Research into Kids Knees Could Prevent ACL Tears

Research into Kids Knees Could Prevent ACL Tears Research into Kids Knees Could Prevent ACL Tears Research into Kids Knees Could Prevent ACL TearsEvery fall football fans keep an eye on the news to watch for season-ending knee injuries. Over the last few years, torn anterior cruciate ligaments ended the seasons of stars such as Julian Edelman, Deshaun Watson, and Carson Wentz. While these injuries are high profile, the athletes most likely to suffer an ACL injury are the so-called pony-tailed hooligans. In the United States, the highest incidence of ACL injury is to females 14 to 17 years old, many of whom are soccer players. In fact, females of all ages suffer these knee injuries between two and seven times mora frequently than males.Read ASMEs Top Story Air Taxi Aces Test FlightKatie Kitchen, a research assistant at Cincinnati Childrens Hospital Medical Center, instructs a high school soccer player to perform a squat for a 3-D motion analysis assessment.Surgery is often required to repair torn ACLs, and surgeons are working with mechanical engineers to better understand the physiology of childrens knees in order to better repair the injuries, or avert them entirely. These engineers and biomechanics specialists are applying techniques normally reserved for hard materials like steel to soft tissue.Ellen Arruda, a professor of mechanical and biomedical engineering at the University of Michigan, has research interests ranging from mechanical behavior of materials including polymers, elastomers, and soft tissue to tissue engineering of tendon and muscle constructs and to modeling of growth and functional adaptation in soft tissue. But she also collaborates with surgeons who conduct ACL reconstructions.The most often cited reason for the increase in these injuries is an increase in the number of children playing sports such as soccer and basketball, year-round, sometimes on multiple teams at once, she said.Read Our Readers Pick YouTube Star Goes Viral with Glitter BombGreg Myer knows the value of engineers to surgeons. Myer is a biomechanist who serves as director of research at the menschlich Performance Laboratory for the Division of Sports Medicine at Cincinnati Childrens Hospital Medical Center, and he holds a position at the College of Medicine at the University of Cincinnati.Mechanical engineers can do many things to support the surgery, the first being helping surgeons select the correct ligament graft, Myer said. But Myer is also studying the way young athletes run and jump and kick to find ways to learn how ligaments can be spared from excess stress to begin with.Were working on the prevention side, he said.The map of the knee looks more like a complicated interstate highway interchange than a simple joint, with four bones, thigh and calf muscles, bits of cartilage, and the meniscus that cushions the bones. Ligaments thread around and between the bones to keep the femur, tibia, fibula, and patella together and play a critical role in stabilizing the joint during loading.The ligaments include the posterior cruciate ligament, the medial collateral ligament, and the lateral collateral ligament. But the anterior cruciate ligament threads through the middle of the joint, making it difficult to see and susceptible to injury. Its the most-often torn ligament in the knee and in sports. Typically, the ACL is injured during landings that involve rapid deceleration and direction change.Full tears of the ligament tissue require complete surgical replacement if a return to physical activities is desired.Theres a lot of debate over the best graft for this, Myer said. The patella tendon that attaches the tibia to the kneecap is a common choice, and the hamstring tendon has increased in popularity, and then theres also the allograft from a cadaver.Listen to the All-New ASME TechCast podcast Innovations in Biomaterials Create New Roles for EngineersCurrent methods of ACL replacement generally work well, as they stabilize the kn ee and allow people to return to sports. But the graft replacement technique doesnt work for everyone, especially kids because theyre still growing. Grafts from a cadaver have the highest failure rates, with estimates of about 20 percent.We think the grafts are too stiff, Arruda said. Its usually an adult cadaver graft going into a young child, so its overdesigned for that child in terms of stiffness.The ideal replacement for a torn ACL restores native anatomy and function to the knee. Mounting evidence, however, suggests current strategies alter the biomechanics of the joint.Instabilities are thought to develop over time through a graft tissue that becomes more lax than the native tissue through loosening, mechanical degradation, or both.As a result, young athletes are at a greatly increased risk for a second ACL injury. Nearly one in four youths who return to high-risk sports sustain another ACL injury at some point in their career. For patients younger than 20, the increased risk for sustaining an ACL graft rupture is as high as threefold, with the risk higher for females than males.Read More on Innovation Drone Deploys in Just Minutes but Flies for HoursEngineers are working with physicians, surgeons, and other healthcare professionals to better understand the biomechanics of ACL injury and how to repair it more permanently.Mechanical engineers can help with the tensile strength of the graft and help us learn how the graft degrades over time following the reconstruction and before it starts to build back up in strength, Myer said. From the surgeons standpoint, helping them understand the best grafts is probably the most direct link to helping in their selection for reconstruction.Experiment and SimulationKaitlyn Mallett saw this first hand, as she previously worked as a graduate student research assistant in the Department of Mechanical Engineering at the University of Michigan. With Arruda as her advisor, she