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How to Navigate Body Challenges Throughout Life · HER

0:07
Dr Pam Peeke (Host): Well, hello there.
0:08
I'm Dr.
0:09
Pam Peeke, and this is episode 564
0:16
of the Bold and Brave HER Podcast.
0:20
And today, I'm joined by a wonderful friend and colleague who has a body story.
0:27
You know what I call this?
0:28
Let's see if I can say it right.
0:30
She's on a bodydsy, right?
0:32
Get odyssey, bodysy.
0:34
Oh, come on, you love it.
0:36
Rebecca, this is awesome.
0:38
So Rebecca, Rotstein is an expert in all things taking care of
0:47
your body, especially your bones.
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So she's the founder of Buff Bones Exercise Method for bone and joint
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health with virtual coaching, online programming, trained instructors
1:01
in more than 30 countries.
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And she's also an industry leader, um, with a background in Pilates.
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Align that body.
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Every time I hear Pilates, I just have to stand tall.
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Um, personal training, dance, and sports medicine.
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And she's…
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I'm not gonna tell you more about her story.
1:21
I want her to do that.
1:23
and that's all about her body and what's happened over the course
1:28
of decades, actually, in her life.
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Because, you know, at the end of the day, a lot of us, as, as women, look
1:36
at our bodies and, and try to, you know, look at the person next to you
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and say, "Oh, you know, I'll take their journey," or, "I'll just sort of be
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inspired by where they're coming from."
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And the answer is no.
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That's a hard no.
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You have to do this by examining yourself and making certain that you are honoring
1:59
every single twist and turn in life, and twist and turns in our body, um, and
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realize that you have to pay attention to you and stop looking at everybody else.
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Really, really important.
2:16
All right, so Rebecca, welcome to the HER Podcast.
2:20
Rebekah Rotstein: Thanks for having me.
2:21
I'm happy to be here
2:23
Dr Pam Peeke (Host): Oh my gosh.
2:24
Um, so when you first told me your story, I, I thought it would be so
2:30
incredible for women out there to hear how you, you know, evolved over time.
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Now you, you did ballet, right?
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Rebekah Rotstein: Correct
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Dr Pam Peeke (Host): And, and did you do it at a high level?
2:45
Rebekah Rotstein: A very high level.
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Um, I left high school to dance, uh, at North Carolina School of the Arts.
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So I left home to move cross-country to dance in high school
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Dr Pam Peeke (Host): Okay.
2:56
And then what happened with the ballet thing?
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Rebekah Rotstein: And I was planning to dance professionally, and I
3:03
ended up quitting with injuries.
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I thought that I would just never deal with the body again.
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And that lasted a brief period of time.
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But those injuries and that experience as a lifelong mover, 'cause
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actually I got into ballet because I was a competitive, ice skater.
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I was a ch- a state championship ice skater.
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And
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Dr Pam Peeke (Host): So you were a state championship ice skater, all right?
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And I take it even before that you were just hanging out of trees and just
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being totally physically active, right?
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Rebekah Rotstein: Well, actually I had skates on at age three,
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so pretty much after I could walk was when I started skating.
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So when I say I'm a lifelong mover, I mean movement literally has been, and
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athleticism to some degree, has been part of my life since just after I could walk.
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Dr Pam Peeke (Host): So you did ice skating and then you ended up in ballet
3:56
Rebekah Rotstein: Yes.
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Because, and I assume it's still the case, but certainly at that time in the
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80s, for competitive ice skating, you re- it required grace and it required that
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element of ballet because that artistry was a, very high component along with the
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athletic aspects of jumping and spinning
4:18
Dr Pam Peeke (Host): Okay.
4:19
So then we did the ballet thing, then, you know, sh- wiping shock
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off faced, you ended up with, you know, a mountain of injuries.
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and then what did you do, um, in terms of just, you know,
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physical activity and all of that?
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Rebekah Rotstein: Well, I quit and I went to college.
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And when I was at college, I worked in the sports medicine department.
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So I worked in, within the, training room, which is athletic training is
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basically physical therapy for athletes.
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So I was still involved in that way, and I was planning to go
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to physical therapy school.
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What did I do for my own body at that time?
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You know, I would try running.
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Um, I…
5:01
And soon after that actually, I started lifting weights very casually, not
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really knowing per se what I was doing, but I still would try to be active.
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And then actually soon after that was when I was introduced to Pilates as a
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rehabilitation method for my injuries.
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And that made everything click for me in my body and mentally because
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there was an element of full body experience that reminded me of dance.
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I think that's why Pilates often has been attractive to many dancers.
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But also there was a, an ability for me to have control over my
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body that I had really lost.
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And also it took me out of pain.
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I mean, that was a big key part.
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So that's kind of the history of what I did and then also how I even
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got into Pilates in the first place.
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Dr Pam Peeke (Host): So then did you become an instructor?
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I mean, did you go through the whole thing?
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Rebekah Rotstein: I did.
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I was doing it as a, a patient in physical therapy and then became a
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client as I segued out of physical therapy for a number of years.
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And then, yes, I went through a rigorous training program, became
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a certified instructor, and then I shortly thereafter joined the faculty
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of, of a major training center in New York City, where I lived at the time.
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Um, after college, I moved to New York City.
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I should give that background.
