This episode is a re-airing of one of our most popular conversations — and for good reason.
We kick off Season Two with a bang! In this episode, we are joined by the one and only Dr. Vonda Wright, an expert in musculoskeletal health, who takes us deep into the musculoskeletal syndrome of menopause. Dr. Wright discusses the dangers of frailty during menopause and the importance of maintaining musculoskeletal strength as we age. She shares proven strategies and expert tips to enhance longevity and prevent frailty during this life stage. Whether you're navigating menopause now or preparing for it in the future, this episode is packed with essential insights that you won’t want to miss!
We kick off Season Two with a bang! In this episode, we are joined by the one and only Dr. Vonda Wright, an expert in musculoskeletal health, who takes us deep into the musculoskeletal syndrome of menopause. Dr. Wright discusses the dangers of frailty during menopause and the importance of maintaining musculoskeletal strength as we age. She shares proven strategies and expert tips to enhance longevity and prevent frailty during this life stage. Whether you're navigating menopause now or preparing for it in the future, this episode is packed with essential insights that you won’t want to miss!
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Today on the Body Pod, we are providing a rerun
of some of our favorite and most popular episodes. This week,
I have the pleasure of reintroducing you to the doctor
Vonda Wright episode. This episode is one of my favorites
with doctor Vonda Wright because we dive deep into the
(00:20):
musculo skeletal syndrome of menopause and what that means for
you and how being frail is fatal. Join me while
we rerun this incredible episode with doctor Vonda Wright. Hey everyone,
this is Haley and I'm Lara, and welcome to the
Body Pod. Welcome to season two of the Body Pod,
(00:48):
where we are beginning this season with the best of
the best, Doctor Vonder Wright. Doctor Wright is an orthopedic
surgeon and mobility specialist and has made a name for
herself for being one of the top longevity specialists for women.
We dive into the muscular skeletal syndrome of menopause, the
(01:08):
importance of a foundation phase of training, the connection between
muscle and bone, and how we can change the trajectory
of our lives for the better with strength training. Let's
get into the show, Okay, So let's go back, starting
with health span versus lifespan.
Speaker 2 (01:30):
You know, when we think about how long we're going
to live, we typically, you know, we talk about the
rare person who lives to one hundred and fourteen. You know,
the Blue zones people one hundred and fourteen, what happened there?
Or we talk about longevity. We're trying to you know,
some of the longevity. Men thing that the baby's being
born now will will not die until they're one hundred
(01:52):
and twenty. And that's fine, I mean, and I think
that everything that the three of us do will extend
our life at expect our lifespan. The average life expectancy
in this country for men is seventy seven point six
years now, it's gone down since COVID, and for women
(02:12):
is slightly more. But that is not the number of
years that we will be healthy. Papers have been published
that show that the average health span, those years that
we can expect not to be limited by disease, is
only sixty three. Sixty three is not that old, and
(02:32):
it is on average when people retire to live the
life they envision, and what happens if they have not
invested along their lives and staying in their health span,
they will spend three days a week in the doctor's
office during the last twenty years of their lives. Now
do I expect to live longer than that? Well, ladies,
my goal is ninety seven, and I can tell you
(02:53):
why that's my goal. Please seven after that, as I think, Well,
because I had my last child at forty and I
am currently fifty seven, and so if I can stick
around until my youngest child is my age, everybody's going
to be good. Actually, my youngest child is so independent
she'd be good now. But I'm just saying, if I
(03:14):
can stick around until she's fifty seven, I'm going to
be good. And so I've just arbitrarily said ninety seven.
But to get to ninety seven takes an investment now,
and took an investment when I was forty. Right, you
can't just start in your sixties and seventies and expect
to optimize the way we could if we started when
(03:37):
we were thirty five or forty. And so I've got
this whole kick going on that I post about with
some frequency called forty ish. It's like, let's get our
proverbial shit together in the critical decade, which in my
mind is thirty five to forty five, when the women
still have estrogen when we're still healthy enough, because we're
trying to extend our health span to equal our lifespan,
(04:02):
and so that both of them instead of health span
going like this and then dropping and then you still
have to live twenty years, that they both come together,
right and then bloop. Whenever it's done, you just go
to sleep and we have an amazing exit? Was that
last year? I know that's what I want, Quina. Look
(04:24):
at Queen Elizabeth. She got frail, but she was still
doing her thing. On Tuesday she met with the Prime Minister.
On Thursday, she just went to sleep and didn't wake up.
I'm raising my hand for that kind of exit, right, Yes,
So that's what I mean by health span versus lifespan.
Speaker 3 (04:45):
Something else you say about this that goes along with
it is that I love is our health and aging
is predetermined by our life lifestyle choices, not our genes.
I feel like this is so power. Will you talk
about that?
Speaker 2 (05:02):
Yeah? You know, all of us, you know, when we're
being formed in utero, received genes from our father, genes
from our mother, and many you know, we for many
years we said that's our destiny. We can't do anything
about it. My dad had this, my mom had this.
My family for three generations have been big boned. By
the way, there's no such thing as big bone. That's
(05:23):
an excuse for not building enough muscle, et cetera.
Speaker 1 (05:28):
That's what I was told my whole life big boned.
Speaker 2 (05:32):
Sorry, my dear, bones are about fifteen percent of our
total weight. That's it, So you can't.
Speaker 4 (05:36):
Yeah, But the thing is, we now know that less
than thirty percent and depend on depending on who you believe,
ten percent of our health and aging is predetermined by
our genome.
Speaker 2 (05:51):
When we work out. When you put people through a workout,
ninety eight hundred of our genes are stimulated to be inscribe.
Transcribe simply means the genes turn on and make proteins.
Your activity affects what your genetics do. That is what
(06:12):
the field of epigenetics is all about. Broccoli is not
just broccoli, it's the phytochemicals that come from plants. Sprinting
is not just sprinting. It stimulates all kinds of gene transcription,
and so we can have a little excuse. There are
(06:33):
some genetically predetermined diseases, but for most of us, our
health and longevity is specific.
Speaker 1 (06:43):
Okay, So what is the role of estrogen as it
relates to these inflammatory injuries that women tend to get
over the age of forty that you see in your practice.
Speaker 2 (06:56):
So I love that you've asked me about the role
of estrogen and the muscular skeletal system. I've just published
a paper. It's just in the proof stage. It'll be out.
I'll send it to you, naming the nomenclature the musculo
skeletal syndrome menopause. Because here's what happens women in midlife.
As you know, every month of our lives. After puberty,
(07:16):
women's hormones go up and down every fourteen days, and
thus we have a period. Men if you're puberty and
their testosterone stays pretty level. So when we have used
up a huge percentage of our eggs, usually by the
age of forty, we only have one percent left, the
amount of estrogen we produce every cycle starts to decline,
(07:37):
and that's the onset of perimenopause. But even before we
have the symptoms of hot flash as night sweats, brain fogs,
start losing muscle and bone, that we become aware of
our hormones, both estrogen and testosterone are declining, and so
what that does in a variety of the musculo skeletal
tissues and in our immune system is changes all the
(08:02):
amazing thing that estrogen does for us. So when it
comes to inflammation, estrogen is a huge anti inflammatory. It
works directly to regulate a chemical called tuminicrosis factor, which
is a huge inflammatory side of kind, as well as
working in the immune system on a molecule called the inflamazon.
But the end result of not having estrogen sitting I
(08:25):
always do this with my hands. This is an estrogen receptor.
This is estrogen. The net effect of having no estrogen
sitting in the estrogen receptor is that none of the
downstream control mechanisms can happen, and so women become highly
inflamed and that manifests in many ways. Number One arthralgia,
(08:47):
which is total body aching. And this was one of
the main symptoms that I arrived into perimenopause with. I'm
an athlete, I was a dancer. I could do anything
with my body and all of us, and I couldn't
get out of bed because everything hurt. And that I
didn't realize that at the time. I fully realize it
now is due to estrogen becoming lower. The second thing
(09:12):
that happened that manifests as is the ever popular frozen
shoulder where women show up with shoulder pain. They didn't
hit the shoulder on the bedroom door, they didn't fall,
they didn't lift too much, but all of a sudden,
their shoulder hurts and they follow their instincts, they don't
move their shoulder, and in less than a week, I'm
not kidding you, women will come in unable to hook
(09:34):
their bra, which I call the can't hook your bra sign,
and they can't their arm. And that's just because of
the raging inflammation in the shoulder capsule. And it starts
out first with hot red pain. Over time the pain
can go away, but the capsule, the connective tissue of
(09:56):
the shoulder actually contracts, and that's where you've got women
for years able to move their arm. That is just
estrogen walking out the door, right. So that's arthragia, that's
frozen shoulder. It manifests a lot of other ways. Within
the musculoskeletal system. We are cartilage becomes less heardy, we
(10:19):
have rapid progression of arthritis, We lose muscle rat mass
at an alarming rate. We can lose ten percent, ten
to fifteen percent in our perimital puzzle period. We lose
three percent of our bone density a year, even before
we realize what's happening, and we redispute our fat, all
those things that we become aware of because we suddenly
(10:40):
have belly fat and we may never have had it before,
but that starts happening. I'm sorry, millennial women about forty three,
forty four, forty five, way before forty seven, which is
when I felt like I was hit by a truck.
Definitely before fifty one or fifty two, which is the
(11:02):
average age of menopause. So there's so much we can
do a decade earlier to get in front of this.
Speaker 1 (11:09):
Okay, So this is like what you call like the
the midlife muscle crisis, like in this age range of
thirty five to forty five. And I didn't start lifting
until I was forty one.
Speaker 2 (11:21):
After yeah, yeah, I saw, yeah, you were a runner.
Speaker 1 (11:25):
Yeah, I was a triathlete. I did iron Man and
then I had this massive knee. I had a complete
root tear of the meniscus. No good, and so I
was non weight bearing for you know, six weeks, and
I was like I'm getting certified, like I'm changing my
whole So I got certified as a personal trainer. I
mean I was teaching plots and doing I was very
(11:47):
active my whole life. But it is a doozy. I
mean I had osteonecrosis in the femur the you know,
for those that don't know osteonocrosis, because some people don't
know what's happening. Do you see that a lot in
your patients.
Speaker 2 (12:03):
Osteo necrosis or osteoporosis.
Speaker 1 (12:07):
Well, let's talk about necrosis. Yeah, not a lot of
people will have but like a lot.
Speaker 2 (12:12):
Of people have it. But that's a disaster. So osteosis means.
Speaker 4 (12:17):
No, I love it.
Speaker 1 (12:17):
Bone death.
Speaker 2 (12:20):
You have a loss of blood supply in your bone,
and bone is a highly vascular structure. But without blood
on the outside of bone is like a tree trunk, thick, rind,
bark on the inside, it's like lace, it's called And
when you don't have a blood supply, that collapses and
you can actually the rounded surface on the end of
(12:42):
your femur, for instance, can collapse and become flat and
it's irreversible. So that's why when we for whatever reason,
people get the osteoonocrosis. It can be for no reason
at all. It can be because of chemotherapy, or steroids
or over drinking. Sometimes nothing. You're like, I did nothing,
and still your bone has lost its blood supply. That's
(13:03):
why we're so careful to protect weight bearing so that
we don't allow your bone to collapse before it heals.
Speaker 1 (13:12):
So it's irreversible.