went on to get her doctorate in mechanical eng ineering. Her dissertation research involved experimentally characterizing native ACL and replacement grafts to define their mechanical properties.Its a challenge researchers have been grappling with for decades.The ACL is actually quite complex, Mallett said. Its made up of two different sections that twist on each other, and as you flex the knee, it twists and untwists, but its always taut. Its very complicated to get the mechanical properties without relieving that tension.Understanding the relationship between the various parts of the knee requires a combination of experiments to characterize the mechanical properties of the tissues and plugging those values into a computer models that employ finite element analysis to simulate the stresses that running, jumping, and landing place on the joint. Even the model is informed with clinical data.The model starts with an MRI of the knee, Arruda said. We convert that into a finite element mesh and translate that from the MRI data file t o volumetric elements used in finite elements. That involves taking every slice of the MRI and finding the outline of each tissue in the knee. We call that segmenting the knee.The model is made of elements that are deformable, so you create the overall geometry and break it into elements and then apply properties to each section, Mallett added.Read More on Bioengineering The Engineering Behind Brain ResearchTo obtain the data on the mechanical properties of the tissues, Mallett took donated tissue and cut out all the soft tissue except for the ACL. She aligned the ACL in a well-known loading state and then subjected it to tests to provide the mechanical properties needed for a computational model.Some of this may sound like working with traditional engineering materials, but Mallett said there are important differences. Ligament tissue doesnt display co-linear behavior like steel in the linear regime. The ACL has several different kinds of parts to it that dont behave the same way.I ts also non-linear, meaning it doesnt exhibit a one-to-one response when strained. Soft tissue like ACL is compliant and begins to stiffen as you pull on it because it has a crimp in the fiber that straightens out.That nonlinearity is difficult to capture, Mallett said.It also exhibits a time-dependent response. If you pull it more quickly, it will behave differently than if you pull it slowly. By taking a large number of samples and pulling them to a certain distance, I was able to get the stress-strain curve, she said.Risk FactorsExperimental biomechanics is also helping inform the way post-surgery rehabilitation is conducted. Theory says rehabilitation after ACL reconstruction should focus on addressing the underlying neuromuscular problems that led to the injury. Myers lab at Cincinnati Childrens Hospital was established in part to put those theories to the test.Instead of just looking at the problem, Myer said, we look at the mechanisms causing it.Working with children and youn g adults, the biomechanical engineers study these athletes as they mature to look for physiological changes. They also do full body motion analysis, and if theyre injured, they determine the biomechanics that led to the injury.Landing in a knock-kneed position is the number one risk factor for injury, Myer said.With this data in hand, the biomechanical engineers have begun to explore steps athletes can take to prevent injuries from occurring. Myers team recommends performing neuromuscular training, which is basically strength- and power-building exercises that translate into support to reduce the risk of injury.Our research has shown we can reduce ACL injuries by more than 50 percent by doing these, Myer said. Ultimately, we dont want the ACL to be loaded that much. We want the forces to be absorbed to the bone structures and the muscular activation.Read More on Teens and Limbs Young Engineer Takes Great Strides with Prosthetic FootArrudas team is looking at another knee injury risk factor repetitive loading. That means that ACL injuries are essentially a fatigue failure.Engineers know that in metals, repetitive or cyclic loading at a load lower than the yield or tensile strength can lead to failure. Biomechanical engineers at Michigan and elsewhere are studying fatigue in the ACL to learn more about these failures in pliable human tissues.How a ligament accumulates damage is still unknown, Arruda said. Once we understand that, we can start thinking about the concepts we apply in fracture mechanics of other materials to understand how much damage a ligament can tolerate.How would fatigue occur in a knee? If you play high-intensity sports year-round doing essentially the same move over and over again without sufficient rest and recovery time, you may be at risk as a young person of tearing a ligament, Arruda said. The overall hypothesis Im trying to explore is that the damage can and does accumulate, and healing can occur as well, given time.A third side of the knee equation is also coming into focus, Arruda said. Engineers are engaged in tissue engineering solutions to replace a torn ACL. Thats also something Ive worked on, again with collaborators including an orthopedic surgeon and faculty members in the med school.Their research has spun off a startup company called STEL Technologies to commercialize the technology. We developed a tissue-engineered graft that could be used as an ACL replacement that actually remodels and grows in vivo to restore native biology and function, she said.Armed with better knowledge of what causes ACLs to tear, trainers and physicians will be able to better prevent the injuries. Athletes will be trained to run, jump, and land in ways that spare the ligaments from overstress. Physicians will constantly monitor the knees for accumulating damage and prescribe measures to mitigate the risk.My vision is to one day have an MRI be a know-how part of a young athletes annual checkup. Using a patient-specific computa tional model of the athlete and replicating her biomechanics, we can assess her injury risk, Arruda said.The hope is to one day relegate ACL injuries from the sports page to the history books.Tom Gibson, P.E. is a consulting mechanical engineer specializing in machine design and green building based in Milton, Pa. Read More Exclusive Stories from ASME.org Five Job Interview Questions Young Engineers Can Expect Lighter Axle Reinvents Drivetrain. Does Detroit Care? Engineers Making Waves in AquacultureMy vision is to one day have an MRI be a routine part of a young athletes annual checkup. Prof. Ellen Arruda, University of Michigan

