The Science of Healing in Women’s Sports — A Conversation with Dr. Jenny Robinson

Dr. Liz Wayne taps in on her wide network of friends and contacts to discuss some of the most important, and often controversial, topics surrounding biomedical engineering, and related areas shaping healthcare. Wayne, an Assistant Professor at the University of Washington and host of our monthly webinar, unpacks today’s most pressing scientific topics and explores how biomedical engineers are building a healthier, more equitable world, one discovery at a time.

In our first episode, Wayne speaks with Dr. Jenny Robinson, an associate professor at the University of Washington, about sports injuries and the future of tissue regeneration. Robinson shares insights into how sex hormones influence healing, with a focus on female athletes and the high rate of ACL injuries among women. Among other topics, she also talks about the limitations of current treatments like autografts and allografts and explores how biomaterials could revolutionize recovery. Don’t miss our first scintillating episode.

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Transcript

Liz Wayne: Hi everyone, and welcome to the office hours podcast with Liz Wayne. A brand-new podcast brought to you by the Biomedical Engineering Society. I'm Liz Wayne. I'm an assistant professor in bioengineering, and I'm going to introduce you to the world of biomedical engineering through my eyes or my voice. And so, whether you're a student, researcher, educator, or just someone who's curious about how science and how the world works, you've come to the right place. Welcome back. 

Today, we have a special topic, and probably the best person in the world to help us talk about it. Sports: they're all around us. If we're not playing them, we're watching them, or we're betting on them (some of us), and we marvel about how athletes use their bodies in a way that looks effortless but absolutely is a result of genes and hard work ethic and things I could absolutely not do. I am not flexible, unfortunately, I am 5'4" in real life, but I think my voice is like 6'4". Personally, she's got big attitude.  

Regardless of where you fit on the spectrum, you do feel like you can live through the experience of the athletes. I mean, think about it. As a fan, you're in the stands of a championship game, and your team is on the verge of victory after a long season, and you see the player leap in the air to finish the play, and then they come back down to the ground, and you think they're just ready to return and bounce back, except everything stops and it feels more like the ground, and the player are attached, and they're grabbing their knee or their ankle, there's a lot of pain, and they're not faking it to get a foul called, and if they're lucky, they can wobble off the court. But the damage has been done. The moment of excitement has ended, and the long road of recovery is starting and then not having the outcome that you thought. And this happens a lot in sports, whether you're talking about football or soccer or basketball, especially the NBA finals that happened recently. This is probably very painful for the Indiana Pacers, but this really happens.  

And so today we're going to talk about sports injuries and how we heal from them, and also maybe sex. And to do that, our special guest is going to be Dr Jennifer, or Jenny Robinson. Jenny is an associate professor at the University of Washington. Dr Robinson uses biomaterial design and estrogen signaling to understand how sex hormones affect tissue regeneration and fibrous connective tissues, which are usually the things that are involved in these injuries. And one of the goals she also wants to do is uncover the mystery of how female elite and lifelong athletes experience increased injury and worse repair outcomes. So welcome. Associate Professor, Dr Jenny Robinson. 

Jenny Robinson: Thanks, Liz, honored to be here. Honored to be here in your presence. 

Liz: Let's talk about it. First of all, my first question for you is, how did you decide to start talking about sex all day long? When did that become like a mission for you that like, I want people, when they think about sports and injuries, to also think about sex? 

Jenny: Yeah, so this is, you know, if it's not your first thought, I will say it's so exciting right now, because women's sports have had a big surgence in the past, I don't know, a couple years really, which has been 50 years in the making, but this, for me, was personal. So, I had tore my anterior cruciate ligament, my knee and my lateral meniscus playing soccer. And I was very young. But again, like I thought, you know, I was going to go to Olympic development the next year. Like it was a big part of my - it's still a big part of my life. It was a big part of my identity. Yeah, so at that point, you know, not knowing any stats, and a lot of the stats weren't there yet, a lot of my teammates started to do it, my sister, you know, all playing soccer. My sister Tore her ACL; my cousin tore hers twice playing soccer. So, it was just very prevalent in this female soccer playing world, and not just soccer. Other friends who played, like, basketball, volleyball, kind of sports were tearing their ACL were having these injuries, and so I just lived it. 