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And, yes, I-- that's really where I made my career.
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It started out in the Pilates realm, and that's, um, what also ha-
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gave me also many opportunities to travel around the world and train
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other exercise professionals and, to present at conferences and such
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Dr Pam Peeke (Host): So did you become a physical therapist?
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Rebekah Rotstein: I did not.
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And that's the irony is that I had decided not to go to physical therapy
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school because I didn't want to do anything with the body ever again.
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Dr Pam Peeke (Host): Oh, isn't that interesting?
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Now, what, what did you mean by that, you never want to do
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anything with the body again?
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Rebekah Rotstein: There was a grieving process, as I quit dancing.
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It was my entire identity.
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When you're at that level of whether it's professional or pre-professional,
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you live and breathe this.
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And all of a sudden, when it's curtailed, you know, I was 18, and I
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had what's essentially a midlife crisis.
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I didn't know who I was anymore without this.
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So, I had decided that I would work in the sports medicine area, um, of my college,
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thinking I'd go to physical therapy school, but soon decided after that I
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just needed to completely move away from anything that dealt with the body, 'cause
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it just felt, it felt painful emotionally.
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And it was, in some ways, an interesting precursor to another kind of grieving
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process I had a number of years later when I was diagnosed with osteoporosis.
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That
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same-
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Dr Pam Peeke (Host): we'll get to in a second.
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So the reason why I brought this whole thing up is because you're
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so open and articulate about how you were dealing with your body.
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so many women, uh, don't wanna have to deal with their body, or they have
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kind of, you know, uh, interesting delusions about what their body is and
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what it can do and, and all of that.
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And, um, I just, uh, found it fascinating that, you know, you were really,
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uh, going through these points where you were so tied up in your body.
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I mean, I did ba- San Francisco Ballet Academy, so I feel your pain.
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Um, but I certainly didn't take it to your level.
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I was just, you know, I'm doing it 'cause it was, you know,
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uh, how shall I say the word?
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Should I say enjoyable?
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Um, I really love doing it.
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It cer- I certainly had no intention of doing this as a career.
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It was just something that I knew I needed to do to get the grace and
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elegance and all the wonderful things you get out of ballet class, and the
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alignment and posture and all that.
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And it's a pretty good muscles too.
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But, you know, women, I think, fall in and out of love with their body.
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And, you know, for you, movement was huge.
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You know?
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It, it, movement was you.
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And when you couldn't do it,
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Rebekah Rotstein: Exactly.
9:13
The absence of
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that is just you don't know who you are.
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Um, and so yes, there's that interesting connection with your body that I think
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I've gone through a number of cycles with this throughout my, I guess, 50
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years now, where you ex- you, your, your identity and your relationship with your
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body changes at different points in life.
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And I think mine just went through a couple extra of those stages because
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of, that dance and athletic background.
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But you're right, there's these shifts that we go through in how we see
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ourselves, how we feel about ourselves, and how we move within this vessel
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Dr Pam Peeke (Host): so many women are not connected with
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their body in a very healthy way.
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Um, they sort of flagellate it and flog it.
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what I'm into is just listening to your body.
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It, you know, I know that sounds, like, earthy crunchy, and I
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should al- you know, offer you a cup of granola right about now.
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But, um, I'm here to tell you after having lived in my body for many decades
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that, uh, the body speaks to you.
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There's actually a word for it, it's called interoception.
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People who are…
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Yes, there you go.
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You know people who are very tied into their bodies, you know,
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athletes in general, and, know, where every square inch of your body
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is located at any point in time.
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We also know, you know, where pain happens, where it shouldn't happen, um,
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when to draw back, when to rein it in.
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We have all kinds of interesting things going on with our body.
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But one of the things I notice is that a lot of women don't have a
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healthy relationship with their body.
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You should wake up, I don't care how old you are out there in the Her Podcast land.
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But when you wake up in the morning, one of your first gratitudes, outside
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of saying you love all your family and friends, is that your body
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still works, and that it is such a blessing to you because it's gonna
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be able to take you amazing places.
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and heads up, girlfriends, as you get older, as you continue to age, 'cause
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you're aging right now, I don't care if you're 19 out there or if you're, you
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know, 69, it doesn't matter, you're aging.
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We all are.
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Okay?
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That your body is gonna continue to go through wild and crazy
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twists and turns in life.
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And when that occurs, you have to do what I love to call, you saw that in all my
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books, A-squaring it, adapt and adjust.
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Just, like, move like a fantastic athlete.
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I always think of tennis players, you know, who are just constantly,
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you know, doing micro adjustments or waiting for that ball.
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Which way is it gonna g- whatever.
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You're adapting and adjusting.
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You know, um, it is not the strongest who survive, it is
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not the smartest who survive.
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It is those who can adapt who survive.
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Rebekah Rotstein: I have to just commend you.
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You are one of the only physicians that I've known who is aware of
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and, and versed in interoception.
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And, uh, it is so important.
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And also that that adaptability is the key to everything.
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And this is what I wish more people understood and also appreciated.
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You're, you're really tapping into a love of mine, which is about somatics
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and that appreciation of your body and embodiment and understanding that pushing
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it is important, but as you said, like flagellation is not really the answer.
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How can we listen to it and how can we be respectful?
