September 18, 2025 • 55 mins
In this must-listen episode of The Body Pod, Dr. Lisa Moore — physical therapist, educator, and founder of Brick House Bones — reveals science-backed strategies to strengthen bones and thrive in midlife. Learn the truth about osteoporosis vs. osteopenia, how to use her 4x4 strength training method, and why bone health is crucial for women over 40.
From fracture prevention to building strength and balance, this episode empowers women to take charge of their fitness, independence, and longevity through movement, nutrition, and smarter training.
From fracture prevention to building strength and balance, this episode empowers women to take charge of their fitness, independence, and longevity through movement, nutrition, and smarter training.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hi everyone. My name is Haley and this is laurav
and welcome to the Body Pod.
Speaker 2 (00:12):
Welcome back everyone for another episode on the Body Pod. Today,
I have the privilege of introducing you to doctor Lisa Moore.
Doctor Lisa Moore is a twenty eight year veteran physical
therapist who supports women who have had a diagnosis of
breast cancer and osteoporosis. She is certified in Cancer Rehabilitation
(00:32):
bone Fit trained through the Bone Health and Osteoporosis Foundation.
She's a certified yoga teacher. She is also certified in
functional nutrition for chronic pain via the Integrative Pain Science Institute.
Lisa has developed the Brick House Bones program for evidence
based exercises to support bone health for people with low
(00:53):
bone mass and osteoporosis. Her many years of clinical work
as a physical therapist have her constantly seeking knowledge about
what truly helps women, how to facilitate change, and how
to empower women toward their own recovery. So this conversation
is very interesting and very educational, so enjoy this episode
(01:15):
with doctor Lisa. All Right, doctor Lisa Moore, we are
so thrilled to have you here today as this massive
osteoporosis name and expert in the field.
Speaker 1 (01:33):
So thank you for sharing your time with us today.
Speaker 3 (01:36):
Oh, thank you, Hailey, Laura.
Speaker 4 (01:38):
It's really an honor and a privilege to be here
and I'm so grateful you invited me.
Speaker 2 (01:41):
Thanks well, our audience is going to love this because
I'll have to tell you, Lisa, in the last year,
since menopause has kind of had this massive.
Speaker 1 (01:52):
Growth the bone.
Speaker 2 (01:54):
You know, bone health is a massive topic, and I
will say that just getting you know, thousands of women
onto my platform, people will you know, women will come
in and they're just like, I don't know what to do,
or they'll tell me their diagnosis and I'm like, what
you know, I'm not diagnosing you? Where do you know?
Speaker 1 (02:14):
But their questions are all like where do I start?
So I want to dive right in to how you like,
how did you come upon this?
Speaker 2 (02:23):
Obviously you you're a physical therapist, and when did the osteoporosis?
Have you always been interested in that or did that
kind of come later on?
Speaker 4 (02:34):
Yes, So later in my career I was focusing on
oncology rehab. So in my fifties, I'm working with women
who've had breast cancers, who are going through breast cancer
treatment and they're at even higher risk for osteoporosis and
bone health issues because of the treatment and because of
estrogen suppression after this, and they're asking me, how can
(02:55):
you help protect my bones? And I didn't know. It
wasn't part of my training. And then I get my
own bone density because well, I'm curious. I'm not waiting
till I'm sixty five to find this out, and I
have low bone density. So it wasn't part of my
traditional PT training. It wasn't part of my normal skill set.
And I knew enough to tell people to limit activity,
(03:16):
but I didn't know enough to really empower them to
take control. So that's when I really took a deep
dive in training and bone fit in the Institute of
Clinical Excellence and really finding what is up to date
research for myself and so I could help my clients.
Speaker 3 (03:31):
It was a huge.
Speaker 4 (03:32):
Gap because most of the information education was aimed at
the most frail and the most vulnerable, and it didn't
really fit people like me that wanted to be strong
and active but just needed to know how to modify
my high intensity strength training, how to incorporate aerobic training
or flexibility that was safe from my body.
Speaker 3 (03:52):
So that's how I got started.
Speaker 2 (03:54):
And how long has this been since this has been
your focus?
Speaker 4 (03:58):
Probably three four years of education and I've only started
really producing content for a year and a half. But
it's been really high demand. People are asking for more
and more about what you exactly said.
Speaker 3 (04:12):
How do I do this? How do I start? And
how do I progress?
Speaker 2 (04:15):
Oh, Lisa, we have nine million conversations. I wish I
was your neighbor right now and we could just hash
it all out for like an entire day.
Speaker 1 (04:23):
So I am super familiar.
Speaker 2 (04:25):
We're super familiar with your with your YouTube, which you're crushing,
by the way. I'm blown away that you've only been
doing that for such a short a short period of time,
so that says a lot. But you've created brick House Bones.
Tell us the story behind that name and your mission
with it.
Speaker 4 (04:43):
Well, I just love the sound brick House Bones, you know,
it's so empowering. But it really is about the children's
book The Parable, Right, It's about building this body for life.
That isn't about quick fixes, gimmicks, fancy gadgets, or just
a drug or pill. It's about these small action steps
that we take over time consistently so that in through
(05:05):
our lifespan, including being an older adult, which we all
want to achieve. It isn't about who is the smallest,
but who is the strongest that gets to stay independent
and active and out of a nursing home and living
the life that they want for as long as possible.
Speaker 1 (05:21):
I love it.
Speaker 2 (05:21):
So through through this YouTube channel, you've had thousands of
women come through getting this information. If we were to
start at the very beginning, let's just start with osteopenia
and osteoporosis. So everyone knows the names of those, but
where does the where do we differentiate osteopenia and osteoprocess
(05:43):
And I'm just curious.
Speaker 1 (05:45):
This wasn't even on my notes.
Speaker 2 (05:47):
What do you see more? Do you get more women
in the osteopenia realm or do you get more women.
Speaker 1 (05:52):
That are osteo or that are already osteoporosis?
Speaker 3 (05:55):
Great question.
Speaker 4 (05:56):
Well, so it's based on a bone density test switch
the gold standard in the world is a DESA scan
that measures the density of our bones. And there was
a cutoff line for determining what is a risk factor
for osteoporosis. So that is osteopenia. Osteopenia is a risk
factor for osteoporosis. It's like pre diabetic. We're getting warning
(06:20):
signs that there's some loss happening, and when we look
at scores, it kind of shows up like a thermometer.
So the more negative the score, the lower the score,
the colder it gets, the worse the number is in
our bone density. So a score of minus one to
minus two point four is that osteopenia or pre osteoporosis stage.
(06:41):
This is really a time where we need to take action.
More people have osteopenia. There's a much larger number of
people that fit this category than osteoporosis, but it is
a sign that we need to take action. Any number
from minus two point five or below is the diagnosis
of osteoporosia. This is a low bone density. And that
(07:01):
number was kind of randomly assigned by a group of
professionals because they had to place some sort of cut
off to say where do we start to pay more
attention and consider treatment options. I would say most of
my clients that I see are in the osteoporosis range.
The people that reach out to me both virtually and
in person, that because often they don't know that this
(07:22):
has happened because they've been tested till later or till
after they've already had a fragility fracture, and then they're
diagnosed with osteoporosis.
Speaker 2 (07:31):
I know where I'm sending every person. I'm just going
to link you on my website. I'm not joking because
when those women come in, I see more of the
osteopenia that are kind of getting into that, or they
might not even know that yet, but that you know,
when somebody comes and says, I have you know, minus
three and what do I do? I'm like, I'm not
(07:52):
prescribing an for you. You know, you need to get
cleared by a physician and you need to have a
physical therapist to guide you through.
Speaker 1 (08:00):
Like that needs to be more one on one treatment.
How do you with your with your YouTube?
Speaker 2 (08:07):
So if somebody, well, tell us first what the four
x four method is, because initially when I love it
and I know what it is, but when I first
saw that, I was like, oh, everyone's talking about four
x four heavy lifting.
Speaker 1 (08:21):
That's is that what she means? But you tell us
what that is?
Speaker 4 (08:25):
Yeah, So my four x four program is four exercises
four rounds working upper body, lower body, core and impact.
So this is moderate to high intensity, depending on how
much weight you use and your ability. I give modifications,
but it's it's just a way for people who are
busy professionals or busy lives that want to get a
(08:47):
targeted exercise program that doesn't have dangerous exercises in it
if they have osteoporosis, but gives them a really strong
stimulus for strength. And I have a bigger program called Build,
which is more eight exercises, four rounds, includes balance and
mobility and more complex moves. But people wanted a more efficient,
(09:10):
compact workout, so that's why I created the four by four.
Speaker 5 (09:12):
Is they ask, and so can any age or any
like if you're a beginner or advanced, can anyone do that?
Speaker 1 (09:21):
Do you feel like?
Speaker 3 (09:21):
Would you?
Speaker 4 (09:22):
The four by four is definitely more more for an
experienced exercise or somebody that's already been doing you know,
weightlifting training, maybe a little bit of jumping, although I
do provide modifications for people that don't want to jump
at all, modifications on styles of push ups or renegade
rows or things like that. I mean, they can use
no weight if they want to go through the movements,
(09:43):
or they can use heavyher weights. But I do recommend
that it's not a beginner's program. It's not a place
to start if you're newly diagnosed and you're figuring out
how to begin safe strength training.
Speaker 2 (09:54):
Okay, so let's dive there because you and I you know,
we're all aware of the messages out there for the
menopausal crowd, and when anything explodes, there's I would say
a potentially dangerous side to information because there's the you know,
(10:19):
women need to lift heavier, yes, and or, but there
are definitely limitations, and let's dive into that because.
Speaker 5 (10:31):
You don't want to create I am aware you don't
want to hurt yourself.
Speaker 2 (10:37):
Well, and it's I mean, it's it's a lot of pressure.
There's a lot of pressure when when you're helping women
and they're like, Okay, cool, I need a jump and
I need to lift heavy, right, but what's your situation?
So what tell us about what that means to you
and how you break that down for someone because I'm
sure you get asked some of those same questions as well.
Speaker 4 (11:01):
Yes, absolutely, And the thing about YouTube is it's really
a general education platform, right, It's not a one size
fits all tool. Yes, there's so much messaging about women
need to lift heavy, but when we put this in
context of bone health, and we have to put it
into context of the individual, and so we have lots
(11:21):
of wonderful evidence that supports low, moderate, and high intensity
strength training to improve muscle mass and bone density. It
is the effort that is produced. So if you're doing
lower weights and higher repetitions and you have a similar
amount of fatigue as somebody with higher weights and lower reps,
we're still getting the benefit we want. We don't have
(11:44):
to add extra force on joints if that's not in
your comfort zone.
Speaker 3 (11:48):
And I think it's.
Speaker 4 (11:49):
Really important, and I love your messaging on this and
building that base, building that stability, getting this this functional
movement patterns correct before we start to add a lot
of load. And for anyone that has other complex medical
history rumatoid arthritis or other conditions spondaloliites, different conditions of
(12:09):
the spine that they have fear about movement, we can
absolutely keep loads small and build movement confident first. To me,
that's one of the most important things in the messaging
is for people to be able to tune into their
bodies and learn this feels good when I do this,
and this feels like too much, So I'm going to
redirect my training that feels better in my body in
(12:31):
this situation. And I think there's always a way to
adapt and modify. That includes movement, not eliminates.
Speaker 1 (12:39):
It includes not eliminates.
Speaker 3 (12:41):
I love that.
Speaker 2 (12:44):
So, all right, if we're a beginner and somebody comes
and they're not even the beginner, that the the descriptions
and the definitions that we give a beginner intermedia advanced
are vast and can get swomen into you know, general programming,
(13:05):
into a potentially wrong program because they may think that
they're advanced, but you know, it all depends on what
the trainer. What the trainer decides is maybe an advanced level.
But if you have someone that just here's they need
to start jumping, even if they have they don't have osteopenia,
or maybe they do slightly, maybe they've just discovered that.
Speaker 1 (13:27):
But either of those camps and they're in their.
Speaker 2 (13:30):
Forties, they're decently fit, they're they're exercising most days.
Speaker 1 (13:36):
Would you start them with just jumping right away?
Speaker 4 (13:40):
No, If they're already exercising, that's great. I like to
go from strength training to power. So power is still
getting more ground reaction forces. We're building up speed because
that's what jumping is, right, we're talking more power exercises.
