever I was talking to Dr. Loads, say, I think we need to add this in. So we already have a battery of roughly 15, uh, physical parameters that we look at, motion strength, all of our hopping tests and some of the psychological and subjective, uh, forms that you mentioned. So we do that battery and that was kind of. The study that led us to say, well, let's, let's add this into our battery of things that we're looking at. And so that was kind of where it started, um, back, uh, I guess, gosh, it's probably been five years ago now, so,

Mike:

Wow. Yeah, that's great. And I love how, you know, you started with a clinical question, right? This wasn't just like based in a, in a research lab, right. It was a very, uh, intelligently designed clinical question and, and. Just studies. And I think that's why I drew a heart, I guess, on my notes. Right. It was that I, I, you know, anytime an article like hits me as, wow, this is going to impact what I do. That's an awesome article in my mind and men, there's no better person probably to look at the sort of data that the new right. Uh, how many ACL's do you think you guys see a year?

Lane:

Well, we have a single surgeon database. We contribute roughly about 400 each year? He does on the order of 400 to 500 ACL's a year. So we see a ton, a ton of patients. And we're now to the point where we have over 2000, uh, 2000 ACL patients enrolled in our. In our study and they, so they come in and they, they receive, uh, you know, starting at around three months, we'll start doing some of these physical, physical performance tests just to try and track, um, how these patients are recovering and really the ultimate goal selfishly on one end is yeah, let's collect research and how can we, you know, help improve outcomes on the other end though. And most importantly, certainly for the patient, Dr. Lowe, is it? Well, if we identify. You know, something's going on. We can hopefully intervene a little earlier in that process and get people back on the right track. And, uh, you know, ultimately I think that's where we're trying to head, but our database is to create some Nora normative recovery data. So, you know, I think we have a decent idea where people are returned to play and where we'd like them to be with our, you know, Lynda symmetry, indices, and the other goals that we have for them. But sometimes it's, I think it's hard for us to diagnose when, when people are getting off that, that track. So, you know, at three months, what should they look like at two months? What should they look like? And so hopefully we can, uh, start to flesh some of that out and then combine that with some of the other work that's going on around national.

Mike:

Yeah. And that's great. And think about it. You, I mean, again, you see four to 500 of these a year and you have this big database, um, You're you're putting this research out there based on such high volume, that us, that, that only see, you know, a handful of ACL's a year we get to benefit from. Because if, when you start seeing that volume, you start to see patterns, right. And, and that's like one of those really cool things that you have access to that most physical therapists don't, um, you know, is, is that volume. So, you know, it really gives you such a unique person. That, um, we all get to benefit from. So, you know, again, appreciate you doing studies like this. Uh, and it's crazy. We talk about quad. We talk about hamstring. We talk about even some, you know, functional type tests, but I do feel like not many people talk about hip abduction strength as, as, um, a return to play criteria, which seems like a no-brainer to me that we should. And I like what you did again, it's, it's essentially 33% of your body weight was kind of the, the number we're looking at. So is your hip abduction strength, at least 33% of what your body weight is? I like that as a starting point, I think it's great. So that's that, that was kind of the why. And I think that makes perfect sense. How did you do the study? So how exactly did you go about.

Lane:

Yeah, that's a, that's a great question. So we, on once a week, we, we actually have a small army, which I'm fortunate to be able to convene together. Um, some of our, some of our faculty members. So we have a sports and orthopedics, uh, sports residency program at our Institute and our sports residents help us do data collection every week. And so our, our physician has a post-op clinic. And on, on that day, which happens to be Tuesday. We have all these folks come in. Uh, at various timeframes and we set up essentially modules that, uh, that the patients run through based on, you know, where they are in their face for coverage. Appropriate to do, um, you know, running, jumping, cutting. Then we have them run through those batteries of tests. But early on, we may just do hit that back. Some strength and forms and motion and things of that nature. So, um, this is one of, this is one of our modules, if you will, in our postop testing protocol that we do every week and we'll have on order of, you know, between. Five to 15 patients, depending on how big the clinic is that we're there, we're testing every week. And so our residents and faculty are heavily involved in that. And, uh, and we've sort of refine that over the course. of the last seven or so years and, um, try to tweak it and the big piece, and hopefully this study highlights it is we try to be. Temporal or timely with what we're including to make sure that it fits that it has some sort of justification that we're not just throwing things at the wall that we put things in there. That makes sense. And so that's kind of where this study came about is we started collecting the data and then about three years later, um, Steve who's one of our faculty members came to me. And then said, you know, I'm interested in looking at this. What, why don't we, why don't we pull this out and start to do some digging? And that's, again, going back to the why, but, um, where we first started this journey was to take the cohort that we included in this, this particular study and start to look at it, um, through that lens. So, but yeah, so we do that every week and, uh, yeah, thanks to the team for doing that. And Steve, Steve obviously kind of drove the ship on this study, so I want to make sure and give him some credit.