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Because that's where the intuition also comes into play.
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Dr Pam Peeke (Host): Exactly.
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Absolutely exactly.
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And, uh, that's something I love for women to really explore.
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This is one of the reasons why, Pilates, yoga, and a number of
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other movements, really help teach you the pieces of your body.
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You know?
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So when you're doing downward dog, you know, where's your little behind anyway?
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It's like flying up there in the air.
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You know, can you actually reach down on the floor?
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Well, that's because you have great core, back, flexibility, um, your hip hinging.
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You're doing all kinds of interesting things, and just being aware of all
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that is kind of extraordinary, and you will never fully appreciate it
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until something happens to your body.
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And
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Rebekah Rotstein: 100%.
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Dr Pam Peeke (Host): does that make sense to you, Rebecca?
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Rebekah Rotstein: Oh, you're, you're so spot on.
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And I think this is also where any kind of diagnosis that comes
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into play can be better dealt with when we come from that recognition
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of, "Oh, well, what's happening?
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What else is happening in, with my body?"
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Or as you pointed out, "What are all the other things that
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are going well with my body?"
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Because the fact that I'm living and breathing, and if you think of
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physiologically all the insane number of actions that are happening on a, uh,
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every second to allow you to function, there are so many things that are
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actually going right as opposed to one perhaps thing or several different
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things that are not going well within it
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Dr Pam Peeke (Host): Well, but here's the thing.
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Girlfriends out there, bank your body.
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Bank your muscles.
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'Cause honey, after the age of 50 especially, you're gonna need it.
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Because suddenly, you know, if you have a good strong core, and we're gonna get into
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how to do all that, but if you have a good strong core of muscle, flexibility, and
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balance, then when something goes awry, and honey, it's going to, guaranteed.
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I have crossed the Rubicon, I'm telling you from over here,
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something's gonna happen to you.
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and whether it's just, you know, arthritis finally did a number on your knee or,
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you know, your hip's kinda doing a little something something, or your back, or,
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you know, just name that body part.
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I always love to call it an organ recital.
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Okay, let's see what works today.
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Is the heart working?
15:45
The lungs are work- Okay, so you need to plan now, I don't care if
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you're 20, 30, 40, now, right now.
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And if it's, if you're already 60, fine.
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That's a perfect time to start.
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Um, some of the best athletes I've ever seen in the Senior Olympics,
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where I'm on the board, started when they were 60 years old.
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They just had this little awakening one day, m- more like a two-by-four
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to their head, like, "Hey, you know, I could be good at this."
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And then suddenly there they are.
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So the body is ridiculously forgiving, right?
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Up to a point.
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So bank your body now, because as you're gonna hear in a moment now, uh,
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Rebecca's now gonna tell you that here she is, she's doing Pilates, she's an
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instructor and all the other stuff.
16:39
Then what happened?
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We had the diagnosis
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Rebekah Rotstein: That's very, on, on spot.
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So I was training others to be Pilates instructors at one
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point when I was in my late 20s.
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I was 28, and I also taught the, what's known as special populations
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curriculum, the injuries and conditions because of that background that I'd
17:01
had, in the sports medicine area.
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And so I had dec- I taught about osteoporosis, among other things,
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but on a very basic level.
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So I was taking some additional curriculum and learned at the time
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how you build a majority of your bone density by the time you're 18 to 20.
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And some light bulbs started going off in my head knowing, okay, well,
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actually I had stopped menstruating.
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I had barely menstruated actually as a teenager, and then stopped, uh,
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amenorrhea
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Dr Pam Peeke (Host): because of the ballet training
17:32
Rebekah Rotstein: Yes.
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Because this is very common, and now we know this, and there's a lot more
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prevention and, intervention that goes on.
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But at the time, it was not unusual just as a ballet dancer
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to stop getting your period.
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And it could be for a variety of reasons, from eating disorders
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to simply not getting the caloric intake that you would need to match
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how much exercise you're doing.
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And that was the second part, was what my situation was.
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And now we know of this as RED-S, Relative Energy Deficiency in Sport.
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At the time, the name didn't exist, and we didn't talk about it.
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So, this is now, uh, this is now flagged with athletes, with dancers, ensuring
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that you don't stop menstruating because that can have deleterious effects down the
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road and even at the time on your bones.
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So, I knew that, wait, I probably would be at risk because of that.
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I also knew that osteoporosis ran in my family.
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Both my parents had it.
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Um, I'm small-boned on top of this, and I thought, "Let me get a baseline."
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Just a baseline DEXA, which is your gold standard for screening
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testing diagnostics of osteoporosis.
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And I thought I was just gonna get a baseline for later in
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life, and then it came back being told, "You have osteoporosis."
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So, that was like the screeching halt of the brakes that you hear in the sound
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effects for my life at that moment, where I had to pause, and yet again,
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just like years earlier, had that moment of reevaluation of everything
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Dr Pam Peeke (Host): once you got the diagnosis of osteoporosis,
19:13
did you even know what it was?
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Rebekah Rotstein: Yes, 'cause I mean, I taught the, the basics of the
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pathology, um, but I didn't understand personally what that really felt like.
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And all of a sudden I understood what most, you know, many seniors and at
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that point some midlife women also were, were talking about, that experience of
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fear and frustration and, um, overwhelm.