Speaker 2 (13:15):
Well, we have techniques now where we try to to
We called it retro drilling. So if this is the
patch of osteenocrosis, we're not going to come through your
joint and far up your cartilage. We're going to come
from behind. We're going to drill little pathways that we
put bone graph in and ask your body to revascularize.
(13:38):
Sometimes that works, sometimes that doesn't work. If it works,
give it time, we'll heal. If it doesn't work, then
there's a high chance that your bone will collapse and
we'll have to resort to some kind of cartilage restoration technique.
Speaker 1 (13:53):
Yeah. I mean that was selfishly for me because I
had been hitting bone on bone because I was undiagnosed
for six months, and so I just kept running it
because I was like, I feel like I'm crazy. They're
like we think it's a bone bruise, and I was like, well, okay,
so I guess I'm just you know, living life in pain.
But anyhow, I mean, that's that's one thing. But as
(14:14):
a as an orthopedic surgeon, for these women that are
coming over, what is the age range where you see
most of the common injuries, And I assume that's rotator
cuff is one.
Speaker 2 (14:30):
Of those the common injuries of midlife or for women.
Speaker 1 (14:35):
Let's say midlife to like from thirty five on.
Speaker 2 (14:39):
Yeah, so for masters age athletes, which you know, Masters
is defined for anybody outside the Olympic pathway because we
have four year olds in the Olympics right now, but
that they're a different athlete than even high level recreational
athletes or and so most injuries in even high level
(15:00):
recreational athletes come for two reasons. Trauma, we fall off
of something, we jump down off of something, we twist hard,
or overuse too much too often, not enough recovery progressing
too quickly, and we just overcome the strength of the tissue,
(15:23):
whether it's the tendon, ligament, bone. Right. The thing about
the muscular skeletal system is even though the bones are
dynamic and they're replacing themselves all the time. Ligaments you
get one set, meniscus you get one set, cartilage you
get one set, And so we have big traumatic injuries
no matter what age we are. I've had twenty year
(15:45):
old football players with end stage arthritis because they've just
had a big traumatic injury. So for midlife people, it's
either trauma or usually overuse less. So things like I
was playing pick up soccer, I was running, I felt
a pop my acl pop. That is due to weakness
(16:06):
and muscling balance. So that would be number three.
Speaker 1 (16:08):
Okay, yeah, and that's like I mean, I think that
goes along with what we try to preach. Yes, women
are getting the message to lift heavy, but there is
a progression that you have to do, and we have
to make sure those small guys are just as healthy
as the strong guys. Because this is what I see
(16:29):
all the time. Somebody will come in and be like, well,
you know, I can't do this because I hurt myself,
and I'm like, well, let's talk about it, and everyone
wants to just like get right into the fun stuff.
They're really heavy lifting and you cannot, you cannot you
do that at a cost.
Speaker 2 (16:46):
Well, I think it's like anything, right. People when they
talk to me about longevity, they want to go right
to the wacko biohacking stuff that I'm happy to discuss
with them. Meanwhile, their general health is not optimized.
Speaker 3 (16:58):
It's such a good point.
Speaker 2 (17:00):
We don't know if your labs, their regular labs are
let alone their biomarker weird labs. So it's the same
way with fitness, I think, and that it seems fast
and sexy and all their friends are all their heroes
are doing it, or they look at you guys and
they're like, look at these specimens. They don't realize the
reps you put in to get there, right, everybody just
(17:22):
wants to jump off. So if I was just writing
about this today from my book if you are, if
you are a adult onset exerciser, I mean you've never
really done it, Nobody ever really taught you. You just
never did it. Or you are a once upon a
timer meaning we're still talking about high school and we're
forty years old. Okay, give that up. That was a
(17:45):
long time ago. Where you're a new person, you get
a new experience, whatever the situation is. Sometimes you just
have to start with figuring out where your knee is
and where your hip is and how you connect them
and when you move your body. If you want to
do a squat, it's a multi joint activity. And if
your ankles aren't limber enough, you are a form for
(18:08):
your squat's not going to be good enough and you're
gonna hurt yourself. So learning how your body moves, learning
to move your body, learning to trust your body. I mean,
putting a bar on your back and doing a back
squad is scary if you don't even know how your
body moves or where your butt's going to end up. So,
you know, building a foundation, which I know is really
(18:30):
important to you. I think is critical for progressing to
a place where you can slam the weights around. I mean,
I feel like a badass when I'm putting weights that
didn't I know, I feel like such a badass, but
that didn't happen overnight. And every time I take a break,
I mean, I'm just coming off an unfortunate break because
(18:50):
I traveled so much. I knew you were just traveling.
It totally screws up my whole routine. I mean, I
am back to weights that I little, smaller weights that
I haven't lifted for a while because I can't get
what I need in a hotel. So anyway, but even
now I know what I'm doing, I know what it's
supposed to feel like. It's a little scary to put
(19:11):
that big red back on my back, so imagine having
not done it ever. Yeah, so please please take some lessons.
I mean, yeah, yeah, please.
Speaker 1 (19:23):
It's arrestingmental So yeah, do you. Let's talk about the
relationship of the bone and the muscle.
Speaker 2 (19:35):
I'm really glad you brought this up because I'm chuckling
as a I'm a muscle scientist. I had a muscle
stem cell lab for a long time and it was
streaming from the mountaintops. It's all about your muscle, people.
I am so glad people are finally listening to that. Right.
But what people need to realize, also as an orth
(19:57):
peak surgeon a bone doctor, is that without your bone bones,
your muscle is just a heap of quivering tissue. It
does nothing on its oone. It's metabolically active, but without
the connection to bone, it's just it's a pile of hamburger.
I mean, not to degrade muscle, but come on, people,
(20:18):
what unless it's connected to bone nothing moves. The fact
of the matter is bone is structural for allowing muscle
to do its magic. It is our storehouse of minerals.
But it is a master communicator through the hormones that
(20:38):
bone makes. Bone is thought of as, to use a funny,
you know, analogy, the strong silence standing in the corner,
not saying much, just you know, looking good. Bone is
a master communicator. It produces multiple hormones, including one that's
(20:59):
I'm starting to talk about all the time called osteocalcin.
Osteocalcin is like a global communicator. And why wouldn't bones
be part of the communication process. We have bones from
our head, we have bones in our pinky toe. We're
connected our entire body by a system of bones. Osteocalcin,
(21:20):
for instance, goes to our muscle and helps our muscle
and our pancreas regulate insulin sensitivity. Amazing, right, Osteoclcon from
the bone, it goes to the brain and helps our
brain produce neurotransmitters. For men, it goes to your testicles
and helps your litig cells make testosteroid. Oh my god,
(21:42):
it gives a whole new meaning to the mey men
love bones serious. And then there are others. Seriously, I
could make a joke, but I want you know. There
are just so many things bone does that nobody realizes.
But the connection between bone and muscle is intimate. Muscle
(22:03):
if it muscle is my arm is connected to bone
through a tendon, which is my hand. It connects to
a bone like this. But we think that muscle is
hanging on the bone. No bone has sent out stem
cells and fibers to hold the muscle the tendon to it.
So they intimately related. They're holding hands. They are not
(22:25):
two organs in the separate sides of the universe. They
are in the same cul de sac, sending out their
little messagers to talk all the time, their coordinated ecosystem.
And so it's kind of amazing. And it's why we
talk about things like osteo I always have to mix
(22:47):
up these words. Sarcopenia plus osteoporosis is thought to be
one disease, actually one continuum. We lose muscle, it can't
talk to bone, we lose bone. Bone can't help form muscle.
It's osteosarcopenia. There, it came out out of the depths
(23:08):
of my brain. One disease. It's an amazing connection that
I just am going to keep talking about every time
I have an opportunity now, because it's not just one thing.
The importance of muscle and bone are also critical in
real life. So you know, you guys are in the
(23:29):
prime of life. I'm in the prime of life. But
as an orthopedic surgeon, I have to take call and
when I'm called to the hospital to meet a patient,
typically because of the kind of hospital that I have
to take call in, what I The person I find
before me is a woman in her seventies or eighties,
and she has fallen and broken her hip, not only
(23:54):
because her bones were so weak, but because her muscle
mass was so little that she tripped over her rug
or her dog, or her suitcase, or sometimes didn't trip
at all, just fell down at the counter in her kitchen.
So there she lays with her broken bone because she
didn't have enough muscle mass, she doesn't probably have a
(24:15):
lot of protein stores to help heal her. She's laying
in bed and continent because she had the gynocourinary syndrome
of menopause from low estrogen. Her heart is so damaged
from having low estrogen and her lifestyle that she may
be too sick for the medicine doctor to clear for
(24:36):
my forty five minute bone surgery, and many times she
has the onset of dementia. Is sometimes Frank Alzheimer's that,
my friends, is the future of women if we allow
ourselves to become frail because we do not care for
our muscles and our bones. And the millennial women like
(24:56):
you guys are getting the message. My generation of women
are screaming now to catch up. But it's the baby
booming women who thought that only pink weights would do. Yeah,
pink many weights would do. And we're never given the
opportunity to lift heavy, build their bone, or to make
(25:17):
an estrogen decision. So I feel like spreading the word
like you're doing, and me getting this passionate about it
is not just because we love fitness, because we're trying
to save the lies of a generation of women.
Speaker 3 (25:32):
I do too, full body chills.
Speaker 1 (25:37):
Okay, So I feel like, yes, I mean, and it's
never too late. It's never too late. The process looks
a little bit different for me on the strength side,
if I'm coaching a seventy year old that's never done
anything versus you know, even a forty nine year old.
But let's shift the conversation to also talk about how
(25:59):
important and nutrition is when we're talking about bone and
muscle for someone that is in a low energy availability
or red S state and for those if you can
describe that, because a lot of women still don't know
what that is. But such a danger for these aggressive
(26:20):
dieters or women that I meet, women that have been
on a diet their whole life. They can't remember when
they weren't on a diet, and they tell me what
they're eating, and I'm like, this isn't you know? You're
sure you're fit now at forty, but what has that
done to your bones and your muscle mass?
Speaker 2 (26:38):
Well, you know who you're seeing now. Women in their
fifties and sixties grew up at a time when the
model a beautiful humanness. Oh we're supermodels from the seventies
and eighties, and they were truly beautiful looking people, but
they were this big.
Speaker 5 (26:59):
They were this because they were bone and fat and listen,
I was once invited listen, I don't hate supermodels. Please,
ladies listening to me, I love you and I'm so
glad you're with me on Instagram. But you know what
I'm talking about you were told to diet, to drink coffee,
(27:19):
smoke cigarettes, and stay this big because if not, you
weren't going to get work right.
Speaker 3 (27:23):
Yeah, over you.
Speaker 2 (27:25):
So I was invited. I don't even know why. That's
another series of stories by Mercedes to go to fashion
Week twenty years ago. And I went and I was
so out of water. I don't know a thing about
That's not true. I do know fashion, but I really
don't know if.
Speaker 3 (27:38):
You know fashion.
Speaker 2 (27:39):
But I'm looking at and just intimidated by all these people,
not only because they were supermodels, but because they literally
were like this and that was the standard of time. Well,
what that does when you're young is prevent you from
laying down bone and muscle, which we max out on
(28:00):
unless we invest with rigor. At about thirty, nature maxis
us out and then we can build more at every age,
but we have to really work at it. Right. So
I am getting to the answer of your question. So
for women in my generation, that's why we ended up
where we are with needing to build better bone, needing
(28:24):
to build more muscle. But listen, here's something people don't
think about. We are fifty two years into Title nine.