Mike:

of course. Yeah, absolutely. We appreciate you, Steve. That was that's, you know, very helpful. Um, tell me, tell me about the, the, the hip abduction strength. So the number that you're using for this study that was at the time of return to play.

Lane:

That's correct. Yeah. So at the time or returned to play there, there supine on the plinth. And, um, we, we have our landmarks that we put in place. We, you know, we, we tried this and piloted it for several, excuse me, several rounds, trying to come up with the best method. And I think, um, maybe something that separates us just due to our volume and this kind of goes back to the, how is, you know, ideally. We put every patient and, you know, a nice 3d motion lab and do these really sophisticated measures. We don't have time to do that. Um, you know, with 15, 15 patients coming in in the morning, uh, and that's really, hopefully some of the clinical utility of this is we need to be able to do some field tests that we actually conduct on our patients in the clinic when we're seeing them. So hopefully this is transferable and that's kind of why we were. Uh, making some of these decisions with 33% and the setup at the testing, but yeah, so the patient's supine, uh, we put a seatbelt strap around, around the plinth and we have a handheld dynamometer that's allowing us to, uh, to take the measure. So we asked them to forcefully, um, build into the dynamometer and hold for five seconds, just so that we, um, you know, can, can acquire that peak torque and then, and then back it out based on their own.

Mike:

Perfect. And again, something that we can all do, you, all you need is a handheld dynamometer. This doesn't need to be, uh, you know, just a research study. This is very applicable to us in the clinic. So again, you know, Great great concept for this. And you know, when we start digging into the results, I think it's going to give us some, uh, some insight, I think, as to where maybe we should have people like almost for like landmark periods, like at what their strengths should be. I think we can kind of like almost reverse build this out from the findings of your study, but, um, but I thought that was, I thought that was a pretty good, you know, In my mind, what I said is, okay, we're going to start building out a sequential hip abduction, strength testing, just like we would quad and hamstring in our clinic. So, you know, we're going to start to apply that. And hopefully what we see is that we gradually improve, because I think one of the things we're going to talk about next, and we talked about the results here is that it's, it's kind of surprising, uh, almost 70%. Of your people. We would deem having low hip abduction strength, so less than one third of their body weight, um, they, they were low. So, so that's the majority. And you could almost argue the vast majority where it's 70%, especially with, you know, females, that type, you know, younger athletes. Um, you know, when you really break down your demographics, which, you know, you guys can look into that when you read it. Um, but man, 76. We're weak. Right? So, you know, for me now I want to reverse hack that a little bit and say, you know, what can we do along the way, if we start testing hip abduction strength a little earlier in our process. So, uh, so when do you guys start testing hip abduction strength? Do you have a set period in the post-op procedure?

Lane:

Typically around three months. And again, we started this more observationally and I, to your point, we, when we got, when we started sifting through the results, I think that was what was shocking to us is that, oh my gosh, most, most people aren't, aren't even getting there. And so more so than anything, it was, it was sort of this aha moment. Like we, we really need to change our practice and that. of wherever you've shifted now. And you know, we can look at it, but now what are we doing to change that? So. part of the response to that, that's started to become a heavier part of our protocol. And I think we traditionally had done a decent job of including low level hip abduction strengthening early on, which I think is somewhat fundamental to most protocols, right. Monster walks or lateral band walks and things of that nature. But I, think now we've started to push that boundary a little further, um, than really getting, um, certainly more attentive to it, but also ramping up the intensity of it as well. Like some ways. Side planks and really trying to work on powerful movements, which I know wasn't contained in this study, but certainly is a component of strength, right? So some lateral hopping and really trying to work on that trans transverse plane movement and stability. So, um, you know, we don't have any effectiveness data to kind of support it, but this was again our aha moment and say, we, we probably can do a better job here.

Mike:

right. I, I, in well said, and I think I would, you know, for us, I think a champion we're going to start looking at that. I think we're going to look at before 12 weeks. Because the good thing about hip abduction strength is you could argue, you can test it almost anytime, right? It doesn't put stress on, on the knee, right? It's not, it's, it's not a stressful moment necessarily for, for the ACL. So I think we were going to probably add that even early. And like you said, while we're looking at the low dose exercises, hopefully we have a good response early on. And then when we get to that eight to 12 week mark, we can really start to load it because we have documentation of where their strength is. And hopefully we see that return. So, um, I thought that was pretty good. So, all right. We, we we've, we've kind of, you know, sneak peak a little bit and alluded it, but, but tell us a little bit more in detail of the results a little bit, like explain, uh, you know, the exact things that.