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And, you know, I even had the benefit of colleagues that were health
19:48
professionals that I could tap into, and still it was very scary
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Dr Pam Peeke (Host): Okay.
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And so you did a lot of homework, more homework, you know, basically saying,
20:00
"Okay, so I've got osteoporosis."
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Now
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Rebekah Rotstein: I did a lot of homework.
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I sought out, uh, healthcare professionals to help, including a top
20:11
endocrinologist in New York City, so that I could really get to the root of it.
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Because obviously it's not typical to be diagnosed at such a young age, which
20:22
also was part of the other challenge.
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You know, I was a young woman of childbearing age.
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I didn't know what medications would do.
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They hadn't been … One from my research that I was exploring, I,
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they hadn't been tested on people of the population of my age.
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And I also wanted to understand more, well, is there something
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else that's causing this?
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I wanted to get at the underlying root cause, and that's why I sought out the
20:46
medical help so that I wasn't just trying to do a guessing game, but I could really
20:50
find out, is there anything else that is, that is going on metabolically in
20:55
my body that could be leading to this?
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Dr Pam Peeke (Host): So you had all that checked out?
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Rebekah Rotstein: Yes
21:02
Dr Pam Peeke (Host): Okay.
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And what did you do?
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You know, what did you find out and what did you do with that?
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Rebekah Rotstein: Well, I found out fortunately that there
21:10
was no other underlying cause.
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You know, all the tests were normal, uh, blood work, bone turnover markers,
21:18
various hormone testing, et cetera.
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and really the one thing, the only thing was that I had a vitamin D
21:24
deficiency, which now everybody's very familiar with this discussion, but
21:30
in what, 2004, this wasn't something that was publicly talked about much.
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Um, and so what I did was I remineralized with vitamin C, or vitamin D, excuse
21:40
me, and I cleaned up my diet, uh, started working on my nutrition,
21:46
and also started strength training, because that is something that, as
21:51
I mentioned, I'd done a little bit casually, but I did it formally.
21:55
I sought out a trainer, um, who could help me with this specifically
22:00
so that I wasn't just trying to piece things together on my own.
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Dr Pam Peeke (Host): So wait a minute.
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You didn't mention something.
22:07
When you saw all the fancy-schmancy endocrinologists and whatever,
22:12
didn't they offer you drugs?
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Rebekah Rotstein: They did.
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And so I was offered bisphosphonates, which the endocrinologist
22:22
recommended against, in fact.
22:24
He said, You're not having bone loss," and that's the purpose of…
22:31
And we won't get into the whole classifications and categories of,
22:34
of osteoporosis medications, but the oldest classification and the
22:37
one that was most widely used at that time, um, halted bone loss.
22:42
But that wasn't the problem.
22:44
It was very clear from some of the testing that I wasn't
22:46
actually experiencing bone loss.
22:48
And so throwing that medication at me was, uh, f- according to the endocrinologist,
22:54
was not the answer, not the solution.
22:56
So he did not recommend that I take medications.
23:00
Um, and of course, just continued monitoring throughout my life,
23:04
but then what were the lifestyle interventions that I could do?
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And so I chose, again, coming as a, as a mover, how can I engage in appropriate
23:15
strength training to make a difference?
23:18
Dr Pam Peeke (Host): So let me go back for a second.
23:21
You're a little person.
23:23
You're what, five feet tall?
23:25
Rebekah Rotstein: I'm five feet and I usually hover a little under 100 pounds
23:29
Dr Pam Peeke (Host): Okay.
23:29
So like I said, you're a little person, um, and I'm not at 5'9".
23:35
So at 5 feet tall, it's an interesting thing.
23:40
Smart endocrinologists will realize that, um, all of the standards
23:45
that are set up were never meant for small people, small-boned,
23:51
petite, and shorter than average.
23:54
If you're loo- looking at like a 5'4-ish average, um, all those
24:00
numbers were meant for those people.
24:02
So where are you?
24:04
Who knows?
24:05
Um, but it doesn't really pertain in a big way to you.
24:09
So when we're really looking at peak bone mass and when we're trying to
24:14
read DEXAs, you know, the bone scans, it's a challenge with small people.
24:21
Rebekah Rotstein: You're…
24:21
Dr Pam Peeke (Host): so, ri- right?
24:22
Does that make
24:23
Rebekah Rotstein: That's spot on, and that is also something that the endocrinologist
24:26
pointed out to me, and that was the first I'd ever heard about how essentially
24:32
as a petite, small-boned woman, you are actually already at a disadvantage
24:37
when it comes to bone density in the ter- in the sense that you have less
24:40
bone mass than somebody who's larger.
24:43
And so he did highlight that to me, and that's something we've
24:46
also tried to share, with people throughout the years as well.
24:51
We meaning with my company.
24:53
But, um, to, to highlight, yes, that it may not necessarily
24:58
be that you have weak bones.
25:00
But when you take a, a twig versus a thicker stick and, uh,
25:06
you look at the mass, one is gonna actually have less mass.
25:10
Now, is it more predisposed to breaking?
25:13
Maybe, not necessarily, but that does have to be taken into
25:16
consideration, what you're pointing out.
25:18
And so yes, A, that, and also there with-- without getting too technical,
25:25
there's the T-score and the Z-score.