How to Discuss Relocation in a Cover Letter and Resume

How to Discuss Reschauplatz in a Cover Letter and ResumeHow to Discuss Relocation in a Cover Letter and ResumeAsk Amanda How Do I Mention Relocation in My Cover Letter?Each week, TopResumes career advice expert, Amanda Augustine, answers user questions like the one below from Quora and our Ask Amanda form. A certified professional career coach (CPCC) and resume writer (CPRW), Amanda has been helping professionals improve their careers for nearly 15 years. Have a question for Amanda? Submit it here.Q How do I address my desire to relocate for work in my cover letter and resume?Im about to start a job search and want to relocate. How do I approach the subject of relocation in my cover letter and resume? AprilGreat question, April Before you update your resume and cover letter for a long-distance job search, I suggest doing some online research to determine which job markets are healthy and have a decent number of job openings in your desired field. Its notlage enough to know you want to relocate to somewhere warm search your favorite job boards to get a better sense of which locations not only meet your personal needs but also have a high demand for professionals in your line of work. Your current location will be less of an issue when your talents are in high demand.Once youve narrowed your search to a few locations, dig a little deeper to determine which is the right place for you to live. Reach out to friends and friends-of-friends who live in the area and can give you the inside scoop on what its like to live and work there. If possible, visit each city to get a feel for each area.Also, make sure you can afford to move to each location. Use resources like Salary.coms customized salary reports and NerdWallets cost of living calculator to estimate the salary range you can expect to earn in each location and determine if it will be enough for you to live comfortably in that area.How to discuss relocation in your resumeApply these relocation tips to your resume and LinkedIn profile, where applicable.Edit the location detailsIf youve narrowed your search to a specific locale, include the city, state, and zip code in your contact details at the top of your resume. If you havent worked in this city before, consider removing the location information for your employers within your resumes Work History section.Update your resume professional summaryTake advantage of the professional summary section of your resume, space previously reserved for your resume objective statement, to address your desire to relocate. Include a blurb similar to the following toward the end of your summary Interested in relocating to the greater location area. You can take it a step further and mention that youre willing to relocate to location at own expense to demonstrate to employers how serious you are about making such a move. If youre still on the fence about relocating for work, leave a line like this out until youve done your research and found a specific locat ion that interests you and is a realistic option, given your career and the locations current job market.Emphasize other aspects of your employersConsider adding a one-line company description underneath each employer listed on your resume that highlights the aspects each has in common with the companies youre currently targeting for your job search. This could be anything from the companys size to its industry to the types of customers it serves. The idea is to downplay the location of each employer by emphasizing other attributes that are relevant to your desired employer.Related How to Build an Employer Dream List for Your Job SearchHow to discuss relocation in your cover letterYour cover letter and the summary section of your LinkedIn profile are great places to add personal details about your desire to relocate that would seem out of place on a resume.While technology is making the world smaller and smaller, employers still tend to favor local candidates over out-of-towners whe n all else is equal. Why? Because non-local candidates typically cost mora money to hire (i.e. relocation costs) and are often considered mora of a flight risk. Use your cover letter to dispel any false assumptions an employer may have about your decision to relocate.Highlight your historyIf you previously worked or studied in the area, or if you have family living there, incorporate these facts into your cover letter. This information shows employers that youre already familiar with the location and will be comfortable living there. In other words, youve already begun to lay down roots and are less likely to jump ship as a result.Demonstrate your researchIf you havent lived in the location before, show the employer that youve done your homework on the area. When explaining why youre interested in the opportunity, drop in a detail or two that demonstrates what youve learned about the location and why it makes the position more appealing. By exhibiting the research youve done on the area, youre showing the employer how serious you are about relocating.Indicate your familys supportWhile you dont necessarily want to go into the nitty-gritty details of your family, it doesnt hurt to mention that My family and I are committed to