But we can do that work on that power that
speed at bell swings, dumbbell clean snatches. We can even
(14:05):
do squats at a different tempo so that we're building
power and speed, maybe working a little bit of agility
training to work that loading.
Speaker 3 (14:14):
We have to train. Then how do you land?
Speaker 4 (14:16):
If you're going to begin jumping, you have to be
able to land correctly and that impact. Some people mistake
thinking they have to land with a stiff leg or
a stiff knee, and that is not the case. We
still want to absorb those forces with some flexibility there.
So I generally start with power and agility strength training
power agility, and then progress up to impact. If they're landing,
(14:37):
if we can step off a low box and have
a good landing platform, then we can build from there.
Speaker 2 (14:43):
Okay, I'm so glad you said that, because that is
what I recommend the same whether anyone takes my advice.
Not everyone will, and people will want to just jump
right into it, but that is.
Speaker 1 (14:57):
Super important that we're.
Speaker 2 (14:59):
Building up the ability because I'm like, when's the last
time you jumped.
Speaker 1 (15:03):
I don't know, when I was a teenager.
Speaker 2 (15:05):
Okay, you don't get to just go back into, you know,
doing these jumps if we haven't really prepped the body.
So I take a similar approach there as well.
Speaker 4 (15:16):
Now, the other thing with that is we're as we're
in perimenopause and menopause and the change in our ability
to adapt and modulate collagen tissue when we when we
rush into ballistic activities like that, that's where plano fasciitis happens.
That's where we get tendon itis issues really quickly. So
we have to build that resilience in our on our
(15:37):
tissues and especially in our tend and ligament tissues to
be able to do that, especially at this time frame
of perimenopause and menopause.
Speaker 2 (15:44):
Oh yeah, it's a different game, no question. So if
we talk about the landing, because there was a study
that came out that talked about the hard, stiff landing
and that's kind of been confusing for for a lot
of women too, including myself, When I was like, wait,
so we're supposed to land hard or we're supposed to
land and actually absorb. So with that, I'm sure you're
(16:05):
familiar with the study that I'm talking about, the one
study that had the sharp, you know, stiff stiff landing.
What are your thoughts on that?
Speaker 4 (16:19):
As a thirty year veteran physical therapist, I do not
like that stiff legged landing when it comes to hips, knees,
and feet.
Speaker 3 (16:26):
I just don't think the.
Speaker 4 (16:27):
Benefits outweigh the risks, and so I don't teach that method.
I don't think the value is there for how to
have healthy, happy joints.
Speaker 1 (16:38):
I love it. I love that stance.
Speaker 2 (16:39):
Okay, thank you for clarifying, because I know that's kind
of a mixed message too. So if we look at
the one the statistics of one one to two women
over fifty will suffer an osteoborotic fracture, and then we
know that your your chance of refracturing is quite high,
(17:00):
or if you've already had a fracture at this age stage.
Speaker 1 (17:03):
So someone comes to.
Speaker 2 (17:05):
You again, I just like basic and real life advice
of someone comes to you, would you how long is
the build up before you would have them, say, using
some heavier loads, And of course it's individual, but is
there kind of like, oh, I see around three, you know,
six months post fracture, depending on the ability level. Or
(17:27):
is that just too broad of an answer that question
to answer?
Speaker 4 (17:31):
Yeah, it is really it is really difficult and it
is really individual. But but what But what I would
want to say is I've worked with many, many clients
who have had either vertebral fractures or hip fractures, wrist, pelvis.
And of those clients that are able without any other
barriers to participate in a strength training program, they do
(17:52):
get up to lifting in a very high intensity and
a very high quality, you know, up to eighty percent
of their one redmax we can do and not all
of them do that. But and the build is based
on control. So as I'm watching somebody and as I'm
guiding somebody, I'm really looking for are they able to
(18:13):
maintain that spinal extension where their goblet squat because that
is protective. Do they need wedges for their squats because
they're getting too much flexion and tipping forward when they're squatting.
How do we modify it to keep them safely? And
if the movements can be done safely, then we progress
as normal.
Speaker 3 (18:31):
And of course they have to have adequate healing.
Speaker 4 (18:34):
They have to have adequate nutrition, they have to be
able to have adequate rest. I worry too much about overtraining,
but there isn't necessarily a limit. When I have someone
who has a history of a fracture, I might just
go a little more slowly and I'm a lot more
critical about the quality of their movement.
Speaker 2 (18:56):
Okay, but they can get back up to heav lifting, yes, jumping.
Speaker 4 (19:03):
Jump jumping maybe jumping maybe even if they if someone's
had a fraction. I do have folks that get into
jumping if they have had a fracture. But one of
the things we do is a fracture risk assessment. So
what is there decks, a score, What are there other
fracture risks? Do they have a family member as fractures
like either parent had a hit practice? So we do
(19:24):
a fracture risk assessment too to weigh the pros and cons.
You know, is it beneficial to do this or should
we just focus on the strength training?
Speaker 1 (19:33):
Okay, So everyone needs a Lisa pt in their life
guiding them through.
Speaker 2 (19:40):
So when we look at the body parts, where we
have these the fracture risks.
Speaker 1 (19:44):
So let's start with the rest.
Speaker 2 (19:46):
Uh, what do you do in maybe even like your
YouTube series to build up that area.
Speaker 3 (19:54):
Well, I love it.
Speaker 4 (19:56):
And first of all, the bone health exercise should be
full body, so we should be treating everything, not just
the areas that are measured. But yes, arms are generally
not weight bearing, right. We don't walk on our hands,
so we don't get the same stimulus to our bones.
Speaker 3 (20:10):
But we can do weight bearing.
Speaker 4 (20:12):
So and anything that involves gripping is working these forearm flexers.
So we can do planks, we can carry weights, farmers,
carry suitcase carries. Any upper extremity strengthening where you're holding
weights is working the forearms. We can hang from a
bar and do dead hanks. That's a great grip strength
(20:32):
exercise to help with forearm bone density.
Speaker 3 (20:36):
I love to use, you know, blaze pods. I love
blaze pods.
Speaker 4 (20:39):
So people are in a plank position and then they've
got to tap out stomp out the light, so we're
getting a little bit of an impact as well at
the same time. So carry push, pull, lift, if it's
in your hands, it's helping your forearms. And then weight
bearing is another thing.
Speaker 5 (20:56):
Okay, I'm so glad you asked that question. Hayley because
I don't know if it's because I knew we were
talking to you today, but when I was taking a
couple of things out of the stove, I felt like
my risks don't feel as strong as they used to,
and so it made me a little bit worried. And
those are things you can do at your house during
(21:17):
the day, little things like that. And maybe I'm just
nervous because I want to stay strong and not be
having any fractures. But that's a really good tip.
Speaker 2 (21:28):
Yes, so, and I love that you say that it's
a systemic. It's a systemic issue, which is why we're
not just targeting risk lumbar.
Speaker 1 (21:42):
You know, hip femur.
Speaker 4 (21:44):
Exactly, that's what was measured, but it affects our bo
metabolism is under attack, so we have to make all
of us strong and resilient.
Speaker 2 (21:53):
Okay, So if we move to the lumbar, how do
we strengthen the lumbar?
Speaker 4 (21:58):
Yeah, so, and again we're still talking. There's a couple
of strategies here to think about. So when we're doing
compound movements, full body movements at a moderate higher intensity,
we have better efficacy for improving lumbar spine bone mineral density.
So we're talking to squats, we're talking deadlifts, we're talking
(22:19):
muscles that cross the back and hip. We're talking working.
Speaker 3 (22:23):
Through the core.
Speaker 4 (22:25):
But lumbar is the area's measured. We can't do decks
of scan on the thoracic spine because of the ribs,
but we know that thoracic area isn't big area at
risk for fracture. Muscles that go along the spine, that
work on our posture, that hold us upright, that help
us be in better positions. If we target those muscles
(22:46):
along the shoulder girdle, along the upper back and lower back,
that is protective against fracture.
Speaker 3 (22:54):
I mean, these are simple things we can do.
Speaker 4 (22:56):
These are things that we can do prone so laying
down like doing W's doing Superwoman's doing swimmers, you know,
things with bands where we're working the muscles of the
upper back. These are protective against fracture because they help
those muscles engage and protect the spine into extension so
we don't get that overflextion that compresses the vertebra.
Speaker 2 (23:19):
Okay, so moving down to like hip femur, same, I mean,
those same exercises are obviously going to be included in there.
But if somebody were like, well, I want to, you know,
talk to exercises that could target those areas.
Speaker 3 (23:35):
Love it so hip.
Speaker 4 (23:37):
So hip fractures generally occur because of a fall to
the side and landing on the side of the hip,
So that's like fracture prevention. But we're talking bone density
to impact exercises and yes, squats, deadlifts, But where I
like to really focus is on moving in different planes
because we so often exercise just working in the sagital plane,
(23:58):
but frontel plane movement really benefit the hip, frontel and
even transverse plane. So I think that variety of stimulus stimulus.
When I'm am working with a client that can do
impacts and jumps, we're jumping in different directions. If they
can't jump, we are lunging in different directions. We don't
just do a front plank, we do a side plank.
We do a sideplank with a leg race. We're doing
(24:21):
different versions of clams single leg bridges, but we have
to change the direction and that novel stimulus is what
helps that cortical bone. It helps that outers hard surface
of the bone to want to remodel and grow stronger.
If we're giving it the same stimulus all the time,
and it's like, yah, I've got this, I'm fine. But
we start to mix it up by moving in different directions,
(24:43):
which is real life, then.
Speaker 3 (24:45):
It adapts and grows stronger. I love moving in different directions.
Speaker 4 (24:49):
I love moving in a frontel plane, not just sad
to the plane for this for hips especially, Yes, I agree.
Speaker 2 (24:54):
So if we're getting the muscle stronger, it's getting the
bone stronger.
Speaker 1 (25:02):
Yes, So that kind of goes hand in hand.
Speaker 2 (25:05):
So when we break down, you know, let's break down
the two main ways that we can really work on
bone health from outside of medication. So we we know
we can heavy resistance train or resistance train with effort
around eighty up to eighty percent of your one rep max.
(25:25):
So with effort, which again is the key, the keyword.
So we're putting a strain or bend on that bone.
But do you recommend jumping some form of jumping and
heavy lifting or do they do the same thing and
you can get you can choose one or the other.
If you can't jump, if you're lifting heavy er, you know,
(25:48):
up to that eighty percent, as we've discussed, does that
count as the pliometric as well.
Speaker 4 (25:55):
Yeah, for someone who is really concerned about jumping and
it isn't safe for them for whatever reason. Absolutely moderate
and high intensity doesn't even have to be high intensity.
Moderate and high intensity strength training and agility and power.
If they can work power without the impact, they are
(26:16):
getting great benefit and they're still going to be able
to enhance their strength and benefit their bone density. The
big thing to think about is we tend to get
really focused on can I increase my bone density? But
what osteopenia or osteoporosis means is you have a risk
factor for a fracture. So to me, the most important
(26:38):
thing is to help people prevent ever having a fracture,
because if you never have a fracture, your osteopenia or
osteproosis doesn't change your life. And when we look at
the effects of medications and we look at the effects
of exercise for fracture prevention, exercise is at the top.
Speaker 3 (26:55):
Strength training is at the top, so.
Speaker 4 (26:56):
Regardless of impact, they don't have to do impact, but
strength training and muscle mass is going to be something
that can improve your balance, improve your resilience, and prevent
you from ever having a fraction.
Speaker 5 (27:07):
What about nutrition and bone health. Outside of calcium and
vitamin D, what are other nutrients or dietary habits that
play the biggest role.
Speaker 3 (27:20):
I love it because this is critical.
Speaker 4 (27:22):
We can't build a strong house if we don't have
the right building materials.
Speaker 3 (27:26):
We can give it the right sea. We have all the.
Speaker 4 (27:28):
Construction workers we want, but if we don't have the
right materials, we can't build a stronger body.
Speaker 3 (27:32):
So protein is right up there.
