Heidi Prather, DO
Professor of Physical Medicine and Rehabilitation
Vice Chair, Department of Orthopedic Surgery
Chief of Section in Physical Medicine and Rehabilitation
PM&R Musculoskeletal Sports Medicine Fellowship Co-Director
Director of Orthopaedic Spine Center
I. Washington University-Woman’s Soccer Injury Repository
PI: Heidi Prather, DO
The purpose of the present study is to develop a soccer repository to facilitate inter-disciplinary investigation into the incidence and prevalence of hip, knee and bone disorders among elite soccer athletes, and the risk factors that contribute to these problems. By studying elite soccer players from the youth to professional levels over time, this study will provide cross-sectional and longitudinal data that will hopefully lead to better mechanisms for injury prevention in this cohort.
This study is designed to follow athletes from elite youth soccer clubs in the St. Louis area as well as professional soccer in the St. Louis area. In collaboration with various clubs, we will ask athletes from the ages of 10 and up to enroll in the study. We have designed modular data collection to facilitate gathering and storing age and gender specific information for athletes on an annual basis. The study is outlined below based on this arrangement.
II. Multidisciplinary Study Group for Coexisting Spine and Hip Disorders
PI: Heidi Prather, DO
First Hypothesis: The formation of a multidisciplinary group of hip and spine healthcare specialists will enable us to define and develop a consensus regarding the critical, clinical components of the hip-spine syndrome.
First Specific Aim:
a. To define the hip-spine syndrome with a multidisciplinary team of hip and spine healthcare specialists.
b. To develop a consensus regarding a critical set of diagnostic criteria (self-report, physical examination, and imaging) that can be used across healthcare disciplines to determine the presence of primary hip, primary spine, or coexisting hip and spine dysfunction (hip-spine syndrome). This critical set of diagnostic criteria will also include a physician self-report developed to monitor physicians’ treatment recommendations.
Second Hypothesis: The prevalence of coexisting hip and spine dysfunction is 10- 20% in patients that present for clinical evaluation hip and/or lumbar spine symptoms.
Second Specific Aim: To conduct two collaborative studies to better describe the prevalence of coexisting hip and spine dysfunction.
a. A retrospective review will be conducted to identify and describe the patient population who have undergone a hip replacement performed at Washington University School of Medicine between 1996 and 2006 (HRPO # 07-0517) and consulted a specialist for low back pain and dysfunction within the two years preceding or following total hip replacement.
b. A prospective pilot study will be conducted across the multiple medical disciplines utilizing the critical set of diagnostic criteria to describe the initial presentation of patients with primary hip disease, primary spine disease or coexistent hip and spine dysfunction (hip-spine syndrome). The care plan for these patients will then be monitored to describe the treatment intervention the patients are offered. We will report each physician’s report of changes in management that may result after utilizing the critical set of diagnostic criteria.
III. Differences in ultrasound imaging of abdominal muscle thickness at rest and with activation and their predictive value for injury in asymptomatic soccer players as compared to controls
PI: Heidi Prather, DO
First Specific Aims:
1. To demonstrate the thickness of the TrA, IO, and EO muscles at rest and the differences in the change of abdominal muscle thickness during activation maneuvers using ultrasonography in asymptomatic volunteers.
2. To demonstrate the thickness of the TrA, IO, and EO muscles at rest and the differences in the change of abdominal muscle thickness during activation maneuvers using ultrasonography in asymptomatic soccer players.
3. To determine the differences with regard to gender and play experience in the resting thickness and thickness during muscle activation maneuvers of TrA, IO, and EO muscles as visualized with ultrasound in asymptomatic volunteers and soccer players.
4. To evaluate side-to-side differences in resting TrA, IO, and EO muscle thickness and the changes in muscle thickness with activation maneuvers in relation to kicking foot preference.
Third Hypothesis: Asymptomatic soccer players who demonstrate a smaller baseline thickness of TrA and IO muscles or who have a smaller percent change in TrA and IO muscle thickness with activation are more likely to sustain injuries to the low back, hips, and lower extremities.
Second Specific Aims:
1. To compare abdominal thickness measurements to incidence of injuries of the lumbar spine, pelvis, hip and lower extremity in soccer players enrolled in the Soccer Repository at Washington University School of Medicine.
2. To determine if there is a correlation between certain types of injury (low back, hips, or lower extremities) and a decreased ability to effectively activate abdominal muscles on ultrasonography.
3. To determine if any abdominal muscle activation maneuver demonstrates a change in muscle thickness that is positively correlated to injury prediction.