Latest / The Body Pod / Best of The Body Pod - Stronger Bones After 40: Dr. Lisa Moore on Osteoporosis, Bone Health & Midlife Fitness

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Best of The Body Pod - Stronger Bones After 40: Dr. Lisa Moore on Osteoporosis, Bone Health & Midlife Fitness · The Body Pod

0:00
Speaker 1: High Bodypod Family. We are back with another best of
0:03
Speaker 1: the Body Pod and this one is one I consider
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Speaker 1: essential listening for every woman in our community. We sit
0:11
Speaker 1: down with doctor Lisa Moore, physical therapist, bone health specialist
0:16
Speaker 1: and founder of the Brick House Bones Program. If you
0:19
Speaker 1: have ever been handed a DEXA result and felt lost
0:23
Speaker 1: or been told to just take calcium and vitamin D
0:27
Speaker 1: and scent on your way, this episode is going to
0:29
Speaker 1: change everything. Here's why this one needed to come back.
0:34
Speaker 1: Doctor Moore breaks down osteopenia and osteoporosis in the clearest,
0:38
Speaker 1: most practical way we have ever heard. We talk about
0:42
Speaker 1: lifting heavy with osteoporosis. Yes you can. She explains how
0:47
Speaker 1: to build up safely, how to modify, and why the
0:50
Speaker 1: goal is fracture prevention not just a better number on
0:53
Speaker 1: a scan. This reframe alone is worth the whole episode.
0:57
Speaker 1: We then move into why nutrition for health goes so
1:01
Speaker 1: much deeper than calcium. Doctor Moore covers protein, magnesium, vitamin
1:06
Speaker 1: K two, boron and even prunes and why being chronically
1:11
Speaker 1: underfueled is one of the biggest silent threats to your bones.
1:15
Speaker 1: And she says something that I often repeat with my clients. Constantly.
1:20
Speaker 1: Muscle loss and bone loss go together. If you are
1:23
Speaker 1: losing muscle, you are losing bone. This is the message
1:27
Speaker 1: that needs to reach every woman in this transition. Doctor
1:31
Speaker 1: Moore is warm, empowering and deeply knowledgeable. Her whole mission
1:36
Speaker 1: is to make sure no woman feels fragile or left behind,
1:40
Speaker 1: and that comes through and every single answer she gives.
1:44
Speaker 1: So let's get into it. This is the best of
1:47
Speaker 1: the Body Pod. Welcome back everyone for another episode on
1:53
Speaker 1: the Body Pod. Today, I have the privilege of introducing
1:56
Speaker 1: you to doctor Lisa Moore. Doctor Lisa will is a
2:00
Speaker 1: twenty eight year veteran physical therapist who supports women who
2:04
Speaker 1: have had a diagnosis of breast cancer and osteoporosis. She
2:08
Speaker 1: is certified in Cancer Rehabilitation Bone Fit trained through the
2:12
Speaker 1: Bone Health and Osteoporosis Foundation. She's a certified yoga teacher.
2:16
Speaker 1: She is also certified in Functional Nutrition for chronic pain
2:21
Speaker 1: via the Integrative Pain Science Institute. Lisa has developed the
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Speaker 1: Brick House Bones program for evidence based exercises to support
2:29
Speaker 1: bone health for people with low bone mass and osteoporosis.
2:34
Speaker 1: Her many years of clinical work as a physical therapist
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Speaker 1: have her constantly seeking knowledge about what truly helps women,
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Speaker 1: how to facilitate change, and how to empower women toward
2:44
Speaker 1: their own recovery. So this conversation is very interesting and
2:51
Speaker 1: very educational, So enjoy this episode with doctor Lisa. All Right,
3:01
Speaker 1: doctor Lisa Moore, we are so thrilled to have you
3:04
Speaker 1: here today as this massive osteoporosis name and expert in
3:11
Speaker 1: the field. So thank you for sharing your time with
3:14
Speaker 1: us today.
3:15
Speaker 2: Oh, thank you, Hailey, Laura. It's really an honor and
3:18
Speaker 2: a privilege to be here and I'm so grateful you
3:19
Speaker 2: invited me.
3:20
Speaker 1: Thanks well, our audience is going to love this because
3:22
Speaker 1: I'll have to tell you, Lisa, in the last year
3:27
Speaker 1: since menopause has kind of had this massive growth the bone.
3:33
Speaker 1: You know, bone health is a massive topic, and I
3:37
Speaker 1: will say that just getting you know, thousands of women
3:40
Speaker 1: onto my platform, people will, you know, women will come
3:44
Speaker 1: in and they're just like, I don't know what to do,
3:46
Speaker 1: or they'll tell me their diagnosis and I'm like, what
3:49
Speaker 1: you know, I'm not diagnosing you?
3:52
Speaker 2: Where do you know?
3:52
Speaker 1: But their questions are all like where do I start?
3:55
Speaker 1: So I want to dive right in to how you like,
4:00
Speaker 1: how did you come upon this obviously you you're a
4:03
Speaker 1: physical therapist, and when did the osteoporosis Have you always
4:09
Speaker 1: been interested in that or did that kind of come
4:11
Speaker 1: later on?
4:12
Speaker 2: Yes, So later in my career, I was focusing on
4:16
Speaker 2: oncology rehab. So in my fifties, I'm working with women
4:20
Speaker 2: who've had breast cancers, are going through breast cancer treatment,
4:23
Speaker 2: and they're at even higher risk for osteoporosis and bone
4:27
Speaker 2: health issues because of the treatment and because of estrogen
4:29
Speaker 2: suppression after this, and they're asking me, how can you
4:33
Speaker 2: help protect my bones? And I didn't know. It wasn't
4:36
Speaker 2: part of my training. And then I get my own
4:38
Speaker 2: bone density because well, I'm curious. I'm not waiting till
4:41
Speaker 2: I'm sixty five to find this out. And I have
4:44
Speaker 2: low bone density. So it wasn't part of my traditional
4:48
Speaker 2: PT training. It wasn't part of my normal skill set.
4:50
Speaker 2: And I knew enough to tell people to limit activity,
4:54
Speaker 2: but I didn't know enough to really empower them to
4:57
Speaker 2: take control. So that's when I really took a deep
5:00
Speaker 2: I have in training and bone fit in the Institute
5:02
Speaker 2: of Clinical Excellence, really finding what is up to date
5:05
Speaker 2: research for myself and so I could help my clients.
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Speaker 2: It was a huge gap because most of the information
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Speaker 2: education was aimed at the most frail and the most vulnerable,
5:17
Speaker 2: and it didn't really fit people like me that wanted
5:20
Speaker 2: to be strong and active but just needed to know
5:22
Speaker 2: how to modify my high intensity strength training, how to
5:27
Speaker 2: incorporate aerobic training or flexibility that was safe from my body.
5:31
Speaker 2: So that's how I got started.
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Speaker 1: And how long has this been since this has been
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Speaker 1: your focus?
5:37
Speaker 2: Probably three four years of education and I've only started
5:41
Speaker 2: really producing content for a year and a half. But
5:44
Speaker 2: it's been really high demand. People are asking for more
5:48
Speaker 2: and more about what you exactly said. How do I
5:51
Speaker 2: do this? How do I start? And how do I progress?
5:53
Speaker 1: Oh, Lisa, we have nine million conversations. I wish I
5:56
Speaker 1: was your neighbor right now and we could just have
6:00
Speaker 1: sho it all out for like an entire day. So
6:03
Speaker 1: I am super familiar. We're super familiar with your with
6:05
Speaker 1: your YouTube, which you're crushing, by the way. I'm blown
6:10
Speaker 1: away that you've only been doing that for for such
6:12
Speaker 1: a short a short period of time, so that says
6:14
Speaker 1: a lot. But you've created brick house Bones. Tell us
6:17
Speaker 1: the story behind that name and your mission with it.
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Speaker 2: Well, I just love the sound brick house bones, you know,
6:24
Speaker 2: it's so empowering. But it really is about the children's
6:27
Speaker 2: book The Parable, right, It's about building this body for life.
6:31
Speaker 2: That isn't about quick fixes, gimmicks, fancy gadgets, or just
6:36
Speaker 2: a drug or pill. It's about these small action steps
6:39
Speaker 2: that we take over time consistently so that through our lifespan,
6:44
Speaker 2: including being an older adult, which we all want to achieve.
6:48
Speaker 2: It isn't about who is the smallest, but who is
6:50
Speaker 2: the strongest that gets to stay independent and active and
6:54
Speaker 2: out of a nursing home and living the life that
6:56
Speaker 2: they want for as long as possible.