Speaker 4 (27:35):
You know, when we look at what the volume of
our bone mass is, it's fifty percent protein. So we
have to have adequate protein. And these amino acids are
also the building backs to blocks for collagen, and collagen
matrix is what the calcium and other minerals attached to
to create strong and flexible bone. So I generally recommend
one point two to one point five grams per kilogram
(27:57):
of ideal body weight.
Speaker 3 (28:00):
I know that's kind of middle of the road.
Speaker 4 (28:02):
I find so many clients struggle sometimes just to get that,
and they struggle to get more. So as I look
at like, you know, the best gains for helping somebody
to achieve that goal, that one point five mark is
what I'm shooting for. So protein being right up there.
Speaker 3 (28:21):
Boron. So I like people to get things through food.
Speaker 1 (28:24):
First.
Speaker 4 (28:24):
We have great studies that support prunes and eating five
to six prunes per day is shown to increase bone
mineral density. And I think it's the boron, but really
it's not just the boron, but how it's packaged with
the fiber and other micro nutrients in the prunes and
how it affects our gut microbiome to help create the
right environment for increasing bone density.
Speaker 1 (28:45):
Oh, that's a two for one because then you can
get the fiber too.
Speaker 3 (28:48):
It's fantastic.
Speaker 1 (28:50):
Yeah, absolutely, all right, I'm revisiting now me too.
Speaker 3 (28:54):
Yes, Yes, it's great.
Speaker 4 (28:57):
Yeah, and the fiber makes a huge diffcause I know
lots of people that take the five out in the
morning and that's just kind of their snack throughout their
day as they're kind of running around their house.
Speaker 3 (29:05):
And that's a simple thing to do that has great benefit. Yeah.
Speaker 4 (29:09):
You mentioned vitamin D, and vitamin D really needs to
be in the sweet spot. Too low is associated with
low bone density, and too high a vitamin D also
can affect our ability to utilize calcium.
Speaker 3 (29:20):
So we want to keep that in the sweet spot.
Speaker 4 (29:23):
Vitamin K two can be helpful, and it comes in
two forms. We have Mk seven and MK four, and
vitamin K two helps direct that calcium more into the
bones than into the vessels. This is kind of of
a gatekeeper where the calcium gets utilized. Can everybody take calcium?
I'm not saying that you should talk to your physician
and see and your nutrition is if vitamin K two
(29:44):
is right for you, but it can be beneficial. We
have nice studies that support vitamin K two four for
bone health. Another one that I often talk about is magnesium,
and magnesium is another component of the minerals that helps
form that matrix good bone density, and we often very
depleted in magnesium as our food supply doesn't often have
a good source of it. So that's one of the
(30:06):
easier ones to supplement. Different forms take different effects, So
depending on your GI system, sometimes magnesium glycinate will be
a little bit easier tolerated versus magnesium citrate that can
have a little bit of a laxative effect.
Speaker 2 (30:20):
Right, Okay, So those are the supplements to pay attention to.
What are the myths that you hear about osteopenia osteoporosis
that you'd like to clear up.
Speaker 4 (30:31):
Oh gosh, well, yeah, there's a whole bunch.
Speaker 3 (30:35):
Yes, yes, we could cover a lot here.
Speaker 4 (30:37):
You know. One is that you can never lift heavy.
You know, you can't lift anything again. You should never bend,
never twist, never lift. And we do have movement precautions
that we follow, but I think we've gone we were
at one too far out of extreme where we scared
people so much about movement that they stopped moving all together.
And scaring people to death is not a strategy, but
(30:58):
empowering and educating them is. And so that's the difference
that we have to make there. What are the strategies
and myths? Gosh, that it's that it's all about that
you can't do anything about it.
Speaker 3 (31:14):
I think that's one.
Speaker 4 (31:14):
That you think that you're that you're stuck in this
situation and that you're and that you're fragile. And what
I think people need to realize is we can take
action steps again to combat that and to be stronger
and more resilient and prevent prevent it from changing our life.
Speaker 2 (31:30):
So you talk about minimalist shoes and who should wear
them and who shouldn't, So with that, I guess I'm
my first question is do you do you start women
that are healthy enough and ready enough to jump? Do
you start them wearing a shoe or would you have
them start barefoot?
Speaker 4 (31:51):
I do start with shoes on, and that is a
bit of my own personal bias because I don't do
barefoot well because I have an aroma, So part.
Speaker 3 (32:00):
That's my own. I don't want them to have what
I have.
Speaker 4 (32:03):
But I do training in Impact and balance shoes on
and shoes off, because I think we need to train
for real life because in real life we're times in
barefoot and we're times we're in shoes, and we're in
different types of shoes all the time. But to answer
your question, if I'm starting impact, I usually start with
with shoes on.
Speaker 1 (32:20):
Yeah, okay, And then when do you recommend the minimalist shoe?
Speaker 4 (32:25):
Minimalist shoes for people that are working and are having
that are doing well with the strength training program, that
don't have a bunion, that don't have an aroma, that
have that are comfortable, they already say they're comfortable walking barefoot,
then they can transition to that minimalist to shoe style.
It is great for improving foot strength and toet strength
(32:46):
and just that pro perception that feeling the ground.
Speaker 3 (32:49):
Underneath your feet.
Speaker 4 (32:51):
There's a lot of benefit to minimalist shoes for people
who can wear them for fall prevention and foot strength.
Speaker 5 (32:56):
For people that don't know what minimalist shoe is, Can
you explain what a minimalist shoe is?
Speaker 3 (33:05):
Sure? Sure?
Speaker 4 (33:06):
So, Like a normal tennis shoe will have a nice
bit of cushioning, you know, between the toe and the heel,
you've got that pad like a running shoe. Some of
them will have a drop, so from the heel to
the forefoot there might be a four milimeter drop or
a ten milimeter drop, so it's like you have a
little bit of a heel. A minimalist shoe has none
(33:26):
of that padding. So it's kind of like wearing a
sock like the Vibrum five Fingers or some of there's many,
many varieties out there, but it's very thin, light weight,
almost like putting on a sock with a rubber coating
on the outside. That's just one layer between your foot
and the ground. It can fold in half. You could
probably roll it up like a taco. Because it is
so flexible that it doesn't restrict your foot movement. It
(33:52):
gives you a good feel of the ground, but it's
not going to have padding and cushion. It's gonna be
laced or it's gonna it's gonna be a hatched your
foot really well, but no padding or cushion. So it's
you change your gate speed. When you have a minimalist shoe,
you change how you walk. You're absorbing force a little
bit differently, and it absolutely can help with increasing foot strength,
(34:14):
which if you live a lifetime in shoes, we we
lose that if we don't train it specifically.
Speaker 1 (34:18):
Right, Okay, this is going to go down a rabbit hole.
Speaker 2 (34:22):
But for for clients that I mean, because this is
something that I see, uh not online obviously because I'm
not in person training anyone, but in you know, in
the women that I do want on one train. So
there's the pronating pronating and collapsing arch and then like
Hallas Valgas, how do you like if somebody can't balance
(34:44):
without a shoe and then they're jumping or they're loading
really heavy and they're collapsing that arch, say down in
a squat, where would you have them wear like an
an insert a insult in their in their shoes so
that they can have some of that protection if they're
choosing to jump on their own or to you know,
(35:06):
be moving.
Speaker 3 (35:07):
Load great, great question.
Speaker 4 (35:10):
Yes, absolutely to me having better joint alignment. So if,
like you say, that pronation where that inside of the ankle,
that arch is flattening out, the big toe is really
pushing over, I do recommend toast spacers to help with that.
But an insert And I'm not a fan of artificial
support in general, but in specific cases like this, if
(35:33):
we can help someone's ankle and foot alignment to be
more optimal so that as they're doing a squat, then
the position of their knee, hip and spine over their
leg is better, This.
Speaker 3 (35:44):
Is more protective.
Speaker 4 (35:45):
We don't want to be moving in such a way
that we're increasing that direction of failure in that joint.
So absolutely an insert and that a supportive shoe is
going to be helpful in that case. And I always
want to put them in the most protected position possible.
Speaker 5 (36:03):
Okay, what about someone that's used an insert in their
shoe for years and has never tried to work out
barefoot or how Hayley does in our socks sometimes what
how do you go from always being massively protected and
in a cushion, shoe to working towards getting there.
Speaker 3 (36:29):
Oh, I love that. That's a great question too.
Speaker 4 (36:31):
You know, I think it's all small bites and snacks,
and like in the clinic or working in an exercise session,
there may be a time where I say, okay, for
these three exercises or these three balanced things, we're going
to work barefoot and you can start in these small
bites of building that strength. And then I would ask
people to try to really slowly ramp up time barefoot.
(36:53):
And when I've worked with clients that have had plantar
fasci itis, they're often shocked when I'm telling them you
need to spend time barefoot, and I'll say thirty two minutes,
thirty to sixty minutes in a day. I want you
walking around your home without your shoes on. I want
your feet to start to adapt. But we're not going
to do it at an accelerated rate. So I'll introduce
it during exercise, but it doesn't have to be the
(37:15):
whole program. And then I'll have them introduce it on
it on a daily basis, but in small doses, and
then how it progresses is based on feedback. How does
it feel, Is there pain? Is there dysfunction, and so
we have to get that movement confidence. But I think
it's a wonderful thing to practice and train. We have
to pay attention to the symptoms and the response and
(37:36):
that's how we progress it from there.
Speaker 5 (37:38):
Okay, I'm motivated to try.
Speaker 2 (37:44):
So let's break down some studies because there's a lot
of the studies can be cherry picked or even you know,
somebody can misunderstand what the study was, or it could
be biased.
Speaker 1 (38:00):
So there's a lot of studies out there.
Speaker 2 (38:02):
Let's focus on the one that everyone knows, which is
the Lift More. The Lift More study, what were what
do you what do you think about that study? And
you know it's the one that always gets like thrown around,
is the lift More studies.
Speaker 1 (38:16):
So yes, I'm curious your thoughts.
Speaker 3 (38:20):
Great.
Speaker 5 (38:21):
Uh.
Speaker 4 (38:22):
I think the Lift More trial was groundbreaking. I think
it was groundbreaking to change our mindset around how we
could work with postmenopausal women with osteoporosis because prior to that,
we did not believe that high intensity strength training was
safe and reasonable. So just to change the mindset of
(38:42):
knowing that this type of exercise can make a difference
was huge. I think it feels it can feel unapproachable
to some women to think about barbelle back squats and
dead lifts and so. And also the structure of the
program doesn't have periodization. There isn't that variety that I
(39:04):
think if we're looking at a year long program needs
to be part of our you know, building phase and
growth phase and recovery phase, deloading phase. I think those
are important and that's that's not a part. But you
know you can't make that part of a randomized control trial.
So that's no fault to the study. The study was
wonderful and how it empowered me to work with my clients.
(39:28):
I think the context that it can be taken out
of is that's the only answer. And we know we
have research that says it doesn't have to be at
that level to be effective. And we also know we
can modify a back squad to be approachable for almost anyone.
They can be doing a sit to stand at body
weight to start if they need to. We can modify
(39:49):
a dead lift, the range of motion, the load, all
of it to make it approachable so somebody can learn
a proper hip hinge. You know, So all of those
exercises within the lift more, trial can be modified and
then graded. You know, this is a lifetime program we do,
right we're doing this for life, so we don't have
to have that that that one REP max eighty percent
thing right away. We can take years to build on
(40:12):
that or even never get there and stay within our saves.
Speaker 2 (40:15):
Okay, So the periodization that you said, if you're programming
for your clients, you're you're choosing periodization as the overlying
You know, that's the template for a year. You wouldn't
just say only stay in low reps all the time,
year round.
Speaker 3 (40:36):
No, I don't think. I don't think we should stay
at that level for every workout.
Speaker 1 (40:40):
No, and for what reasons.
Speaker 4 (40:43):
I think we need that change in tempo and load
for joint protection, for ligament and tended. I think it
allows for recovery. That also, adaptation likes the variability, and
I think when we're doing the same exact thing over
and over, it keeps us stuck in a pattern where
(41:04):
maybe we're losing a little bit of the endurance side
of that muscle performance, or maybe we're losing a little
bit of that power side of that muscle informance. So
I way prefer variety than just a one recipe over
and over and over.
Speaker 1 (41:17):
Yes, agreed. All right, So.