Liz: So, you know, I played soccer in high school, and I was, I was like, district level, good. I wasn't like, Olympic team potential level good. But I do remember people talking about, stretching, and like ways to stretch, and how different bones were shaped, or like, there's like the v shape in your knee, versus like a round shape that men might have. And they were talking about injuries a lot, and it was just prevalent, but also, like, I just didn't know, are they making this up? Or like, what's really happening? Why are you getting all these injuries? But for you, again, it was really personal, because it happened to you. Like, what was that like to have your life kind of trajectory changing as thinking I could be an athlete and dedicating so many hours a day to doing soccer, to then having to do - not that, watching other people do it? 

Jenny: Yeah. So, I think, and some of this has been unraveling, the more I've come back to this space and going to conferences about female athlete injury and stuff. So, the physical toll is really hard, and because these types of injuries still take about a year, if all goes well, to come back from; the elite athletes are at the same time scale. It takes about a year. And, you know, you watch people walk and can't see yourself walking like that. You cannot envision that. I couldn't for like, a month after the injury. I just couldn't envision my knee, you know, whatever, going flexion, doing that behavior. And yeah, you do think your life is kind of, you know, how am I going to shift? How am I going to get back? I never thought I couldn't get back to playing, and I did get back to playing, but you adapt in different ways. So, for my example, I still can't shoot with my right- the knee that's injured. I cannot. I can physically do it, but my mind cannot go through the whole process of shooting. So, I became left footed. So, the rest of my career I was left footed, and it's not terrible, because it's some nice things that can be afforded by being a left footed player, but that was a very mental, I think, remnant of this injury. And so now there is way more effort into the mental healing as well, through sports, than there was when I had that experience, and even maybe not at all at the youth level. 

Liz: Did you connect the dots then? 

Jenny: No. 

Liz: So, I know that you -you talked about how you had this injury, then your sister had the same injury, but did you really think sex was involved then? Like, when did you start thinking, okay, sex was involved? Or really trying to think, what about sex is involved here? 

Jenny: I want to say probably when I started in Biomedical Engineering undergrad, I started to piece together, not this, let's tie hormones and not any of that yet. But I think I started to think about this problem because I knew I wanted to try to solve, not the sex differences problem, per se, but just like the problem of, why don't we regenerate this tissue, which we don't very well, that's another aspect that my lab is very we're very interested in. But I think then I started to piece together just my personal epidemiological data to say, wow, it seems to be that there were more. It seemed very common. You know, my male cousins, my whole family's played soccer. My male cousins did. None of them had this injury. My friends playing on the, you know, male teams at different at comparable stages. It was just less prevalent. And I think when I got into research, you know, then you start to, like, understand, you can read papers. And you start to pool like, oh, let me like, see if anything's out there, and then you start to see there's data suggesting higher prevalence in a biological female population. 

Liz: So maybe let's take a step back, in case people don't know. So, you tear your ACL like, what does it mean to regenerate or heal after an ACL injury? What's actually happening to people? 

Jenny: Yeah, and like I said, we don't fully quite know this with these connective tissues yet, but the idea is that you have, you know, like a rope that's been completely broken, because a lot of these tissues are just a lot of aligned collagen connected in very intricate, nice ways to resist stretch, and when you break that you need cells. And a lot of times that's immune cells to come in, clear up that debris, and then you need signaling in that space to occur to either a stem cell or a progenitor cell or a mature, you know, tissue resident cell, to come in and start making, producing and organizing new tissue, you know, collagens, connective proteins, et cetera. And right now, that is not happening innately well in these connective tissues in certain environments, a lot of that has been attributed to potentially lower blood supply, and so just reduced spleen and reduced migration through the blood, including, like the immune cells, right? But I think the other thing is, we have yet, as engineers want to figure out how to tap into that progenitor stem cell population and get them active, and we're even at the point right now that we don't even quite understand that progenitor. 

Liz: Okay, so I think I hear what you're saying. And so, the connective tissues, they don't have a lot of blood supply, and they really are just like strings of polymers or nice, thick materials that keep our bones together, that attach our muscles to the bones. Hence why they're just called connective tissue. Their job is to connect. And so, when we think about healing in any other part of the body, you would have this immune response where you have the cells come in, they clean up all the cells that have died, and then they populate new cells there. But connective tissues are harder because they don't have a lot of blood supply. There’s not a lot of cells. 