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Speaker 1: I love it. So through your through this YouTube channel,
7:03
Speaker 1: you've had thousands of women come through getting this information.
7:06
Speaker 1: If we were to start at the very beginning, let's
7:10
Speaker 1: just start with osteopenia and osteoporosis. So everyone knows the
7:15
Speaker 1: names of those, but where does the where do we
7:18
Speaker 1: differentiate osteopenia and osteoporosis? And I'm just curious, this wasn't
7:24
Speaker 1: even on my notes. What do you see more? Do
7:27
Speaker 1: you get more women in the osteopenia realm or do
7:30
Speaker 1: you get more women that are osteo or that are
7:32
Speaker 1: already osteoporosis.
7:33
Speaker 2: Great question. Well, so it's based on a bone density test,
7:38
Speaker 2: which the gold standard in the in the world is
7:41
Speaker 2: a DESA scan that measures the density of our bones.
7:45
Speaker 2: And there was a cut off line for determining what
7:48
Speaker 2: is a risk factor for osteoporosis, so that is osteopenia.
7:52
Speaker 2: Osteopenia is a risk factor for osteoporosis. It's like pre diabetic.
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Speaker 2: We're getting warning signs that there's some loss happening, and
8:01
Speaker 2: when we look at scores, it kind of shows up
8:03
Speaker 2: like a thermometer. So the more negative the score, the
8:07
Speaker 2: lower the score, the colder it gets, the worse the
8:10
Speaker 2: number is in our bone density. So a score of
8:12
Speaker 2: minus one to minus two point four is that osteopenia
8:16
Speaker 2: or pre osteoporosis stage. This is really a time where
8:20
Speaker 2: we need to take action. More people have osteopenia. There's
8:25
Speaker 2: a much larger number of people that fit this category
8:28
Speaker 2: than osteoporosis, but it is a sign that we need
8:31
Speaker 2: to take action. Any number from minus two point five
8:34
Speaker 2: or below is the diagnosis of osteoporosis and low bone density.
8:39
Speaker 2: And that number was kind of randomly assigned by a
8:42
Speaker 2: group of professionals because they had to place some sort
8:44
Speaker 2: of cut off to say where do we start to
8:46
Speaker 2: pay more attention and consider treatment options. I would say
8:51
Speaker 2: most of my clients that I see are in the
8:53
Speaker 2: osteoporosis range, the people that reach out to me, both
8:56
Speaker 2: virtually and in person. That because often and they don't
9:00
Speaker 2: know that this has happened because they've been tested till
9:03
Speaker 2: later or till after they've already had a fragility fracture
9:06
Speaker 2: and then they're diagnosed with osteoporosis.
9:09
Speaker 1: I know where I'm sending every person. I'm just gonna
9:12
Speaker 1: link you on my website. I'm not joking because when
9:15
Speaker 1: those women come in, I see more of the osteopenia
9:18
Speaker 1: that are kind of getting into that or they might
9:21
Speaker 1: not even know that yet, but that you know, when
9:23
Speaker 1: somebody comes and says, I have you know minus three
9:27
Speaker 1: and what do I do? I'm like, I'm not prescribing
9:32
Speaker 1: anything for you. You know, you need to get cleared
9:35
Speaker 1: by a physician and you need to have a physical
9:37
Speaker 1: therapist to guide you through. Like that needs to be
9:40
Speaker 1: more one on one treatment. How do you with your
9:44
Speaker 1: with your YouTube? So if somebody, Well, tell us first
9:48
Speaker 1: what the four x four method is, because initially when
9:52
Speaker 1: I love it and I know what it is. But
9:54
Speaker 1: when I first saw that, I was like, oh, everyone's
9:57
Speaker 1: talking about four x four heavy lifting. That is that
10:00
Speaker 1: what she means? But you tell us what that is.
10:03
Speaker 2: Yeah. So my four x four program is four exercises,
10:08
Speaker 2: four rounds, working upper body, lower body, core and impact.
10:13
Speaker 2: So this is moderate to high intensity, depending on how
10:16
Speaker 2: much weight you use and your ability. I give modifications,
10:19
Speaker 2: but it's just a way for people who are busy
10:22
Speaker 2: professionals or busy lives that want to get a targeted
10:26
Speaker 2: exercise program that doesn't have dangerous exercises in it if
10:30
Speaker 2: they have osteoporosis, but gives them a really strong stimulus
10:34
Speaker 2: for strength. And I have a bigger program called Build,
10:39
Speaker 2: which is more eight exercises, four rounds, includes balance and
10:42
Speaker 2: mobility and more complex moves. But people wanted a more efficient,
10:48
Speaker 2: compact workout, so that's what I created. The four by
10:51
Speaker 2: four is they ask, and.
10:52
Speaker 3: So can any age or any like, if you're beginner
10:56
Speaker 3: or advanced, can anyone do that?
10:59
Speaker 1: Do you feel?
11:00
Speaker 2: I would you be? Four by four is definitely more
11:02
Speaker 2: more for an experienced exercise or somebody that's already been
11:06
Speaker 2: doing you know, weightlifting training, maybe a little bit of jumping,
11:10
Speaker 2: although I do provide modifications for people that don't want
11:13
Speaker 2: to jump at all, modifications on styles of push ups
11:16
Speaker 2: or renegade rows or things like that. I mean, they
11:18
Speaker 2: can use no weight if they want to go through
11:21
Speaker 2: the movements, or they can use heavier weights. But I
11:24
Speaker 2: do recommend that it's not a beginner's program. It's not
11:27
Speaker 2: a place to start if you're newly diagnosed and you're
11:29
Speaker 2: figuring out how to begin safe strength training.
11:33
Speaker 1: Okay, so let's dive there because you and I, you know,
11:38
Speaker 1: we're all aware of the messages out there for the
11:41
Speaker 1: menopausal crowd, and when anything explodes, there's I would say
11:49
Speaker 1: a potentially dangerous side to information because there's the you know,
11:57
Speaker 1: women need to lift heavier, yeah, us and or but
12:03
Speaker 1: there are definitely limitations, and let's dive into that because you.
12:10
Speaker 3: Don't want to create I'm aware you don't want to
12:13
Speaker 3: hurt yourself.
12:16
Speaker 1: Well, and it's I mean, it's it's a lot of pressure.
12:18
Speaker 1: There's a lot of pressure when when you're helping women
12:20
Speaker 1: and they're like, okay, cool, I need a jump and
12:22
Speaker 1: I need to lift heavy, right, But what's your situation?
12:28
Speaker 1: So what tell us about what that means to you
12:33
Speaker 1: and how you break that down for someone because I'm
12:35
Speaker 1: sure you get asked some of those same questions as well.
12:39
Speaker 2: Yes, absolutely, And the thing about YouTube is it's really
12:42
Speaker 2: a general education platform, right, It's not a one size
12:46
Speaker 2: fits all tool. Yes, there's so much messaging about women
12:50
Speaker 2: need to lift heavy, but when we put this in
12:53
Speaker 2: context of bone health, and we have to put it
12:55
Speaker 2: in the context of the individual. And so we have
12:59
Speaker 2: lots of wonderful evidence that supports low, moderate, and high
13:04
Speaker 2: intensity strength training to improve muscle mass and bone density.
13:08
Speaker 2: It is the effort that is produced. So if you're
13:11
Speaker 2: doing lower weights and higher repetitions and you have a
13:15
Speaker 2: similar amount of fatigue as somebody with higher weights and
13:18
Speaker 2: lower reps, we're still getting the benefit we want. We
13:22
Speaker 2: don't have to add extra force on joints if that's
13:25
Speaker 2: not in your comfort zone. And I think it's really
13:27
Speaker 2: important and I love your messaging on this and building
13:31
Speaker 2: that base, building that stability, getting this functional movement patterns
13:36
Speaker 2: correct before we start to add a lot of load.
13:39
Speaker 2: And for anyone that has other complex medical history, rumatoid
13:43
Speaker 2: arthritis or other conditions bondalo the these different conditions of
13:47
Speaker 2: the spine that they have fear about movement, we can
13:51
Speaker 2: absolutely keep loads small and build movement confident first. To me,
13:55
Speaker 2: that's one of the most important things in the messaging
13:58
Speaker 2: is for people to be able to too into their
14:00
Speaker 2: bodies and learn this feels good when I do this,
14:04
Speaker 2: and this feels like too much, So I'm going to
14:06
Speaker 2: redirect my training that feels better in my body in
14:09
Speaker 2: this situation. And I think there's always a way to
14:12
Speaker 2: adapt and modify. That includes movement, not eliminates.
14:17
Speaker 1: It includes not eliminates.
