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Episode 51: Persistent Myths About Osteoporosis
1.2k Plays1 year ago
Welcome to Episode 51 of the Movement Logic podcast! In this episode, Laurel and Sarah discuss myths around osteoporosis and osteopenia, including why yoga and Pilates are poor choices for bone building (yes, we’ll talk about THAT study, again) and ultimately how weight training and impact training are both safe options when applied with the proper dosage and programming.
You will learn:
- Osteoporosis and osteopenia, defined
- Why so many people with osteoporosis are afraid of falling
- What the fear-mongering messaging around osteoporosis is disempowering people with osteoporosis
- Why strength training is not only tolerable for people with osteoporosis, it’s essential
- How no progressive overload in weight training is like staying in kindergarten forever
- Why the myth that yoga reverses osteoporosis from the Fishman study prevails to this day, and why this is proof that we need to keep a critical eye about research
- Why the Fishman paper does not prove what it claims to prove
- How yoga asana might help bone density for a very short time, but strength and impact training are your best bets overall
- What is cellular accommodation and what does it mean for your bone density building
- Types of movement classes for osteoporosis and their respective claims around their safety and efficacy
- Is Osteosteong a good choice to build bone density?
- Do Osteostrong’s claims match up with what research has found so far?
And more!
Sign up here for the Live Strength Training Webinar on Sept 14th with 30 day replay
Episode 5 Does Yoga Asana Build Bone Density?
Episode 38 Got Bones? Yoga Asana Isn’t Enough
Twelve-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss
BonES Lab at University of Waterloo Video Questions Efficacy of Osteostrong Program
Is OSTEOSTRONG Misleading Vulnerable People Regarding Claims of High Increases in Bone Density?
High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial
Recommended
Transcript
Osteoporosis: Contradictions and Dilemmas
00:00:00
Speaker
So so then this is the problem like what are we supposed to do? Where we are presented with this list of contra indications and yet we know from research that Some of these contra indications are actually useful for improving bone density. It's a it's a pickle. It is a pickle and
Introduction to Movement Logic Podcast
00:00:21
Speaker
Welcome to the Movement Logic podcast with yoga teacher and strength coach Laurel Beaversdorf and physical therapist, Dr. Sarah Court. With over 30 years combined experience in the yoga, movement, and physical therapy worlds, we believe in strong opinions loosely held, which means we're not hyping outdated movement concepts. Instead, we're here with up to date and cutting edge tools, evidence, and ideas to help you as a mover and a teacher.
00:00:53
Speaker
Welcome to the Movement Logic Podcast. I'm Sarah Court and I'm here with my co-host, Laurel Beecherstorff.
Myths and Evidence in Osteoporosis
00:00:59
Speaker
And today we're talking about the evidence versus the myths around what you can and quote unquote cannot do movement wise when you have been diagnosed with osteoporosis or osteopenia. And I don't know about you, Laurel, but I'm really excited to talk about this topic because there is so much misinformation around and definitely a fair amount of
00:01:20
Speaker
confusion and conflicting ideas just like flying around out there agreed so we are just going to jump right into this but before we do we're going to read one of our lovely reviews from one of our lovely reviewers on apple podcasts and this is from someone named ak princess warrior and it's a five-star review
00:01:42
Speaker
I do sometimes I do want to see a one star review. Just I'm not really curious what you would write if you wrote a one star review. Like I think you would just have to be like
00:01:52
Speaker
This was a terrible recipe, and when I tried it, nothing worked or something. You'd have to be super confused. I'm absurd. Yeah. Okay, so this person says, keep up the great information. Yoga teacher and health and wellness coach here who is loving your podcast. Thank you for the excellent information, accessible approach, and good jokes. Good jokes. They like our jokes. They like our jokes.
00:02:13
Speaker
Please keep the great content coming, looking forward to your 2023 content. Well, so are we. Yes. And you know what? If you feel like you want to write us a review,
00:02:23
Speaker
We would love it. Please do. Maybe we'll read it. Or you can specify if you don't want it. You can say, I'm writing you this review for you, but please don't read it on air. We will honor that request. We're honorable people.
Understanding Osteoporosis and Osteopenia
00:02:34
Speaker
So let's get back to the topic at hand, which is osteoporosis, bone mineral density, bone building versus bone maintaining, contraindications,
00:02:44
Speaker
covering your ass all of the above. So before we get into all of that, let's make sure we're all on the same page. What is osteoporosis? What is osteopenia, Laurel? Osteoporosis is a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes or deficiency of calcium or vitamin D. Osteopenia is reduced bone mass of lesser severity than osteoporosis.