25:27
And for somebody of that age that I was at, really what should've been
25:32
looked at is a Z-score because that's where it's gonna be age-matched to
25:38
somebody who's also a young individual as opposed to comparing your s- uh,
25:42
as opposed to s- uh, a T-score, which is really used more for around the
25:47
time of menopause and, afterwards
25:50
Dr Pam Peeke (Host): Right.
25:50
So it's not age-appropriate for someone who's 28, who's small-boned and petite.
25:56
All right.
25:57
Now, when we come back, we're gonna find out how Buff Bones was born
27:01
And we're back.
27:02
All right, so Rebecca, here you are with the osteoporosis.
27:06
You've chosen, thank you, to utilize my favorite, which is strength training,
27:14
um, to be able to address the issue.
27:17
and you were smart enough to do due diligence and realize that you really are
27:23
an outlier as a small, petite humanoid.
27:27
Um, and so because of that, you know, you had to think for yourself
27:33
and hopefully get a terrific A-team of medical providers around you who
27:39
understood what was really going on.
27:42
So when did Buff Bones, when did you come up with this whole concept
27:47
of putting together, a program and a company around this whole issue?
27:56
Rebekah Rotstein: It was probably a few years later.
27:58
So initially after that, I was working on myself and, but within that year, I
28:04
started looking at research to see what, what's the story here with all of this.
28:09
and I also started within about a year or so, I created a workshop, and I started
28:17
creating some workshops that were just for the public to help educate them with what
28:22
I'd learned, and then also for exercise professionals, a lot
28:26
of whom were Pilates from that background that I'd had at the time.
28:30
And then within a few years, there was request for more.
28:34
So there was request for, for more direction, more guidance, and that's
28:39
really how Buff Bones came about.
28:41
I wanted a, a name that didn't have osteoporosis in it because then and
28:47
still now, it conjures a lot of fear and it deters people, and I wanted
28:51
something that would be empowering because that is the biggest part
28:56
that I found personally was stripped.
28:59
There's no other diagnosis that comes to mind for me, at least,
29:04
where the actual physiological action and discussion or description
29:10
matches the emotional experience.
29:14
You're told your bones are crumbling or your bones are frail.
29:18
All of a sudden you feel that, and going back to that discussion before of
29:23
more mindset, it's very disempowering.
29:25
It's very disheartening.
29:27
And so I wanted something that could basically turn that upside down and
29:30
help reclaim your, your sense of self and how you identify with your body.
29:36
So Buff came up, uh, with Buff Bones.
29:40
So it was within a couple years, and looking at all the, the literature, I
29:45
had to also along those lines, I was invited by Hatherleigh Medical Education
29:50
that, I don't know if it still exists, but in the '00s, that was big for, for
29:54
physicians like yourself to get their continuing medical, um, uh, your, your
29:58
CMEs, your education credits and such.
30:01
They were starting a branch at the time that was for exercise, so they asked me to
30:05
write a paper and I do a whole lit review for this on exercise and osteoporosis.
30:12
And that's really what became the genesis of how I really saw everything
30:18
that was out there to understand, what has been researched, what is
30:22
being advocated, on a, deeper level
30:26
Dr Pam Peeke (Host): Okay.
30:27
So then you put together Buff Bones.
30:30
Now let me go back to your journey.
30:34
When you started strength training, did you notice any change in
30:39
your bone scans over time?
30:41
Rebekah Rotstein: Yes, absolutely.
30:43
I mean, I moved, I, I have to look back exactly the length of time, but I
30:48
moved from osteoporosis to osteopenia.
30:50
I mean, that…
30:51
Dr Pam Peeke (Host): Okay.
30:51
Osteopenia means that, you know, you have a, some loss of bone mineral density,
30:58
again, per the norms, per norms, right?
31:03
But you haven't lost enough bone mineral density to actually cross over
31:11
to osteoporosis, which is more severe.
31:14
So now you, you are able to pull a U-ey come back into just low
31:20
bone density, which is fine.
31:23
And during this entire time, have you fractured at all?
31:27
Rebekah Rotstein: Thankfully, no.
31:28
And I hope
31:29
Dr Pam Peeke (Host): Okay.
31:29
No fracture.
31:30
No, no, no fracture.
31:32
You were able to turn it around.
31:33
I want people out there that listen to this, strength training is
31:38
extremely, you know, therapeutic when it comes to your bones.
31:43
Um, of course, it really depends upon where you are on that bone journey.
31:49
But regardless, everyone could get some level of benefit, whether you
31:55
already have osteoporosis or, you know, osteopenia, or quite frankly,
32:02
you're looking to prevent or slow down the bone mineral density loss.
32:08
Look, let, let's get real here.
32:10
Bone mineral density peaks for average individuals, and this is
32:16
women, right around the age of 30.
32:18
So that's plus or minus, you know.
32:20
Some people 28, some people 32, whatever, but right around the age of 30.
32:25
And then I don't care who you are, you will be dropping some
32:29
level of bone mineral density.
32:31
But you can mitigate the, how fast that loss is gonna take place, that,
32:38
as it were, slope of the curve, um, by doing strength training,
32:43
which is so terribly important.