Speaker 2 (41:21):
If we look at daily habits for women that can
help with their say someone that's I mean, there's a
wide range that listens to this podcast, but I think
the numbers Laura are like mid thirties probably to mid sixties.
That might be the same group that you're working with
somewhere in that as well. But just like good habits
(41:44):
and routines that women over forty can adopt now to
prevent potentially prevent any bone issues later in life.
Speaker 3 (41:54):
Great, great question. Well, you know, I think.
Speaker 4 (41:58):
Posture exercise is a great protective mechanism. So paying attention
to posture, but not just attention to it, but building
the muscles in the upper back that help us have
We have to lengthen the front body and strengthen the
back body, and that will pay big dividends for years
to come. Balance training, we can start to begin to
(42:19):
see declines and balance in our thirties and forties, and
when you still have the ability, if you can start
early at dynamic balance training, reactive balance training, things that
really challenge you, that's going to be protective for a
long time. If you don't train it you lose it. Right,
So balance and posture training I think are critical. Fuel
(42:41):
your body for the activity you need to do. Okay,
I'm not in the business that helping people be smaller.
I want to help them be stronger. Fuel your body.
It's not a daily habits. So fuel your body well
and then strength training three times a week.
Speaker 3 (42:57):
I think that's a great balance. You can work in
your cardio on other days.
Speaker 4 (43:02):
And mobility mobility training so that you have the mobility
and your hips, the mobility and your knees and ankles
that keep you moving really well. And that's another you know,
that's a lifespan thing that helps us feel good. And
if you can move your hips and knees and ankles well,
it protects your spine. Right when we see people with
(43:24):
stiff hips and stiff ankles, where do we compensate. We
compensate by bending back right, see this in the moves.
You can see this in a squad. So that mobility
is really really critical.
Speaker 3 (43:36):
Rest. Sleep.
Speaker 4 (43:39):
Optimizing your sleep is an important part of decreasing inflammation.
There's a connection to poor sleep and poor bone health.
So optimizing our sleep is something that we can do
every day to help improve how we feel.
Speaker 2 (43:52):
Now, you mentioned something that I want to touch on.
So you said, I'm not in the business of making
women smaller. I'm in the business of making them stronger.
And I love that that message is kind of echoing
in the space. With that being said, you know, the second,
maybe most common question that I get asked all the
(44:13):
time is well, but I have you know, forty pounds
to lose. That's a different conversation. But if what I
want to ask you is is not fueling your body
and not you know, always kind of being trying to
become smaller on fewer calories, is that good.
Speaker 1 (44:32):
For bone health, especially postmenopausal.
Speaker 4 (44:37):
No, being underfed is not good for bone health. It
makes it more difficult to reach our goals. And we
know that. And sometimes it's just your genet, your makeup
of being really petite and smaller, but smaller women have
lower bone density, being underfueled and constantly in a calorie deficit.
If I mean, if you're not at your ideal weight
(44:57):
and you're trying to get to a healthy weight and
you're exercising and strength training and maintaining muscle mass.
Speaker 3 (45:04):
To me, that's the most important feature.
Speaker 4 (45:07):
You know, some of the physicians that are doing the
medications to help with weight loss, and they're focusing on
muscle mass, And to me, that's the critical piece. If
you are losing weight in a healthy way, but you're
maintaining your muscle mass, and it's probably not as big
of an effect. Because we know muscle loss and bone
loss go together. Osteosycopa, they go together. So if you're
(45:30):
losing weight at a.
Speaker 3 (45:30):
Rate that's affecting your muscle mass, yes, you're affecting your bone.
Speaker 2 (45:36):
That is the microtaph right there that I think that
most women don't think about because they think about, Okay,
I need to you know, I need to exercise for
bone health. I can jump for bone health. I can
take vitamin C, vitamin D, blah blah blah, calcium, you know,
go on some of these medications. But if you're losing muscle,
(45:59):
the bone is along with that. Yes, And you know
it's months and months for women that to regain muscle
in the gym setting. We know that, but bone is
even longer. So if somebody, if you know, if somebody
(46:20):
were coming in and they wanted to see a change
in bone health and they were doing all the right
things and controlling the controllables of what they can.
Speaker 1 (46:28):
What is the minimum amount of time.
Speaker 2 (46:30):
That you would go back for a DEXA that you
would recommend to go back for a DEXA because some
women are you know, I in here, I'm going to
go back in three months, You're not going to find much.
Speaker 3 (46:41):
Yeah, it can really take a long time.
Speaker 4 (46:46):
The earliest I would have someone check is in a year,
and insurance covers it every two years, and it may
or may not show a difference, but it may show
up a slight change. One of the important things I
understand about DEXA because there's lots of mobiles by running
around doing these tests. But a true DEXA scan and
to get true accuracy, should be done on the same machine,
(47:08):
same location, every time. If you really wanted apples to
apples comparison, if you're going to one dex of device
and then you're going to a mobile device the next time,
you're not getting an accurate representation of that change. So
go to the same location each time. A year would
be the soonest I would have somebody recheck, you know,
with optimizing everything, nutrition, maybe hormone therapy which we call
(47:31):
pet therapy. Now that's exercise, nutrition, eight months, you know,
eight months to twelve months to see a detectable change,
and two years it can be even longer.
Speaker 3 (47:44):
For that. But we want to stop the loss.
Speaker 1 (47:47):
No change.
Speaker 4 (47:47):
When normal loss is two percent a year for a
postmenopausal female, zero loss is a win, that is it.
Speaker 2 (47:56):
And I say the same about muscle, maintaining your muscle
or even going up you know, a pound or two
a year, and.
Speaker 1 (48:06):
Somebody might think that they're that's pointless.
Speaker 2 (48:10):
Why why did I even do all of that work
for well, you didn't lose any that's the goal at
this age, you know, especially postmenopauseal.
Speaker 1 (48:17):
Are you a fan of hormone therapy?
Speaker 4 (48:20):
Yes, absolutely, I have personally been on hormone therapy for
multiple years.
Speaker 3 (48:25):
I don't ever plan to stop it.
Speaker 4 (48:27):
We know hormone therapy is protective for bone density because
as we lose estrogen, the osteoclasts, these are the cells
that break down bone. Estrogen is a gatekeeper for these
bone breakdown cells and estrogen leaves and we start to
see a rapid loss of bone density. So estrogen is
(48:48):
absolutely protective when it comes to bone density and fracture prevention.
Speaker 1 (48:54):
Okay, so two percent of bone a year postmenopausal.
Speaker 4 (48:59):
Yes, we can lose twe twenty percent of our total
bone in that perimenopause menopause transition is a lot. Yes, Yes,
And the unfortunate thing is they don't recommend testing until
age sixty five, So at that point you already mean
osteoporosis and you've never had an opportunity to really address
(49:19):
it if it wasn't tested sooner. I do recommend if
people talk to their position about any risk factors, they
may have to get an earlier test. We should know
in our forties, we should know in perimenopause what our
baseline bone density is.
Speaker 2 (49:32):
This needs to change in America that I don't know
about other countries. I know that it's easy to get
a Dexa in Australia, but here it seems like, okay,
there's the mobile carts. But as you said, I'm guessing
that you test on the same machine because it's calibrated differently.
But also I'm sure that there's different versions, just like anything,
(49:55):
there's like a cheaper version of the Dexa, an older
model versus something that's hospital grade.
Speaker 1 (50:01):
Is that a fair assumption it is?
Speaker 4 (50:03):
But also training, training of the technician and certification of
the people reading the data makes a huge difference. And
we don't have consistency in the United States on that
certified people that do the DEXA and as well as
the trainer, the training and the you know, the data
you put in is the data you get out. If
you get bad data in, you're going to get bad
(50:23):
data out. So the training of the technician, the accuracy
of the test, and then the training of the person
that interprets that data makes a big.
Speaker 5 (50:30):
So how do you know you're going to a well trained,
certified place.
Speaker 3 (50:37):
That's difficult. That's really difficult.
Speaker 4 (50:39):
Doctor Lonnie Simpson is one of the prominent teachers in
osteporosis and bone health and she's a certified dosometrist and
has been doing this for years and years and years,
And she talks about how asking if they ask if
they're certified, that's one, and then whenever possible, you know,
just checking in with your technicians, because it's a technician,
(51:02):
like an X ray technician that does the test. You know, what,
what's your training on doing these DEXA scans and do
you do it the same way every time? And what
is the positioning that I need to make sure I do,
because a position of the joint is really what matters
for them to get the correct view. You know, what's
the proper position to make sure that the radiologists can
read this correctly? And is the radiologists are they trained
(51:24):
and certified to read DEXA scans?
Speaker 3 (51:26):
Many times they're not going to be.
Speaker 2 (51:29):
Well, I'm going to tell you that the first one
I ever had, like twelve years ago and the JC
Penny parking lot in Utah with the eighteen.
Speaker 1 (51:38):
Year old, I'm positive that was not a hospital great
machine or that was certified.
Speaker 2 (51:49):
So that's hard though, because if you're if you can't,
I mean, money is the other issue. Yes, you know,
it's easy to say, okay, well everyone should be getting
one every year, especially if you're but for a lot
of women, it's like, great, one more thing that I
have to pay for that my insurance isn't going to cover, right,
I'm angry about this.
Speaker 3 (52:07):
Yeah, it is.
Speaker 4 (52:08):
Unfortunately, it really does need to change, and I think
the more that we talk about this, the more likely
that is to happen, because we can like preemptively help
protect women from fractures down the line by having this
test done much earlier, because if you don't know that
you need to address it, you may not create the
change that needs to happen until you're sixty five and
then you wish someone had told you earlier.
Speaker 5 (52:30):
Yeah, we should be having it at thirty five or
forty minimum.
Speaker 4 (52:35):
Yes, absolutely, absolutely, because if you didn't build peak bone
mass when you were a teen in early twenties, then
you maybe didn't start from the highest point possible.
Speaker 3 (52:47):
So yeah, we do need to know before we go
through perimenopause.
Speaker 2 (52:50):
In that pause, okay, if we're wrapping this up, and
you could share one message with every female over forty
who wants to age well and stay independent, what's your message.
Speaker 4 (53:01):
HM, Be kind to your body, move it, move it
in ways that feel good, move it in ways that
bring you joy. Work on your strength. It doesn't have
to look like somebody else. And don't compare your strength
and your program to anybody else. This is not a competition.
You know, we're not here comparing whose weights. It's doing
(53:24):
what we're here to build our best body. This is
what's going to give you joy for the rest of
your life, so that you stay active, you stay independent,
and you continue to do the things you love.
Speaker 3 (53:35):
With the people you love. Strength training is the elixir
for positive aging.
Speaker 1 (53:40):
Oh my gosh, Lisa, I don't even want to wrap
this up. I'm so mad.
Speaker 2 (53:46):
So where can women find you and find your brick
House Bones program?
Speaker 4 (53:52):
Oh?
Speaker 3 (53:52):
Thank you?
Speaker 4 (53:53):
So uh, Doctor Lisa Moore, DPT dot com. Dr Lisa Moore,
DPT dot com. That's where all my collections and programs
are and my workshop that really goes into a deep
dive on this information.
Speaker 3 (54:05):
I am in University Place, Washington.
Speaker 4 (54:07):
I'm in Washington State near Seattle, so my clinic is
strongbonesptstrongbonespt dot com if they want to email me or
reach me there, and then it's at doctor Lisa more
DPT on YouTube where I have hundreds of free videos
and collections from the Foundation series, which is for beginners.
Just hit play and I hold your hand through it,
as well as like the four my four and moderate
(54:29):
intensity workouts too.
Speaker 1 (54:32):
Well.
Speaker 2 (54:32):
Thank you Lisa for sharing your time and everyone should
be following you. Do you know I didn't even know
about you. I found out about you and one of
my Facebook groups somebody threw you out and I'm so
glad because now I can't I can't get enough of
your message and everything that you're sharing on your YouTube
(54:53):
and Instagram platforms. So thank you for joining us today
and sharing your time and your wisdom. This is going
to be a fantastic stick episode for our audience.
Speaker 4 (55:03):
I'm really grateful you invited me and give me the
opportunity to meet with you.
Speaker 3 (55:06):
Honestly, thank you so much for having me.
Speaker 1 (55:09):
Thanks for listening everyone.