Title nine is the law that equalized sports participation for
men and women. And I am thankful for that law
such that at the college level there must be equal
participants for women and men. And it's a beautiful law.
(28:48):
But here's what I see many times athlete, young female
athletes today, I see it. I still have twenty eight
year olds who have broken hips. They are in a
constant state of relative energy deficiency, meaning they're working out
like crazy, they're burning seven to ten thousand calories a
(29:09):
day and they're nowhere eating that. My soccer team, I
won't name the school, used to survive on gummy worms
and gatorade. I mean, are we kidding ourselves? If we
are outpouring the energy we need to compete in an
elite level, we need to refuel warning tonight and taken
enough protein. You know. And I'm not a sports nutritionist,
(29:32):
but for the women I serve, I insist on one
grammar protein per ideal pound actually build muscle mass, and
it has to be high, high quality protein so that
we can stimulate this mTOR system which is the chemical
pathway for building muscles. So it needs to be high
(29:53):
and lucine and the essential amino acid. Right, it's not
just empty calories. It's how you fuel your with enough calories,
the enough different kind of macros so that you can
build muscle and bone. Because here's what we know. Our
bodies are so smart. If it sees that we do
(30:13):
not have enough energy to fuel our brain, or to
keep our heart healthy, or to fuel the organs that
are going to actually keep us alive, it will sacrifice
what it views as accessory, and that is our bone
and our muscle, because bone and muscle ranked below brain
and heart in the body's hierarchy, and our body will
(30:34):
sacrifice those unless there's enough to go around.
Speaker 3 (30:37):
Yes, it makes total sense. In addition to nutrition, what
are the supplements that you believe really make a difference
as far as bone, health and muscle?
Speaker 2 (30:51):
You know what, I think there are a lot. There
are gozillions of them, and I can't keep track of
them all. But so and I find people get really
confused if I suggest too many things that in my practice,
so when I talk about this, it's always one gram
of protein per ideal pound. No simple sugar. You have
to read labels. We do not eat added sugar. You
(31:13):
got to read every label. Even healthy yogurt has nine
grams of added sugar. I am not against carbs, but
I insist on complex carbs and fiber. So you got
to really know what you're putting in and read labels
about you know, make brand muffins with wheat germ instead
of you know whatever. But from a supplement standpoint, we
(31:34):
need to have our vitamin D tested. Everybody's low on
vitamin D. If you don't, if you have the capacity
to have it tested, just start taking it. Most of
us will be safe to start taking it anyway. Two
to three internation three thousand international units. Get your vitamin
D tested. You don't want it to be over the moon,
but most of us live under normal. Vitamin D should
(31:56):
be taken with potassium to help its absorption. And I
like everyone to take five hundred milligrams of magnesium either
L three and eate yep, L three innate or glycinate,
not citrate unless you want of diarrhea. There's lots of
different lines of I mean, if that's your purpose, fine
do that. But L three innate and glycinate and then
(32:20):
you know what everybody talks about it. But it's true.
One of the most well studied supplements is creatine. I
started becoming aware of it in nineteen ninety two when
we started using it in wrestlers to help them build
muscle cut weight. It's evolved since then. For most people,
I tell them to take five grams a day and
that's enough. And so let's see those things. And then
(32:47):
I'm closing my eyes to look at my cabinet right now,
just not out there. I personally take an M N
supplement so that my body will make that into an
AD plus NAD is a coenzyme of more than four
hundred reactions that our mitochondria need to make energy. And
(33:08):
with aging, it drops from an intracellular level of about
sixty to the first time I measured mine it was eighteen.
And how does that manifest well? For me? Every day
about three o'clock in the afternoon, I would be done,
like falling asleep on my desk, searching out the next
(33:28):
energy source. But now that I supplement an m and
for my body to make ANAD, which is what you
have to do. You can't just take an AD, you
have to make it. I'm like this until about eight
thirty when I start my bedtime routine, and I notice
a huge difference. So that and then The other thing
that I do as part of my longevity practice is
(33:53):
I take something called feiss ten, which is derived from strawberries,
but its role in the body, pisotin and qcertin is
to help eliminate senescent cells. Sinescent cells are those cells
in your body that have stopped doing their good work
and should turn on to program cell death. Because in
(34:15):
our bodies, we either have stem cells that can do anything,
you have mature cells that do their job. They are
then supposed to turn off and program themselves to die,
but some of them get so damaged at the DNA
level that they're just sitting there sputtering and churning out
bad side of kind. So I want to get rid
of those, and so psotin is what I take. So
(34:38):
it's not many, it's five. You could take a dozen,
but those are the basics because I find once I
like to layer on lifestyle for my people. So once
we get these things optimized, then we can do more.
But to hand people a packet of twelve supplements, it's
just too much.
Speaker 3 (34:57):
Over too much. This is switching gears a little bit.
But what's your stance on hormone replacement therapy?
Speaker 2 (35:06):
My stance on hormone replacement therapy is that every woman
gets to make her own decision because she is a
sentient being with agency. But here's what I insist on.
When a woman is going to make this decision, I
insist that she surround herself with science, that she stops
(35:26):
listening to the lady next door or her grandma Mini,
or the bad data that has been largely refuted. The
WHI Sorry guys, okay, the WHI, which was the study
published in nineteen ninety two which uniformly took hormones away
(35:50):
from women, has been largely refuted. In fact, the book
that changed my life is called Estrogen Matters. And when
I ask women to make their hormone decision, I ask
them to read that book. I'm not asking them to
believe me, although many of them do. I want them
to know that hormone replacement, in my opinion, will save
(36:10):
us from the ravages of chronic disease that I see
in women in the hospital, including hip fracture UTIs that
lead to eurosypsis, heart disease, and dementia. And so if
you choose not to or you can't because you truly
have genetics that will cause you breast an ovarian cancer. Fine,
(36:32):
but it's still your decision. Here's the other thing. I
want people to know, whether you decide to take hormones, estrogen, progesterone, testosterone,
whether you decide to do that or whether you decide
not to. They're not a magic bullet. I could take
all the estrogen I wanted all day, but in last
I got under a bar and put some plates on it.
(36:54):
I am not going to have muscles the way I
want to. People think that one thing is enough, ever
is no. So I just wanted to make that clear
that all hope is not lost if you decide not
to or cannot. It's an entire roadmap of things.
Speaker 1 (37:11):
Yes, And I love that you as a longevity doc
talking about all of this instead of just you know.
I mean, I was obviously forty one when I had
this knee surgery. But my surgeon, who was amazing, but like,
there was no conversation about anything outside of, oh, this
is your problem that you're presented with, that you're coming
(37:34):
in with, let's treat this and you know, go on
your way, bye bye. Didn't see it. But how do
you incorporate that into your practice?
Speaker 2 (37:45):
Well? I do, and it's evolved over time. So I
am a whole person doctor, And so just because your
orthopedic surgeon sees you as a knee doesn't mean you're
not gonna get good knee. But that's probably all you're
going to get. Right. But as a whole person doctor,
(38:05):
I still can fix your root tear, and I can
still reconstruct cartilage and all the technical things that we
expect orthopedic surgeonists to do. But I view my driving force,
my why in orthopedic surgery is the mantra. It's on
all my slide decks. By saving mobility, by saving your
(38:29):
knees so that you can lift, by saving your shoulder,
by sending people back to work, by saving their mobility,
I am saving them from the ravages of chronic disease.
It is never going to be enough for me to
know where to put the screws in an ACL ever
I can. I know. I was trained at the number
one orthopedic hospital in the world, hospital for special surgery,
(38:53):
but that is not enough for me.
Speaker 4 (38:56):
Right.
Speaker 2 (38:57):
So here's two examples three, and we have examples all day.
I had a fifty seven year old woman who was
being treated by doctor Google, and she was determined not
to age like her mother, who was frail and depressed
and all the things that she didn't want to be.
(39:18):
So she thought she was eating well, But what she
was doing is starving herself. She was lifting really heavy,
but she wasn't her feeding her body to support that.
She had decided not to take hormones because not because
she had known the literature, but because she was scared
by the unknown. Right, so she was doing the right thing,
(39:41):
but she broke her hip because she wasn't supporting. She
had osteoporosis and she didn't know it. So she came
to me. I met her in the er. We fixed
her hip. I fixed her hip, I put metal in it,
and I could have left it at that. That was
my job as an northea surgeon, but I immediately started
(40:06):
asking about nutrition. Do we have enough protein in our
body to heal? I started acting asking about how she
was lifting because I knew we needed to correct that.
When she got out, I got her a DEXA scan.
I set her up with an endochronologist. We found her
a menopause specialist to make her hormone decisions. Not only
(40:27):
did I put her in physical therapy, but when she
was done with physical therapy, which basically she could walk again.
I hooked her up with our elite trainers in the
Lake Nona Performance Club where I am, and you know,
the last video I have of her is doing box
step ups holding a free weight like a goblet. Step up.
Because we're going to train you back to be healthy, vital,
(40:50):
act and joyful. That is whole person care, not just
the metal in your bone, but getting you back better
than you were. Or I had a nineteen year old
the other day. We're talking about young athletes. He was
playing soccer and he felt the ominous pop and he
had torn his acl but his family was in transition.
(41:11):
He tore it at home. They had just moved to Orlando.
They didn't have any doctors, they didn't know anybody. They
were moving into a house. So I didn't see him
for three weeks after his injury. When he got to me,
his thigh had gone from like this to like this.
He couldn't move his knee. They didn't know anybody in town,
(41:34):
and he had lost his team. Remember, for athletes, your
team is your social network. So it comes to me
and my entire conversation could legitimately have been you tore
your acl We got to get your knee moving. I'll
see you in a month or three weeks and when
you can move it, and we'll put some metal in you.
(41:56):
But that was not my entire conversation. My entire conversationation
was to talking him off the ledge that at nineteen
years old, his sporting life was not over and to
calm his anxiety. It was to hook him up with
great sports therapist who would get his motion back and
build his quad. It was to set his mom up
with a social network of here's how you here's where
(42:19):
you go in this town, here's where this is, because
she knew nobody right and so that is and we
talked about nutrition, what are you eating? Are you a
typical starving teenager or are we getting enough protein? And
getting the whole family involved in this recovery, that is
whole person care. And so when your orthopod was just
(42:41):
focused on your root tear, they wanted to fix your
root tear so that you would have a need that
functioned in the future. But not everybody chooses to take
the approach I take. And I choose to take this
approach because what's my mantra By saving your mobility. I'm
saving you from the avages of chronic disease. So I
(43:01):
have a long term disease perspective and not a short
term put metal and bone perspective, and that serves me
and it serves my patients really well.
Speaker 1 (43:11):
Uh yes, I actually I'm gonna shout out hospital for
Special Surgery because that's where I had my surgery. Oh
oh no, they were he was. He was taught like
one of the best knee knee surgeons specifically, and so
like I went to him and I was so desperate
by that point. He was like, They're like, he doesn't
(43:31):
take insurance. I'm like, I don't care, Like if you
could fix my knee because I had been out for
like nine months just from other doctors not so it
was worth it. But I love that you have taken
this full body, whole person approach because really a lot
of the stuff comes down to not everything. I'm never
(43:56):
going to fix a knee or anything, but diet like
new attrition and good exercise programming and mobility. They all
go hand in hand to help be preventative for a
lot of these things. Things are going to come down
the pipeline that for some of us that we couldn't
have prevented, but a lot of it. Definitely.