14:20
Speaker 2: I love that.
14:23
Speaker 1: So all right, if we're a beginner and somebody comes
14:27
Speaker 1: and they're not even the beginner, that the the descriptions
14:32
Speaker 1: and the definitions that we give a beginner intermedia advanced
14:35
Speaker 1: are vast and that can get swimmen into you know,
14:42
Speaker 1: general programming, into a potentially wrong program because they may
14:47
Speaker 1: think that they're advanced, but you know, it all depends
14:50
Speaker 1: on what the trainer. What the trainer decides is maybe
14:54
Speaker 1: an advanced level. But if you have someone that just
14:57
Speaker 1: here's they need to start jumping, even if they have
15:00
Speaker 1: they don't have osteopenia, or maybe they do slightly, maybe
15:04
Speaker 1: they've just discovered that. But either of those camps and
15:07
Speaker 1: they're in their forties, they're decently fit, they're they're exercising
15:12
Speaker 1: most to days. Would you start them with just jumping
15:17
Speaker 1: right away.
15:18
Speaker 2: No, If they're already exercising, that's great. I like to
15:23
Speaker 2: go from strength training to power. So power is still
15:27
Speaker 2: getting more ground reaction forces. We're building up speed because
15:31
Speaker 2: that's what jumping is. Right, we're talking more power exercises,
15:34
Speaker 2: But we can do that work on that power, that speed,
15:38
Speaker 2: kettlebell swings, dumbbell clean snatches, We can even do squats
15:44
Speaker 2: at a different tempo, so that we're building power and speed,
15:48
Speaker 2: maybe working a little bit of agility training to work
15:51
Speaker 2: that loading. We have to train. Then how do you land?
15:54
Speaker 2: If you're going to begin jumping, you have to be
15:56
Speaker 2: able to land correctly and that impact. Some people mistake
16:00
Speaker 2: thinking they have to land with a stiff leg or
16:02
Speaker 2: stiff knee, and that is not the case. We still
16:04
Speaker 2: want to absorb those forces with some flexibility there. So
16:08
Speaker 2: I generally start with power and agility strength training, power agility,
16:12
Speaker 2: and then progress up to impact. If they're landing. If
16:16
Speaker 2: we can you know, step off a low box and
16:18
Speaker 2: have a good landing platform, then we can build from there.
16:22
Speaker 1: Okay, I'm so glad you said that, because that is
16:24
Speaker 1: what I recommend the same whether anyone takes my advice.
16:28
Speaker 1: Not everyone will, and people will want to just jump
16:31
Speaker 1: right into it. But that is super important that we're
16:37
Speaker 1: building up the ability because I'm like, when's the last
16:41
Speaker 1: time you jumped. I don't know, when I was a teenager. Okay,
16:45
Speaker 1: you don't get to just go back into you know,
16:48
Speaker 1: doing these jumps if we haven't really prepped the body.
16:51
Speaker 1: So I take a similar approach there as well. Now.
16:56
Speaker 2: So the other thing with that is we're as we're
16:58
Speaker 2: in perimenopause and menopause and change in our ability to
17:01
Speaker 2: adapt and modulate collagen tissue when we when we rush
17:05
Speaker 2: into ballistic activities like that, that's where planer fasciitis happens.
17:10
Speaker 2: That's where we get tendon itis issues really quickly. So
17:13
Speaker 2: we have to build that resilience in our on our
17:15
Speaker 2: tissues and especially in our ten and ligament tissues to
17:18
Speaker 2: be able to do that, especially at this time frame
17:20
Speaker 2: of perimenopause and menopause Oh.
17:22
Speaker 1: Yeah, it's a different game, no question. So if we
17:24
Speaker 1: talk about the landing, because there was a study that
17:26
Speaker 1: came out that talked about the hard, stiff landing and
17:31
Speaker 1: that's kind of been confusing for for a lot of
17:33
Speaker 1: women too, including myself when I was like, wait, so
17:36
Speaker 1: we're supposed to land hard or we're supposed to land
17:40
Speaker 1: and actually absorb. So with that, I'm sure you're familiar
17:44
Speaker 1: with the study that I'm talking about, the one study that.
17:46
Speaker 2: Had the.
17:49
Speaker 1: Sharp, you know, stiff stiff landing, right, what are your
17:55
Speaker 1: thoughts on that?
17:57
Speaker 2: As a thirty year veteran physical therapist, I do not
18:01
Speaker 2: like that stiff legged landing when it comes to hips, knees,
18:03
Speaker 2: and feet. I just don't think the benefits outweigh the risks,
18:08
Speaker 2: and so I don't teach that method. I don't think
18:11
Speaker 2: the value is there for how to have healthy, happy joints.
18:16
Speaker 1: I love it. I love that stance. Okay, thank you
18:18
Speaker 1: for clarifying, because I know that's kind of a mixed
18:22
Speaker 1: message too. So if we look at the one the
18:26
Speaker 1: statistics of one one to two women over fifty will
18:29
Speaker 1: suffer an osteoborotic fracture, and then we know that your
18:35
Speaker 1: chance of refracturing is quite higher if you've already had
18:39
Speaker 1: a fracture at this age stage. So someone comes to
18:43
Speaker 1: you again, I just like basic in real life advice
18:48
Speaker 1: of someone comes to you, would you how long is
18:52
Speaker 1: the build up before you would have them say, using
18:55
Speaker 1: some heavier loads. And of course it's individual, But is
18:58
Speaker 1: there kind of like, oh I see it on three
19:00
Speaker 1: you know, six months post fracture, depending on the ability
19:05
Speaker 1: level or is that just too broad of an answer
19:08
Speaker 1: question to answer?
19:09
Speaker 2: Yeah, it is really, it is really difficult, and it
19:12
Speaker 2: is really individual. But but what But what I would
19:15
Speaker 2: want to say is I've worked with many, many clients
19:17
Speaker 2: who have had either vertebral fractures or hip fractures, wrist, pelvis.
19:22
Speaker 2: And of those clients that are able without any other
19:26
Speaker 2: barriers to participate in a strength training program, they do
19:31
Speaker 2: get up to lifting in a very high intensity and
19:34
Speaker 2: a very high quality, you know, up to eighty percent
19:39
Speaker 2: of their one redmax we can do and not all
19:42
Speaker 2: of them do that. But and the build is based
19:46
Speaker 2: on control. So as I'm watching somebody and as I'm
19:48
Speaker 2: guiding somebody, I'm really looking for are they able to
19:52
Speaker 2: maintain that spinal extension with their goblet squat because that
19:55
Speaker 2: is protective. Are do they need wedges for their squad
20:00
Speaker 2: because they're getting too much flexion and tipping forward when
20:03
Speaker 2: they're squatting. How do we modify it to keep them safely?
20:05
Speaker 2: And if the movements can be done safely, then we
20:08
Speaker 2: progress as normal. And of course they have to have
20:12
Speaker 2: adequate healing, they have to have adequate nutrition, they have
20:15
Speaker 2: to be able to have adequate rest. I worry too
20:18
Speaker 2: much about overtraining, so but there there isn't necessarily a limit.
20:24
Speaker 2: When I have someone who has a history of a fracture,
20:28
Speaker 2: I might just go a little more slowly and I'm
20:30
Speaker 2: a lot more critical about the quality of their movement.
20:35
Speaker 1: Okay, but they can get back up to heavier lifting.
20:39
Speaker 2: Yes, jumping, jump jumping maybe jumping maybe if they if
20:46
Speaker 2: someone's had a fraction. I do have folks that get
20:48
Speaker 2: into jumping if they have had a fracture. But one
20:51
Speaker 2: of the things we do is a fracture risk assessment.
20:54
Speaker 2: So what is there decks, a score, what are there
20:57
Speaker 2: other fracturists? They have a family member as fractures like
21:00
Speaker 2: either parent had to hit practice, so we do a
21:02
Speaker 2: fracture risk assessment too to weigh the pros and cons.
21:06
Speaker 2: You know, is it beneficial to do this or should
21:08
Speaker 2: we just focus on the strength training?
21:11
Speaker 1: Okay, so everyone needs a Lisa pt in that life
21:17
Speaker 1: guiding them through. So when we look at the body
21:20
Speaker 1: parts where we have these the fracture risks, So let's
21:23
Speaker 1: start with the rest. What do you do in maybe
21:27
Speaker 1: even like your YouTube series to build up that area?