Jenny: Yeah, they're pretty acellular, like reduced Cell amount compared to others, yeah. 

Liz: Pretty acellular. And so how do you heal that? And what you're getting at, what I heard you say, is that one of the frontiers that a biomedical engineer thinks about is that, well, how do we work with the cells that already are there, like those progenitor cells, and maybe they can differentiate, or they can become those innate immune cells without having to have them come from other parts of the body. Is that the idea here? 

Jenny: Yes, one part of the idea, we're, you know… 

Liz: One part of the idea. 

Jenny: We're not putting all our eggs in one basket, but, yeah, I think for us, we're, I'm very interested in tapping into the bodies, if we wouldn't have to inject in… And this comes for other reasons, right? Like, if we could just put an acellular material into the body, then we don't have to worry about all the regulations of a cellular product, but we could put an acellular material, and that material using, we think a lot about mechanical cues, but using some form of information from that material brings the cells that we want to come into that space is really like one of the mantras of our mission, of our... 

Liz: I see. So, what other things are actually available now? And why don't they work well? 

Jenny: Yeah, so far we've been talking about the ACL a lot, and so I'll start with that, and then my lab does a lot of the other the meniscus, which is another really important connective tissue, which usually you injure them at the same time, which is what happened to me. But for that ligament, that cruciate ligament, most times, you get either an autograft, so a tendon or ligament from your own body gets excised from a different place and screwed into the bone, femur and tibia, and that tendon or ligament from another place your body is now your new ACL, and that's what I had done. 

Liz: Doesn't that make another part of your body weaker? 

Jenny: Yeah. So I had my hamstring tendon, so I used to pull my- luckily, I never had a major strain, but I would have a minor strain in my hamstring often, and likely that's because remodeling had to occur at that and probably Fibro, you know, fibrous tissue, like not good, healthy tissue form around that injury site. And you can also use a cadaveric graft, so an allograft from a deceased patient. I have an exciting opportunity right now, when we're working with the WNBA Storm team- 

Liz: Yeah, that’s what I wanted to ask you about. 

Jenny: Which is super cool, lifelong dream. I want to work with the Reign. I want to work, you know, and I want to move into soccer if I can. There's some unique ties with the Storm, which is how this got started. But what's interesting is, so we've been working with- they have three athletes who are at different stages of ACL recovery, reconstruction, you know, had they had the surgery, and they're recovering. And so, we've been working with one of the athletes who's a little bit further along, and I asked her what she had done, because I assumed they would, at an elite athlete level, maybe not use your own tissue for that repair. And she did. She had a quad, I think it was a quad tendon. So they took her own tendon and replaced it back in in her ACL. The beauty of that is that's your own tissue, right? Your body's ability to recognize, I don't think they decellularize it, so if the cells that are there is all recognized to be not foreign, but that means she has another injury at her quad, another muscle site, because they removed it, 

Liz: Right. 

Jenny: That's what is currently the gold standard. That's an elite athlete getting that procedure. Ideally, we don't want to create another injury, ideally, we have something that can be put back in to give the correct cues information to promote regeneration. And so, one of the products that's been making a move lately is, I believe it's bovine, but an animal collagen sponge that gets recellularized with the patient's own, I think, just blood, and then put back in. And so that's been the most recent step in that anterior cruciate ligament space to go from taking your own or a cadaveric tissue and moving away from that into a material, per se. Now for us, our ideal situation is that with a collagen sponge, you're not controlling the whole environment, right? You get the collagen, you might treat it a certain way, and then you typically freeze-dry that to make a sponge, a foam. And so, the environment is not really well engineered, unlike native tissue that has very organized structure, very spatially different components, maybe. And so that's where we're very interested in using, you know, material science and biomaterials to do our best to try to recapitulate structural features of the native tissue that are actually really important for cells. And cells know how to respond to that. 