Speaker 3 (44:18):
I think I wish more doctors had your mindset of
the whole person care. It would really change so many
more lives.
Speaker 2 (44:29):
It would. And in doctor's defense, I have to tell
you who the people we should be screaming at is
your insurance.
Speaker 3 (44:35):
Comes so true.
Speaker 2 (44:38):
For this hour long conversation that I had with this family,
which is what they needed. Insurance companies will pay me
half of what a massage therapist makes, Joe if you're
in New York. Yeah, And so it becomes you know,
doctors are teachers. We would not have gone into this.
Did we not have a heart for people? When you
(45:00):
see yourself getting rushed through clinics, sometimes it's because gosh,
how do I take care of people and keep the
lights on? And unfortunately, so we should all be screaming
at the insurance companies that we deserve better care.
Speaker 1 (45:15):
Frankly a million percent. Okay, So your book, which holy cow,
I mean, how recent is this? It's real book, the
book that I'm talking about, Unbreakable.
Speaker 2 (45:31):
Unbreakable Actually this is the first podcast I've talked about
it because I just announced the deal. So you know Unbreakable.
The deal to write it, although I've been writing it
for a few months now, has just been announced. And
what it is is it takes the conversation. It takes
what I do. I mean, I have a part of
(45:51):
my business called Precision Longevity, where we build precision longevity
plans that optimize health take people through peak performance. Because
I'm an elite sports doctor, It's what I've done my
whole life. I apply what we apply to pro people
to mere mortals like me and executives, and then if
(46:12):
we get there, will take you to precision longevity and
all the interesting things down the road. Right. So this
book is meant to surround people with the tools they need,
the modern tools they need to be and live unbreakable
(46:32):
physically mentally from a resilient standpoint. So it's about optimizing
your health lifting, heavy base training, why sprinting is so
good for you to recompose your body. It's about the
smart nutrition that we need. But it's also framed in
the pillars of longevity. It is formulated to give you
(47:00):
the principles of what you need to find a good
plan that that will lead you to longevity. But it's
also framed around epigenetics, about around stem cell rejuvenation, about
building your telomerors. It's the pillars of aging that are
typically viewed in a negative sense. What are the twelve
things that are going to kill us as we age?
(47:20):
And pivoting that conversation to say, how when you lift
heavy does the transcription of ninety eight hundred genes change
our future?
Speaker 3 (47:30):
I cannot wait for this boat. I can't believe we
have to wait till twenty twenty five.
Speaker 2 (47:35):
I know, but you know we'll have a whole year
of you know, I've released yesterday, I released a little
weightless because what I intend to do as it's I
intend to leak out some of the tidbits like bone
information about osteocalcin, and so we'll get stuff along the way.
But you're right, it won't be fully out until twenty five.
(47:56):
But it is the extension of the conversation that's happening now,
especially as it pertains to midlife women who have been
ignored from a programming standpoint, who have been ignored from
a research funding standpoint. Have you heard these data? Research
for research funding for midlife women for all all NIH
(48:19):
funding is about four hundred and fifty billion dollars. These
numbers are not quite right, but the magnitudes are spot on.
Research for women in general about four hundred and fifty million,
so ten percent, I am research for midlife and menopause
fifteen million.
Speaker 3 (48:40):
That's it.
Speaker 2 (48:41):
Forty four hundred and fifty billion, four hundred and fifty million,
fifteen million, And so no wonder we don't know exactly
what to do. There's been no research on us. It's
all been on it's all been on men. Research is expensive,
so it's usually done on men and spread across the board.
But I think this book is what women will be
waiting on because gosh, I love men. I'm married to
(49:06):
a man. Most of my colleagues are men. But we
have a real bro culture when it comes to longevity,
you know. And when I I was on this is
just so typical, and to this, I say, get in line.
But I just did a podcast with the Diary of
(49:26):
a CEO, and one of the bro culture guys, without
listening to one word of the podcast, put up some
snarky remark and I just think to myself, A, get
in line. B. There is no place for that because
fifty one percent of all the population in this country
are women. So by dismarting women fit women unfit women,
(49:53):
you are disregarding the majority of people in this country. Yeah,
that is wrong.
Speaker 1 (50:00):
Oh I'm doing an Instagram live with you when your
book comes out next year, because I'm already going to
be talking about it. I was so excited to see that.
I was finally yep. So what would your Okay, so
you talked about we know heavy strength training, we know
we have to have a lot of protein. What about
the pliometrics. What are some bone tips for keeping really
(50:23):
strong clones?
Speaker 2 (50:24):
Yes, okay. The way bones build is that they turn
the biomechanical stimulus that they feel into biom chemical messages
to the cells to tell it to resorb or build.
So the biomechanical stimulus is jumping, is pounding, Walking's fine,
(50:49):
Rebounding is fine, Climbing is fine. But if you really
want some bang for your book, you're jumping rope, you're stomping,
you're skipping. You are How about this? This is the
biggest one. Although I don't do this. It's kind of
pain in the butt. It's a squat vertical leap starting
(51:11):
to squat, vertical leap up and land hard. That gives
your bones like seven point times seven point five times impact.
Not take jumping that's about four times. It's easier twenty
jumps a day that will give you enough bio mechanical
stimulus to lay down bone. What if I get this
(51:34):
question all the time. What if your knees already hurt?
What if you can't do that impact? Well? Listen, when
NASA returns astronauts from space, they use trampolines and rebounding,
you can do it. They use vibratory plates, for which
the research is a little less hardy than rebounding has
some really good research. Vibratory plates has a little less
(51:57):
But the thing is what you're doing for women every
day is critical. The stimulus of muscle pulling on bone
will build better bone. Yeah, so build some muscle and
you'll be building better bone.
Speaker 1 (52:10):
It's actually quite when I have my clients jump, it's
like we go like this far off the crowd. It's
like wait, I think the basketball players, you know, and
then it's like wow, this speed and you know, power
really really can't be neglected either for multiple reasons.
Speaker 2 (52:28):
That's because their butts are so weak they have no
I mean, just being honest, It takes button leg power
to get off the ground.
Speaker 3 (52:36):
Yeah, I'm jumping twenty times a day now, Yeah, jumping
twenty times a day.
Speaker 2 (52:42):
Get a jump rope. When I have my retreats, I
give women jump ropes and they're like, I haven't done
this since I was a child. And that's the point.
If it's easy enough for a kid to do, it's easy.
Speaker 3 (52:54):
Enough for you. I text Haley, I'm like, we got
to start jump roping. You probably jump rope all the time?
Speaker 1 (53:00):
No, because but I had to film it for one
of my you know, exercise library and my husband was like,
when's the last time you've skipped? I like, you won't
get down in a chub rope. I was like, I know,
I've got I'm rusty.
Speaker 2 (53:16):
Well, it takes me real muscular coordination too. Isn't that funny?
We just take it for granted.
Speaker 1 (53:21):
Yeah, oh so funny. So if you had some advice,
we have a couple of questions that will end with that.
People were really excited about me talking to you, But
if you had some like a few takeaways for someone listening,
that's like, Okay, I get it, I know I need
to do this. What would be your advice? For any
(53:42):
like three pieces of advice, maybe for anyone who wants
to start.
Speaker 2 (53:47):
Yeah. So, if you were truly starting from zero, you've
gotten the message, you've decided you're worth it, and you
just don't know where to start. The easiest thing to
do for seven days in a row, just to prove
to yourself that you can be consistent, is after dinner,
push back from the dinner table, leave the dishes on
(54:08):
the table, and go for a walk. You have been
walking since you've been one year old. There is no
skill involved, you know how to do it, but the
mere fact that you are walking after a meal, you
will start pushing your glucose into your muscles and it
will start working on your insulin resistance. The mere fact
(54:30):
that you prioritize yourself over the dishes will reinforce for
you that you are important. And then the walking walking.
I'm not asking you to walk eight thousand steps after dinner,
but if you walk that many steps a day, it
decreases your all cause morbidity and mortality up to thirty percent.
(54:55):
You're doing real change without the intimidation of showing up
to some big gym and putting a bar bell on
your back. So that's number one. If you're truly starting out,
just commit for seven days. Another easy thing to do
if you're starting is on the days you're walking in
(55:16):
a row, you're going to stop eating sugar. And it's
harder than it sounds, but if you're doing that for
seven days, at the end of seven days, your taste
buds will change and you won't crave it as much anymore,
and you will have started to control your blood sugar. Right.
I love rocket science. This is easy. And then the
(55:42):
last piece of advice, two pieces advice found find a
good foundational program. I mean when I ask you, Haley,
when I just put out a building, better bone course,
but I so many of my women were sitting on
the couch and they don't know where to start. And
I said, what do they do? You built a foundation
course for them. Find a foundation's course so someone can
(56:04):
hold your hand through how your body moves, so that
you don't feel so wigged out by it. And the
last piece of advice that is really important is to
realize that you are worth the daily investment in your health.
Nothing is more important, not the people you serve, not
(56:26):
the people you love. Until you take care of yourself
nothing else matters.
Speaker 3 (56:33):
I'm going to cry. This is that's the best advice.
Speaker 1 (56:41):
I'm like, how do you get all of it? And
one person? It's amazing, Laura, do you have some questions?
Those a couple few questions, and then we're going to
get get doctor Vonda Wright on on a way.
Speaker 3 (56:54):
Only everything else the only thing I wanted. One of
the most powerful things that I think goes along with
this that is very simple that you talk about is
the city, the sitting epidemic, and I feel like we
can end, Yeah, we can end with that. I just
think it's powerful and it relates to everyone, and so
(57:16):
you can kind of just briefly discuss that.
Speaker 2 (57:21):
You know what, through our work, through through the amazing
digital technology, right, we are no longer in agrarian society.
We're not growing our own food, we're not out chasing
animals around. Most of us are sitting most of the day,
even you know, as an orthopedic surgeon, three days a
(57:42):
week I'm sitting writing or doing that kind of work.
The other days of the week, I'm pacing up and
down my clinical hallway or I'm doing surgery. But that
being said, even for most of us, our lives are
since spit are spent sitting. When we're sitting hunched over
in a chair, our back core, the muscles along our
(58:05):
back get really weak, our front core gets really weak,
our belly sticks out, and we atrophy our glutes. That
is a setup for low back pain. Eighty percent of
all people in this country get low back pain. Not
because there's something wrong with our backs. There is something
wrong with the muscles that support our backs because we
(58:27):
sit all day. So that's number one. Number two, we
are designed to move. What do I mean by that?
If we were designed to sit all day, we would
be nature in nature form follows function. We were made
with our strongest bones and our biggest muscles be low
(58:49):
our belly button. If we were meant to sit all day,
we would be made like a mushroom with a big
sessile stock like job of the hut where you just
kind of he's like laying there with a head. Right,
Nature intended us to sit all day. We would have
(59:09):
been designed like that. We were designed to move. That
should tell us something.
Speaker 1 (59:17):
Ah, okay, well, this has been such a fantastic conversation.
I would love, love love, I'm looking forward to your book.
We're looking forward to having you on at another point
in time, and I just want to thank you for
everything that you're sharing in the world, and not only
for your time today, but for just what you're doing
(59:39):
for women and the longevity spectrum that you take and
the whole body approach. So thank you for being who
you are and I hope to meet you and Fred too.