relocating to location to show your familys support of the move. If youre relocating because your spouse or partner was transferred to this location for work, be sure to specify this in your cover letter, as it may alleviate any fears the employer has about your genuine interest in relocation. How to approach relocation in your cover letter and resumeOnce youve updated your job-application materials to demonstrate your commitment to relocation, focus on developing a strong network of connections in your desired city to help you sidestep the ATS software and put your application directly into the hands of the recruiter or hiring manager. Click on the following link for more tips for conducting a long-distance job search.Need help positioning your resume for relocation? TopResume can helpRecommended Reading6 Questions to Ask Yourself Before Relocating for WorkWhat Is an ATS? How to Write a Resume to Beat the BotsDont Answer These Off-Limits Interview Questions

Your most powerful tools for making a career change

Your most powerful tools for making a career changeYour most powerful tools for making a career changeTime for a change in cubicle scenery?Yearning for a fresh start in a new occupation can stem from any number of reasons. The idea of the grass being greener on the other side can lead us to daydream of lost opportunities elsewhere, even if were not particularly unhappy with a current job. Stagnant salaries, indifference, frustrations, or even just the desire for a challengethe list goes on and on.No matter the push, a career change seems romantic and inspiring in theory, but the execution part of it is daunting and seemingly light years away. Leaving behind a salary to focus on continuing education isnt a viable vorkaufsrecht for most and gaining relevant experience in a new profession cant be done without proven competency. All behauptung roadblocks can provide a formidable barrier to pursuing the idea of a career change any further.However, you dont need a Fairy Job Mother or an ad ditional degree to move in the right direction. The most powerful tools to change your 9-5 are easily accessible to people of all backgrounds and means. What can you leverage to start moving in the right direction?Informational interviews and mentorshipA quick Google search for experiences in X-position or Y-company leads to mountains of first-hand accounts, forums, and blog articles highlighting what to expect. People are eager to share how they worked hard to achieve their career goal and the steps theyve seen others take as well. Using LinkedIn to search a specific industry or position will also yield real people with a snapshot of their professional journey to get to where they are now.Once youve compiled some anthroponyms and contact info of people in a position similar to where you would eventually like to be, youre ready to start outreach. While cold calling and unsolicited emails are usually not the best way to get your name out, reaching out with a genuine inquiry about som eones life is even a form of flattery. Youre not spamming or selling anything, so introduce yourself with confidenceThese contacts can turn into professional relationships that down the road that result in mentor figures and a solid network.Networking at local meetupsNot everyone promotes their professional journey and achievements on the web, and it may be challenging to get a foot into the local scene in such a broad online community. If you cant find a local organization dedicated to the career youre looking to pursue, try looking on more general community sites like Meetup that have member-created groups for anything from Data Science to Women Entrepreneurs.If conferences are out of the budget, then these smaller meetups of dedicated professionals provide a more affordable and friendlier alternative.Work with a recruiting agencyWorking with a firm typically doesnt cost a dime for job seekers, as the expense is fronted by employers looking for specific talent that dont have the r esources or network available to search a wide pool. A leadership search firm can help match executive-level candidates with hard-to-fill positions that require uncommon skillsets or knowledge.For those looking to make a career change, working with a firm to identify transferable skills can help you identify where you may be a good fit. Screening benefits both parties, as a search firm has an obligation to employers to deliver the best matching candidates.Gaining experience through a side hustleSome look at a side hustle as an additional income stream. But these part-time ventures can also be a powerful tool to flex new skills and explore different careers without the risk and investment that come with quitting your job and starting a business.Professional-level side hustles can be anything from personal coaching to database management consulting, building on knowledge and skills you already have, but also giving room to grow and expand in other directions.Your current employerOf co urse, a career change doesnt need to involve scraping your current job and starting over in a new industry and position. Working towards a transfer within your current company has the benefits of already knowing the business and the necessary contacts. If you feel your ambition and growth potential are better served in a different department, your human resources team could give some pointers on how to proceed.Your ability to succeed in a new environment truly boils down to dedication and the age-old mantra of its all about who you know. A career change doesnt require having a brother-in-law in the C-Suite who can pull a few strings. Its about tapping into up-to-date networks of people who are locked into their industry and can lead you in the right direction. Your grit and focus will do the rest to pull you along into new opportunities.Brett Farmiloe is a cofounder of Y Scouts, a leadership search firm that helps connect people to work that matters.