Liz: I see. Biology is interesting because it tells you which cells or genes and like the connections of these different entities, like, how are things involved? But then our bodies also are kind of mechanical. They inform their function. And so how do we redesign what nature already has? Because if you have the right design, the cells will then perform the right function because they know where to be. So, cells that are in the bone, where it's stiffer, will behave differently than cells that are in the brain, which is squishy, right? This is like two really polar extremes here. And so, to be able to recapitulate that outside of the body, we have to use material science tools and polymer chemistry to actually understand how we make those architectures, probably even combined with some 3d printing and manufacturing. So, it's a really interesting overlap of like the engineering and then knowing what biology wants you to do, what does nature want us to do? What signals do they need? And I'm guessing, in terms of the signaling aspect, this is partially where you get to the idea of sex hormones. And so, what is the role of hormones? I guess the other, more directed question would be, if you kind of go along with what you said, which is that we can try to recreate the structure, then the cells will come. Then why do you need to do anything about hormones? 

Jenny: So, this is, like, an amazing question. Liz, what I'm what I'm going to say is, this is the career’s worth of a question, I think, especially around hormone signaling for us, and something that, I will say, I think it's one of, not in my Achilles- not to bring up a connective tissue example, but like, it's my Achilles heel. I feel like when we started this hormone signaling- 

Liz: Was that a pun? 

Jenny: Yes, yes, it was, which I didn't intend it to be, but it was the sex hormones, much like other hormones, like insulin and glucose, you can kind of put in that role, are these global controlling molecules that are like largely overseeing so much of this intricate signaling that goes on in organ systems, to tissues, to cells. And for me, it's this vast question of how such a small molecule, what we're learning is such a small molecule, can be so critical across the body. And so maybe it would be that, you know, we could just put a material back in and not worry about the signaling. And that's actually part of my mantra, like, I kind of believe that a little bit, or, you know, I'd rather not mess with this intricate signaling in the body. However, because our systems are so reliant on these hormones, and so for, you know, both biological males and females, estrogen is critical during development, to close your growth plate, to stop your bones from growing. That's in boys and girls. Estrogen is critical for the fact that we're all here, or estrogen, progesterone, all these kinds of hormones that work together, right? We wouldn't all be here as birthed humans if the system didn't work in reproductive tissues. 

Liz: So maybe, maybe we should take a step back. So, I am not a hormone expert. I probably know what the general population knows, maybe a little bit more, but not enough more. So, I know we say sex hormones, because there are some hormones that are more upregulated in some sexes versus others, but everyone has all the hormones, and they do certain functions. So, estrogen, women may have produced more estrogen, or ovaries produce estrogen, testes: testosterone. But we all have varying levels of them, right? And they all perform these very complicated functions, which is why no scientist I really know feels comfortable giving a one-sentence like yes or no, because they do so much. And then the other thing is that they do a lot, and they both have this weird space of helping people define differences between sexes, and, because they are in sexes, they also don't define sex. So, they have this really special, this really like bi-communication interaction. So, what is testosterone, what is estrogen, and what do they have to do with healing? 

Jenny: So, to take a step back to biochemistry, which I'm not a biochemist either, but they're small molecules. They're not proteins, they're not peptide you know, they're not made up of amino acids. They're just like small molecules that are all derived from cortisol. So, there's this synthetic pathway where testosterone, progesterone, 17 beta, estradiol, which is the main estrogen, along with 20 something other, I believe, small molecules derive from cortisol. That is where they come from, that gets synthesized in different parts of the cells. I don't know all, you know, don't remember all of that. However, what this means is that it is very easy for testosterone to become what I'm going to call estrogen with one enzyme. So, this is where this is very interesting, because that can happen at different parts in your body. Certain cells can produce this enzyme, fat, for example. And so, we can have testosterone being cleaved to estrogen. This is actually one of the major, if I'm correct, ways males get estrogen. And so, it's this very dynamic process, because it's not that hard to make estrogen from testosterone.  

So, what do we know about injury? Actually, we don't know a whole lot about injury. That's one of the things we're trying to figure out. When we think about injury, what we think about is that injury has potentially occurred because of the tissue becoming vulnerable to load, no longer resistant. So, like, on a material property scale, like it has no longer been, you know, maybe it's reduced thickness, maybe it's reduced cross link, you know, like all of the collagen being linked together, and so that makes it vulnerable to pulling it really quickly when you would plant and turn, those are the kind of things we're thinking about, and others. And there are ties to estrogen, for example, that estrogen at certain higher levels may reduce the cross linking of the tissue, and thus make it more susceptible to tears, because it can't resist, like when you would pull really quickly it fails. 

