Shoulders are intricate systems of bones, muscles, joints, tendons, and ligaments, and possess more range of motion than any other joint in the body. Most of us tend to take our shoulders for granted – until we have an injury or pain.

As Director of Physical Therapy Research in Intercollegiate Athletic Health and Performance, Assistant Professor Justin Staker, PT, PhD, has a deep respect for the shoulder. He works with athletes in shoulder-heavy sports such as softball and swimming to improve their performance, help treat their shoulder injuries, and learn more about the complex interaction of performance, injury, and movement quality of the athletes’ shoulders.

Justin Staker, PT, PhD

More to do
After 12 years working as a clinical physical therapist, Staker (pictured here) saw there was more to do in the profession. “I wanted to answer the questions I had from my clinical practice,” he said, and started his PhD program at the U in 2013. Staker worked with his mentor, Professor and Director of the Physical Therapy Division Paula Ludewig, PhD, PT, to focus his research on shoulder issues and sports injuries of the shoulder. “I reached out to the UMN Department of Intercollegiate Athletics to engage them in my research and some of the relationship building I did then is helping me now,” he said.

Staker then joined the Rehabilitation Medicine Department in 2018 as a faculty member in both the Physical Therapy and Rehabilitation Science Divisions. Thirty percent of his time is devoted to research; ten percent is funded by U of M Intercollegiate Athletics. “That portion of my time is split between doing clinical consultations with the athletes and collaborating with athletic trainers,” he said. “The other part is devoted to developing research projects with the swimming and softball teams.” Staker has worked with the swim team for three years and just started working with softball. Additionally, he is developing projects with other teams such as baseball, gymnastics, and tennis.

Mitigate risk/maximize performance
His primary research focus is to mitigate athletic injury risk and maximize performance. “We don’t know all we need yet to know to reach those goals,” Staker said. “We’ve started accumulating basic measures that we repeat season over season: range of motion, strength, flexibility, and joint integrity, and we track injuries and performance.”

Staker finds that college-level athletes are great research subjects. “It’s difficult to recruit people with similar movement patterns and exposures to the same risk factors over a long term,” he explained. “The neat thing about Division 1 athletes is that they’re high-performing, have similar risks for injury, and perform the same movement types. They are also all doing similar, high-volume workouts.”

The athletes may be alike in certain ways but are diverse in others. “Athletes tend to be pulled from a more heterogenous population than is often typical in biomechanical research , which helps us with our diversity, equity, and inclusion goals,” Staker said.

Ready access
Another advantage of working with athletes is that they tend to be with an academic program for at least four years. “We have ready access to them, and can track them over time,” Staker explained. “It helps us study how they progress longitudinally and allows us to answer questions you really can’t from a one-day data collection of someone from the general community.”

Staker is also able to gather data from his research subjects multiple times a year. “There are new hypotheses I’m generating just through that process,” he said. “When I’m doing a clinical exam in the office, we typically do it in a static, nondynamic way as a one-time assessment that is isolated from their problematic activity. I believe it’s more informative when you’re assessing an athlete multiple times and immediately, for example, after they swim 3,000 yards.”

Novel approach
One of the more novel ways Staker is employing to assess these athletes is to capture their simulated swimming motions through the use of a bi-plane video radiography system. “We’re doing this with the swimmers in a randomized controlled trial I’m running that is funded by the grant-in-aid mechanism from the U,” he said. “The video radiography setup allows us to see very precise, accurate bone-to-bone relationships. We can directly see how our interventions are affecting their biomechanics.” The study combines clinical interventions with the high-end biomechanical analysis. Staker noted that there are only a few places in the country that can do this.

Working on his research and with the athletes in general is helping Staker build his understanding of how shoulder injuries develop. “We think we have general ideas about the most efficient ways to move, which will help avoid injury,” he said. “Our studies and the interprofessional relationships we are building give us an opportunity to collaborate with the athletic trainers and coaches on suggestions for the athletes, which should have an impact on their symptoms and hopefully help their performance.”

Residency work
In addition, Staker leads the research aspect of M Health Fairview’s sports residency in orthopedics. “We have physical therapy residents in sports and orthopedic specialties, and I help coordinate their research experience at the U,” he said. “For orthopedics residents, I coordinate with faculty members in the Division of Physical Therapy and sometimes in Rehabilitation Science. The sports physical therapy residents stay with me and are integrated into my work with the athletes.”

Staker believes that the environment in the department and the emphasis on collaboration is what has led to his research success and will enable where the department can go in the future.