32:46
And as well, you know, stimulating your bones with physical activity
32:50
per se, whether you're a runner, you know, a jogger, uh, jumping up and
32:55
down, you're a brisk walker, hiker.
32:58
All those things are fantastic 'cause they're weight-bearing
33:01
and gravity's your friend.
33:03
Um, just ask any astronaut whose bones melt when they go up in space.
33:09
So, you know, you can actually slow it down, but you can never stop it per se.
33:15
You know, something is gonna be happening even at a very small
33:18
level, um, all throughout the rest of your bo- uh, your life.
33:23
And the big time, and this is why I said bank your body, right at the time of
33:30
menopause, which is around the age of, you know, anywhere from 50 to 52-ish, right
33:35
around that time, when your sex hormones drop, you know, they take a big drop,
33:43
then what ends up happening is, you drop a lot of bone mineral density, a lot.
33:51
And so again, you can mitigate a lot of that by already
33:55
being on top of the program.
33:57
And that means that when you hit menopause, you're not already like
34:02
literally perched on the edge of osteoporosis, um, and that you've got,
34:08
you know, enough bone to work with now.
34:11
So that's just the reality of being a woman and her bones.
34:15
But Rebecca's story is really remarkable for the fact that she used strength
34:22
training in a petite, small-boned body that had already been formally diagnosed
34:31
with osteoporosis, even though the norms are different for small people.
34:36
And so, um, she was able to turn that around.
34:39
And have you kind of maintained that, um, for the time being?
34:44
Rebekah Rotstein: I have.
34:45
You know, I think the other one thing I wanna clarify is that there is an
34:51
advantage when you have a lot more estrogen in your system, as I did.
34:56
and so it is harder to make changes as estrogen declines.
35:01
but yes, I've been able to, again, stay out of the osteoporosis range,
35:07
and I hope to be able to do that.
35:08
But I also knew very clearly that I was gonna be at greater risk around
35:14
the time I am now, at 50, because again, of that estrogen decline.
35:20
And it's, it's also interesting seeing how there's been more discussion about
35:27
that time of perimenopause than there even used to be, because the data analysis
35:33
has, has even shown that within that one year prior to the final menstrual period
35:41
is when there's really rapid bone loss.
35:44
It's not even after menopause, it's actually just before.
35:48
there was some…
35:48
There was something presented at the recent international, or the, excuse
35:52
me, the Interdisciplinary Symposium on Osteoporosis just two months ago,
35:55
where you and I actually met last year,
35:57
um, that was pointing out about this critical period that, if I remember it
36:02
correctly, it was that entering menopause, even with osteopor- osteopenia, which
36:09
is borderline right there, will lead, without any other kind of intervention,
36:14
will decline to the level of osteoporosis by the time, I think it was 65.
36:18
Dr Pam Peeke (Host): that's exactly correct.
36:20
So to clarify, by the time you hit menopause, let's define menopause, 12
36:27
consecutive months of no menstrual cycle.
36:30
Well, 12 months ago is when everything disappeared, otherwise
36:35
you'd have a menstrual cycle.
36:36
So, or it, it didn't necessarily disappear, it just fell to such
36:41
low levels and your ovaries were done secreting these, uh, sex
36:46
hormones, um, at a higher level.
36:49
So you, to your point, you were already experiencing a dip at that time, and
36:56
then menopause hits 12 months later.
37:00
Uh, and then it just basically, you know, continues.
37:03
I should, you know, say that one of the current, algorithms that, uh, menopause
37:10
certified providers are now using is to actually introduce the concept of getting
37:17
a woman on estrogen, um, you know, even in perimenopause based upon her symptoms.
37:24
you know, I think that, um, that is extremely important.
37:28
Estrogen is an absolutely powerful bone builder, and so more and more women
37:35
are demanding estrogen patches, um, and get them on board as soon as possible.
37:42
They say that the window is a 10-year window from the time
37:46
that, um, you hit menopause.
37:49
Um, so if you hit menopause at six- at 52, then you're up to 62.
37:54
What happens beyond that is still, you know, being debated.
37:58
People are trying to figure out like, mm, you know, if you're 65, i- you
38:02
know, would that be appropriate?
38:04
here's the answer.
38:05
You sit down with a menopause certified provider, and you could find any
38:12
of these, uh, providers by going to the Menopause Society's, website.
38:19
Um, because all you have to do is enter your zip code and then they'll,
38:22
uh, tell you where you can find one of these, uh, highly trained providers.
38:28
They could be GYNs.
38:30
It could be, um, endocrinologists.
38:33
It could be, uh, family practitioners, internal medicine.
38:38
They come from all kinds of interesting backgrounds.
38:41
Um, a lot of g- uh, gynecologists are doing this now.
38:44
So that being said, um, to your point, estrogen can still be on board if you
38:52
are a good candidate for that, and your provider has to be able to look
38:57
at your personal family history and figure out what's going on, right?
39:01
Rebekah Rotstein: But I, I can do that.
39:02
I'm happy to be very transparent.
39:04
I, I knew for a while that I'd probably do that, and I've been on estrogen, estradiol
39:11
obviously, as well as progesterone, which, uh, for those who are not
39:14
aware,
39:15
Dr Pam Peeke (Host): because you still have a uterus.
39:17
Yeah.
39:18
So for all of us who do not, um, we just have the estrogen patch, and
39:23
I've been wearing that for many years.