00:03:12
Speaker
So your osteopenia is, you know, just the same thing as osteoporosis, just not quite as bad.
The Truth About DEXA Scans
00:03:19
Speaker
So we talk a lot about how osteoporosis is diagnosed in episode 38, which is in season two. So if you want more detail about that, you can go listen to that episode, but essentially.
00:03:30
Speaker
The way that your bone density is measured is with something called a DEXA scan. And depending on your score, you might be diagnosed with osteopenia or osteoporosis. And I didn't know this before I researched this. There is more than 3 million cases of osteoporosis diagnosed per year in the US alone. It's a lot.
00:03:51
Speaker
Laurel, here's my question for you about DEXA scans. And we're not going to go super deep into this, but what do we know about them? Are they accurate? Unfortunately, they're not. And I find that very concerning because they are considered to be the gold standard.
00:04:07
Speaker
If your bone density is getting tested for any reason, this is how it's being tested. Neither one of us is a medical doctor, neither one of us is reading DEXA scans, but my understanding is that there's also- A lot of room for error. Yes, in the way that you interpret the information. Yep. Generally speaking, DEXA scans can also provoke a lot of fear in people. If you do get a bad result and it turns out that you have osteoporosis or osteopenia,
00:04:37
Speaker
I think it's really easy to fall into this like doom spiral of like my bones are brittle. What if I fall? What if that means I have to go to the hospital?
00:04:47
Speaker
being in the hospital for so long means I become so deconditioned and weakened that I never leave the hospital. And actually, that could happen. It's very rare, I would say, relative to the number of people walking around with this diagnosis. It's not a guarantee that you're going to fall, or it's also not a guarantee that you're going to break your bone in some way. In fact, a lot of people have osteoporosis and don't fracture. But it's hard to not have those thoughts.
Dealing with Fear and Misconceptions
00:05:12
Speaker
And so I think it's important to
00:05:15
Speaker
remind people, and unfortunately I think this is not done very well on like medical websites, remind people that like it is not a death
00:05:23
Speaker
sentence and there's something you can do about it. Right. Yeah. I mean, this is like worst case scenario, right? And it's really only likely if you're already very deconditioned, you have pretty advanced osteoporosis. In other words, just having a diagnosis of osteoporosis does not automatically mean that this sequence of events where you fall, you fracture, you go to the hospital is going to happen to you.
00:05:48
Speaker
you could see how this would be kind of terrifying if you were in your seventies or eighties right and maybe at that point i mean all of the clients that i have that i work with who are older are worried about falling like it's just across the board something that they're worried about maybe because themselves
00:06:03
Speaker
They're already feeling more unsteady or it's just you know among their friends It's like well, you know Abigail fell last week and you know things like that I don't know who Abigail is but you know what I'm saying, right? You have you're feeling unsteady Maybe you have a history of falling yourself You feel like you're just one bad fall away from this happening And it's it is something like one in five people who go into hospital with a fracture from the sequence of events Don't make it back out of the hospital and that's scary
00:06:31
Speaker
And another problem is a lot of the messaging around it doesn't help either. So I went on the Mayo Clinic's website and this is what they say about osteoporosis. And this is verbatim. Osteoporosis causes bones to become weak and brittle. So brittle that a fall or even mild stresses such as bending over or coughing can cause a fracture.
00:06:55
Speaker
And the site goes on to recommend avoiding high-impact activities like jumping, running, jogging, or any jerky, rapid movements, and that if you have osteoporosis, you should choose exercises with slow, controlled movements. And they don't specify, but I'm assuming they're thinking about things like tai chi or gentle yoga.
00:07:13
Speaker
It's funny, you could also say strength training, because strength training involves slow controlled movements. Definitely. Under load. Right. Yes. I would be surprised if that's what they had in mind. I don't think so. I don't think so. But yes, that is true.
Exercise and Bone Health
00:07:27
Speaker
And it does go on to say that if you're generally fit and strong, despite having osteoporosis, you might be able to do somewhat higher impact exercise than someone who is frail.
00:07:38
Speaker
which in my opinion is a very cover your ass kind of a sentence. They also say on this site that if you have osteoporosis, you should avoid bending or twisting as this can increase fracture risk in the spine. And they say specifically, they pick some really odd things specifically, do not touch your toes, do not do sit ups and avoid golf, tennis, bowling.