Speaker 5 (55:10):
If you enjoyed this episode, please consider giving us a
five star rating and sharing the body Pod with your friends.
Hi everyone. My name is Haley and this is laurav
and welcome to the Body Pod.
Speaker 2 (00:12):
Welcome back everyone for another episode on the Body Pod. Today,
I have the privilege of introducing you to doctor Lisa Moore.
Doctor Lisa Moore is a twenty eight year veteran physical
therapist who supports women who have had a diagnosis of
breast cancer and osteoporosis. She is certified in Cancer Rehabilitation
(00:32):
bone Fit trained through the Bone Health and Osteoporosis Foundation.
She's a certified yoga teacher. She is also certified in
functional nutrition for chronic pain via the Integrative Pain Science Institute.
Lisa has developed the Brick House Bones program for evidence
based exercises to support bone health for people with low
(00:53):
bone mass and osteoporosis. Her many years of clinical work
as a physical therapist have her constantly seeking knowledge about
what truly helps women, how to facilitate change, and how
to empower women toward their own recovery. So this conversation
is very interesting and very educational, so enjoy this episode
(01:15):
with doctor Lisa. All Right, doctor Lisa Moore, we are
so thrilled to have you here today as this massive
osteoporosis name and expert in the field.
Speaker 1 (01:33):
So thank you for sharing your time with us today.
Speaker 3 (01:36):
Oh, thank you, Hailey, Laura.
Speaker 4 (01:38):
It's really an honor and a privilege to be here
and I'm so grateful you invited me.
Speaker 2 (01:41):
Thanks well, our audience is going to love this because
I'll have to tell you, Lisa, in the last year,
since menopause has kind of had this massive.
Speaker 1 (01:52):
Growth the bone.
Speaker 2 (01:54):
You know, bone health is a massive topic, and I
will say that just getting you know, thousands of women
onto my platform, people will you know, women will come
in and they're just like, I don't know what to do,
or they'll tell me their diagnosis and I'm like, what
you know, I'm not diagnosing you? Where do you know?
Speaker 1 (02:14):
But their questions are all like where do I start?
So I want to dive right in to how you like,
how did you come upon this?
Speaker 2 (02:23):
Obviously you you're a physical therapist, and when did the osteoporosis?
Have you always been interested in that or did that
kind of come later on?
Speaker 4 (02:34):
Yes, So later in my career I was focusing on
oncology rehab. So in my fifties, I'm working with women
who've had breast cancers, who are going through breast cancer
treatment and they're at even higher risk for osteoporosis and
bone health issues because of the treatment and because of
estrogen suppression after this, and they're asking me, how can
(02:55):
you help protect my bones? And I didn't know. It
wasn't part of my training. And then I get my
own bone density because well, I'm curious. I'm not waiting
till I'm sixty five to find this out, and I
have low bone density. So it wasn't part of my
traditional PT training. It wasn't part of my normal skill set.
And I knew enough to tell people to limit activity,
(03:16):
but I didn't know enough to really empower them to
take control. So that's when I really took a deep
dive in training and bone fit in the Institute of
Clinical Excellence and really finding what is up to date
research for myself and so I could help my clients.
Speaker 3 (03:31):
It was a huge.
Speaker 4 (03:32):
Gap because most of the information education was aimed at
the most frail and the most vulnerable, and it didn't
really fit people like me that wanted to be strong
and active but just needed to know how to modify
my high intensity strength training, how to incorporate aerobic training
or flexibility that was safe from my body.
Speaker 3 (03:52):
So that's how I got started.
Speaker 2 (03:54):
And how long has this been since this has been
your focus?
Speaker 4 (03:58):
Probably three four years of education and I've only started
really producing content for a year and a half. But
it's been really high demand. People are asking for more
and more about what you exactly said.
Speaker 3 (04:12):
How do I do this? How do I start? And
how do I progress?
Speaker 2 (04:15):
Oh, Lisa, we have nine million conversations. I wish I
was your neighbor right now and we could just hash
it all out for like an entire day.
Speaker 1 (04:23):
So I am super familiar.
Speaker 2 (04:25):
We're super familiar with your with your YouTube, which you're crushing,
by the way. I'm blown away that you've only been
doing that for such a short a short period of time,
so that says a lot. But you've created brick House Bones.
Tell us the story behind that name and your mission
with it.
Speaker 4 (04:43):
Well, I just love the sound brick House Bones, you know,
it's so empowering. But it really is about the children's
book The Parable, Right, It's about building this body for life.
That isn't about quick fixes, gimmicks, fancy gadgets, or just
a drug or pill. It's about these small action steps
that we take over time consistently so that in through
(05:05):
our lifespan, including being an older adult, which we all
want to achieve. It isn't about who is the smallest,
but who is the strongest that gets to stay independent
and active and out of a nursing home and living
the life that they want for as long as possible.
Speaker 1 (05:21):
I love it.
Speaker 2 (05:21):
So through through this YouTube channel, you've had thousands of
women come through getting this information. If we were to
start at the very beginning, let's just start with osteopenia
and osteoporosis. So everyone knows the names of those, but
where does the where do we differentiate osteopenia and osteoprocess
(05:43):
And I'm just curious.
Speaker 1 (05:45):
This wasn't even on my notes.
Speaker 2 (05:47):
What do you see more? Do you get more women
in the osteopenia realm or do you get more women.
Speaker 1 (05:52):
That are osteo or that are already osteoporosis?
Speaker 3 (05:55):
Great question.
Speaker 4 (05:56):
Well, so it's based on a bone density test switch
the gold standard in the world is a DESA scan
that measures the density of our bones. And there was
a cutoff line for determining what is a risk factor
for osteoporosis. So that is osteopenia. Osteopenia is a risk
factor for osteoporosis. It's like pre diabetic. We're getting warning
(06:20):
signs that there's some loss happening, and when we look
at scores, it kind of shows up like a thermometer.
So the more negative the score, the lower the score,
the colder it gets, the worse the number is in
our bone density. So a score of minus one to
minus two point four is that osteopenia or pre osteoporosis stage.
(06:41):
This is really a time where we need to take action.
More people have osteopenia. There's a much larger number of
people that fit this category than osteoporosis, but it is
a sign that we need to take action. Any number
from minus two point five or below is the diagnosis
of osteoporosia. This is a low bone density. And that
(07:01):
number was kind of randomly assigned by a group of
professionals because they had to place some sort of cut
off to say where do we start to pay more
attention and consider treatment options. I would say most of
my clients that I see are in the osteoporosis range.
The people that reach out to me both virtually and
in person, that because often they don't know that this
(07:22):
has happened because they've been tested till later or till
after they've already had a fragility fracture, and then they're
diagnosed with osteoporosis.
Speaker 2 (07:31):
I know where I'm sending every person. I'm just going
to link you on my website. I'm not joking because
when those women come in, I see more of the
osteopenia that are kind of getting into that, or they
might not even know that yet, but that you know,
when somebody comes and says, I have you know, minus
three and what do I do? I'm like, I'm not
(07:52):
prescribing an for you. You know, you need to get
cleared by a physician and you need to have a
physical therapist to guide you through.
Speaker 1 (08:00):
Like that needs to be more one on one treatment.
How do you with your with your YouTube?
Speaker 2 (08:07):
So if somebody, well, tell us first what the four
x four method is, because initially when I love it
and I know what it is, but when I first
saw that, I was like, oh, everyone's talking about four
x four heavy lifting.
Speaker 1 (08:21):
That's is that what she means? But you tell us
what that is?
Speaker 4 (08:25):
Yeah, So my four x four program is four exercises
four rounds working upper body, lower body, core and impact.
So this is moderate to high intensity, depending on how
much weight you use and your ability. I give modifications,
but it's it's just a way for people who are
busy professionals or busy lives that want to get a
(08:47):
targeted exercise program that doesn't have dangerous exercises in it
if they have osteoporosis, but gives them a really strong
stimulus for strength. And I have a bigger program called Build,
which is more eight exercises, four rounds, includes balance and
mobility and more complex moves. But people wanted a more efficient,
(09:10):
compact workout, so that's why I created the four by four.
Speaker 5 (09:12):
Is they ask, and so can any age or any
like if you're a beginner or advanced, can anyone do that?
Speaker 1 (09:21):
Do you feel like?
Speaker 3 (09:21):
Would you?
Speaker 4 (09:22):
The four by four is definitely more more for an
experienced exercise or somebody that's already been doing you know,
weightlifting training, maybe a little bit of jumping, although I
do provide modifications for people that don't want to jump
at all, modifications on styles of push ups or renegade
rows or things like that. I mean, they can use
no weight if they want to go through the movements,
(09:43):
or they can use heavyher weights. But I do recommend
that it's not a beginner's program. It's not a place
to start if you're newly diagnosed and you're figuring out
how to begin safe strength training.
Speaker 2 (09:54):
Okay, so let's dive there because you and I you know,
we're all aware of the messages out there for the
menopausal crowd, and when anything explodes, there's I would say
a potentially dangerous side to information because there's the you know,
(10:19):
women need to lift heavier, yes, and or, but there
are definitely limitations, and let's dive into that because.
Speaker 5 (10:31):
You don't want to create I am aware you don't
want to hurt yourself.
Speaker 2 (10:37):
Well, and it's I mean, it's it's a lot of pressure.
There's a lot of pressure when when you're helping women
and they're like, Okay, cool, I need a jump and
I need to lift heavy, right, but what's your situation?
So what tell us about what that means to you
and how you break that down for someone because I'm
sure you get asked some of those same questions as well.
Speaker 4 (11:01):
Yes, absolutely, And the thing about YouTube is it's really
a general education platform, right, It's not a one size
fits all tool. Yes, there's so much messaging about women
need to lift heavy, but when we put this in
context of bone health, and we have to put it
into context of the individual, and so we have lots
(11:21):
of wonderful evidence that supports low, moderate, and high intensity
strength training to improve muscle mass and bone density. It
is the effort that is produced. So if you're doing
lower weights and higher repetitions and you have a similar
amount of fatigue as somebody with higher weights and lower reps,
we're still getting the benefit we want. We don't have
(11:44):
to add extra force on joints if that's not in
your comfort zone.
Speaker 3 (11:48):
And I think it's.
Speaker 4 (11:49):
Really important, and I love your messaging on this and
building that base, building that stability, getting this this functional
movement patterns correct before we start to add a lot
of load. And for anyone that has other complex medical
history rumatoid arthritis or other conditions spondaloliites, different conditions of
(12:09):
the spine that they have fear about movement, we can
absolutely keep loads small and build movement confident first. To me,
that's one of the most important things in the messaging
is for people to be able to tune into their
bodies and learn this feels good when I do this,
and this feels like too much, So I'm going to
redirect my training that feels better in my body in
(12:31):
this situation. And I think there's always a way to
adapt and modify. That includes movement, not eliminates.
Speaker 1 (12:39):
It includes not eliminates.
Speaker 3 (12:41):
I love that.
Speaker 2 (12:44):
So, all right, if we're a beginner and somebody comes
and they're not even the beginner, that the the descriptions
and the definitions that we give a beginner intermedia advanced
are vast and can get swomen into you know, general programming,
(13:05):
into a potentially wrong program because they may think that
they're advanced, but you know, it all depends on what
the trainer. What the trainer decides is maybe an advanced level.
But if you have someone that just here's they need
to start jumping, even if they have they don't have osteopenia,
or maybe they do slightly, maybe they've just discovered that.
Speaker 1 (13:27):
But either of those camps and they're in their.
Speaker 2 (13:30):
Forties, they're decently fit, they're they're exercising most days.
Speaker 1 (13:36):
Would you start them with just jumping right away?
Speaker 4 (13:40):
No, If they're already exercising, that's great. I like to
go from strength training to power. So power is still
getting more ground reaction forces. We're building up speed because
that's what jumping is, right, we're talking more power exercises.
But we can do that work on that power that
speed at bell swings, dumbbell clean snatches. We can even
(14:05):
do squats at a different tempo so that we're building
power and speed, maybe working a little bit of agility
training to work that loading.
Speaker 3 (14:14):
We have to train. Then how do you land?
Speaker 4 (14:16):
If you're going to begin jumping, you have to be
able to land correctly and that impact. Some people mistake
thinking they have to land with a stiff leg or
a stiff knee, and that is not the case. We
still want to absorb those forces with some flexibility there.