Lane:

Yeah. So we, we divvied the groups up. We had roughly 500 or 550, or so patients within the, within the study. And as you mentioned, we had around 70% that were in our low below 33% body weight. Um, and. Hip abduction peak torque versus, you know, on the order of 25% that. we're above that threshold. So we had two groups that were. Uh, put into those various categories and then looked at them at the time of return to play, which for us is somewhere between eight and nine months just for context. Um, and then we, we have, at that time, we basically, this was a retrospective study. So we pulled the data from their return to sport testing, and essentially compared between the two groups. And so we looked at, you know, subjective function, the psychological aspects with the ACL RSI. Um, range of motion, strength, all of the hot testing, But really what fell out and the results was, as you mentioned or alluded to earlier, we saw higher ICDC scores in the group that had greater than 33% of their body weight to be torque, as well as a more robust psychological profile, which really caught us off guard. I'll be honest. I don't know that we were necessarily forecasting that. Um, and then we also,

Mike:

I mean, you feel more confident in your limb if you have appropriate hip abduction strength, and you're probably have better kinematics of the knee when you're doing things and then you're going to feel better.

Lane:

Right. I, I think that kind of speaks to the story, I guess, that we saw w with the results, you know, and we didn't see a tremendous amount of, uh, you know, difference within. Let's say For instance, hot testing, which I know is pretty popular within this, but I think it's also important to recognize that that's the sagittal plane movement, right? Not necessarily happening on the, on, on, on the coronal plane. So maybe that's why it didn't fall out. Not to mention there's who knows how many compensation strategies that can be a part of that right. To, to kind of. Be veiled within those limb symmetry indices. But what we also saw, uh, as far as the, the differences between the groups, we saw a difference in hamstring peak torque. So they also had, uh, more symmetry, um, when we compared to the uninvolved limb. And so we didn't break that down by body weight. We certainly could go back and look at that we haven't done. So, uh, just yet, but, but I think it speaks to the fact that they just have. Better strength and muscular performance. Whenever we looked at them at return to play. And I think all those things cascaded to, I feel better. I'm more confident. Um, and, and, you know, we haven't gone really too far out to follow these folks up, but you know, it may bear out long-term that this is a better, better outcome for our patients.

Mike:

For sure. For sure. Well, w one additional finding though that you had, or technically two findings, which I think are pretty important here is there was no increased reinjury risk. So even if you were weak, so you may have not felt better, your scores were worse on, on your, your exams that you, you gave them, but they didn't have a higher chance of reinjury. And. Um, come back to play at a lower level, for example, which I thought was pretty interesting. So essentially you're saying that both groups, groups technically did well though for.

Lane:

right. Yeah. And I think some of the, some of the reinjury risks is. Is is a complex story. When we talk about specifically what activities and the levels, but on the whole, and you know, when we put everybody into the same bucket and look at level one and two cutting and pivoting sports. Yeah. We didn't find, we didn't find a significant difference there, which again, Maybe speaks to some differences that, um, that were found in the power study, but we still, you know, with due to the relevance of, uh, you know, their subjective function, their psychological outcome, we know those are significant predictors. So. Indirectly, uh, you know, positive ways that we can influence that we need to try and change that. So, um, you know, our goal is to obviously carry this stuff, uh, prospectively to see if there's more of a link, uh, if we more tightly controlled some of those parameters, but yeah, that, that was something we were a little bit surprised about our reinjury risk though. Uh, If we're going to power the study, this has plenty of patients in it, but, um, that's something that we don't fortunately have a ton of. And so that kind of covers up some of the results as well, but, but again, in a prospective manner, I think, would we be able to better understand that relationship? And, um, and that's hopefully what we can do here in the coming year.

Mike:

right. And you could argue that it speaks volumes for not only your surgical technique, right? You, you have a, um, an expert surgeon performing all of these procedures, but then you also have a very comprehensive and clearly well followed rehabilitation protocol. Right. And if you look at the strength of their, you know, their quads looked great, which, you know, you checked off that box, which I think a lot of people don't right. So you could, you could actually argue that this is a cream of the crop type setting for those patients, that they're going to get the, the, the top level of care for both surgical procedures, as well as the rehabilitation. And that probably had a big impact on the reinjury rates. So, you know, when you put it all together, I think this is. Clinically significant, even though it didn't increase reinjury rates, I think we'd be very short-sighted if we said that, uh, there is no correlation. I think what it shows is that your everything else that you did was probably exceptional. So that way those, those people did well despite having this week.