Speaker 2 (59:52):
Oh we will thank you for having me. It's been fun.
Speaker 1 (59:57):
Thanks for listening.
Speaker 3 (59:58):
If you enjoyed this episode, please consider giving us a
five star review and sharing the body Pod with your friends.
Speaker 1 (01:00:06):
Until next time,
Today on the Body Pod, we are providing a rerun
of some of our favorite and most popular episodes. This week,
I have the pleasure of reintroducing you to the doctor
Vonda Wright episode. This episode is one of my favorites
with doctor Vonda Wright because we dive deep into the
(00:20):
musculo skeletal syndrome of menopause and what that means for
you and how being frail is fatal. Join me while
we rerun this incredible episode with doctor Vonda Wright. Hey everyone,
this is Haley and I'm Lara, and welcome to the
Body Pod. Welcome to season two of the Body Pod,
(00:48):
where we are beginning this season with the best of
the best, Doctor Vonder Wright. Doctor Wright is an orthopedic
surgeon and mobility specialist and has made a name for
herself for being one of the top longevity specialists for women.
We dive into the muscular skeletal syndrome of menopause, the
(01:08):
importance of a foundation phase of training, the connection between
muscle and bone, and how we can change the trajectory
of our lives for the better with strength training. Let's
get into the show, Okay, So let's go back, starting
with health span versus lifespan.
Speaker 2 (01:30):
You know, when we think about how long we're going
to live, we typically, you know, we talk about the
rare person who lives to one hundred and fourteen. You know,
the Blue zones people one hundred and fourteen, what happened there?
Or we talk about longevity. We're trying to you know,
some of the longevity. Men thing that the baby's being
born now will will not die until they're one hundred
(01:52):
and twenty. And that's fine, I mean, and I think
that everything that the three of us do will extend
our life at expect our lifespan. The average life expectancy
in this country for men is seventy seven point six
years now, it's gone down since COVID, and for women
(02:12):
is slightly more. But that is not the number of
years that we will be healthy. Papers have been published
that show that the average health span, those years that
we can expect not to be limited by disease, is
only sixty three. Sixty three is not that old, and
(02:32):
it is on average when people retire to live the
life they envision, and what happens if they have not
invested along their lives and staying in their health span,
they will spend three days a week in the doctor's
office during the last twenty years of their lives. Now
do I expect to live longer than that? Well, ladies,
my goal is ninety seven, and I can tell you
(02:53):
why that's my goal. Please seven after that, as I think, Well,
because I had my last child at forty and I
am currently fifty seven, and so if I can stick
around until my youngest child is my age, everybody's going
to be good. Actually, my youngest child is so independent
she'd be good now. But I'm just saying, if I
(03:14):
can stick around until she's fifty seven, I'm going to
be good. And so I've just arbitrarily said ninety seven.
But to get to ninety seven takes an investment now,
and took an investment when I was forty. Right, you
can't just start in your sixties and seventies and expect
to optimize the way we could if we started when
(03:37):
we were thirty five or forty. And so I've got
this whole kick going on that I post about with
some frequency called forty ish. It's like, let's get our
proverbial shit together in the critical decade, which in my
mind is thirty five to forty five, when the women
still have estrogen when we're still healthy enough, because we're
trying to extend our health span to equal our lifespan,
(04:02):
and so that both of them instead of health span
going like this and then dropping and then you still
have to live twenty years, that they both come together,
right and then bloop. Whenever it's done, you just go
to sleep and we have an amazing exit? Was that
last year? I know that's what I want, Quina. Look
(04:24):
at Queen Elizabeth. She got frail, but she was still
doing her thing. On Tuesday she met with the Prime Minister.
On Thursday, she just went to sleep and didn't wake up.
I'm raising my hand for that kind of exit, right, Yes,
So that's what I mean by health span versus lifespan.
Speaker 3 (04:45):
Something else you say about this that goes along with
it is that I love is our health and aging
is predetermined by our life lifestyle choices, not our genes.
I feel like this is so power. Will you talk
about that?
Speaker 2 (05:02):
Yeah? You know, all of us, you know, when we're
being formed in utero, received genes from our father, genes
from our mother, and many you know, we for many
years we said that's our destiny. We can't do anything
about it. My dad had this, my mom had this.
My family for three generations have been big boned. By
the way, there's no such thing as big bone. That's
(05:23):
an excuse for not building enough muscle, et cetera.
Speaker 1 (05:28):
That's what I was told my whole life big boned.
Speaker 2 (05:32):
Sorry, my dear, bones are about fifteen percent of our
total weight. That's it, So you can't.
Speaker 4 (05:36):
Yeah, But the thing is, we now know that less
than thirty percent and depend on depending on who you believe,
ten percent of our health and aging is predetermined by
our genome.
Speaker 2 (05:51):
When we work out. When you put people through a workout,
ninety eight hundred of our genes are stimulated to be inscribe.
Transcribe simply means the genes turn on and make proteins.
Your activity affects what your genetics do. That is what
(06:12):
the field of epigenetics is all about. Broccoli is not
just broccoli, it's the phytochemicals that come from plants. Sprinting
is not just sprinting. It stimulates all kinds of gene transcription,
and so we can have a little excuse. There are
(06:33):
some genetically predetermined diseases, but for most of us, our
health and longevity is specific.
Speaker 1 (06:43):
Okay, So what is the role of estrogen as it
relates to these inflammatory injuries that women tend to get
over the age of forty that you see in your practice.
Speaker 2 (06:56):
So I love that you've asked me about the role
of estrogen and the muscular skeletal system. I've just published
a paper. It's just in the proof stage. It'll be out.
I'll send it to you, naming the nomenclature the musculo
skeletal syndrome menopause. Because here's what happens women in midlife.
As you know, every month of our lives. After puberty,
(07:16):
women's hormones go up and down every fourteen days, and
thus we have a period. Men if you're puberty and
their testosterone stays pretty level. So when we have used
up a huge percentage of our eggs, usually by the
age of forty, we only have one percent left, the
amount of estrogen we produce every cycle starts to decline,
(07:37):
and that's the onset of perimenopause. But even before we
have the symptoms of hot flash as night sweats, brain fogs,
start losing muscle and bone, that we become aware of
our hormones, both estrogen and testosterone are declining, and so
what that does in a variety of the musculo skeletal
tissues and in our immune system is changes all the
(08:02):
amazing thing that estrogen does for us. So when it
comes to inflammation, estrogen is a huge anti inflammatory. It
works directly to regulate a chemical called tuminicrosis factor, which
is a huge inflammatory side of kind, as well as
working in the immune system on a molecule called the inflamazon.
But the end result of not having estrogen sitting I
(08:25):
always do this with my hands. This is an estrogen receptor.
This is estrogen. The net effect of having no estrogen
sitting in the estrogen receptor is that none of the
downstream control mechanisms can happen, and so women become highly
inflamed and that manifests in many ways. Number One arthralgia,
(08:47):
which is total body aching. And this was one of
the main symptoms that I arrived into perimenopause with. I'm
an athlete, I was a dancer. I could do anything
with my body and all of us, and I couldn't
get out of bed because everything hurt. And that I
didn't realize that at the time. I fully realize it
now is due to estrogen becoming lower. The second thing
(09:12):
that happened that manifests as is the ever popular frozen
shoulder where women show up with shoulder pain. They didn't
hit the shoulder on the bedroom door, they didn't fall,
they didn't lift too much, but all of a sudden,
their shoulder hurts and they follow their instincts, they don't
move their shoulder, and in less than a week, I'm
not kidding you, women will come in unable to hook
(09:34):
their bra, which I call the can't hook your bra sign,
and they can't their arm. And that's just because of
the raging inflammation in the shoulder capsule. And it starts
out first with hot red pain. Over time the pain
can go away, but the capsule, the connective tissue of
(09:56):
the shoulder actually contracts, and that's where you've got women
for years able to move their arm. That is just
estrogen walking out the door, right. So that's arthragia, that's
frozen shoulder. It manifests a lot of other ways. Within
the musculoskeletal system. We are cartilage becomes less heardy, we
(10:19):
have rapid progression of arthritis, We lose muscle rat mass
at an alarming rate. We can lose ten percent, ten
to fifteen percent in our perimital puzzle period. We lose
three percent of our bone density a year, even before
we realize what's happening, and we redispute our fat, all
those things that we become aware of because we suddenly
(10:40):
have belly fat and we may never have had it before,
but that starts happening. I'm sorry, millennial women about forty three,
forty four, forty five, way before forty seven, which is
when I felt like I was hit by a truck.
Definitely before fifty one or fifty two, which is the
(11:02):
average age of menopause. So there's so much we can
do a decade earlier to get in front of this.
Speaker 1 (11:09):
Okay, So this is like what you call like the
the midlife muscle crisis, like in this age range of
thirty five to forty five. And I didn't start lifting
until I was forty one.
Speaker 2 (11:21):
After yeah, yeah, I saw, yeah, you were a runner.
Speaker 1 (11:25):
Yeah, I was a triathlete. I did iron Man and
then I had this massive knee. I had a complete
root tear of the meniscus. No good, and so I
was non weight bearing for you know, six weeks, and
I was like I'm getting certified, like I'm changing my
whole So I got certified as a personal trainer. I
mean I was teaching plots and doing I was very
(11:47):
active my whole life. But it is a doozy. I
mean I had osteonecrosis in the femur the you know,
for those that don't know osteonocrosis, because some people don't
know what's happening. Do you see that a lot in
your patients.
Speaker 2 (12:03):
Osteo necrosis or osteoporosis.
Speaker 1 (12:07):
Well, let's talk about necrosis. Yeah, not a lot of
people will have but like a lot.
Speaker 2 (12:12):
Of people have it. But that's a disaster. So osteosis means.
Speaker 4 (12:17):
No, I love it.
Speaker 1 (12:17):
Bone death.
Speaker 2 (12:20):
You have a loss of blood supply in your bone,
and bone is a highly vascular structure. But without blood
on the outside of bone is like a tree trunk, thick, rind,
bark on the inside, it's like lace, it's called And
when you don't have a blood supply, that collapses and
you can actually the rounded surface on the end of
(12:42):
your femur, for instance, can collapse and become flat and
it's irreversible. So that's why when we for whatever reason,
people get the osteoonocrosis. It can be for no reason
at all. It can be because of chemotherapy, or steroids
or over drinking. Sometimes nothing. You're like, I did nothing,
and still your bone has lost its blood supply. That's
(13:03):
why we're so careful to protect weight bearing so that
we don't allow your bone to collapse before it heals.
Speaker 1 (13:12):
So it's irreversible.
Speaker 2 (13:15):
Well, we have techniques now where we try to to
We called it retro drilling. So if this is the
patch of osteenocrosis, we're not going to come through your
joint and far up your cartilage. We're going to come
from behind. We're going to drill little pathways that we
put bone graph in and ask your body to revascularize.
(13:38):
Sometimes that works, sometimes that doesn't work. If it works,
give it time, we'll heal. If it doesn't work, then
there's a high chance that your bone will collapse and
we'll have to resort to some kind of cartilage restoration technique.
Speaker 1 (13:53):
Yeah. I mean that was selfishly for me because I
had been hitting bone on bone because I was undiagnosed
for six months, and so I just kept running it
because I was like, I feel like I'm crazy. They're
like we think it's a bone bruise, and I was like, well, okay,
so I guess I'm just you know, living life in pain.