21:32
Speaker 2: Well, I love it. And first of all, the bone
21:35
Speaker 2: health exercise should be full body, so we should be
21:38
Speaker 2: treating everything, not just the areas that are measured. But yes,
21:43
Speaker 2: arms are generally not weight bearing, right, we don't walk
21:45
Speaker 2: on our hands, so we don't get the same stimulus
21:47
Speaker 2: to our bones, but we can do weight bearing. So
21:51
Speaker 2: and anything that involves gripping is working these forearm flexers.
21:56
Speaker 2: So we can do planks. We can carry wait, it's
22:00
Speaker 2: Farmers carry suitcase carries any upper extremity strengthening where you're
22:04
Speaker 2: holding weights is working the forearms. We can hang from
22:07
Speaker 2: a bar and do dead hanks. That's a great grip
22:10
Speaker 2: strength exercise to help with forearm bone density. I love
22:15
Speaker 2: to use you know, Blaize pods. I love Blaze pods.
22:18
Speaker 2: So people are in a plank position and then they
22:20
Speaker 2: got to tap out stomp out the light, so we're
22:22
Speaker 2: getting a little bit of an impact as well at
22:25
Speaker 2: the same time. So carries, push, pull, lyft. If it's
22:30
Speaker 2: in your hands, it's helping your forearms. And then weight
22:33
Speaker 2: bearing is another thing.
22:34
Speaker 3: Okay, I'm so glad you asked that question, Hayley, because
22:37
Speaker 3: I don't know if it's because I knew we were
22:39
Speaker 3: talking to you today, but when I was taking a
22:42
Speaker 3: couple of things out of the stove, I felt like
22:46
Speaker 3: my wrists don't feel as strong as they used to,
22:50
Speaker 3: and so it made me a little bit worried. And
22:53
Speaker 3: those are things you can do at your house during
22:56
Speaker 3: the day, little things like that. And maybe I'm just
23:00
Speaker 3: nervous because I want to stay strong and not be
23:03
Speaker 3: having any fractures.
23:04
Speaker 2: But that's a really good tip.
23:07
Speaker 1: Yes, so, and I love that you say that it's
23:11
Speaker 1: a systemic. It's a systemic issue, which is why we're
23:16
Speaker 1: not just targeting wrists. Lumbar you know, hip femur.
23:22
Speaker 2: Exactly, that's what was measured, but it affects our bone.
23:26
Speaker 2: Metabolism is under attack, so we have to make all
23:30
Speaker 2: of us strong and resilient.
23:31
Speaker 1: Okay, so if we move to the lumbar, how do
23:34
Speaker 1: we strengthen the lumbar.
23:37
Speaker 2: Yeah, so again we're still talking. Was a couple of
23:40
Speaker 2: strategies here to think about. So when we're doing compound movements,
23:45
Speaker 2: full body movements at a moderate higher intensity, we have
23:49
Speaker 2: better efficacy for improving lumbar spine bone mineral density. So
23:55
Speaker 2: we're talking to squats, talking deadlifts, we're talking muscles that
23:58
Speaker 2: cross the back and hip. We're talking working through the core.
24:03
Speaker 2: But lumbar is the area is measured. We can't do
24:06
Speaker 2: decks to scan on the thoracic spine because of the ribs,
24:09
Speaker 2: but we know that thoracic area isn't big area at
24:13
Speaker 2: risk for fracture. Muscles that go along the spine, that
24:18
Speaker 2: work on our posture, that hold us upright, that help
24:21
Speaker 2: us be in better positions. If we target those muscles
24:24
Speaker 2: along the shoulder girdle, along the upper back and lower back,
24:28
Speaker 2: that is protective against fracture. I mean, these are simple
24:33
Speaker 2: things we can do. These are things that we can
24:35
Speaker 2: do prone So laying down like doing W's doing Superwoman's,
24:39
Speaker 2: doing swimmers, you know, things with bands where we're working
24:43
Speaker 2: the muscles of the upper back. These are protective against
24:47
Speaker 2: fracture because they help those muscles engage and protect the
24:50
Speaker 2: spine into extension, so we don't get that overflextion that
24:54
Speaker 2: compresses the vertebra.
24:57
Speaker 1: Okay, so moving down to like hip femur same, I mean,
25:02
Speaker 1: those same exercises are obviously going to be included in there.
25:06
Speaker 1: But if somebody were like, well, I want to, you know,
25:08
Speaker 1: talk to exercises that could target those areas.
25:14
Speaker 2: Love it so hip. So hip fractures generally occur because
25:18
Speaker 2: of a fall to the side and landing on the
25:20
Speaker 2: side of the hip, So that's like fracture prevention. But
25:22
Speaker 2: we're talking bone density to impact exercises and yes, squats, deadlifts.
25:29
Speaker 2: But where I like to really focus is on moving
25:31
Speaker 2: in different planes because we so often exercise just working
25:35
Speaker 2: in the sagital plane, but frontel plane movements really benefit
25:39
Speaker 2: the hip, frontel and even transverse plane. So I think
25:43
Speaker 2: that variety of stimulus stimulus. When I'm am working with
25:47
Speaker 2: a client that can do impacts and jumps, we're jumping
25:50
Speaker 2: in different directions. If they can't jump, we are lunging
25:53
Speaker 2: in different directions. We don't just do a front plank,
25:55
Speaker 2: we do a sideplank, we do a sideplank with a
25:58
Speaker 2: leg raise. We're doing different versions of clams single leg bridges.
26:02
Speaker 2: But we have to change the direction and that novel
26:06
Speaker 2: stimulus is what helps that cortical bone. It helps that
26:10
Speaker 2: outers hard surface of the bone to want to remodel
26:13
Speaker 2: and grow stronger. If we're giving it the same stimulus
26:16
Speaker 2: all the time and it's like yeah, I've got this
26:18
Speaker 2: and fine, but we start to mix it up by
26:20
Speaker 2: moving in different directions, which is real life, then it
26:24
Speaker 2: adapts and grows stronger. I love moving in different directions.
26:27
Speaker 2: I love moving in a frontal plane, not just sad
26:29
Speaker 2: to the plane for this for hips especially.
26:32
Speaker 1: Yes, I agree. So if we're getting the muscle stronger,
26:38
Speaker 1: it's getting the bone stronger. Yes, So that kind of
26:42
Speaker 1: goes hand in hand. So when we break down, you know,
26:47
Speaker 1: let's break down the two main ways that we can
26:50
Speaker 1: really work on bone health from outside of medication. So
26:56
Speaker 1: we know we can heavy resistance train distance trained with
27:00
Speaker 1: effort around eighty up to eighty percent of your one
27:03
Speaker 1: rep max. So with effort, which again is the key,
27:06
Speaker 1: the keyword. So we're putting a strain or bend on
27:09
Speaker 1: that bone. But do you recommend jumping some form of
27:15
Speaker 1: jumping and heavy lifting or do they do the same
27:18
Speaker 1: thing and you can get you can choose one or
27:21
Speaker 1: the other. If you can't jump, if you're lifting heavy
27:25
Speaker 1: err you know, up to that eighty percent as we've discussed,
27:29
Speaker 1: does that count as the pliometric as well.
27:34
Speaker 2: Yeah, for someone who is really concerned about jumping and
27:37
Speaker 2: it isn't safe for them for whatever reason. Absolutely, moderate
27:42
Speaker 2: and high intensity doesn't even have to be high intensity.
27:45
Speaker 2: Moderate and high intensity strength training and agility and power.
27:51
Speaker 2: If they can work power without the impact, they are
27:54
Speaker 2: getting great benefit and they're still going to be able
27:58
Speaker 2: to enhance their strength and benefit their bone density. The
28:02
Speaker 2: big thing to think about is we tend to get
28:05
Speaker 2: really focused on can I increase my bone density? But
28:08
Speaker 2: what osteopenia or osteoporosis means is you have a risk
28:12
Speaker 2: factor for a fracture. So to me, the most important
28:16
Speaker 2: thing is to help people prevent ever having a fracture,
28:19
Speaker 2: because if you never have a fracture, your osteopenia or
28:22
Speaker 2: osteroproosis doesn't change your life. And when we look at
28:25
Speaker 2: the effects of medications and we look at the effects
28:28
Speaker 2: of exercise for fracture prevention. Exercise is at the top.
28:33
Speaker 2: Strength training is at the top, so regardless of impact,
28:36
Speaker 2: they don't have to do impact. But strength training and
28:38
Speaker 2: muscle mass is going to be something that can improve
28:41
Speaker 2: your balance, improve your resilience, and prevent you from ever
28:44
Speaker 2: having a fracture.
28:46
Speaker 3: What about nutrition and bone health outside of calcium and
28:50
Speaker 3: vitamin D, what are other nutrients or dietary habits that
28:56
Speaker 3: play the biggest role.