39:26
Um, always ahead of the curve.
39:28
But, um, that being said, I'm just really happy to see that
39:32
there's yet something else we can do that's actually quite natural.
39:38
if you have the appropriate provider, they'll watch you
39:40
over time and, uh, help monitor.
39:44
Because, you know, women are, you know, moving targets.
39:48
You know, this is a dynamic process.
39:50
It's lo- it's not like, "Okay, I've arrived.
39:53
Bye."
39:53
You know, it's more like, mm, your body is gonna continue to do some
39:58
wild and crazy things, uh, all the way through the menopause transition
40:03
and then into post-menopause.
40:05
So you need a really good A team, and you have to do some homework.
40:09
When, uh, women roll their eyes and go, "Mm, homework," yeah.
40:12
What do you do when you want a good hairstylist?
40:15
Now, come on, girlfriends.
40:16
You know, you go through 35 people.
40:19
You, you're doing, like, intense vetting, and you're asking acid questions.
40:23
Well, hello, this is your health, and you gotta do exactly the same
40:28
thing to find the appropriate menopause certified provider for you.
40:34
All right?
40:34
So make sure to do your homework and get someone like that.
40:38
Um, and, you know, the reason why I'm saying that, and instead of just
40:41
saying, "Eh, just go to your GYN," the reason why is a lot of GYNs are not
40:47
yet trained in this, and I am shocked.
40:50
I mean, I think it's only, like, 20%.
40:52
Hopefully, that number is increasing.
40:55
you know, we have the Menopause Society meeting coming up in
40:58
October, another several months.
41:00
So let's, let's get some new numbers here.
41:03
But, um, I hope more and more and more, especially in medical school
41:08
and, during the training years per se, they're talking more and more
41:12
about this and staying up to date on, uh, menopause science in a big way.
41:18
So I love that.
41:19
Now, you've been lifting weights.
41:20
Um, you know, all right, let's do it.
41:22
Let's, let's do the gun show.
41:24
All right, you put your arm up.
41:25
Here we go.
41:26
Let me see.
41:30
There you are.
41:30
Look at this, this little person.
41:30
I'm gonna put mine up, okay?
41:31
We got, we got our little guns here.
41:33
It's the, it's the two-gun salute.
41:36
Um, and why are we doing that?
41:39
Not to be little nasty people and, and showing off, but we're doing
41:43
that to say we're women and we have the guns to show for it, okay?
41:49
And that means that there's a wonderful payoff, that will save your life one day.
41:55
I guarantee you, it will save your life.
41:58
Having a body that's well-prepared to be able to do, um, what you want it to,
42:06
especially when you're working around maybe some short-term or even chronic
42:11
impairments, 'cause it's going to happen.
42:14
It's the wear and tear of life, and that's the way it is.
42:18
So, tell us all what Buff Bones does and, and if someone went to the website, tell
42:24
us the website so we understand that.
42:27
Um, and who's it for?
42:29
Who shows up at your doorstep?
42:33
Rebekah Rotstein: Well, the website is buff dash or hyphen
42:36
bones, B-O-N-E-S, . com.
42:39
Who is this for?
42:41
It's, you know, we really have our primary focus on midlife women.
42:45
I created it for that when the term didn't exist.
42:48
So, you know, 2009 was formally when it, it started, and I would describe people
42:54
who are not baby boomers, but also who are not, you know, young 20-somethings.
42:59
We didn't really have the terminology we have now.
43:02
And so it was those women who I'm now part of this population, I wasn't at
43:07
the time, who were really overlooked, and that's the history of it, is that
43:12
there was a disservice to women in this point in life where they were capable
43:17
of so much more than just doing seated exercises, lifting their arms up overhead
43:21
as a senior was often considered.
43:23
And I should give a, a shout-out to my 80-year-old mother who weight
43:27
trains, who can out-plank most people.
43:30
Uh, so, you know, there's a, there's a difference now of, of, you know what, of
43:33
what we consider with chronological age.
43:35
But also at a different point in life than, than what a 25-year-old
43:39
might be seeking and might even be capable of with certain things going
43:42
on with joint pain or other issues they might have in their bodies.
43:47
And so I wanted to speak to that population, which again,
43:50
ironically, I'm now part of.
43:51
So what we do is we help, really, we help midlife women with osteoporosis
43:57
and/or, I should say, or osteopenia, low bone mass, to get strong, to
44:04
be resilient, to move well, because also there's elements of mobility
44:09
that we haven't talked about as well.
44:10
There's elements of balance, agility, uh, power output, various things,
44:16
body organization and motor control, which really is the basis before
44:20
you even start adding in loads.
44:23
For instance, if your joints are limited in range of motion, or you have different
44:28
compensations that you do when you try and lift your arm up overhead, and then
44:32
you wanna start adding weight, that's how the joints can actually become, um,
44:37
impaired, or you could get a rotator cuff tear because you're not really
44:41
moving the, the joint appropriately.
44:44
That has to really be looked at before we start adding in loads or
44:47
bigger loads, I should even say.
44:49
So we look at it from a really comprehensive approach.
44:52
And then of course, you know, there's elements of muscle mass
44:55
that we're talking about, and strength, certainly muscle strength.