But anyhow, I mean, that's that's one thing. But as
(14:14):
a as an orthopedic surgeon, for these women that are
coming over, what is the age range where you see
most of the common injuries, And I assume that's rotator
cuff is one.
Speaker 2 (14:30):
Of those the common injuries of midlife or for women.
Speaker 1 (14:35):
Let's say midlife to like from thirty five on.
Speaker 2 (14:39):
Yeah, so for masters age athletes, which you know, Masters
is defined for anybody outside the Olympic pathway because we
have four year olds in the Olympics right now, but
that they're a different athlete than even high level recreational
athletes or and so most injuries in even high level
(15:00):
recreational athletes come for two reasons. Trauma, we fall off
of something, we jump down off of something, we twist hard,
or overuse too much too often, not enough recovery progressing
too quickly, and we just overcome the strength of the tissue,
(15:23):
whether it's the tendon, ligament, bone. Right. The thing about
the muscular skeletal system is even though the bones are
dynamic and they're replacing themselves all the time. Ligaments you
get one set, meniscus you get one set, cartilage you
get one set, And so we have big traumatic injuries
no matter what age we are. I've had twenty year
(15:45):
old football players with end stage arthritis because they've just
had a big traumatic injury. So for midlife people, it's
either trauma or usually overuse less. So things like I
was playing pick up soccer, I was running, I felt
a pop my acl pop. That is due to weakness
(16:06):
and muscling balance. So that would be number three.
Speaker 1 (16:08):
Okay, yeah, and that's like I mean, I think that
goes along with what we try to preach. Yes, women
are getting the message to lift heavy, but there is
a progression that you have to do, and we have
to make sure those small guys are just as healthy
as the strong guys. Because this is what I see
(16:29):
all the time. Somebody will come in and be like, well,
you know, I can't do this because I hurt myself,
and I'm like, well, let's talk about it, and everyone
wants to just like get right into the fun stuff.
They're really heavy lifting and you cannot, you cannot you
do that at a cost.
Speaker 2 (16:46):
Well, I think it's like anything, right. People when they
talk to me about longevity, they want to go right
to the wacko biohacking stuff that I'm happy to discuss
with them. Meanwhile, their general health is not optimized.
Speaker 3 (16:58):
It's such a good point.
Speaker 2 (17:00):
We don't know if your labs, their regular labs are
let alone their biomarker weird labs. So it's the same
way with fitness, I think, and that it seems fast
and sexy and all their friends are all their heroes
are doing it, or they look at you guys and
they're like, look at these specimens. They don't realize the
reps you put in to get there, right, everybody just
(17:22):
wants to jump off. So if I was just writing
about this today from my book if you are, if
you are a adult onset exerciser, I mean you've never
really done it, Nobody ever really taught you. You just
never did it. Or you are a once upon a
timer meaning we're still talking about high school and we're
forty years old. Okay, give that up. That was a
(17:45):
long time ago. Where you're a new person, you get
a new experience, whatever the situation is. Sometimes you just
have to start with figuring out where your knee is
and where your hip is and how you connect them
and when you move your body. If you want to
do a squat, it's a multi joint activity. And if
your ankles aren't limber enough, you are a form for
(18:08):
your squat's not going to be good enough and you're
gonna hurt yourself. So learning how your body moves, learning
to move your body, learning to trust your body. I mean,
putting a bar on your back and doing a back
squad is scary if you don't even know how your
body moves or where your butt's going to end up. So,
you know, building a foundation, which I know is really
(18:30):
important to you. I think is critical for progressing to
a place where you can slam the weights around. I mean,
I feel like a badass when I'm putting weights that
didn't I know, I feel like such a badass, but
that didn't happen overnight. And every time I take a break,
I mean, I'm just coming off an unfortunate break because
(18:50):
I traveled so much. I knew you were just traveling.
It totally screws up my whole routine. I mean, I
am back to weights that I little, smaller weights that
I haven't lifted for a while because I can't get
what I need in a hotel. So anyway, but even
now I know what I'm doing, I know what it's
supposed to feel like. It's a little scary to put
(19:11):
that big red back on my back, so imagine having
not done it ever. Yeah, so please please take some lessons.
I mean, yeah, yeah, please.
Speaker 1 (19:23):
It's arrestingmental So yeah, do you. Let's talk about the
relationship of the bone and the muscle.
Speaker 2 (19:35):
I'm really glad you brought this up because I'm chuckling
as a I'm a muscle scientist. I had a muscle
stem cell lab for a long time and it was
streaming from the mountaintops. It's all about your muscle, people.
I am so glad people are finally listening to that. Right.
But what people need to realize, also as an orth
(19:57):
peak surgeon a bone doctor, is that without your bone bones,
your muscle is just a heap of quivering tissue. It
does nothing on its oone. It's metabolically active, but without
the connection to bone, it's just it's a pile of hamburger.
I mean, not to degrade muscle, but come on, people,
(20:18):
what unless it's connected to bone nothing moves. The fact
of the matter is bone is structural for allowing muscle
to do its magic. It is our storehouse of minerals.
But it is a master communicator through the hormones that
(20:38):
bone makes. Bone is thought of as, to use a funny,
you know, analogy, the strong silence standing in the corner,
not saying much, just you know, looking good. Bone is
a master communicator. It produces multiple hormones, including one that's
(20:59):
I'm starting to talk about all the time called osteocalcin.
Osteocalcin is like a global communicator. And why wouldn't bones
be part of the communication process. We have bones from
our head, we have bones in our pinky toe. We're
connected our entire body by a system of bones. Osteocalcin,
(21:20):
for instance, goes to our muscle and helps our muscle
and our pancreas regulate insulin sensitivity. Amazing, right, Osteoclcon from
the bone, it goes to the brain and helps our
brain produce neurotransmitters. For men, it goes to your testicles
and helps your litig cells make testosteroid. Oh my god,
(21:42):
it gives a whole new meaning to the mey men
love bones serious. And then there are others. Seriously, I
could make a joke, but I want you know. There
are just so many things bone does that nobody realizes.
But the connection between bone and muscle is intimate. Muscle
(22:03):
if it muscle is my arm is connected to bone
through a tendon, which is my hand. It connects to
a bone like this. But we think that muscle is
hanging on the bone. No bone has sent out stem
cells and fibers to hold the muscle the tendon to it.
So they intimately related. They're holding hands. They are not
(22:25):
two organs in the separate sides of the universe. They
are in the same cul de sac, sending out their
little messagers to talk all the time, their coordinated ecosystem.
And so it's kind of amazing. And it's why we
talk about things like osteo I always have to mix
(22:47):
up these words. Sarcopenia plus osteoporosis is thought to be
one disease, actually one continuum. We lose muscle, it can't
talk to bone, we lose bone. Bone can't help form muscle.
It's osteosarcopenia. There, it came out out of the depths
(23:08):
of my brain. One disease. It's an amazing connection that
I just am going to keep talking about every time
I have an opportunity now, because it's not just one thing.
The importance of muscle and bone are also critical in
real life. So you know, you guys are in the
(23:29):
prime of life. I'm in the prime of life. But
as an orthopedic surgeon, I have to take call and
when I'm called to the hospital to meet a patient,
typically because of the kind of hospital that I have
to take call in, what I The person I find
before me is a woman in her seventies or eighties,
and she has fallen and broken her hip, not only
(23:54):
because her bones were so weak, but because her muscle
mass was so little that she tripped over her rug
or her dog, or her suitcase, or sometimes didn't trip
at all, just fell down at the counter in her kitchen.
So there she lays with her broken bone because she
didn't have enough muscle mass, she doesn't probably have a
(24:15):
lot of protein stores to help heal her. She's laying
in bed and continent because she had the gynocourinary syndrome
of menopause from low estrogen. Her heart is so damaged
from having low estrogen and her lifestyle that she may
be too sick for the medicine doctor to clear for
(24:36):
my forty five minute bone surgery, and many times she
has the onset of dementia. Is sometimes Frank Alzheimer's that,
my friends, is the future of women if we allow
ourselves to become frail because we do not care for
our muscles and our bones. And the millennial women like
(24:56):
you guys are getting the message. My generation of women
are screaming now to catch up. But it's the baby
booming women who thought that only pink weights would do. Yeah,
pink many weights would do. And we're never given the
opportunity to lift heavy, build their bone, or to make
(25:17):
an estrogen decision. So I feel like spreading the word
like you're doing, and me getting this passionate about it
is not just because we love fitness, because we're trying
to save the lies of a generation of women.
Speaker 3 (25:32):
I do too, full body chills.
Speaker 1 (25:37):
Okay, So I feel like, yes, I mean, and it's
never too late. It's never too late. The process looks
a little bit different for me on the strength side,
if I'm coaching a seventy year old that's never done
anything versus you know, even a forty nine year old.
But let's shift the conversation to also talk about how
(25:59):
important and nutrition is when we're talking about bone and
muscle for someone that is in a low energy availability
or red S state and for those if you can
describe that, because a lot of women still don't know
what that is. But such a danger for these aggressive
(26:20):
dieters or women that I meet, women that have been
on a diet their whole life. They can't remember when
they weren't on a diet, and they tell me what
they're eating, and I'm like, this isn't you know? You're
sure you're fit now at forty, but what has that
done to your bones and your muscle mass?
Speaker 2 (26:38):
Well, you know who you're seeing now. Women in their
fifties and sixties grew up at a time when the
model a beautiful humanness. Oh we're supermodels from the seventies
and eighties, and they were truly beautiful looking people, but
they were this big.
Speaker 5 (26:59):
They were this because they were bone and fat and listen,
I was once invited listen, I don't hate supermodels. Please,
ladies listening to me, I love you and I'm so
glad you're with me on Instagram. But you know what
I'm talking about you were told to diet, to drink coffee,
(27:19):
smoke cigarettes, and stay this big because if not, you
weren't going to get work right.
Speaker 3 (27:23):
Yeah, over you.
Speaker 2 (27:25):
So I was invited. I don't even know why. That's
another series of stories by Mercedes to go to fashion
Week twenty years ago. And I went and I was
so out of water. I don't know a thing about
That's not true. I do know fashion, but I really
don't know if.
Speaker 3 (27:38):
You know fashion.
Speaker 2 (27:39):
But I'm looking at and just intimidated by all these people,
not only because they were supermodels, but because they literally
were like this and that was the standard of time. Well,
what that does when you're young is prevent you from
laying down bone and muscle, which we max out on
(28:00):
unless we invest with rigor. At about thirty, nature maxis
us out and then we can build more at every age,
but we have to really work at it. Right. So
I am getting to the answer of your question. So
for women in my generation, that's why we ended up
where we are with needing to build better bone, needing
(28:24):
to build more muscle. But listen, here's something people don't
think about. We are fifty two years into Title nine.
Title nine is the law that equalized sports participation for
men and women. And I am thankful for that law
such that at the college level there must be equal
participants for women and men. And it's a beautiful law.