So I generally start with power and agility strength training
power agility, and then progress up to impact. If they're landing,
(14:37):
if we can step off a low box and have
a good landing platform, then we can build from there.
Speaker 2 (14:43):
Okay, I'm so glad you said that, because that is
what I recommend the same whether anyone takes my advice.
Not everyone will, and people will want to just jump
right into it, but that is.
Speaker 1 (14:57):
Super important that we're.
Speaker 2 (14:59):
Building up the ability because I'm like, when's the last
time you jumped.
Speaker 1 (15:03):
I don't know, when I was a teenager.
Speaker 2 (15:05):
Okay, you don't get to just go back into, you know,
doing these jumps if we haven't really prepped the body.
So I take a similar approach there as well.
Speaker 4 (15:16):
Now, the other thing with that is we're as we're
in perimenopause and menopause and the change in our ability
to adapt and modulate collagen tissue when we when we
rush into ballistic activities like that, that's where plano fasciitis happens.
That's where we get tendon itis issues really quickly. So
we have to build that resilience in our on our
(15:37):
tissues and especially in our tend and ligament tissues to
be able to do that, especially at this time frame
of perimenopause and menopause.
Speaker 2 (15:44):
Oh yeah, it's a different game, no question. So if
we talk about the landing, because there was a study
that came out that talked about the hard, stiff landing
and that's kind of been confusing for for a lot
of women too, including myself, When I was like, wait,
so we're supposed to land hard or we're supposed to
land and actually absorb. So with that, I'm sure you're
(16:05):
familiar with the study that I'm talking about, the one
study that had the sharp, you know, stiff stiff landing.
What are your thoughts on that?
Speaker 4 (16:19):
As a thirty year veteran physical therapist, I do not
like that stiff legged landing when it comes to hips, knees,
and feet.
Speaker 3 (16:26):
I just don't think the.
Speaker 4 (16:27):
Benefits outweigh the risks, and so I don't teach that method.
I don't think the value is there for how to
have healthy, happy joints.
Speaker 1 (16:38):
I love it. I love that stance.
Speaker 2 (16:39):
Okay, thank you for clarifying, because I know that's kind
of a mixed message too. So if we look at
the one the statistics of one one to two women
over fifty will suffer an osteoborotic fracture, and then we
know that your your chance of refracturing is quite high,
(17:00):
or if you've already had a fracture at this age stage.
Speaker 1 (17:03):
So someone comes to.
Speaker 2 (17:05):
You again, I just like basic and real life advice
of someone comes to you, would you how long is
the build up before you would have them, say, using
some heavier loads, And of course it's individual, but is
there kind of like, oh, I see around three, you know,
six months post fracture, depending on the ability level. Or
(17:27):
is that just too broad of an answer that question
to answer?
Speaker 4 (17:31):
Yeah, it is really it is really difficult and it
is really individual. But but what But what I would
want to say is I've worked with many, many clients
who have had either vertebral fractures or hip fractures, wrist, pelvis.
And of those clients that are able without any other
barriers to participate in a strength training program, they do
(17:52):
get up to lifting in a very high intensity and
a very high quality, you know, up to eighty percent
of their one redmax we can do and not all
of them do that. But and the build is based
on control. So as I'm watching somebody and as I'm
guiding somebody, I'm really looking for are they able to
(18:13):
maintain that spinal extension where their goblet squat because that
is protective. Do they need wedges for their squats because
they're getting too much flexion and tipping forward when they're squatting.
How do we modify it to keep them safely? And
if the movements can be done safely, then we progress
as normal.
Speaker 3 (18:31):
And of course they have to have adequate healing.
Speaker 4 (18:34):
They have to have adequate nutrition, they have to be
able to have adequate rest. I worry too much about overtraining,
but there isn't necessarily a limit. When I have someone
who has a history of a fracture, I might just
go a little more slowly and I'm a lot more
critical about the quality of their movement.
Speaker 2 (18:56):
Okay, but they can get back up to heav lifting, yes, jumping.
Speaker 4 (19:03):
Jump jumping maybe jumping maybe even if they if someone's
had a fraction. I do have folks that get into
jumping if they have had a fracture. But one of
the things we do is a fracture risk assessment. So
what is there decks, a score, What are there other
fracture risks? Do they have a family member as fractures
like either parent had a hit practice? So we do
(19:24):
a fracture risk assessment too to weigh the pros and cons.
You know, is it beneficial to do this or should
we just focus on the strength training?
Speaker 1 (19:33):
Okay, So everyone needs a Lisa pt in their life
guiding them through.
Speaker 2 (19:40):
So when we look at the body parts, where we
have these the fracture risks.
Speaker 1 (19:44):
So let's start with the rest.
Speaker 2 (19:46):
Uh, what do you do in maybe even like your
YouTube series to build up that area.
Speaker 3 (19:54):
Well, I love it.
Speaker 4 (19:56):
And first of all, the bone health exercise should be
full body, so we should be treating everything, not just
the areas that are measured. But yes, arms are generally
not weight bearing, right. We don't walk on our hands,
so we don't get the same stimulus to our bones.
Speaker 3 (20:10):
But we can do weight bearing.
Speaker 4 (20:12):
So and anything that involves gripping is working these forearm flexers.
So we can do planks, we can carry weights, farmers,
carry suitcase carries. Any upper extremity strengthening where you're holding
weights is working the forearms. We can hang from a
bar and do dead hanks. That's a great grip strength
(20:32):
exercise to help with forearm bone density.
Speaker 3 (20:36):
I love to use, you know, blaze pods. I love
blaze pods.
Speaker 4 (20:39):
So people are in a plank position and then they've
got to tap out stomp out the light, so we're
getting a little bit of an impact as well at
the same time. So carry push, pull, lift, if it's
in your hands, it's helping your forearms. And then weight
bearing is another thing.
Speaker 5 (20:56):
Okay, I'm so glad you asked that question. Hayley because
I don't know if it's because I knew we were
talking to you today, but when I was taking a
couple of things out of the stove, I felt like
my risks don't feel as strong as they used to,
and so it made me a little bit worried. And
those are things you can do at your house during
(21:17):
the day, little things like that. And maybe I'm just
nervous because I want to stay strong and not be
having any fractures. But that's a really good tip.
Speaker 2 (21:28):
Yes, so, and I love that you say that it's
a systemic. It's a systemic issue, which is why we're
not just targeting risk lumbar.
Speaker 1 (21:42):
You know, hip femur.
Speaker 4 (21:44):
Exactly, that's what was measured, but it affects our bo
metabolism is under attack, so we have to make all
of us strong and resilient.
Speaker 2 (21:53):
Okay, So if we move to the lumbar, how do
we strengthen the lumbar?
Speaker 4 (21:58):
Yeah, so, and again we're still talking. There's a couple
of strategies here to think about. So when we're doing
compound movements, full body movements at a moderate higher intensity,
we have better efficacy for improving lumbar spine bone mineral density.
So we're talking to squats, we're talking deadlifts, we're talking
(22:19):
muscles that cross the back and hip. We're talking working.
Speaker 3 (22:23):
Through the core.
Speaker 4 (22:25):
But lumbar is the area's measured. We can't do decks
of scan on the thoracic spine because of the ribs,
but we know that thoracic area isn't big area at
risk for fracture. Muscles that go along the spine, that
work on our posture, that hold us upright, that help
us be in better positions. If we target those muscles
(22:46):
along the shoulder girdle, along the upper back and lower back,
that is protective against fracture.
Speaker 3 (22:54):
I mean, these are simple things we can do.
Speaker 4 (22:56):
These are things that we can do prone so laying
down like doing W's doing Superwoman's doing swimmers, you know,
things with bands where we're working the muscles of the
upper back. These are protective against fracture because they help
those muscles engage and protect the spine into extension so
we don't get that overflextion that compresses the vertebra.
Speaker 2 (23:19):
Okay, so moving down to like hip femur, same, I mean,
those same exercises are obviously going to be included in there.
But if somebody were like, well, I want to, you know,
talk to exercises that could target those areas.
Speaker 3 (23:35):
Love it so hip.
Speaker 4 (23:37):
So hip fractures generally occur because of a fall to
the side and landing on the side of the hip,
So that's like fracture prevention. But we're talking bone density
to impact exercises and yes, squats, deadlifts, But where I
like to really focus is on moving in different planes
because we so often exercise just working in the sagital plane,
(23:58):
but frontel plane movement really benefit the hip, frontel and
even transverse plane. So I think that variety of stimulus stimulus.
When I'm am working with a client that can do
impacts and jumps, we're jumping in different directions. If they
can't jump, we are lunging in different directions. We don't
just do a front plank, we do a side plank.
We do a sideplank with a leg race. We're doing
(24:21):
different versions of clams single leg bridges, but we have
to change the direction and that novel stimulus is what
helps that cortical bone. It helps that outers hard surface
of the bone to want to remodel and grow stronger.
If we're giving it the same stimulus all the time,
and it's like, yah, I've got this, I'm fine. But
we start to mix it up by moving in different directions,
(24:43):
which is real life, then.
Speaker 3 (24:45):
It adapts and grows stronger. I love moving in different directions.
Speaker 4 (24:49):
I love moving in a frontel plane, not just sad
to the plane for this for hips especially, Yes, I agree.
Speaker 2 (24:54):
So if we're getting the muscle stronger, it's getting the
bone stronger.
Speaker 1 (25:02):
Yes, So that kind of goes hand in hand.
Speaker 2 (25:05):
So when we break down, you know, let's break down
the two main ways that we can really work on
bone health from outside of medication. So we we know
we can heavy resistance train or resistance train with effort
around eighty up to eighty percent of your one rep max.
(25:25):
So with effort, which again is the key, the keyword.
So we're putting a strain or bend on that bone.
But do you recommend jumping some form of jumping and
heavy lifting or do they do the same thing and
you can get you can choose one or the other.
If you can't jump, if you're lifting heavy er, you know,
(25:48):
up to that eighty percent, as we've discussed, does that
count as the pliometric as well.
Speaker 4 (25:55):
Yeah, for someone who is really concerned about jumping and
it isn't safe for them for whatever reason. Absolutely moderate
and high intensity doesn't even have to be high intensity.
Moderate and high intensity strength training and agility and power.
If they can work power without the impact, they are
(26:16):
getting great benefit and they're still going to be able
to enhance their strength and benefit their bone density. The
big thing to think about is we tend to get
really focused on can I increase my bone density? But
what osteopenia or osteoporosis means is you have a risk
factor for a fracture. So to me, the most important
(26:38):
thing is to help people prevent ever having a fracture,
because if you never have a fracture, your osteopenia or
osteproosis doesn't change your life. And when we look at
the effects of medications and we look at the effects
of exercise for fracture prevention, exercise is at the top.
Speaker 3 (26:55):
Strength training is at the top, so.
Speaker 4 (26:56):
Regardless of impact, they don't have to do impact, but
strength training and muscle mass is going to be something
that can improve your balance, improve your resilience, and prevent
you from ever having a fraction.
Speaker 5 (27:07):
What about nutrition and bone health. Outside of calcium and
vitamin D, what are other nutrients or dietary habits that
play the biggest role.
Speaker 3 (27:20):
I love it because this is critical.
Speaker 4 (27:22):
We can't build a strong house if we don't have
the right building materials.
Speaker 3 (27:26):
We can give it the right sea. We have all the.
Speaker 4 (27:28):
Construction workers we want, but if we don't have the
right materials, we can't build a stronger body.
Speaker 3 (27:32):
So protein is right up there.
Speaker 4 (27:35):
You know, when we look at what the volume of
our bone mass is, it's fifty percent protein. So we
have to have adequate protein. And these amino acids are
also the building backs to blocks for collagen, and collagen
matrix is what the calcium and other minerals attached to
to create strong and flexible bone. So I generally recommend
one point two to one point five grams per kilogram
(27:57):
of ideal body weight.
Speaker 3 (28:00):
I know that's kind of middle of the road.
Speaker 4 (28:02):
I find so many clients struggle sometimes just to get that,
and they struggle to get more. So as I look
at like, you know, the best gains for helping somebody
to achieve that goal, that one point five mark is
what I'm shooting for. So protein being right up there.