28:58
Speaker 2: I love it because this is critical. We can't build
29:01
Speaker 2: a strong house if we don't have the right building materials.
29:05
Speaker 2: We can give it the right See, we have all
29:06
Speaker 2: the construction workers we want, but if we don't have
29:08
Speaker 2: the right materials, we can't build a stronger body. So
29:12
Speaker 2: protein is right up there. You know, when we look
29:14
Speaker 2: at what the volume of our bone mass is, it's
29:17
Speaker 2: fifty percent protein. So we have to have adequate protein.
29:20
Speaker 2: And these amino acids are also the building backs blocks
29:23
Speaker 2: for collagen and collagen matrix is what the calcium and
29:26
Speaker 2: other minerals attached to to create strong and flexible bone.
29:32
Speaker 2: So I generally recommend one point two to one point
29:35
Speaker 2: five grams per kilogram of ideal body weight. I know
29:38
Speaker 2: that's kind of middle of the road. I find so
29:41
Speaker 2: many clients struggle sometimes just to get that, and they
29:45
Speaker 2: struggle to get more. So as I look at, like,
29:48
Speaker 2: you know, the best gains for helping somebody to achieve
29:52
Speaker 2: that goal, that one point five mark is what I'm
29:54
Speaker 2: shooting for, so protein being right up there. So I
30:01
Speaker 2: like people to get things through food. First. We have
30:03
Speaker 2: great studies that support prunes and eating five to six
30:07
Speaker 2: prunes per day is shown to increase bone mineral density.
30:11
Speaker 2: And I think it's the boron, but really it's not
30:13
Speaker 2: just the boron, but how it's packaged with the fiber
30:16
Speaker 2: and other micro nutrients in the prunes and how it
30:18
Speaker 2: affects our gut microbiome to help create the right environment
30:22
Speaker 2: for increasing bone density.
30:24
Speaker 1: Oh, that's a two for month because then you can
30:26
Speaker 1: get the fiber two.
30:27
Speaker 2: It's fantastic. It's fantastic. Yeah, absolutely, all.
30:30
Speaker 1: Right, I'm revisiting now me too.
30:33
Speaker 2: Yes, it's great. Yeah, and the fiber makes a huge
30:37
Speaker 2: diffcause I know lots of people that will take the
30:38
Speaker 2: five out in the morning and that's just kind of
30:40
Speaker 2: their snack throughout their day as they're kind of running
30:42
Speaker 2: around their house, and that's a simple thing to do
30:45
Speaker 2: that has great benefit. Yeah, you mentioned vitamin D, and
30:48
Speaker 2: vitamin D really needs to be in the sweet spot.
30:51
Speaker 2: Too low is associated with low bone density, and too
30:54
Speaker 2: high of vitamin D also can affect our ability to
30:58
Speaker 2: utilize calcium, so we want to keep that in the
31:00
Speaker 2: sweet spot. Vitamin K two can be helpful and it
31:04
Speaker 2: comes in two forms. We have Mk seven and MK four,
31:07
Speaker 2: and vitamin K two helps direct that calcium more into
31:11
Speaker 2: the bones than into the vessels. This is kind of
31:13
Speaker 2: a gatekeeper and where the calcium gets utilized. Can everybody
31:17
Speaker 2: take calcium. I'm not saying that you should talk to
31:19
Speaker 2: your physician and see and your nutrition is if vitamin
31:22
Speaker 2: K two is right for you, but it can be beneficial.
31:25
Speaker 2: We have nice studies that support vitamin K two four
31:28
Speaker 2: for bone health. Another one that I often talk about
31:32
Speaker 2: is magnesium, and magnesium is another component of the minerals
31:36
Speaker 2: that helps form that matrix of good bone density, and
31:39
Speaker 2: we often very depleted in magnesium is our food supply
31:42
Speaker 2: doesn't often have a good source of it, so that's
31:44
Speaker 2: one of the easier ones to supplement. Different forms take
31:49
Speaker 2: different effects, so depending on your GI system, sometimes magnesium
31:52
Speaker 2: glyconate will be a little bit easier tolerated versus magnesium
31:56
Speaker 2: citrate that can have a little bit of a laxative effect.
31:59
Speaker 1: Right, Okay, So those are the supplements to pay attention to.
32:04
Speaker 1: What are the myths that you hear about osteopenia osteoporosis
32:08
Speaker 1: that you'd like to clear up?
32:10
Speaker 2: Oh gosh, well yeah, there's a whole bunch. Yes, yes,
32:14
Speaker 2: we could cover a lot here. You know. One is
32:16
Speaker 2: that you can never lift heavy. You know, you can't
32:18
Speaker 2: lift anything again. You should never bend, never twist, never lift.
32:23
Speaker 2: And we do have movement precautions that we follow, but
32:26
Speaker 2: I think we've gone we were at one too far
32:28
Speaker 2: of extreme where we scared people so much about movement
32:31
Speaker 2: that they stopped moving all together. Uh, And and scaring
32:34
Speaker 2: people to death is not a strategy, but empowering and
32:37
Speaker 2: educating them is. And so that's the difference that we
32:39
Speaker 2: have to make there. What are the strategies and myths? Gosh,
32:47
Speaker 2: that it's that it's all about that you can't do
32:51
Speaker 2: anything about it. I think that's one that you think
32:53
Speaker 2: that you're that you're stuck in this situation and that
32:56
Speaker 2: you're and that you're fragile, and what I think people
32:58
Speaker 2: need to realize is we can and take action steps
33:01
Speaker 2: again to combat that and to be stronger and more
33:04
Speaker 2: resilient and prevent it from changing our life.
33:08
Speaker 1: So you talk about minimalist shoes and who should wear
33:12
Speaker 1: them and who shouldn't. So with that, I guess I'm
33:17
Speaker 1: My first question is do you start women that are
33:22
Speaker 1: healthy enough and ready enough to jump? Do you start
33:25
Speaker 1: them wearing a shoe or would you have them start barefoot?
33:29
Speaker 2: I do start with shoes on, and that is a
33:32
Speaker 2: bit of my own personal bias because I don't do
33:35
Speaker 2: barefoot well because I have a auroma, So part of
33:38
Speaker 2: that's my own. I don't want them to have what
33:40
Speaker 2: I have. But I do training in impact and balance
33:44
Speaker 2: shoes on and choose off because I think we need
33:46
Speaker 2: to train for real life because in real life we're
33:49
Speaker 2: times in barefoot and we're times we're in shoes, and
33:51
Speaker 2: we're in different types of shoes all the time. But
33:54
Speaker 2: to answer your question, if I'm starting impact, I usually
33:56
Speaker 2: start with with shoes on.
33:59
Speaker 1: Yeah, okay, And then when do you recommend the minimalist shoe?
34:04
Speaker 2: Minimalist shoes for people that are working and are having
34:07
Speaker 2: that are doing well with the strength training program, that
34:10
Speaker 2: don't have a bunion, that don't have an aroma, that
34:15
Speaker 2: are comfortable, they already say they're comfortable walking barefoot, then
34:17
Speaker 2: they can transition to that minimalist to shoe style. It
34:21
Speaker 2: is great for improving foot strength and toet strength and
34:25
Speaker 2: just that pro perception that feeling the ground underneath your feet.
34:29
Speaker 2: There's a lot of benefit to minimalist shoes for people
34:32
Speaker 2: who can wear them for fall prevention then foot strength.
34:35
Speaker 3: For people that don't know what a minimalist shoe is,
34:39
Speaker 3: Can you explain what a minimalist shoe is?
34:43
Speaker 2: Sure? Sure? So, like a normal tennis shoe will have
34:46
Speaker 2: a nice bit of cushioning, you know, between the toe
34:49
Speaker 2: and the heel, you've got that pad like a running shoe.
34:52
Speaker 2: Some of them will have a drop, so from the
34:55
Speaker 2: heel to the forefoot there might be a four milimeter
34:58
Speaker 2: drop or ten milimeter drops, so it's like you have
35:00
Speaker 2: a little bit of a heel. A minimalist shoe has
35:04
Speaker 2: none of that padding, so it's kind of like wearing
35:08
Speaker 2: a sock like the Vibrum five fingers or some of
35:10
Speaker 2: There's many, many varieties out there. But it's very thin, lightweight,
35:14
Speaker 2: almost like putting on a sock with a rubber coating
35:17
Speaker 2: on the outside. That's just one layer between your foot
35:20
Speaker 2: and the ground. It can fold in half. You could
35:22
Speaker 2: probably roll it up like a taco because it is
35:25
Speaker 2: so flexible that it doesn't restrict your foot movement. It
35:30
Speaker 2: gives you a good feel of the ground. But it's
35:32
Speaker 2: not going to have padding and cushion. It's going to
35:36
Speaker 2: be laced or it's it's gonna be attached to your
35:38
Speaker 2: foot really well, but no padding or cushion. So it's
35:42
Speaker 2: you change your gate speed when you have a minimalist shoe,
35:45
Speaker 2: you change how you walk. You're absorbing force a little
35:48
Speaker 2: bit differently, and it absolutely can help with increasing foot strength,
35:52
Speaker 2: which if you live a lifetime and shoes we lose
35:55
Speaker 2: that if we don't train it specifically.
