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

Transcript

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

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