Speaker 3 (28:21):
Boron. So I like people to get things through food.
Speaker 1 (28:24):
First.
Speaker 4 (28:24):
We have great studies that support prunes and eating five
to six prunes per day is shown to increase bone
mineral density. And I think it's the boron, but really
it's not just the boron, but how it's packaged with
the fiber and other micro nutrients in the prunes and
how it affects our gut microbiome to help create the
right environment for increasing bone density.
Speaker 1 (28:45):
Oh, that's a two for one because then you can
get the fiber too.
Speaker 3 (28:48):
It's fantastic.
Speaker 1 (28:50):
Yeah, absolutely, all right, I'm revisiting now me too.
Speaker 3 (28:54):
Yes, Yes, it's great.
Speaker 4 (28:57):
Yeah, and the fiber makes a huge diffcause I know
lots of people that take the five out in the
morning and that's just kind of their snack throughout their
day as they're kind of running around their house.
Speaker 3 (29:05):
And that's a simple thing to do that has great benefit. Yeah.
Speaker 4 (29:09):
You mentioned vitamin D, and vitamin D really needs to
be in the sweet spot. Too low is associated with
low bone density, and too high a vitamin D also
can affect our ability to utilize calcium.
Speaker 3 (29:20):
So we want to keep that in the sweet spot.
Speaker 4 (29:23):
Vitamin K two can be helpful, and it comes in
two forms. We have Mk seven and MK four, and
vitamin K two helps direct that calcium more into the
bones than into the vessels. This is kind of of
a gatekeeper where the calcium gets utilized. Can everybody take calcium?
I'm not saying that you should talk to your physician
and see and your nutrition is if vitamin K two
(29:44):
is right for you, but it can be beneficial. We
have nice studies that support vitamin K two four for
bone health. Another one that I often talk about is magnesium,
and magnesium is another component of the minerals that helps
form that matrix good bone density, and we often very
depleted in magnesium as our food supply doesn't often have
a good source of it. So that's one of the
(30:06):
easier ones to supplement. Different forms take different effects, So
depending on your GI system, sometimes magnesium glycinate will be
a little bit easier tolerated versus magnesium citrate that can
have a little bit of a laxative effect.
Speaker 2 (30:20):
Right, Okay, So those are the supplements to pay attention to.
What are the myths that you hear about osteopenia osteoporosis
that you'd like to clear up.
Speaker 4 (30:31):
Oh gosh, well, yeah, there's a whole bunch.
Speaker 3 (30:35):
Yes, yes, we could cover a lot here.
Speaker 4 (30:37):
You know. One is that you can never lift heavy.
You know, you can't lift anything again. You should never bend,
never twist, never lift. And we do have movement precautions
that we follow, but I think we've gone we were
at one too far out of extreme where we scared
people so much about movement that they stopped moving all together.
And scaring people to death is not a strategy, but
(30:58):
empowering and educating them is. And so that's the difference
that we have to make there. What are the strategies
and myths? Gosh, that it's that it's all about that
you can't do anything about it.
Speaker 3 (31:14):
I think that's one.
Speaker 4 (31:14):
That you think that you're that you're stuck in this
situation and that you're and that you're fragile. And what
I think people need to realize is we can take
action steps again to combat that and to be stronger
and more resilient and prevent prevent it from changing our life.
Speaker 2 (31:30):
So you talk about minimalist shoes and who should wear
them and who shouldn't, So with that, I guess I'm
my first question is do you do you start women
that are healthy enough and ready enough to jump? Do
you start them wearing a shoe or would you have
them start barefoot?
Speaker 4 (31:51):
I do start with shoes on, and that is a
bit of my own personal bias because I don't do
barefoot well because I have an aroma, So part.
Speaker 3 (32:00):
That's my own. I don't want them to have what
I have.
Speaker 4 (32:03):
But I do training in Impact and balance shoes on
and shoes off, because I think we need to train
for real life because in real life we're times in
barefoot and we're times we're in shoes, and we're in
different types of shoes all the time. But to answer
your question, if I'm starting impact, I usually start with
with shoes on.
Speaker 1 (32:20):
Yeah, okay, And then when do you recommend the minimalist shoe?
Speaker 4 (32:25):
Minimalist shoes for people that are working and are having
that are doing well with the strength training program, that
don't have a bunion, that don't have an aroma, that
have that are comfortable, they already say they're comfortable walking barefoot,
then they can transition to that minimalist to shoe style.
It is great for improving foot strength and toet strength
(32:46):
and just that pro perception that feeling the ground.
Speaker 3 (32:49):
Underneath your feet.
Speaker 4 (32:51):
There's a lot of benefit to minimalist shoes for people
who can wear them for fall prevention and foot strength.
Speaker 5 (32:56):
For people that don't know what minimalist shoe is, Can
you explain what a minimalist shoe is?
Speaker 3 (33:05):
Sure? Sure?
Speaker 4 (33:06):
So, Like a normal tennis shoe will have a nice
bit of cushioning, you know, between the toe and the heel,
you've got that pad like a running shoe. Some of
them will have a drop, so from the heel to
the forefoot there might be a four milimeter drop or
a ten milimeter drop, so it's like you have a
little bit of a heel. A minimalist shoe has none
(33:26):
of that padding. So it's kind of like wearing a
sock like the Vibrum five Fingers or some of there's many,
many varieties out there, but it's very thin, light weight,
almost like putting on a sock with a rubber coating
on the outside. That's just one layer between your foot
and the ground. It can fold in half. You could
probably roll it up like a taco. Because it is
so flexible that it doesn't restrict your foot movement. It
(33:52):
gives you a good feel of the ground, but it's
not going to have padding and cushion. It's gonna be
laced or it's gonna it's gonna be a hatched your
foot really well, but no padding or cushion. So it's
you change your gate speed. When you have a minimalist shoe,
you change how you walk. You're absorbing force a little
bit differently, and it absolutely can help with increasing foot strength,
(34:14):
which if you live a lifetime in shoes, we we
lose that if we don't train it specifically.
Speaker 1 (34:18):
Right, Okay, this is going to go down a rabbit hole.
Speaker 2 (34:22):
But for for clients that I mean, because this is
something that I see, uh not online obviously because I'm
not in person training anyone, but in you know, in
the women that I do want on one train. So
there's the pronating pronating and collapsing arch and then like
Hallas Valgas, how do you like if somebody can't balance
(34:44):
without a shoe and then they're jumping or they're loading
really heavy and they're collapsing that arch, say down in
a squat, where would you have them wear like an
an insert a insult in their in their shoes so
that they can have some of that protection if they're
choosing to jump on their own or to you know,
(35:06):
be moving.
Speaker 3 (35:07):
Load great, great question.
Speaker 4 (35:10):
Yes, absolutely to me having better joint alignment. So if,
like you say, that pronation where that inside of the ankle,
that arch is flattening out, the big toe is really
pushing over, I do recommend toast spacers to help with that.
But an insert And I'm not a fan of artificial
support in general, but in specific cases like this, if
(35:33):
we can help someone's ankle and foot alignment to be
more optimal so that as they're doing a squat, then
the position of their knee, hip and spine over their
leg is better, This.
Speaker 3 (35:44):
Is more protective.
Speaker 4 (35:45):
We don't want to be moving in such a way
that we're increasing that direction of failure in that joint.
So absolutely an insert and that a supportive shoe is
going to be helpful in that case. And I always
want to put them in the most protected position possible.
Speaker 5 (36:03):
Okay, what about someone that's used an insert in their
shoe for years and has never tried to work out
barefoot or how Hayley does in our socks sometimes what
how do you go from always being massively protected and
in a cushion, shoe to working towards getting there.
Speaker 3 (36:29):
Oh, I love that. That's a great question too.
Speaker 4 (36:31):
You know, I think it's all small bites and snacks,
and like in the clinic or working in an exercise session,
there may be a time where I say, okay, for
these three exercises or these three balanced things, we're going
to work barefoot and you can start in these small
bites of building that strength. And then I would ask
people to try to really slowly ramp up time barefoot.
(36:53):
And when I've worked with clients that have had plantar
fasci itis, they're often shocked when I'm telling them you
need to spend time barefoot, and I'll say thirty two minutes,
thirty to sixty minutes in a day. I want you
walking around your home without your shoes on. I want
your feet to start to adapt. But we're not going
to do it at an accelerated rate. So I'll introduce
it during exercise, but it doesn't have to be the
(37:15):
whole program. And then I'll have them introduce it on
it on a daily basis, but in small doses, and
then how it progresses is based on feedback. How does
it feel, Is there pain? Is there dysfunction, and so
we have to get that movement confidence. But I think
it's a wonderful thing to practice and train. We have
to pay attention to the symptoms and the response and
(37:36):
that's how we progress it from there.
Speaker 5 (37:38):
Okay, I'm motivated to try.
Speaker 2 (37:44):
So let's break down some studies because there's a lot
of the studies can be cherry picked or even you know,
somebody can misunderstand what the study was, or it could
be biased.
Speaker 1 (38:00):
So there's a lot of studies out there.
Speaker 2 (38:02):
Let's focus on the one that everyone knows, which is
the Lift More. The Lift More study, what were what
do you what do you think about that study? And
you know it's the one that always gets like thrown around,
is the lift More studies.
Speaker 1 (38:16):
So yes, I'm curious your thoughts.
Speaker 3 (38:20):
Great.
Speaker 5 (38:21):
Uh.
Speaker 4 (38:22):
I think the Lift More trial was groundbreaking. I think
it was groundbreaking to change our mindset around how we
could work with postmenopausal women with osteoporosis because prior to that,
we did not believe that high intensity strength training was
safe and reasonable. So just to change the mindset of
(38:42):
knowing that this type of exercise can make a difference
was huge. I think it feels it can feel unapproachable
to some women to think about barbelle back squats and
dead lifts and so. And also the structure of the
program doesn't have periodization. There isn't that variety that I
(39:04):
think if we're looking at a year long program needs
to be part of our you know, building phase and
growth phase and recovery phase, deloading phase. I think those
are important and that's that's not a part. But you
know you can't make that part of a randomized control trial.
So that's no fault to the study. The study was
wonderful and how it empowered me to work with my clients.
(39:28):
I think the context that it can be taken out
of is that's the only answer. And we know we
have research that says it doesn't have to be at
that level to be effective. And we also know we
can modify a back squad to be approachable for almost anyone.
They can be doing a sit to stand at body
weight to start if they need to. We can modify
(39:49):
a dead lift, the range of motion, the load, all
of it to make it approachable so somebody can learn
a proper hip hinge. You know, So all of those
exercises within the lift more, trial can be modified and
then graded. You know, this is a lifetime program we do,
right we're doing this for life, so we don't have
to have that that that one REP max eighty percent
thing right away. We can take years to build on
(40:12):
that or even never get there and stay within our saves.
Speaker 2 (40:15):
Okay, So the periodization that you said, if you're programming
for your clients, you're you're choosing periodization as the overlying
You know, that's the template for a year. You wouldn't
just say only stay in low reps all the time,
year round.
Speaker 3 (40:36):
No, I don't think. I don't think we should stay
at that level for every workout.
Speaker 1 (40:40):
No, and for what reasons.
Speaker 4 (40:43):
I think we need that change in tempo and load
for joint protection, for ligament and tended. I think it
allows for recovery. That also, adaptation likes the variability, and
I think when we're doing the same exact thing over
and over, it keeps us stuck in a pattern where
(41:04):
maybe we're losing a little bit of the endurance side
of that muscle performance, or maybe we're losing a little
bit of that power side of that muscle informance. So
I way prefer variety than just a one recipe over
and over and over.
Speaker 1 (41:17):
Yes, agreed. All right, So.
Speaker 2 (41:21):
If we look at daily habits for women that can
help with their say someone that's I mean, there's a
wide range that listens to this podcast, but I think
the numbers Laura are like mid thirties probably to mid sixties.
That might be the same group that you're working with
somewhere in that as well. But just like good habits
(41:44):
and routines that women over forty can adopt now to
prevent potentially prevent any bone issues later in life.
Speaker 3 (41:54):
Great, great question. Well, you know, I think.