35:57
Speaker 1: Right, Okay, this is going to go down a rabbit hole.
36:00
Speaker 1: But for for clients that I mean, because this is
36:04
Speaker 1: something that I see, uh, not online obviously, because I'm
36:07
Speaker 1: not in person training anyone, but in you know, in
36:11
Speaker 1: the women that I do want on one train. So
36:13
Speaker 1: there's the pronating pronating and collapsing arch and then like
36:18
Speaker 1: Hallas valgas. How do you like if somebody can't balance
36:22
Speaker 1: without a shoe and then they're jumping or they're loading
36:26
Speaker 1: really heavy and they're collapsing that arch, say down in
36:29
Speaker 1: a squat, where would you have them wear like an
36:35
Speaker 1: an insert insult in their in their shoes so that
36:39
Speaker 1: they can have some of that protection if they're choosing
36:42
Speaker 1: to jump on their own or to you know, be
36:45
Speaker 1: moving load.
36:46
Speaker 2: Great, great question, Yes, absolutely to me. Having better joint alignment.
36:54
Speaker 2: So if like you say that pronation where that inside
36:57
Speaker 2: of the ankle, that arch is flattening out, the big
36:59
Speaker 2: toe is really pushing over, I do recommend toast spacers
37:02
Speaker 2: to help with that, but an insert and I'm not
37:06
Speaker 2: a fan of artificial support in general, but in specific
37:11
Speaker 2: cases like this, if we can help someone's ankle and
37:14
Speaker 2: foot alignment to be more optimal so that as they're
37:17
Speaker 2: doing a squat, then the position of their knee, hip
37:20
Speaker 2: and spine over their leg is better, This is more protective.
37:24
Speaker 2: We don't want to be moving in such a way
37:26
Speaker 2: that we're increasing that direction of failure in that joint.
37:31
Speaker 2: So absolutely an insert that a supportive shoe is going
37:36
Speaker 2: to be helpful in that case. And I always want
37:39
Speaker 2: to put them in the most protected position possible.
37:41
Speaker 3: Okay, what about someone that's used an insert in their
37:45
Speaker 3: shoe for years and has never tried to work out barefoot?
37:52
Speaker 3: Or how Hayley does in our socks sometimes? What how
37:57
Speaker 3: do you go from always being massively protected and in
38:02
Speaker 3: a cushion shoe to working towards getting there?
38:08
Speaker 2: Oh? I love that. That's a great question too. You know,
38:10
Speaker 2: I think it's all small bites and snacks, and like
38:14
Speaker 2: in the clinic or working in an exercise session, there
38:16
Speaker 2: may be a time where I say, okay, for these
38:18
Speaker 2: three exercises or these three balanced things, we're going to
38:21
Speaker 2: work barefoot and you can start in these small bites
38:24
Speaker 2: of building that strength. And then I would ask people
38:28
Speaker 2: to try to really slowly ramp up time barefoot. And
38:32
Speaker 2: when I've worked with clients that have had plantar fasci itis,
38:34
Speaker 2: they're often shocked when I'm telling them you need to
38:36
Speaker 2: spend time barefoot. And I'll say thirty two minutes, thirty
38:41
Speaker 2: to sixty minutes in a day. I want you walking
38:43
Speaker 2: around your home without your shoes on. I want your
38:46
Speaker 2: feet to start to adapt. But we're not going to
38:48
Speaker 2: do it at an accelerated rate. So I'll introduce it
38:51
Speaker 2: during exercise, but it doesn't have to be the whole program.
38:55
Speaker 2: And then I'll have them introduce it on it on
38:57
Speaker 2: a daily basis, but in small doses, and then how
39:00
Speaker 2: it progresses is based on feedback. How does it feel?
39:04
Speaker 2: Is there pain, is there dysfunction? And so we have
39:07
Speaker 2: to get that movement confidence. But I think it's a
39:09
Speaker 2: wonderful thing to practice and train. We have to pay
39:13
Speaker 2: attention to the symptoms and the response and that's how
39:15
Speaker 2: we progress it from there.
39:17
Speaker 3: Okay, I'm motivated to try.
39:22
Speaker 1: So let's break down some studies because there's a lot
39:27
Speaker 1: of the studies can be h cherry picked or even
39:31
Speaker 1: you know, somebody can misunderstand what the study was or
39:37
Speaker 1: it could be biased. So there's a lot of studies
39:39
Speaker 1: out there. Let's focus on the one that everyone knows,
39:42
Speaker 1: which is the lift More. The lift More study? What
39:47
Speaker 1: were what do you? What do you think about that study?
39:50
Speaker 1: And you know it's the one that always gets like
39:52
Speaker 1: thrown around, is the lift more studies? So yes, I'm
39:57
Speaker 1: curious your thoughts.
39:59
Speaker 2: Great? Uh, I think the Lift Moore trial was groundbreaking.
40:03
Speaker 2: I think it was groundbreaking to change our mindset around
40:08
Speaker 2: how we could work with postmenopausal women with osteoporosis, because
40:12
Speaker 2: prior to that, we did not believe that high intensity
40:15
Speaker 2: strength training was safe and reasonable. So just to change
40:20
Speaker 2: the mindset of knowing that this type of exercise can
40:23
Speaker 2: make a difference was huge. I think it feels it
40:28
Speaker 2: can feel unapproachable to some women to think about barbelle
40:31
Speaker 2: back squats and deadlifts and so. And also the structure
40:37
Speaker 2: of the program doesn't have periodization. There isn't that variety
40:42
Speaker 2: that I think if we're looking at a year long
40:44
Speaker 2: program needs to be part of our you know, building
40:48
Speaker 2: phase and growth phase and recovery phase, deloading phase. I
40:53
Speaker 2: think those are important and that's that's not that's not
40:55
Speaker 2: a part, but you know you can't make that part
40:57
Speaker 2: of a randomized control trial. So that's no fault to
40:59
Speaker 2: the study. The study was wonderful and how it empowered
41:03
Speaker 2: me to work with my clients. I think the context
41:07
Speaker 2: that it can be taken out of is that's the
41:10
Speaker 2: only answer, And we know we have research that says
41:14
Speaker 2: it doesn't have to be at that level to be effective,
41:18
Speaker 2: and we also know we can modify a backsquad to
41:21
Speaker 2: be approachable for almost anyone. They can be doing a
41:24
Speaker 2: sit to stand at body weight to start if they
41:26
Speaker 2: need to. We can modify a deadlift, the range of motion,
41:30
Speaker 2: the load, all of it to make it approachable so
41:32
Speaker 2: somebody can learn a proper hip hinge. You know, so
41:35
Speaker 2: all of those exercises within the lift more trial can
41:38
Speaker 2: be modified and then graded. You know, this is a
41:41
Speaker 2: lifetime program we do, right We're doing this for life,
41:43
Speaker 2: so we don't have to have that that one rep
41:46
Speaker 2: max eighty percent thing right away. We can take years
41:50
Speaker 2: to build on that or even never get there and
41:52
Speaker 2: stay within our safes.
41:54
Speaker 1: Okay, So the puritization that you said, if you're programming
41:58
Speaker 1: for your clients, you're you're choosing periodization as the overlying
42:06
Speaker 1: you know, that's the template for a year. You wouldn't
42:09
Speaker 1: just say only stay in low reps all the time,
42:13
Speaker 1: year round.
42:14
Speaker 2: No, I don't think. I don't think we should stay
42:16
Speaker 2: at that level for every workout.
42:18
Speaker 1: No, and for what reasons?
42:21
Speaker 2: I think we need that change in tempo and load
42:26
Speaker 2: for joint protection, for ligament and tended. I think it
42:30
Speaker 2: allows for recovery. That also, adaptation likes the variability, and
42:36
Speaker 2: I think when we're doing the same exact thing over
42:39
Speaker 2: and over. It keeps us stuck in a pattern where
42:42
Speaker 2: maybe we're losing a little bit of the endurance side
42:45
Speaker 2: of that muscle performance, or maybe we're losing a little
42:47
Speaker 2: bit of that power side of that muscle informance. So
42:50
Speaker 2: I way prefer variety than just a one recipe over
42:54
Speaker 2: and over and over.