45:00
But really a very comprehensive approach, and then providing education as well.
45:04
Um, and this is what we do in our virtual coaching specifically so
45:08
that people also understand what are tests, what are screens, what are
45:12
diagnostic tools that are out there?
45:14
What are these medications?
45:15
What do they do?
45:16
What do they not do?
45:18
So that you can better advocate for yourself when you meet with your
45:21
healthcare professional and, and are not just sort of caught in the
45:25
headlights of confusion and overwhelm.
45:28
And you can really reclaim your own identity, your power, um, your
45:33
voice, and move well and adapt in the way that you were talking about.
45:38
Because, yeah, life is gonna throw things at you.
45:41
You know, there's gonna be other things or injuries or conditions or tears that
45:45
happen in your body because life happens.
45:49
How do you work through that, and how do you continue to move
45:52
forward even when you might be temporarily sidelined by something?
45:57
Dr Pam Peeke (Host): The more fit you are mentally and physically, the
46:01
better you're going to stay resilient.
46:04
That's the rule.
46:06
So I don't-- again, I don't care what your age is right now, it's
46:10
never, ever, ever, ever too late.
46:13
Rebecca's living proof of having gone through, you know, quite a bodacy,
46:19
you know, um, over the years, uh, of everything from joy to grief to joy
46:25
to grief, um, and constantly adapting, listening to her body, more of that
46:31
interoception, um, and finding a way, navigating, What's, the, workaround?
46:39
Um, and that's what our job is in life, isn't it?
46:42
You know, when stuff happens to us, uh, it's those people who can figure out that
46:47
workaround quick enough, you know, who are those who can survive and thrive.
46:52
I don't care about just survival.
46:54
I want thriving.
46:56
You know?
46:56
Thriving is where it's at.
46:58
So, you know, yes, you have to be realistic about the fact that there are
47:02
gonna be certain things in life you can no longer do because of X, Y, and Z.
47:06
Okay.
47:08
Work around it.
47:08
What else can you do?
47:10
Always stay in the positive, because it's that four-letter word, hope.
47:16
People thrive on hope, and that's why, you know, when I saw the title of
47:21
the company Buff Bones, I loved that.
47:24
Immediately, you know, women can imagine, you know, their little bones being
47:28
all tough and, little, biceps muscles on every single bone and, you know.
47:33
It's, it's a great visual.
47:35
So it's, uh, you know, kudos to you for coming up with such a great, title for
47:39
the company, and also for you being such an inspiration and motivation to all of
47:44
your, um, teachers that you're teaching as well as, um, just regular clients.
47:50
Tell everyone how they can get ahold of, uh, your company and engage with you.
47:56
Rebekah Rotstein: So you can, for one thing, you can find us on Instagram.
48:00
Uh, the handle
48:03
is @gotbuffbones.
48:04
our gen X, uh, generation remembers the Got Milk campaign.
48:09
And then our website again, uh, buff-hyphen-or-dash-bones.com
48:16
is how you can reach out to us for more information and see if we can help you.
48:20
we also, you know, try to provide free public information as well, whether it's,
48:24
again, educational through our Instagram or through webinars that we offer.
48:30
You know, we are educators at heart, and I think that's a, a key thing
48:33
is that education is the forefront for us, uh, pedagogy, education.
48:38
And we want people to understand not just what to do with their
48:42
bodies, but how their bodies operate.
48:44
Because when you come from that point of view, you actually appreciate
48:48
it more, and it goes full circle to what you said at, at the beginning
48:52
with interoception and hope.
48:55
and it, you come from a place of curiosity, and I think that really
48:59
deserves more recognition for all of us
49:03
Dr Pam Peeke (Host): Fantastic.
49:04
What a beautiful way to end this.
49:06
Um, Rebecca Rothstein, I can't begin to thank you enough.
49:10
Everyone, the group is Buff Bones, right?
49:16
uh, you can learn more about that, um, through the websites and the
49:20
Instagram, uh, that Rebecca just shared.
49:23
Um, Rebecca, you will now be a, a repeat offender, meaning that we will
49:28
have you back again and again, because we are very hungry for that education.
49:34
So thank you, Rebecca
49:36
Rebekah Rotstein: Thanks so much for inviting me to be here.
49:38
It's been wonderful talking with you
49:40
Dr Pam Peeke (Host): All right.
49:41
And I also want to thank my wonderful sponsor, and that is Stop
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50:31
Oh my goodness.
50:33
All right.
50:34
Oh my goodness.
50:35
This has just been a fantastic podcast.
50:39
So I want all of you to leave us a review because we love to hear from you.
50:47
Now, this has been a production of Podcast Health.
50:53
Ah, what a fantastic production team it is.
50:57
And I got a little something for you.
50:59
I love Emily Dickinson.
51:00
I don't know about you, but she wrote something once that I really love.
51:04
And as a physician, it kind of hits home, and, Rebecca, especially since
51:09
you're also in the healing arts.
51:11
"If I can stop one heart from breaking, I shall not live in vain.
51:16
If I can ease one life the aching or cool one pain or help one fainting robin unto
51:25
his nest again, I shall not live in vain."
51:31
I love that.
51:32
What a great way to end that.
51:33
So all right everyone, go on out there.
51:36
Carpe diem, seize the day, and thanks for listening