Lane:

Yeah, I would absolutely agree with that. And this is one piece of the puzzle to your point, right? We, we have a lot of things that we can look at, and I think this is just one of those missing pieces that maybe hasn't had a ton of attention here recently in terms of what we include in our batteries. And so, um, you know, from. From a clinician standpoint, this is just an, another tool in my tool bag that I need to make sure I'm addressing with my patient and hopefully checking on off the list. But, um, yeah, we, we, we certainly, um, set, try to set the bar high with our patients and routinely assessed them and in a very. Um, standardized way. And I think, uh, the Alliance that we have within our sports medicine group helps us do that. So it's really a credit to the team and the people that are helping out. But our, our patients know when they come in there, they're definitely going to be sweating.

Mike:

Right, right. Well, and you know, one other question you could actually think of here too. If 70% of people almost were 68% to be precise, had this weakness. Is there a chance that maybe 33% is too high of a threshold?

Lane:

I think that's, that's an argument, but I, I prefer to set the bar high if that's the case. Um, and while it may not necessarily be related to the reinjury rate, the fact that I know it's related to higher function, higher confidence for me is enough of a selling point. So I think we're, we're pretty comfortable leaving it there. And again, if we, um, hopefully can go back here in, in the coming years and look at a dedicated intervention program that focuses on really increasing that ability. I think we can hopefully shift those percentages. And as a result, maybe we see an added benefit there. So yeah, that's always, I think our bias is let's set the bar high, hoping that, you know, we'll hit it or exceed it.

Mike:

that's awesome. And that's what I was hoping you were saying. You were, you were going to say so that's that's great. Well said there, we didn't talk about this. Um, just to let the listeners know, but that, that, that's what I was hoping, you'd say, which is fantastic. That's awesome. So, um, anyway, great article lane, uh, great research, again, pumping out a bunch of great stuff, um, you know, kudos to you and all your other authors that, that were part of this study because these types of things make a huge difference to us clinically. And I know we're going to change a lot of things that we do at champion because of the study. So thank you.

Lane:

Oh, no, I appreciate it. Thank you for saying that.

Mike:

All right. Well, we we'd like to end the podcast with what I'm currently calling the high five. We'll see a little cheat, a little cheesy, everyone. Everyone keeps telling me that's too cheesy. So I'm a first suggestions to any of the listeners, but you know what? The high five is, is five quick questions. I just want to get quick answers, almost like a lightning round at the end from, yeah. I think this is some pretty insightful stuff that a lot of people can learn from experts like yourself. So, first question real quick is what are you currently doing yourself? Like either reading or content? What are you doing to make sure that you continue to grow?

Lane:

Oh, um, yeah, I'm going to let my nerd flag fly here just a little bit. Um, so I'm, uh, we've got a lot of numbers and that's a, that's a great. resource for us. I'll be honest. That's one of the main reasons I'm where I'm at is w we see a lot of patients. Um, but I'm a self-proclaimed nerd when it comes to looking at numbers. One of the big things I'm looking at right now is, And I think everybody can appreciate this documentation is never the most fun part of our job, right? It's a necessary evil. Um, and my goal, at least in our institution is how do I leverage that? How do I take all the work and effort that, that our therapist are providing and all the scores and all the data that we're putting in there and actually pull it out EMR systems aren't made to do that. Um, but we're trying to set that up. So, um, we have some of that that we're pulling into a large, uh, data lake and really trying to better understand, but for me, Um, I'm not the expert in this area, but I'm trying to educate myself on machine learning and AI, which is really just fancy statistics, right. To say, well, who's going to do well and why are they going to do well? You know, is it, is it the provider? Is it the treatment intervention? Is it just who they are? Demographically. There's a lot we can learn there. And there's, there's pretty big shift, uh, moving in this direction with, with value-based care. My ultimate goal with that is to apply that to, you know, our clinical research to, again, hopefully better understand how patients should cover and where the opportunities are to get them better. Um, and so this, this type of sophisticated, uh, machine learning, which full disclaimer, I have no idea how to do. That's not my, it's not, I'm not trying to, uh, assert myself as being, uh, you know, the person that can figure that out, but I want to know enough to be dangerous. And so that's trying, and that's what really, what I'm trying to. Educate my cell phone right now. So hopefully some, some good stuff to come.

Mike:

that's great. And it sounds like a future podcast episode. When you do figure this out, we can talk about it.

Lane:

good. Now I'd love to be back.

Mike:

Awesome. All right. Question number two. What's one thing that you've recently changed your mind, or maybe evolved your thoughts.