Liz: Interesting, and this is probably a chronic effect, like long term estrogen, and they're trying to figure out what that link really is. 

Jenny: There's a lot of very specific questions to ask about: Why, because the mechanism of it is what we're interested in. Why? Why would cells, in a tissue that sees estrogen, so does a male tissue, but, but the male doesn't seem to be responsive that way - the male tissues. 

Liz: And so that’s injury. 

Jenny: That’s injury. 

Liz: Then what about the healing, regeneration process? What are hormones doing there - sex hormones? 

Jenny: Again, as a biomedical engineer, we make this like a little bit oversimplified, so we think a lot about certain collagens and certain components of a proteoglycan, the kind of sugar rich proteins that connect in certain ways, the collagen. We look at: are the cells, as a function of hormone dosing or treatment, producing more collagen, for example. And is that collagen organized? So, you know, you can make a lot of collagen, and guess what? That's a scar. That’s fibrosis. That's not good. We need to make sure they're making it and they're organizing it. And so those are the kind of questions that we have to be direct to try to get results to form some conclusion. But those are the things we're thinking about. We also are very interested in- this isn't in a static environment. So, when you put the cells in tissue, or, you know, in our case, like tissue mimetic materials, when you strain them, guess what? The hormone response is different. And I don't have answers there, per se, but that's what we're, with colleagues, trying to determine. The hormone coupled with the stretch, strain, load, what, however you're applying, that is a whole other variable. 

Liz: Why do you think it’s so hard for people to answer these questions? 

Jenny: Part of this is people weren't asking these questions. So, for example, in other fields of regeneration, let's say the heart, you know, because in the space I'm in here, a lot of people think about the heart. People have been working on this for a while, and so you have many, many million brilliant minds trying to answer this. And for us, in the we are in a space where, you know, the ACL and the meniscus, no one was really worried about them for a while. Like, just the biology of them is less known, and then you're thinking about throwing in hormones. If you talk to a biochemist, or if I talk to a biochemist, I've talked to many, they're like, I'm not going to touch those. I'm not going to touch that. Like, I don't want to. That's very complicated, and it's very hard to decouple or to determine- 

Liz: is it because of the enzyme conversion that you mentioned? 

Jenny: Potentially, or even in the lab, some of it -we're trying to, like, really simplify this. And so, we're trying to just put cells, you know, give a certain concentration of hormones to the cells, but the way the cells take the hormones up is- there are many different ways that can happen. So, it just gets overly... 

So, we're working with people to, like, try to sense hormones in the in the cell, which is really exciting. So, we're trying to actually determine, if we put this amount of hormone and throw it at cells, are they actually taking it up? Because it depends on the type of cell, like it depends on how- what environment that cell is in, as far as you know, connecting the hormone on the outside of the cell to something across the membrane, or it can diffuse the membrane. There's a lot of ways it can get into the cell. So, I think, and it's not clear across - why across biological sex, these hormones behave differently, at least in the in our world of thinking about it, for these tissues and healing and regeneration. 

Liz: So, sort of like there are some epidemiological differences this question all started with, we're noticing that women athletes are getting more injuries than men, and then really trying to drill down what is different. And you can think about many factors, but whether it's like nutrition or height, or when do they play? What environments do they play? Like, are there any kind of structural things happening, or, like, not getting the right equipment, right, that fits their bone structure, whatever? And then on the molecular levels, like, well, what about these sex hormones that we also know kind of shape many things that are happening? Yeah, and this just seems really, really challenging.  

I'm going to ask you a question that most biomedical engineers get asked, and sometimes it's very frustrating, but I will do it to you. Let's say that you figure out the answer to this. What will you do with the answers? Like, is this going to be something that helps a new test? Would it be something where you would help stratify patients? What is the ultimate goal here? 

Jenny: I do get asked this question a lot, Liz. 

Liz: Isn’t it frustrating? 

