My career spans basic, applied, clinical & translational sciences, and currently focuses on characterising healthy neuromusculoskeletal ageing, particularly of the spine. I have a global network and enjoy collaborations that harness diversity and leave egos behind.
I offer research consultancy & project partnerships.
I am an anatomist, human movement scientist (specialisation in biomechanics) and specialist musculoskeletal physiotherapist with over 30 years clinical experience in the public and private healthcare sectors in Australia, the UK, the Netherlands, and Switzerland. I have a strong clinical, scientific, and teaching background in neuromusculoskeletal disorders, particularly of the spine.
My curiosity to understand what defines healthy 'normal' came early. My first undergraduate degree [BSc double major in Anatomy & Human Biology, and Human Movement, University of Western Australia (UWA), 1992] represents my formal introduction, and the kick-off to a career in pursuit of such discovery. Since, I have taught aspects of anatomy, biomechanics, and health, to a wide variety of learners; natural therapists, yoga instructors, movement practitioners, architects & urbanists, under- & post-graduate medical and allied health professionals, and even to incarcerated prisoners!
I've long been passionate about understanding and improving symmetry in how people move. My second undergraduate degree [BSc Physiotherapy (First Class Honours), Curtin University, 1995] exposed me to 'abnormal' as a revelation for 'normal'. My honours thesis, 'Normal and degenerative anatomy of the thoracic intervertebral discs and vertebral bodies: age and gender relationships', comprised a morphological description of the thoracic spine based on 51 hemisected complete cadaveric spines, 16 thoracic columns sectioned at the mid-disc level in the transverse plane, and 90 post-mortem spinal column radiographs. This work features in the book "Clinical Anatomy and Management on Thoracic Spine Pain" [2000, Eds LGF Giles & KP Singer]. I centre my attention on characterising 'normal', and defining the natural history of ageing 'healthy' bodies.
After a decade of clinical practise in private and public sectors in Australia and the UK, I returned to Western Australia to complete a Masters in Manual Therapy [UWA, 2006]. On return to specialist practise in the UK, I recognised that I had many unresolved questions borne from clinical instinct that may have been better understood in a move to academia.
My PhD [University of Western Australia, 2011] involved a prospective, longitudinal study examining clinical outcomes for two years after lumbar surgery augmented with DIAM interspinous implant. In particular, my focus was to identify change to spinal curvature [surface (via rasterstereography) & skeletal (via radiography)], pain & function. My PhD thesis had eleven collateral studies including 3D kinematics and MRI analyses, and enrolled surgical patients with various spinal disorders like lumbar spinal stenosis and degenerative disc disease. The thesis PDF is included for interest below.
Since 2014 (in Switzerland), my scientific focus has been in characterising the natural history and degenerative change to muscle & tendon tissues, and particularly spinal muscles in relation to neuromusculoskeletal disorders. A specific interest is in defining advanced imaging biomarkers that distinguish symptomatic pathology from healthy ageing. I am a recognised international expert in spinal muscle morphology analysis and scholar of the healthy spine phenotype. I have a wide collaboration network, and have led or partnered studies with several international author groups. I'm a member of global MuscleMaps consortium, an international collaboration striving toward open-access standardised image analysis and dataset to characterise healthy whole body muscle tissues. I'm dedicated to understanding ageing anatomy and kinematics of the body as key to preventing many musculoskeletal conditions that burden society. Methods to improve public health remain an important driver to defining healthy ageing.
I created the concept of body urbanism and 'bodyfulness' (The Netherlands, 2018) as a response to the public health problems awaiting our ageing population. The need to build engaging and challenging public spaces that promote healthy activity behaviours for our bodies is urgent. Further details are in a separate tab.
First study to report age/sex-aggregated quantification of lumbar spine muscles [L1-S1] employing whole body multi-echo MRI in asymptomatic adults (in Switzerland) spanning four decades [1]. Volunteers without known disease or pain, and normal BMI recruited to provide normative values for lumbar paravertebral muscle composition that make useful reference to pathologies (eg back surgery). We revealed patterns in the spatial distribution of muscle fat content that have since been confirmed and elaborated across various spine populations.