Lane:

Um, you know, I ki I, I would say this is something that I probably keep going back to. Um, I know we continue to explore and it's, It's our goal to kind of push the envelope and find new ways. But in terms of my clinical scope of practice, it's really all about returning back to the fundamentals and making sure I'm always checking off those boxes. You know, if it's our, ACL's ensuring that as we go through phase progressions, we're always coming back and assessing, do they have all their knee motion? Are the symptoms, you know, still, still staying absent and then do they have good patellafemoral mobility? All of the fundamentals. I think. Really are what drive progressions and good outcomes. And I think some of that can get lost when we sort of put the cart before the horse and try to move on too far functionally. And so I always find myself having to kind of put checks and balances on that and say, let's go back and reassess and make sure we have, you know, strength. Let's make sure we have motion and then, then we can build upon that. But it's really a house of cards. If you don't, if you don't have those things, it's all gonna fall apart, which I'm sure you and most of your listeners already already know.

Mike:

It's impressive to me that the more you hang out and talk to advanced experienced people that they talk about, that they're shifting more of their focused on mastering the fundamentals and really being great at the simple versus trying to get super complex with everything. So I think a lot of people would appreciate that one for. Uh, next one. Let me see, what is your best piece of advice that you would give a student or early career professional? Right now?

Lane:

Um, yeah, I, that's a great question. I, well, I think one, your listeners are probably already doing that, right? They're, they're seeking outside opportunities just to learn and it shows that they have, you know, the dedication, the passion to really, um, B B to the best of their ability and the top of the profession. So really seeking mentorship and ways of, uh, you know, developing professional relationships. And I'll be the first to admit I was probably when I, when I got in, uh, PT. I wasn't probably as focused on this as I could have been, but I've slowly learned over the course of, uh, you know, the last decade or two or three that, um, it, it certainly is a it's, it's an important thing. And it comes back to pay dividends. Not only do you learn a lot from, you know, uh, being around whether that's a formal mentorship process through a residency or. Like, you know, con ed and podcasts and things of that nature, but you, you can obviously learn a lot from people who've been doing it. Um, and also try to build a multidisciplinary relationship networks. So surgeons, strength, coaches, other therapists, um, you name it. Those folks can help you out tremendously in your career. Um, and I've been personally, uh, the beneficiary of some, some great relationships with, uh, surgeons and other colleagues such as yourself. So I would say, you know, don't, don't undervalue that and really invest time and effort in doing that because it'll, it'll pay off in your.

Mike:

that's fantastic advice. Love it. A fourth question. What's coming up next for you. What, what should we be expecting to see more of from you?

Lane:

Um, yeah, so we we've been doing a lot of ACL research, but I'm happy to say that. Uh, so John Conway, who was, uh, he's, uh, a big shoulder and elbow surgeon was the. Uh, team physician for the Texas Rangers for a number of years, he was in Fort worth, but he's come to join us here in Houston. So we've, uh, we've recently. Yeah, we've recently ramped up and started to put in, uh, some, um, uh, basically an overnight athlete. Um, That's a pillar of research, if you? will. And so we've hired Natalie Myers, who's a PTA TC or a PhD ATC. Who's helping us run some of that, but we're going to start doing a lot more, uh, over at athlete research, which we had been doing some up, but that's my roots. Mike is, you know, so I'm excited to get that going. We'll be doing that with, uh, with U of H and some of our other, um, relationships in town. So, um, getting that off the ground. So we're really just expanding our research and where we're doing that within our sports medicine facilities.

Mike:

that's great. I'm excited for that too. And selfishly excited because then I know I get more great clinical research from your yourself, so fantastic. So thank you. And then the last thing, how do we learn more about. Do we, uh, you have a social media profiles or website, anything where people can go to find out more about what you're up to.

Lane:

Yeah. So, um, I'm, I'm employed by Memorial Hermann, so you can go to Memorial hermann.org and it's got my short bio and, uh, where I live and work. And then, um, I'll be engaged in the sports academy and a lot of those functions here in the future. And then, uh, on Twitter and Instagram, I, uh, My network name is, is at Bailey lb 2001. So, um, you can probably find me commenting a little bit more on Twitter than, than Instagram, but, um, but yeah, those, those are probably the best ways. And then hopefully, um, on pub med or, or some other research network.

Mike:

awesome. Great. Well, thanks again. We really appreciate it lane. Thanks for taking time out, to share a little bit more insight into your recent research and to hear about some of the exciting things coming up for you. So, uh, always a pleasure to get to chat with you and, uh, Thank you so much.

Lane:

Yeah, same here. Thanks again, Mike. Thanks for having me.