00:08:02
Speaker
I mean, yeah, fine. I understand why bowling, but like, is that the next most possible popular thing after golf and tennis is bowling? But anyway, golf tennis bowling and I should take it back. I love bowling. Bowling's really fun. And then also they say some yoga poses. That's clear. Some. Some. Yeah, just, you know, some yoga poses. Don't do some of them. Do slow control movement like yoga, but avoid some poses. So take the class, but don't do all of it. We're not going to tell you what of it not to do.
00:08:27
Speaker
So the general language that's out there in the world around osteoporosis is basically, oh my god, be careful. You could sneeze yourself into a fracture and die. While also being incredibly vague. Yeah. It's wholly unhelpful. It's super unhelpful. And if I'm trying to learn more about my new osteoporosis diagnosis and I go online and I read this,
00:08:49
Speaker
I mean, I'm now just gonna lie on my couch in a straight line and never bend or twist or move suddenly, and I'm just gonna stay right here, because that's the only safe place to be, but the horrible irony is that by doing that, I'm making my osteoporosis worse.
00:09:02
Speaker
Now, I'm going to be clear. I'm not saying that these things can't happen. I'm not saying that it's impossible to sneeze and fracture a rib. It does happen, but generally speaking, it's really only applying to people with much more advanced osteoporosis and who are probably pretty deconditioned, maybe sedentary for most of their day, maybe
00:09:24
Speaker
bed bound, not people who are out and moving around and active and continuing to maintain their capacity. I hear from 40-year-olds, 50-year-olds all the time that they've been recently diagnosed with osteoporosis. These are people who are teaching yoga. They're maybe even doing some strength training or just got into strength training. When we think of osteoporosis, I think we immediately think of this super fragile, brittle,
00:09:49
Speaker
Bone person that what are your your friend has osteoporosis and she calls her her her bone strengthening exercises her crumbly bone exercise. Yes I mean like people have this idea that they could break apart at any second But meanwhile like really fit healthy people otherwise are walking around too with osteoporosis and like it'd be a shame if those people who were engaging in activities that were potentially like
00:10:11
Speaker
slowing bone loss down to a certain degree, or even maybe starting to build bone, would hear something like this, like, oh, now you have brittle bones, or your frail, and therefore stop. Stop moving. Stop all of it. Because that is literally going to make it worse. Yeah.
00:10:26
Speaker
Yeah. And you know, for the majority of people who are diagnosed with osteoporosis, I would argue that doing something to positively impact your bone density, like impact or strength training is not only tolerable with proper programming,
00:10:43
Speaker
But it's essential and it is to date, it is the best researched method that has been shown to improve bone density. And Laurel, what do I mean when I say proper programming? Proper programming is programming that begins for you where you are. So it's not a cookie cutter program that tells you how much weight you should be lifting. It's one where
00:11:05
Speaker
You're taken through the process of figuring out what is an appropriate starting weight for you. And then over the course of that program, you increase the load as your strength increases. So it can be the case that small weights could be a moderate to heavy load for someone in the beginning. Proper also means that you don't stay with those small to moderate load weights for the rest of the time that you're training.
00:11:35
Speaker
Right. So a lot of times you go into like a Pilates studio or a bar studio and you see that there are a bunch of prettily colored hand weights and there's nothing bigger than seven pounds. Right. Or even five. Right. So the what's implied there is that like this is the amount of weight that you're only ever going to need.
00:11:55
Speaker
And frankly, that is a fraction of how heavy a lot of the things you're lifting already in your daily life are, like your cat, your dog, your child, your suitcase, a gallon of milk. So if you want to have a properly programmed regimen, it's one that systematically and progressively overloads your body as your capacity, as your strength,
00:12:23
Speaker
rises to meet that demand. It'd be like sending someone to kindergarten and then expecting them to just stay in kindergarten for their entire life. Yeah.
00:12:33
Speaker
That's a two-pound handweight right there. Definitely. Here you go. Here's kindergarten six-year-old. And then the next year, it's like back to kindergarten the next year. And then by the time they're 18 and ready to go to college, you're like, are you ready for kindergarten again? This is what we're talking about here. This is not a properly programmed way to grow. So same thing with strength training. You have to progress if you want to get anywhere.
Introduction to Strength Training Course
00:12:58
Speaker
That's right. I love that analogy. That's a really great example.
00:13:02
Speaker
And also it's like the messaging is, well, yes, we're putting you in kindergarten again because first grade is not safe for you, right? Completely. You need to stay in kindergarten. It's the only safe place you can be. First grade might make you bulky. Or you might sneeze yourself into the hospital in first grade, right? Oh my God. Well, so not in a creepy way.