Employed data simulation methods using existing literature for asymptomatic adults to first report the parameter ‘rate of change’ comparing lumbar muscles decline in quality (increasing fat content) to the prevalence of vertebral column and intervertebral disc features [2]. Alongside colleagues, we initiated a publication series (lumbar, cervical, hip, foot to date) aiming to standardise region of interest definitions for muscle segmentation from MRI using anatomical (E12 plastinates) cross reference [3 lumbar spine].
Proposed a role of muscle tissues in the spinal degenerative cascade and exposed different rates of decline between lumbar muscles that appear clinically meaningful and show demographic and ethnic susceptibilities [4].
Our subsequent work, and that of others, highlight the temporality of muscle decline as a promising phenotypic biomarker in differentiating pathology [eg 5]. Additional value was in innovatively repurposing existing cross-sectional studies that used mixed imaging modalities [6], offering a springboard for application to clinical (and other) data to train and test machine learning models that can be applied to stratify recovery trajectories for patients with spinal conditions.
The spatial distribution of spinal muscle fat content in relation to degenerative and painful spine conditions is increasingly recognised as a key parameter in novel study of the spine that may reveal phenotypic expression of disease [7].
My PhD thesis, my list of peer-reviewed publications, and the top five cited papers I've co-authored are included for interest below as pdfs.
1. Crawford RJ, Filli L, Elliott J, et al. Age- and level-dependence of fatty infiltration in lumbar paravertebral muscles of healthy volunteers. Am J Neurorad 2016;37(4):742-748.
2. Crawford RJ, Volken T, Valentin S, et al. Rate of lumbar paravertebral muscle fat infiltration versus spinal degeneration in asymptomatic populations: An age- aggregated cross-sectional simulation study. BMC Scol & Sp Disorders, 2016;5;11:21.
3. Crawford RJ, Cornwall J, Abbott R, et al. Manually defining regions of interest when quantifying paravertebral muscles fatty infiltration from axial magnetic resonance imaging: a proposed method for the lumbar spine with anatomical cross-reference. BMC Musculoskeletal Disorders, 2017;18(1):25.
4. Crawford RJ, Volken T, Ni Mhuiris A, et al. Geography of lumbar paravertebral muscle fatty infiltration: The influence of demographics, low back pain, and disability. Spine, 2019;44(18):1294-1302.
5. Bailey JF, Nyayapati P, Johnson GTA, et al. Biomechanical changes in the lumbar spine following spaceflight and factors associated with post spaceflight disc herniation. SpineJ, 2022;22(2):197-206.
6. Crawford RJ, Elliott JM, Volken T. Change in fatty infiltration of lumbar multifidus, erector spinae, and psoas muscles in asymptomatic adults of Asian or Caucasian ethnicities. Eur Spine J, 2017;26(12).
7. Khattab K, Dziesinski LK, Crawford RJ, et al. Spatial distribution of fat infiltration within the paraspinal muscles: implications for chronic low back pain. Eur Spine J, 2022; .
Project partner (funded) for grant application development and projects needing my neuromusculoskeletal clinical & research expertise. Also desk-based tasks in the research pipeline, including design, planning, management, & writing (grants, proposals, reporting, publications).
Consultant to industry for healthcare (or aligned) product development, including think-tanks, round-tables, funding acquisition, prototypes, testing, revisions, and research.
Biomechanical and human movement analysis and needs assessment in collaboration with coaches. Optimise physical performance at recreational to competitive age-group level for most sports (particularly multi-sport (triathlon), throwing, water-based and older athletes.
My scientific consultancy services are typically engaged through existing contacts. If my expertise may be a useful addition to your project, enquiries via email are best.
My publications list, top 4 cited peer-reviewed journal articles (metric via Google Scholar), and PhD thesis are available below.
Standardisation and automation of muscles imaging & analysis.
Co-author
Exploring the geography of spine muscle quality in pain conditions.
Co-author
Dynamic stability in surgical back pain patients.
Project partner
International collaboration toward open-access image analysis and
a dataset to characterise healthy whole body muscle tissue.