42:56
Speaker 1: Yes, agreed. All right, So if we look at daily
43:02
Speaker 1: habits for women that can help with their say someone
43:06
Speaker 1: that's I mean, there's a wide range that listens to
43:10
Speaker 1: this podcast, but I think the numbers Laura are like
43:13
Speaker 1: mid thirties, probably to mid sixties. That might be the
43:17
Speaker 1: same group that you're working with somewhere in that as well.
43:21
Speaker 1: But just like good habits and routines that women over
43:24
Speaker 1: forty can adopt now to prevent potentially prevent any bone
43:31
Speaker 1: issues later in life.
43:33
Speaker 2: Great, great question. Well, you know, I think posture exercise
43:38
Speaker 2: is a great protective mechanism. So paying attention to posture,
43:42
Speaker 2: but not just attention to it, but building the muscles
43:44
Speaker 2: in the upper back that help us have We have
43:47
Speaker 2: to lengthen the front body and strengthen the back body,
43:50
Speaker 2: and that will pay big dividends for years to come.
43:55
Speaker 2: Balance training, we can start to begin to see declines
43:58
Speaker 2: and balance in our thirties and four and when you
44:01
Speaker 2: still have the ability. If you can start early at
44:05
Speaker 2: dynamic balance training, reactive balance training, things that really challenge you,
44:10
Speaker 2: that's going to be protective for a long time. If
44:13
Speaker 2: you don't train it, you lose it. Right. So, balance
44:16
Speaker 2: and posture training, I think are critical. Fuel your body
44:21
Speaker 2: for the activity you need to do. Okay, I'm not
44:24
Speaker 2: in the business that helping people be smaller. I want
44:26
Speaker 2: to help them be stronger. Fuel your body. It's not
44:31
Speaker 2: a daily habit, So fuel your body well and then
44:33
Speaker 2: strength training three times a week. I think that's a
44:36
Speaker 2: great balance. You can work in your cardio on other days.
44:40
Speaker 2: And mobility mobility training so that you have the mobility
44:45
Speaker 2: and your hips, the mobility and your knees and ankles
44:48
Speaker 2: that keep you moving really well. And that's another you know,
44:51
Speaker 2: that's a lifespan thing that helps us feel good. And
44:54
Speaker 2: if you can move your hips and knees and ankles well,
44:57
Speaker 2: it protects your spine. Right. When we see people with
45:02
Speaker 2: stiff hips and stiff ankles, where do we compensate. We
45:06
Speaker 2: compensate by bending back right, see this in the moves.
45:09
Speaker 2: You can see this in a squat, so that mobility
45:12
Speaker 2: is really really critical. Rest sleep. Optimizing your sleep is
45:19
Speaker 2: an important part of decreasing inflammation. There's a connection to
45:23
Speaker 2: poor sleep and poor bone health. So optimizing our sleep
45:26
Speaker 2: is something that we can do every day to help
45:28
Speaker 2: improve how we feel.
45:30
Speaker 1: Now, you mentioned something that I want to touch on.
45:33
Speaker 1: So you said, I'm not in the business of making
45:35
Speaker 1: women smaller. I'm in the business of making them stronger.
45:38
Speaker 1: And I love that that message is kind of echoing
45:42
Speaker 1: in the space. With that being said, you know, the second,
45:49
Speaker 1: maybe most common question that I get asked all the
45:52
Speaker 1: time is well, but I have, you know, forty pounds
45:55
Speaker 1: to lose. That's a different conversation. But if what I
45:58
Speaker 1: want to ask you is is not fueling your body
46:03
Speaker 1: and not you know, always kind of being trying to
46:06
Speaker 1: become smaller on fewer calories, is that good for bone health,
46:12
Speaker 1: especially postmenopausal.
46:15
Speaker 2: No, being underfed is not good for bone health. It
46:17
Speaker 2: makes it more difficult to reach our goals. And we
46:21
Speaker 2: know that. And sometimes it's just your genet, your makeup
46:26
Speaker 2: of being really petite and smaller, but smaller women have
46:30
Speaker 2: lower bone density, being underfueled and constantly in a calorie deficit.
46:34
Speaker 2: If I mean, if you're not at your ideal weight
46:36
Speaker 2: and you're trying to get to a healthy weight and
46:39
Speaker 2: you're exercising and strength training and maintaining muscle mass, to me,
46:42
Speaker 2: that's the most important feature. You know, some of the
46:46
Speaker 2: physicians that are doing the medications to help with weight
46:50
Speaker 2: loss and they're focusing on muscle mass, And to me,
46:53
Speaker 2: that's the critical piece. If you are losing weight in
46:57
Speaker 2: a healthy way, but you're maintaining your muscle mass, and
47:00
Speaker 2: it's probably not as big of effect because we know
47:03
Speaker 2: muscle loss and bone loss go togetherscop and they go together.
47:07
Speaker 2: So if you're losing weight at a rate that's affecting
47:10
Speaker 2: your muscle mass, yes, you're affecting your bone.
47:14
Speaker 1: That is the microdrop right there that I think that
47:18
Speaker 1: most women don't think about because they think about, Okay,
47:21
Speaker 1: I need to you know, I need to exercise for
47:24
Speaker 1: bone health. I can jump for bone health. I can
47:26
Speaker 1: take vitamin C, vitamin D, blah blah blah, calcium, you know,
47:31
Speaker 1: go on some of these medications. But if you're losing muscle,
47:37
Speaker 1: the bone is coming along with that. Yes, and we
47:42
Speaker 1: you know, it's months and months for women that to
47:46
Speaker 1: regain muscle in the gym setting. We know that, but
47:51
Speaker 1: bone is even longer. So if somebody, if you know,
47:58
Speaker 1: if somebody were coming in and they wanted to see
48:00
Speaker 1: a change in bone health and they were doing all
48:02
Speaker 1: the right things and controlling the controllables of what they can,
48:07
Speaker 1: what is the minimum amount of time that you would
48:09
Speaker 1: go back for a DEXA that you would recommend to
48:12
Speaker 1: go back for a DEXA because some women are you know,
48:15
Speaker 1: I in here, I'm going to go back in three months,
48:17
Speaker 1: You're not going to find much.
48:20
Speaker 2: Yeah, it can really take a long time. The earliest
48:26
Speaker 2: I would have someone check is in a year, and
48:28
Speaker 2: insurance covers it every two years. Uh, and it may
48:31
Speaker 2: or may not show a difference, but it may show
48:33
Speaker 2: a slight change. One of the important things to understand
48:35
Speaker 2: about DEXA because there's lots of mobile devices running around
48:39
Speaker 2: doing these tests, but a true DEXA scan and to
48:43
Speaker 2: get true accuracy, should be done on the same machine,
48:47
Speaker 2: same location, every time. If you really wanted apples to
48:50
Speaker 2: Apple's comparison, if you're going to one DEXA device and
48:52
Speaker 2: then you're going to a mobile device. The next time,
48:55
Speaker 2: you're not getting an accurate representation of that change. So
48:58
Speaker 2: go to the same location each time. A year would
49:02
Speaker 2: be the soonest. I would have somebody recheck, you know,
49:05
Speaker 2: with optimizing everything. Nutrition, maybe hormone therapy which we call
49:10
Speaker 2: pet therapy. Now that's exercise nutrition eight months, you know,
49:16
Speaker 2: eight months to twelve months to see a detectable change,
49:20
Speaker 2: and two years it can be even longer for that.
49:23
Speaker 2: But we want to stop the loss. No change when
49:26
Speaker 2: normal loss is two percent a year for a postmenopausal female,
49:30
Speaker 2: zero loss is a win.
49:33
Speaker 1: That is it. And I say the same about muscle,
49:36
Speaker 1: maintaining your muscle or even going up you know a
49:41
Speaker 1: pound or two a year, and somebody might think that
49:45
Speaker 1: they're that's pointless. Why why did I even do all
49:49
Speaker 1: of that work for well, you didn't lose any that's
49:52
Speaker 1: the goal at this age, you know, especially postmenopausal. Are
49:55
Speaker 1: you a fan of hormone therapy.