Jenny: Yeah, no, I have answers. I mean, I think there's many ways. I think on the injury prevention side, what are human cells in these environments we build can tell us is, they're in vitro- they're models. They're theoretically supposed to be models of the tissue. So, if we can determine that some combination of hormone milieu, whatever group with some combination of loading. This is oversimplified, right? And this would come through, actually, way more than just us humans like, we'd have to do a lot of, like, machine learning. You know, we can take patient information, their hormone levels, we're trying to do this, and combine that with what we know they do cyclically, and then we can dose, you know, we could get their own selves theoretically, and we could get some early information in our models. We could then inform how the patient will respond with a trainer or a physical therapist, or, you know, they're like, stretch training, whatever regime, we could theoretically inform that to protect the tissues, maybe, because we're promoting this collagen remodeling homeostasis kind of environment, instead of breakdown, that's one way and slash after injury, could we inform a functional regeneration process in that tissue for that patient. 

Liz: I can see that because a lot of athletes, particularly, you can envision this most easily at the professional level, where they actually this is their job. They have nutritionists, physical therapists, and they have very regimented schedules that I'm trying to tune to get the up the most consistent performance from these individuals, right? And so, understanding, if someone were to say, I've got a blood test, and I know what your levels and the ratios of all the things look like, you might be more prone to injury. And then I'm thinking about women in particular, where I'd heard some information, and anecdotally, I believe it's true. You know, menstrual cycle also impacting your performance, and so even being able to figure out how to train around all the biological changes that happen to you during a menstrual cycle, and so you can envision, like, there being these fine-tuned changes that you could make, and then that some of that can eventually trickle down even to the future Olympiad, who won't lose out on their soccer dreams, right? Because they're not going to have a threatening injury at such a young age. 

Jenny: And I mean, the exciting thing around that point for me, at least, is because I have lived this and just to be a little vulnerable, but we're supposed to be cycling, right? Like a female body at certain stage is supposed to be cycling well, at certain amounts of high activity, you can stop cycling. It's also tied to, like, sleep and nutrition, et cetera, like the female athlete triad. There's, like, a lot of work around this. So, I didn't cycle for periods of my life. And now you look back and you think, you know, how did that impact anything, right? 

Liz: What other cycles were disrupted that might have actually- knowing what the little we know about the relationship between hormones and then the degradation or building up of collagen, which is a big part of the connective tissues. 

Jenny: Yeah, that like balance or like birth control, right? That's a whole other. So, there's all these things. There's just all these elements that also complicate the epidemiological data. So, I think that's where it gets really, really- It just gets very intertwined. 

Liz: one thing I was thinking about as an experimental control, if we think about men, biological, assign birth at sex, and when you have people who then undergo hormone replacement therapies, what are their injuries like? I mean, I think that is something that could be interesting, because we don't really have any other models in which you would actually be able to ethically switch off or on something, right? But if you really want to know if estrogen or testosterone were doing something that is a way to determine that right? Or maybe even without, like, thinking about trans individuals, I could see them, maybe even, even ethically, like we're saying, hey, let's use you. But you can think about menopause as an example, where there is now a loss, and we know that without estrogen, the bone degradation begins, and it's harder to gain muscle mass and easier to gain fat. So, there's all these things that are interesting, 

Jenny: I was just going to say, and there, there are other biomedical engineers who are working on models like- like mouse models, to start to try to answer some of these questions. So, where you're able to take male assigned at birth Mice, and I don't remember the details, but you know, then I think it is through hormone conversion, and they're assessing right now bone quality during that conversion. So, we're starting to, well, we were starting to get some of that data. Not sure where those studies are now. And then same with menopause. I mean, we're working on a couple of menopause projects because it's very detrimental during that transition. So yes, there's a lot of implications. 

Liz: I was very interested about something that you mentioned, and I want to talk about but like, how did you get connected to the Seattle storm? Like, how did you get connected to a professional women's basketball league. 