Speaker 4 (41:58):
Posture exercise is a great protective mechanism. So paying attention
to posture, but not just attention to it, but building
the muscles in the upper back that help us have
We have to lengthen the front body and strengthen the
back body, and that will pay big dividends for years
to come. Balance training, we can start to begin to
(42:19):
see declines and balance in our thirties and forties, and
when you still have the ability, if you can start
early at dynamic balance training, reactive balance training, things that
really challenge you, that's going to be protective for a
long time. If you don't train it you lose it. Right,
So balance and posture training I think are critical. Fuel
(42:41):
your body for the activity you need to do. Okay,
I'm not in the business that helping people be smaller.
I want to help them be stronger. Fuel your body.
It's not a daily habits. So fuel your body well
and then strength training three times a week.
Speaker 3 (42:57):
I think that's a great balance. You can work in
your cardio on other days.
Speaker 4 (43:02):
And mobility mobility training so that you have the mobility
and your hips, the mobility and your knees and ankles
that keep you moving really well. And that's another you know,
that's a lifespan thing that helps us feel good. And
if you can move your hips and knees and ankles well,
it protects your spine. Right when we see people with
(43:24):
stiff hips and stiff ankles, where do we compensate. We
compensate by bending back right, see this in the moves.
You can see this in a squad. So that mobility
is really really critical.
Speaker 3 (43:36):
Rest. Sleep.
Speaker 4 (43:39):
Optimizing your sleep is an important part of decreasing inflammation.
There's a connection to poor sleep and poor bone health.
So optimizing our sleep is something that we can do
every day to help improve how we feel.
Speaker 2 (43:52):
Now, you mentioned something that I want to touch on.
So you said, I'm not in the business of making
women smaller. I'm in the business of making them stronger.
And I love that that message is kind of echoing
in the space. With that being said, you know, the second,
maybe most common question that I get asked all the
(44:13):
time is well, but I have you know, forty pounds
to lose. That's a different conversation. But if what I
want to ask you is is not fueling your body
and not you know, always kind of being trying to
become smaller on fewer calories, is that good.
Speaker 1 (44:32):
For bone health, especially postmenopausal.
Speaker 4 (44:37):
No, being underfed is not good for bone health. It
makes it more difficult to reach our goals. And we
know that. And sometimes it's just your genet, your makeup
of being really petite and smaller, but smaller women have
lower bone density, being underfueled and constantly in a calorie deficit.
If I mean, if you're not at your ideal weight
(44:57):
and you're trying to get to a healthy weight and
you're exercising and strength training and maintaining muscle mass.
Speaker 3 (45:04):
To me, that's the most important feature.
Speaker 4 (45:07):
You know, some of the physicians that are doing the
medications to help with weight loss, and they're focusing on
muscle mass, And to me, that's the critical piece. If
you are losing weight in a healthy way, but you're
maintaining your muscle mass, and it's probably not as big
of an effect. Because we know muscle loss and bone
loss go together. Osteosycopa, they go together. So if you're
(45:30):
losing weight at a.
Speaker 3 (45:30):
Rate that's affecting your muscle mass, yes, you're affecting your bone.
Speaker 2 (45:36):
That is the microtaph right there that I think that
most women don't think about because they think about, Okay,
I need to you know, I need to exercise for
bone health. I can jump for bone health. I can
take vitamin C, vitamin D, blah blah blah, calcium, you know,
go on some of these medications. But if you're losing muscle,
(45:59):
the bone is along with that. Yes, And you know
it's months and months for women that to regain muscle
in the gym setting. We know that, but bone is
even longer. So if somebody, if you know, if somebody
(46:20):
were coming in and they wanted to see a change
in bone health and they were doing all the right
things and controlling the controllables of what they can.
Speaker 1 (46:28):
What is the minimum amount of time.
Speaker 2 (46:30):
That you would go back for a DEXA that you
would recommend to go back for a DEXA because some
women are you know, I in here, I'm going to
go back in three months, You're not going to find much.
Speaker 3 (46:41):
Yeah, it can really take a long time.
Speaker 4 (46:46):
The earliest I would have someone check is in a year,
and insurance covers it every two years, and it may
or may not show a difference, but it may show
up a slight change. One of the important things I
understand about DEXA because there's lots of mobiles by running
around doing these tests. But a true DEXA scan and
to get true accuracy, should be done on the same machine,
(47:08):
same location, every time. If you really wanted apples to
apples comparison, if you're going to one dex of device
and then you're going to a mobile device the next time,
you're not getting an accurate representation of that change. So
go to the same location each time. A year would
be the soonest I would have somebody recheck, you know,
with optimizing everything, nutrition, maybe hormone therapy which we call
(47:31):
pet therapy. Now that's exercise, nutrition, eight months, you know,
eight months to twelve months to see a detectable change,
and two years it can be even longer.
Speaker 3 (47:44):
For that. But we want to stop the loss.
Speaker 1 (47:47):
No change.
Speaker 4 (47:47):
When normal loss is two percent a year for a
postmenopausal female, zero loss is a win, that is it.
Speaker 2 (47:56):
And I say the same about muscle, maintaining your muscle
or even going up you know, a pound or two
a year, and.
Speaker 1 (48:06):
Somebody might think that they're that's pointless.
Speaker 2 (48:10):
Why why did I even do all of that work
for well, you didn't lose any that's the goal at
this age, you know, especially postmenopauseal.
Speaker 1 (48:17):
Are you a fan of hormone therapy?
Speaker 4 (48:20):
Yes, absolutely, I have personally been on hormone therapy for
multiple years.
Speaker 3 (48:25):
I don't ever plan to stop it.
Speaker 4 (48:27):
We know hormone therapy is protective for bone density because
as we lose estrogen, the osteoclasts, these are the cells
that break down bone. Estrogen is a gatekeeper for these
bone breakdown cells and estrogen leaves and we start to
see a rapid loss of bone density. So estrogen is
(48:48):
absolutely protective when it comes to bone density and fracture prevention.
Speaker 1 (48:54):
Okay, so two percent of bone a year postmenopausal.
Speaker 4 (48:59):
Yes, we can lose twe twenty percent of our total
bone in that perimenopause menopause transition is a lot. Yes, Yes,
And the unfortunate thing is they don't recommend testing until
age sixty five, So at that point you already mean
osteoporosis and you've never had an opportunity to really address
(49:19):
it if it wasn't tested sooner. I do recommend if
people talk to their position about any risk factors, they
may have to get an earlier test. We should know
in our forties, we should know in perimenopause what our
baseline bone density is.
Speaker 2 (49:32):
This needs to change in America that I don't know
about other countries. I know that it's easy to get
a Dexa in Australia, but here it seems like, okay,
there's the mobile carts. But as you said, I'm guessing
that you test on the same machine because it's calibrated differently.
But also I'm sure that there's different versions, just like anything,
(49:55):
there's like a cheaper version of the Dexa, an older
model versus something that's hospital grade.
Speaker 1 (50:01):
Is that a fair assumption it is?
Speaker 4 (50:03):
But also training, training of the technician and certification of
the people reading the data makes a huge difference. And
we don't have consistency in the United States on that
certified people that do the DEXA and as well as
the trainer, the training and the you know, the data
you put in is the data you get out. If
you get bad data in, you're going to get bad
(50:23):
data out. So the training of the technician, the accuracy
of the test, and then the training of the person
that interprets that data makes a big.
Speaker 5 (50:30):
So how do you know you're going to a well trained,
certified place.
Speaker 3 (50:37):
That's difficult. That's really difficult.
Speaker 4 (50:39):
Doctor Lonnie Simpson is one of the prominent teachers in
osteporosis and bone health and she's a certified dosometrist and
has been doing this for years and years and years,
And she talks about how asking if they ask if
they're certified, that's one, and then whenever possible, you know,
just checking in with your technicians, because it's a technician,
(51:02):
like an X ray technician that does the test. You know, what,
what's your training on doing these DEXA scans and do
you do it the same way every time? And what
is the positioning that I need to make sure I do,
because a position of the joint is really what matters
for them to get the correct view. You know, what's
the proper position to make sure that the radiologists can
read this correctly? And is the radiologists are they trained
(51:24):
and certified to read DEXA scans?
Speaker 3 (51:26):
Many times they're not going to be.
Speaker 2 (51:29):
Well, I'm going to tell you that the first one
I ever had, like twelve years ago and the JC
Penny parking lot in Utah with the eighteen.
Speaker 1 (51:38):
Year old, I'm positive that was not a hospital great
machine or that was certified.
Speaker 2 (51:49):
So that's hard though, because if you're if you can't,
I mean, money is the other issue. Yes, you know,
it's easy to say, okay, well everyone should be getting
one every year, especially if you're but for a lot
of women, it's like, great, one more thing that I
have to pay for that my insurance isn't going to cover, right,
I'm angry about this.
Speaker 3 (52:07):
Yeah, it is.
Speaker 4 (52:08):
Unfortunately, it really does need to change, and I think
the more that we talk about this, the more likely
that is to happen, because we can like preemptively help
protect women from fractures down the line by having this
test done much earlier, because if you don't know that
you need to address it, you may not create the
change that needs to happen until you're sixty five and
then you wish someone had told you earlier.
Speaker 5 (52:30):
Yeah, we should be having it at thirty five or
forty minimum.
Speaker 4 (52:35):
Yes, absolutely, absolutely, because if you didn't build peak bone
mass when you were a teen in early twenties, then
you maybe didn't start from the highest point possible.
Speaker 3 (52:47):
So yeah, we do need to know before we go
through perimenopause.
Speaker 2 (52:50):
In that pause, okay, if we're wrapping this up, and
you could share one message with every female over forty
who wants to age well and stay independent, what's your message.
Speaker 4 (53:01):
HM, Be kind to your body, move it, move it
in ways that feel good, move it in ways that
bring you joy. Work on your strength. It doesn't have
to look like somebody else. And don't compare your strength
and your program to anybody else. This is not a competition.
You know, we're not here comparing whose weights. It's doing
(53:24):
what we're here to build our best body. This is
what's going to give you joy for the rest of
your life, so that you stay active, you stay independent,
and you continue to do the things you love.
Speaker 3 (53:35):
With the people you love. Strength training is the elixir
for positive aging.
Speaker 1 (53:40):
Oh my gosh, Lisa, I don't even want to wrap
this up. I'm so mad.
Speaker 2 (53:46):
So where can women find you and find your brick
House Bones program?
Speaker 4 (53:52):
Oh?
Speaker 3 (53:52):
Thank you?
Speaker 4 (53:53):
So uh, Doctor Lisa Moore, DPT dot com. Dr Lisa Moore,
DPT dot com. That's where all my collections and programs
are and my workshop that really goes into a deep
dive on this information.
Speaker 3 (54:05):
I am in University Place, Washington.
Speaker 4 (54:07):
I'm in Washington State near Seattle, so my clinic is
strongbonesptstrongbonespt dot com if they want to email me or
reach me there, and then it's at doctor Lisa more
DPT on YouTube where I have hundreds of free videos
and collections from the Foundation series, which is for beginners.
Just hit play and I hold your hand through it,
as well as like the four my four and moderate
(54:29):
intensity workouts too.
Speaker 1 (54:32):
Well.
Speaker 2 (54:32):
Thank you Lisa for sharing your time and everyone should
be following you. Do you know I didn't even know
about you. I found out about you and one of
my Facebook groups somebody threw you out and I'm so
glad because now I can't I can't get enough of
your message and everything that you're sharing on your YouTube
(54:53):
and Instagram platforms. So thank you for joining us today
and sharing your time and your wisdom. This is going
to be a fantastic stick episode for our audience.
Speaker 4 (55:03):
I'm really grateful you invited me and give me the
opportunity to meet with you.
Speaker 3 (55:06):
Honestly, thank you so much for having me.
Speaker 1 (55:09):
Thanks for listening everyone.
Speaker 5 (55:10):
If you enjoyed this episode, please consider giving us a
five star rating and sharing the body Pod with your friends.
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Las Culturistas with Matt Rogers and Bowen Yang
Ding dong! Join your culture consultants, Matt Rogers and Bowen Yang, on an unforgettable journey into the beating heart of CULTURE. Alongside sizzling special guests, they GET INTO the hottest pop-culture moments of the day and the formative cultural experiences that turned them into Culturistas. Produced by the Big Money Players Network and iHeartRadio.
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.