49:58
Speaker 2: Yes, absolutely, I have personally been on hormone therapy for
50:03
Speaker 2: multiple years. I don't ever plan to stop it. We
50:06
Speaker 2: know hormone therapy is protective for bone density because as
50:11
Speaker 2: we lose estrogen, the osteoclasts, these are the cells that
50:15
Speaker 2: break down bone. Estrogen is a gatekeeper for these bone
50:19
Speaker 2: breakdown cells, and estrogen leaves and we start to see
50:23
Speaker 2: a rapid loss of bone density. So estrogen is absolutely
50:27
Speaker 2: protective when it comes to bone density and fracture prevention.
50:32
Speaker 1: Okay, so two percent of bone a year postmenopausal.
50:37
Speaker 2: Yes, we can lose twenty percent of our total bone
50:40
Speaker 2: in that perimenopause menopause transition. Yes is a lot if
50:43
Speaker 2: we yes, yes. And the unfortunate thing is they don't
50:47
Speaker 2: recommend testing until age sixty five. So at that point
50:53
Speaker 2: you already meany osteoporosis and you've never had an opportunity
50:57
Speaker 2: to really address it if it wasn't tested sooner. I
50:59
Speaker 2: do recommend and if people talk to their position about
51:02
Speaker 2: any risk factors, they may have to get an earlier test.
51:05
Speaker 2: We should know in our forties, we should know in
51:07
Speaker 2: perimenopause what our baseline bone density is.
51:10
Speaker 1: This needs to change in America that I don't know
51:13
Speaker 1: about other countries. I know that it's easy to get
51:15
Speaker 1: a DEXA in Australia, but here it seems like, okay,
51:20
Speaker 1: there's the mobile carts. But as you said, I'm guessing
51:24
Speaker 1: that you test on the same machine because it's calibrated differently.
51:28
Speaker 1: But also I'm sure that there's different versions, just like anything,
51:33
Speaker 1: there's like a cheaper version of the DEXA, an older
51:36
Speaker 1: model versus something that's hospital grade. Is that a fair
51:40
Speaker 1: assumption it is?
51:41
Speaker 2: But also training, training of the technician, and certification of
51:46
Speaker 2: the people reading the data makes a huge difference. And
51:49
Speaker 2: we don't have consistency in the United States on that
51:52
Speaker 2: certified people that do the DEXA and as well as
51:55
Speaker 2: the trainer, the training and the you know, the data
51:58
Speaker 2: you put in is the data you get out. If
52:00
Speaker 2: you get bad data in, you're going to get bad
52:02
Speaker 2: data out. So the training of the technician, the accuracy
52:04
Speaker 2: of the test, and then the training of the person
52:07
Speaker 2: that interprets that data makes a big So.
52:09
Speaker 3: How do you know you're going to a well trained,
52:13
Speaker 3: certified place.
52:15
Speaker 2: That's difficult. That's really difficult. Doctor Lonnie Simpson is one
52:19
Speaker 2: of the prominent teachers in osteporosis and bone health, and
52:24
Speaker 2: she's a certified dosometrist and has been doing this for
52:27
Speaker 2: years and years and years, And she talks about how
52:30
Speaker 2: asking if they ask if they're certified, that's one and
52:34
Speaker 2: then whenever possible, you know, just checking in with your technicians,
52:39
Speaker 2: because it's a technician like an X ray technician that
52:41
Speaker 2: does the test. You know, what's your training on doing
52:45
Speaker 2: these DEXA scant and do you do it the same
52:46
Speaker 2: way every time? And what is the positioning that I
52:49
Speaker 2: need to make sure I do because a position of
52:52
Speaker 2: the joint is really what matters for them to get
52:54
Speaker 2: the correct view. You know, what's the proper position to
52:57
Speaker 2: make sure that the radiologists can read this correctly? Is
53:00
Speaker 2: the radiologist are they trained and certified to read DEXA scants?
53:04
Speaker 2: Many times they're not going to be.
53:07
Speaker 1: Well, I'm going to tell you that the first one
53:09
Speaker 1: I ever had, like twelve years ago and the JC
53:13
Speaker 1: Penny parking lot in Utah with the eighteen year old,
53:17
Speaker 1: I'm positive that was not a hospital great machine or
53:26
Speaker 1: that was certified. So that's hard though, because if you're
53:30
Speaker 1: if you can't, I mean, money is the other issue. Yes,
53:34
Speaker 1: you know, it's easy to say, okay, well everyone should
53:36
Speaker 1: be getting one every year, especially if you're but for
53:39
Speaker 1: a lot of women, it's like, great, one more thing
53:41
Speaker 1: that I have to pay for that my insurance isn't
53:42
Speaker 1: going to cover. Right right, I'm angry about this.
53:46
Speaker 2: Yeah, it is. Unfortunately, it really does need to change,
53:48
Speaker 2: and I think the more that we talk about this,
53:50
Speaker 2: the more likely that is to happen, because we can
53:53
Speaker 2: like preemptively help protect women from fractures down the line
53:57
Speaker 2: by having this test done much earlier, because if you
54:00
Speaker 2: don't know that you need to address it, you may
54:03
Speaker 2: not create the change that needs to have it until
54:05
Speaker 2: you're sixty five and then you wish someone had told
54:08
Speaker 2: you earlier.
54:08
Speaker 3: Yeah, we should be having it at thirty five or
54:11
Speaker 3: forty minimum.
54:13
Speaker 2: Yes, absolutely, absolutely, because if you didn't build peak bone
54:19
Speaker 2: mass when you were a teen in early twenties, then
54:22
Speaker 2: you maybe didn't start from the highest point possible. So yeah,
54:26
Speaker 2: we do need to know before we go through perimenopause
54:28
Speaker 2: and menopause.
54:29
Speaker 1: Okay, if we're wrapping this up, and you could share
54:32
Speaker 1: one message with every female over forty who wants to
54:36
Speaker 1: age well and stay independent, what's your message.
54:40
Speaker 2: HM, Be kind to your body, move it, move it
54:45
Speaker 2: in ways that feel good, move it in ways that
54:47
Speaker 2: bring you joy. Work on your strength. It doesn't have
54:51
Speaker 2: to look like somebody else, and don't compare your strength
54:56
Speaker 2: and your program to anybody else. This is not a competition,
55:00
Speaker 2: you know, We're not here comparing whose weights. It's doing
55:02
Speaker 2: what We're here to build our best body. This is
55:06
Speaker 2: what's going to give you joy for the rest of
55:08
Speaker 2: your life, so that you stay active, you stay independent,
55:11
Speaker 2: and you continue to do the things you love with
55:14
Speaker 2: the people you love. Strength training is the elixir for
55:17
Speaker 2: positive aging.
55:19
Speaker 1: Oh my gosh, Lisa, I don't even want to wrap
55:23
Speaker 1: this up. I'm so mad. So where can women find
55:27
Speaker 1: you and find your brick House Bones program?
55:31
Speaker 2: Oh? Thank you so, Doctor Lisa Moore, DPT dot com.
55:35
Speaker 2: Dr Lisa Moore DPT dot com. That's where all my
55:37
Speaker 2: collections and programs are and my workshop that really goes
55:41
Speaker 2: into a deep dive on this information. I am in
55:44
Speaker 2: University Place, Washington. I'm in Washington State near Seattle. So
55:48
Speaker 2: my clinic is STRONGBONESPTORSTRONGBONESPT dot com if they want to
55:51
Speaker 2: email me or reach me there, and then it's at
55:54
Speaker 2: doctor Lisa Moore DPT on YouTube where I have hundreds
55:58
Speaker 2: of free videos and elections from the Foundation series which
56:02
Speaker 2: is for beginners to hit play and I hold your
56:05
Speaker 2: hand through it, as well as like the four y
56:07
Speaker 2: four and moderate intensity workouts too.
56:10
Speaker 3: Well.
56:11
Speaker 1: Thank you Lisa for sharing your time and everyone should
56:13
Speaker 1: be following you. Do you know what, I didn't even
56:17
Speaker 1: know about you. I found out about you and one
56:19
Speaker 1: of my Facebook groups. Somebody threw you out, and I'm
56:22
Speaker 1: so glad because now I can't I can't get enough
56:26
Speaker 1: of your message and everything that you're sharing on your
56:31
Speaker 1: YouTube and Instagram platforms. So thank you for joining us
56:34
Speaker 1: today and sharing your time and your wisdom. This is
56:37
Speaker 1: going to be a fantastic episode for our audience.
56:41
Speaker 2: I'm really grateful you invited me and give me the
56:44
Speaker 2: opportunity to meet with you. Honestly, thank you so much
56:46
Speaker 2: for having me.
56:47
Speaker 1: Thanks for listening.
56:48
Speaker 3: Everyone you enjoyed this episode, please consider giving us a
56:52
Speaker 3: five star rating and sharing the body Pod with your friends.
57:00
Speaker 2: Yeah.