Jenny: Well, I'm trying out. I'm trying out to actually play. So that's part of it. I'm kidding. I'm kidding. I have zero basketball training- wouldn't that be crazy? Professor turned WNBA star. I'm just kidding. That's like in a dream. You know, the position I have here at [The University of Washington], very grateful to have an endowment, an endowed part of that position. And that endowment is tied to women's sports medicine and Lifetime Fitness. And so, one of the owners of the Storm initiated, or was part of the founding group to pay into the endowment. And so, through connections, kind of putting that all together, I was able to meet with her and start talking about ways we could, us and colleagues, could help them collect data. And, you know, they want to know informed information about the health and performance of their athletes. So that's where we are. We're trying to set up kind of how we can provide information and what information we could glean to feed into our in-vitro models. 

Liz: So there's some computational aspects that you're saying here and I think what I'm also getting from you is that, because there's so many variables, and that those variables have different ranges and different interactions between other variables that it becomes too challenging to either even figure out one experiment to solve that problem, or even, like, 10 experiments to solve that problem. And this is like a higher order computation, something that's really geared towards computation, to really suss out what those interactions might be. 

Jenny: Yeah, and I think there's other there's a couple groups that do this, not for connective tissue, but that do that for like heart muscle and stuff. But I've been trying to set up some collaborations to do something on the computational biology side, with some of the data we're able to get to feed into the signaling models to try to say, who wins up? 

Liz: What is the last thing you want to say to people that you think they should know about this research? What's coming up, what's on the outlook, what's looking good for you and for this research? 

Jenny: I guess the one thing I want everyone to take away, one of my big missions, is that we recognize that on a research perspective, that male and female cells do not behave the same way. And I think this is just because most people I talk to don't believe me. And so, I want to make sure we put forth effort and money and research interest and making sure we understand that, 

Liz: What do you mean, don't believe you? 

Jenny: They don't believe that biological sex translates to the cell scale. Yeah, in ways that there would be outcome, you know, different outcomes. And mind you, there are sex chromosomes that drive differences in these cells, which we haven't even talked about. 

Liz: And sex- There's sex immune related genes on- 

Jenny: Yes. 

Liz: sex chromosomes which change- 

Jenny: Genetic, yeah. 

Liz: which people respond to viral versus bacterial infections and... 

Jenny: And I do also want to say that we're not trying, I'm not trying to say that we want to understand, in the context of injury and regeneration, for Athletics to be comparable to men. We're trying to do this so that we can determine optimal performance or regeneration or resistance to injury for women. That comes up often too. And we've been designed unique. You know, the system's designed how it is. We want to try to understand that system for optimal function. 

Liz: And because there's also because of how population diversity works, there will also be people who are biologically male, who might have high estrogen, right, or may get higher levels of estrogen over the course of their life due to- to other things, obesity. And so, these things actually become really relevant for many people. Yeah, I always like pointing at, like, having a target audience, but really like it trickles down. This is the only kind of trickle-down politics I like because it actually does end up trickling down because it works, yeah, powerful, very powerful. I like this. I'm excited about this, and I think it's a real intersection of like BME and all the hats you have to wear, because you have to be able to talk to clinicians, biochemists, who understand receptors but don't understand cell structure, and then talk to polymer scientists who understand how to make materials that have certain stiffness and characterization, but you should never let them touch anything that's alive ever. And so, you work with all these people. And then there's also this very human aspect, which I think really is a hallmark of BME, I would say, because I have to convince people of why this technology is the best, or why this integrated approach is going to really help people, and how it intersects with our daily, lived experiences, what we think we know, how we've done things before, and how we could do them differently. 

Jenny: Right? And that we're not, I'm not creating a bionic human, or I'm not completely changing our genome. 

Liz: Yeah, you're not touching the genome. 

Jenny: But I just, I mean, if I tell anyone that we do secret, you know, anything that touches some level of genetics, it's like, oh, gosh, well, you're playing God. These are conversations I've had with people and so just, just, yeah, making clear that we're just trying to enhance the lived experience of each of us.  

Liz: Thank you again for being on the podcast.  

Jenny: Thanks, Liz.  

Liz: I really appreciate it. That's it for now. This is office hours with Liz Wayne and special guest Jenny Robinson. Say bye, Jenny,  

Jenny: Bye, thanks everyone.  

Liz: Okay, see you. You can find us on all of our socials, please listen to this podcast. Download, like, subscribe, send to all your friends and again, it can be found wherever you like to find your podcast.