(28:48):
But here's what I see many times athlete, young female
athletes today, I see it. I still have twenty eight
year olds who have broken hips. They are in a
constant state of relative energy deficiency, meaning they're working out
like crazy, they're burning seven to ten thousand calories a
(29:09):
day and they're nowhere eating that. My soccer team, I
won't name the school, used to survive on gummy worms
and gatorade. I mean, are we kidding ourselves? If we
are outpouring the energy we need to compete in an
elite level, we need to refuel warning tonight and taken
enough protein. You know. And I'm not a sports nutritionist,
(29:32):
but for the women I serve, I insist on one
grammar protein per ideal pound actually build muscle mass, and
it has to be high, high quality protein so that
we can stimulate this mTOR system which is the chemical
pathway for building muscles. So it needs to be high
(29:53):
and lucine and the essential amino acid. Right, it's not
just empty calories. It's how you fuel your with enough calories,
the enough different kind of macros so that you can
build muscle and bone. Because here's what we know. Our
bodies are so smart. If it sees that we do
(30:13):
not have enough energy to fuel our brain, or to
keep our heart healthy, or to fuel the organs that
are going to actually keep us alive, it will sacrifice
what it views as accessory, and that is our bone
and our muscle, because bone and muscle ranked below brain
and heart in the body's hierarchy, and our body will
(30:34):
sacrifice those unless there's enough to go around.
Speaker 3 (30:37):
Yes, it makes total sense. In addition to nutrition, what
are the supplements that you believe really make a difference
as far as bone, health and muscle?
Speaker 2 (30:51):
You know what, I think there are a lot. There
are gozillions of them, and I can't keep track of
them all. But so and I find people get really
confused if I suggest too many things that in my practice,
so when I talk about this, it's always one gram
of protein per ideal pound. No simple sugar. You have
to read labels. We do not eat added sugar. You
(31:13):
got to read every label. Even healthy yogurt has nine
grams of added sugar. I am not against carbs, but
I insist on complex carbs and fiber. So you got
to really know what you're putting in and read labels
about you know, make brand muffins with wheat germ instead
of you know whatever. But from a supplement standpoint, we
(31:34):
need to have our vitamin D tested. Everybody's low on
vitamin D. If you don't, if you have the capacity
to have it tested, just start taking it. Most of
us will be safe to start taking it anyway. Two
to three internation three thousand international units. Get your vitamin
D tested. You don't want it to be over the moon,
but most of us live under normal. Vitamin D should
(31:56):
be taken with potassium to help its absorption. And I
like everyone to take five hundred milligrams of magnesium either
L three and eate yep, L three innate or glycinate,
not citrate unless you want of diarrhea. There's lots of
different lines of I mean, if that's your purpose, fine
do that. But L three innate and glycinate and then
(32:20):
you know what everybody talks about it. But it's true.
One of the most well studied supplements is creatine. I
started becoming aware of it in nineteen ninety two when
we started using it in wrestlers to help them build
muscle cut weight. It's evolved since then. For most people,
I tell them to take five grams a day and
that's enough. And so let's see those things. And then
(32:47):
I'm closing my eyes to look at my cabinet right now,
just not out there. I personally take an M N
supplement so that my body will make that into an
AD plus NAD is a coenzyme of more than four
hundred reactions that our mitochondria need to make energy. And
(33:08):
with aging, it drops from an intracellular level of about
sixty to the first time I measured mine it was eighteen.
And how does that manifest well? For me? Every day
about three o'clock in the afternoon, I would be done,
like falling asleep on my desk, searching out the next
(33:28):
energy source. But now that I supplement an m and
for my body to make ANAD, which is what you
have to do. You can't just take an AD, you
have to make it. I'm like this until about eight
thirty when I start my bedtime routine, and I notice
a huge difference. So that and then The other thing
that I do as part of my longevity practice is
(33:53):
I take something called feiss ten, which is derived from strawberries,
but its role in the body, pisotin and qcertin is
to help eliminate senescent cells. Sinescent cells are those cells
in your body that have stopped doing their good work
and should turn on to program cell death. Because in
(34:15):
our bodies, we either have stem cells that can do anything,
you have mature cells that do their job. They are
then supposed to turn off and program themselves to die,
but some of them get so damaged at the DNA
level that they're just sitting there sputtering and churning out
bad side of kind. So I want to get rid
of those, and so psotin is what I take. So
(34:38):
it's not many, it's five. You could take a dozen,
but those are the basics because I find once I
like to layer on lifestyle for my people. So once
we get these things optimized, then we can do more.
But to hand people a packet of twelve supplements, it's
just too much.
Speaker 3 (34:57):
Over too much. This is switching gears a little bit.
But what's your stance on hormone replacement therapy?
Speaker 2 (35:06):
My stance on hormone replacement therapy is that every woman
gets to make her own decision because she is a
sentient being with agency. But here's what I insist on.
When a woman is going to make this decision, I
insist that she surround herself with science, that she stops
(35:26):
listening to the lady next door or her grandma Mini,
or the bad data that has been largely refuted. The
WHI Sorry guys, okay, the WHI, which was the study
published in nineteen ninety two which uniformly took hormones away
(35:50):
from women, has been largely refuted. In fact, the book
that changed my life is called Estrogen Matters. And when
I ask women to make their hormone decision, I ask
them to read that book. I'm not asking them to
believe me, although many of them do. I want them
to know that hormone replacement, in my opinion, will save
(36:10):
us from the ravages of chronic disease that I see
in women in the hospital, including hip fracture UTIs that
lead to eurosypsis, heart disease, and dementia. And so if
you choose not to or you can't because you truly
have genetics that will cause you breast an ovarian cancer. Fine,
(36:32):
but it's still your decision. Here's the other thing. I
want people to know, whether you decide to take hormones, estrogen, progesterone, testosterone,
whether you decide to do that or whether you decide
not to. They're not a magic bullet. I could take
all the estrogen I wanted all day, but in last
I got under a bar and put some plates on it.
(36:54):
I am not going to have muscles the way I
want to. People think that one thing is enough, ever
is no. So I just wanted to make that clear
that all hope is not lost if you decide not
to or cannot. It's an entire roadmap of things.
Speaker 1 (37:11):
Yes, And I love that you as a longevity doc
talking about all of this instead of just you know.
I mean, I was obviously forty one when I had
this knee surgery. But my surgeon, who was amazing, but like,
there was no conversation about anything outside of, oh, this
is your problem that you're presented with, that you're coming
(37:34):
in with, let's treat this and you know, go on
your way, bye bye. Didn't see it. But how do
you incorporate that into your practice?
Speaker 2 (37:45):
Well? I do, and it's evolved over time. So I
am a whole person doctor, And so just because your
orthopedic surgeon sees you as a knee doesn't mean you're
not gonna get good knee. But that's probably all you're
going to get. Right. But as a whole person doctor,
(38:05):
I still can fix your root tear, and I can
still reconstruct cartilage and all the technical things that we
expect orthopedic surgeonists to do. But I view my driving force,
my why in orthopedic surgery is the mantra. It's on
all my slide decks. By saving mobility, by saving your
(38:29):
knees so that you can lift, by saving your shoulder,
by sending people back to work, by saving their mobility,
I am saving them from the ravages of chronic disease.
It is never going to be enough for me to
know where to put the screws in an ACL ever
I can. I know. I was trained at the number
one orthopedic hospital in the world, hospital for special surgery,
(38:53):
but that is not enough for me.
Speaker 4 (38:56):
Right.
Speaker 2 (38:57):
So here's two examples three, and we have examples all day.
I had a fifty seven year old woman who was
being treated by doctor Google, and she was determined not
to age like her mother, who was frail and depressed
and all the things that she didn't want to be.
(39:18):
So she thought she was eating well, But what she
was doing is starving herself. She was lifting really heavy,
but she wasn't her feeding her body to support that.
She had decided not to take hormones because not because
she had known the literature, but because she was scared
by the unknown. Right, so she was doing the right thing,
(39:41):
but she broke her hip because she wasn't supporting. She
had osteoporosis and she didn't know it. So she came
to me. I met her in the er. We fixed
her hip. I fixed her hip, I put metal in it,
and I could have left it at that. That was
my job as an northea surgeon, but I immediately started
(40:06):
asking about nutrition. Do we have enough protein in our
body to heal? I started acting asking about how she
was lifting because I knew we needed to correct that.
When she got out, I got her a DEXA scan.
I set her up with an endochronologist. We found her
a menopause specialist to make her hormone decisions. Not only
(40:27):
did I put her in physical therapy, but when she
was done with physical therapy, which basically she could walk again.
I hooked her up with our elite trainers in the
Lake Nona Performance Club where I am, and you know,
the last video I have of her is doing box
step ups holding a free weight like a goblet. Step up.
Because we're going to train you back to be healthy, vital,
(40:50):
act and joyful. That is whole person care, not just
the metal in your bone, but getting you back better
than you were. Or I had a nineteen year old
the other day. We're talking about young athletes. He was
playing soccer and he felt the ominous pop and he
had torn his acl but his family was in transition.
(41:11):
He tore it at home. They had just moved to Orlando.
They didn't have any doctors, they didn't know anybody. They
were moving into a house. So I didn't see him
for three weeks after his injury. When he got to me,
his thigh had gone from like this to like this.
He couldn't move his knee. They didn't know anybody in town,
(41:34):
and he had lost his team. Remember, for athletes, your
team is your social network. So it comes to me
and my entire conversation could legitimately have been you tore
your acl We got to get your knee moving. I'll
see you in a month or three weeks and when
you can move it, and we'll put some metal in you.
(41:56):
But that was not my entire conversation. My entire conversationation
was to talking him off the ledge that at nineteen
years old, his sporting life was not over and to
calm his anxiety. It was to hook him up with
great sports therapist who would get his motion back and
build his quad. It was to set his mom up
with a social network of here's how you here's where
(42:19):
you go in this town, here's where this is, because
she knew nobody right and so that is and we
talked about nutrition, what are you eating? Are you a
typical starving teenager or are we getting enough protein? And
getting the whole family involved in this recovery, that is
whole person care. And so when your orthopod was just
(42:41):
focused on your root tear, they wanted to fix your
root tear so that you would have a need that
functioned in the future. But not everybody chooses to take
the approach I take. And I choose to take this
approach because what's my mantra By saving your mobility. I'm
saving you from the avages of chronic disease. So I
(43:01):
have a long term disease perspective and not a short
term put metal and bone perspective, and that serves me
and it serves my patients really well.
Speaker 1 (43:11):
Uh yes, I actually I'm gonna shout out hospital for
Special Surgery because that's where I had my surgery. Oh
oh no, they were he was. He was taught like
one of the best knee knee surgeons specifically, and so
like I went to him and I was so desperate
by that point. He was like, They're like, he doesn't
(43:31):
take insurance. I'm like, I don't care, Like if you
could fix my knee because I had been out for
like nine months just from other doctors not so it
was worth it. But I love that you have taken
this full body, whole person approach because really a lot
of the stuff comes down to not everything. I'm never
(43:56):
going to fix a knee or anything, but diet like
new attrition and good exercise programming and mobility. They all
go hand in hand to help be preventative for a
lot of these things. Things are going to come down
the pipeline that for some of us that we couldn't
have prevented, but a lot of it. Definitely.
Speaker 3 (44:18):
I think I wish more doctors had your mindset of
the whole person care. It would really change so many
more lives.
Speaker 2 (44:29):
It would. And in doctor's defense, I have to tell
you who the people we should be screaming at is
your insurance.
Speaker 3 (44:35):
Comes so true.
Speaker 2 (44:38):
For this hour long conversation that I had with this family,
which is what they needed. Insurance companies will pay me
half of what a massage therapist makes, Joe if you're
in New York. Yeah, And so it becomes you know,
doctors are teachers. We would not have gone into this.
Did we not have a heart for people? When you
(45:00):
see yourself getting rushed through clinics, sometimes it's because gosh,
how do I take care of people and keep the
lights on? And unfortunately, so we should all be screaming
at the insurance companies that we deserve better care.
Speaker 1 (45:15):
Frankly a million percent. Okay, So your book, which holy cow,
I mean, how recent is this? It's real book, the
book that I'm talking about, Unbreakable.
Speaker 2 (45:31):
Unbreakable Actually this is the first podcast I've talked about
it because I just announced the deal. So you know Unbreakable.
The deal to write it, although I've been writing it
for a few months now, has just been announced. And
what it is is it takes the conversation. It takes
what I do. I mean, I have a part of
(45:51):
my business called Precision Longevity, where we build precision longevity
plans that optimize health take people through peak performance. Because
I'm an elite sports doctor, It's what I've done my
whole life. I apply what we apply to pro people
to mere mortals like me and executives, and then if
(46:12):
we get there, will take you to precision longevity and
all the interesting things down the road. Right. So this
book is meant to surround people with the tools they need,
the modern tools they need to be and live unbreakable
(46:32):
physically mentally from a resilient standpoint. So it's about optimizing
your health lifting, heavy base training, why sprinting is so
good for you to recompose your body. It's about the
smart nutrition that we need. But it's also framed in
the pillars of longevity. It is formulated to give you
(47:00):
the principles of what you need to find a good
plan that that will lead you to longevity. But it's
also framed around epigenetics, about around stem cell rejuvenation, about
building your telomerors. It's the pillars of aging that are
typically viewed in a negative sense. What are the twelve
things that are going to kill us as we age?
(47:20):
And pivoting that conversation to say, how when you lift
heavy does the transcription of ninety eight hundred genes change
our future?
Speaker 3 (47:30):
I cannot wait for this boat. I can't believe we
have to wait till twenty twenty five.
Speaker 2 (47:35):
I know, but you know we'll have a whole year
of you know, I've released yesterday, I released a little
weightless because what I intend to do as it's I
intend to leak out some of the tidbits like bone
information about osteocalcin, and so we'll get stuff along the way.
But you're right, it won't be fully out until twenty five.
(47:56):
But it is the extension of the conversation that's happening now,
especially as it pertains to midlife women who have been
ignored from a programming standpoint, who have been ignored from
a research funding standpoint. Have you heard these data? Research
for research funding for midlife women for all all NIH
(48:19):
funding is about four hundred and fifty billion dollars. These
numbers are not quite right, but the magnitudes are spot on.
Research for women in general about four hundred and fifty million,
so ten percent, I am research for midlife and menopause
fifteen million.
Speaker 3 (48:40):
That's it.
Speaker 2 (48:41):
Forty four hundred and fifty billion, four hundred and fifty million,
fifteen million, And so no wonder we don't know exactly
what to do. There's been no research on us. It's
all been on it's all been on men. Research is expensive,
so it's usually done on men and spread across the board.
But I think this book is what women will be
waiting on because gosh, I love men. I'm married to
(49:06):
a man. Most of my colleagues are men. But we
have a real bro culture when it comes to longevity,
you know. And when I I was on this is
just so typical, and to this, I say, get in line.
But I just did a podcast with the Diary of
(49:26):
a CEO, and one of the bro culture guys, without
listening to one word of the podcast, put up some
snarky remark and I just think to myself, A, get
in line. B. There is no place for that because
fifty one percent of all the population in this country
are women. So by dismarting women fit women unfit women,
(49:53):
you are disregarding the majority of people in this country. Yeah,
that is wrong.
Speaker 1 (50:00):
Oh I'm doing an Instagram live with you when your
book comes out next year, because I'm already going to
be talking about it. I was so excited to see that.
I was finally yep. So what would your Okay, so
you talked about we know heavy strength training, we know
we have to have a lot of protein. What about
the pliometrics. What are some bone tips for keeping really
(50:23):
strong clones?
Speaker 2 (50:24):
Yes, okay. The way bones build is that they turn
the biomechanical stimulus that they feel into biom chemical messages
to the cells to tell it to resorb or build.
So the biomechanical stimulus is jumping, is pounding, Walking's fine,
(50:49):
Rebounding is fine, Climbing is fine. But if you really
want some bang for your book, you're jumping rope, you're stomping,
you're skipping. You are How about this? This is the
biggest one. Although I don't do this. It's kind of
pain in the butt. It's a squat vertical leap starting
(51:11):
to squat, vertical leap up and land hard. That gives
your bones like seven point times seven point five times impact.
Not take jumping that's about four times. It's easier twenty
jumps a day that will give you enough bio mechanical
stimulus to lay down bone. What if I get this
(51:34):
question all the time. What if your knees already hurt?
What if you can't do that impact? Well? Listen, when
NASA returns astronauts from space, they use trampolines and rebounding,
you can do it. They use vibratory plates, for which
the research is a little less hardy than rebounding has
some really good research. Vibratory plates has a little less
(51:57):
But the thing is what you're doing for women every
day is critical. The stimulus of muscle pulling on bone
will build better bone. Yeah, so build some muscle and
you'll be building better bone.
Speaker 1 (52:10):
It's actually quite when I have my clients jump, it's
like we go like this far off the crowd. It's
like wait, I think the basketball players, you know, and
then it's like wow, this speed and you know, power
really really can't be neglected either for multiple reasons.
Speaker 2 (52:28):
That's because their butts are so weak they have no
I mean, just being honest, It takes button leg power
to get off the ground.
Speaker 3 (52:36):
Yeah, I'm jumping twenty times a day now, Yeah, jumping
twenty times a day.
Speaker 2 (52:42):
Get a jump rope. When I have my retreats, I
give women jump ropes and they're like, I haven't done
this since I was a child. And that's the point.
If it's easy enough for a kid to do, it's easy.
Speaker 3 (52:54):
Enough for you. I text Haley, I'm like, we got
to start jump roping. You probably jump rope all the time?
Speaker 1 (53:00):
No, because but I had to film it for one
of my you know, exercise library and my husband was like,
when's the last time you've skipped? I like, you won't
get down in a chub rope. I was like, I know,
I've got I'm rusty.
Speaker 2 (53:16):
Well, it takes me real muscular coordination too. Isn't that funny?
We just take it for granted.
Speaker 1 (53:21):
Yeah, oh so funny. So if you had some advice,
we have a couple of questions that will end with that.
People were really excited about me talking to you, But
if you had some like a few takeaways for someone listening,
that's like, Okay, I get it, I know I need
to do this. What would be your advice? For any
(53:42):
like three pieces of advice, maybe for anyone who wants
to start.
Speaker 2 (53:47):
Yeah. So, if you were truly starting from zero, you've
gotten the message, you've decided you're worth it, and you
just don't know where to start. The easiest thing to
do for seven days in a row, just to prove
to yourself that you can be consistent, is after dinner,
push back from the dinner table, leave the dishes on
(54:08):
the table, and go for a walk. You have been
walking since you've been one year old. There is no
skill involved, you know how to do it, but the
mere fact that you are walking after a meal, you
will start pushing your glucose into your muscles and it
will start working on your insulin resistance. The mere fact
(54:30):
that you prioritize yourself over the dishes will reinforce for
you that you are important. And then the walking walking.
I'm not asking you to walk eight thousand steps after dinner,
but if you walk that many steps a day, it
decreases your all cause morbidity and mortality up to thirty percent.
(54:55):
You're doing real change without the intimidation of showing up
to some big gym and putting a bar bell on
your back. So that's number one. If you're truly starting out,
just commit for seven days. Another easy thing to do
if you're starting is on the days you're walking in
(55:16):
a row, you're going to stop eating sugar. And it's
harder than it sounds, but if you're doing that for
seven days, at the end of seven days, your taste
buds will change and you won't crave it as much anymore,
and you will have started to control your blood sugar. Right.
I love rocket science. This is easy. And then the
(55:42):
last piece of advice, two pieces advice found find a
good foundational program. I mean when I ask you, Haley,
when I just put out a building, better bone course,
but I so many of my women were sitting on
the couch and they don't know where to start. And
I said, what do they do? You built a foundation
course for them. Find a foundation's course so someone can
(56:04):
hold your hand through how your body moves, so that
you don't feel so wigged out by it. And the
last piece of advice that is really important is to
realize that you are worth the daily investment in your health.
Nothing is more important, not the people you serve, not
(56:26):
the people you love. Until you take care of yourself
nothing else matters.
Speaker 3 (56:33):
I'm going to cry. This is that's the best advice.
Speaker 1 (56:41):
I'm like, how do you get all of it? And
one person? It's amazing, Laura, do you have some questions?
Those a couple few questions, and then we're going to
get get doctor Vonda Wright on on a way.
Speaker 3 (56:54):
Only everything else the only thing I wanted. One of
the most powerful things that I think goes along with
this that is very simple that you talk about is
the city, the sitting epidemic, and I feel like we
can end, Yeah, we can end with that. I just
think it's powerful and it relates to everyone, and so
(57:16):
you can kind of just briefly discuss that.
Speaker 2 (57:21):
You know what, through our work, through through the amazing
digital technology, right, we are no longer in agrarian society.
We're not growing our own food, we're not out chasing
animals around. Most of us are sitting most of the day,
even you know, as an orthopedic surgeon, three days a
(57:42):
week I'm sitting writing or doing that kind of work.
The other days of the week, I'm pacing up and
down my clinical hallway or I'm doing surgery. But that
being said, even for most of us, our lives are
since spit are spent sitting. When we're sitting hunched over
in a chair, our back core, the muscles along our
(58:05):
back get really weak, our front core gets really weak,
our belly sticks out, and we atrophy our glutes. That
is a setup for low back pain. Eighty percent of
all people in this country get low back pain. Not
because there's something wrong with our backs. There is something
wrong with the muscles that support our backs because we
(58:27):
sit all day. So that's number one. Number two, we
are designed to move. What do I mean by that?
If we were designed to sit all day, we would
be nature in nature form follows function. We were made
with our strongest bones and our biggest muscles be low
(58:49):
our belly button. If we were meant to sit all day,
we would be made like a mushroom with a big
sessile stock like job of the hut where you just
kind of he's like laying there with a head. Right,
Nature intended us to sit all day. We would have
(59:09):
been designed like that. We were designed to move. That
should tell us something.
Speaker 1 (59:17):
Ah, okay, well, this has been such a fantastic conversation.
I would love, love love, I'm looking forward to your book.
We're looking forward to having you on at another point
in time, and I just want to thank you for
everything that you're sharing in the world, and not only
for your time today, but for just what you're doing
(59:39):
for women and the longevity spectrum that you take and
the whole body approach. So thank you for being who
you are and I hope to meet you and Fred too.
Speaker 2 (59:52):
Oh we will thank you for having me. It's been fun.
Speaker 1 (59:57):
Thanks for listening.
Speaker 3 (59:58):
If you enjoyed this episode, please consider giving us a
five star review and sharing the body Pod with your friends.
Speaker 1 (01:00:06):
Until next time,
Popular Podcasts
Fudd Around And Find Out
UConn basketball star Azzi Fudd brings her championship swag to iHeart Women’s Sports with Fudd Around and Find Out, a weekly podcast that takes fans along for the ride as Azzi spends her final year of college trying to reclaim the National Championship and prepare to be a first round WNBA draft pick. Ever wonder what it’s like to be a world-class athlete in the public spotlight while still managing schoolwork, friendships and family time? It’s time to Fudd Around and Find Out!
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.