00:13:28
Speaker
Your eyes say different. Your eyes say different. But I do think this is a good opportunity for us to actually talk about our six month progressive overload, strength training, weight lifting, bone density course. Don't you? Yeah, I do. So our bone density course is a six month course.
00:13:55
Speaker
And it includes a six month program within it. It also includes bonus courses like Strength Training 101 and all about osteoporosis. But the bulk of the content is really the program. And the program is six months because why, Sarah? Because six months is
00:14:13
Speaker
in the research when you are able to start seeing changes to bone density. So if you are going to start doing this kind of progressive overload, no matter what weight you're starting from, you're not going to see any change in your bone density typically until you're past that six month mark. Right. And so we need at least that amount of time to make a change.
00:14:34
Speaker
It's properly programmed, which means that we start you where you are. So in the beginning, we're going to be focusing a ton on techniques. So you might be lifting what would be more moderate or even lightweight in the beginning for you so that you can really dial in the technique of of working with a barbell. Now it is a barbell.
00:14:51
Speaker
specific program, but that doesn't mean that you can't take a lot of the information we're sharing and apply it to using dumbbells and kettlebells. You certainly can. We just simply believe that a barbell is the best, most logical piece of equipment that you would want to become familiar with if you want to be able to progressively overload for life. And so this is the other thing too. This is a six month program, but that's not to say that you are going to
00:15:18
Speaker
ideally lift weights for six months and then stop. This is basically us helping you get started over a course of time where you will have ample time to learn how to use weights, learn how to strength train, learn how to progressively overload, learn how to progress toward lifting heavy weights. And barbells are the best way to be able to progress for life, but then we want you to keep going when this program ends. And we'll give you ways of continuing to use our program
00:15:48
Speaker
to continue going, right? So it doesn't end at six months. It's something that we can continue to cycle back on and use. You know what it reminds me of? Sorry, to break in. Yeah, yeah. But I was just thinking while you were talking about that, it reminds me of like, you know when you see a parent helping a child learn how to ride a bicycle with no training wheels? And I mean, I remember this. This is how I learned. My dad held on to the back of the bike.
00:16:10
Speaker
And I started pedaling and he's running alongside me and at some point he lets go and I kept going, right? And it's that moment where like, you don't know as the person I'm like, when did that happen, right? So in that metaphor analogy story, Laurel and I are like your parent. We're going to hold on to you.
00:16:25
Speaker
Is that weird? We're going to hold on to your bike, your metaphorical bike, and we are going to hold your hand the whole way through, and then our goal is to make ourselves no longer necessary so that you can then continue to work on your strength for the rest of your life. The course is called Lift for Longevity for a Reason. Yeah, and two things that are really important. One, you own the course when you buy it, so it's yours forever. It'll always live in your computer.
00:16:52
Speaker
And then number two is that this course is structured in a way that we have not encountered any others. First of all, there are no like six month programs that are guided with live option and recorded follow along classes included with it. So.
00:17:06
Speaker
a rude awakening for me when I was going from yoga into the strength training world and like I wanted to get stronger. It's like, oh, I need a program. Okay. I finally got that through my head. I can't just be one off classes all the time. So then I invested in a program and I got emailed a PDF. I was like, wait, where's the program? Where, where's the content? Literally all the PDF. So the PDF was linked to videos on Vimeo.
00:17:26
Speaker
So yes, you're like, how do I do a bent over row? Let me click over to this one-minute demo video on Vimeo. And look, that's a fine way to be given a program. The thing is that it's actually very, very different, though, than how yoga practitioners
00:17:43
Speaker
And even Pilates teachers are used to being taught movement. We're used to going to a class where there's a group of people and being guided step by step through what to do in the class. And so I think that it's more yoga slash Pilates teacher friendly to do the course the way we're doing it. We're offering one live class a week. You don't have to attend live. It's all going to be recorded. We're going to ask you to strength train more than one time a week.
00:18:10
Speaker
But we are not only going to provide you with a demo video of every single exercise that you're going to do in the program, we're also going to provide you with a full-length class of every single workout in the program. So you will always have the option to just watch a quick demo and work out on your own like the rest of the strength training world is doing, or you will always have the option to take the workouts as though it were kind of like a yoga class or a Pilates class
00:18:34
Speaker
for it to be a guided follow along experience. I cannot find anything like this, not to mention the fact that we have a physical therapist. Who's that? And a strength coach. Who's that? Teaming up. Who are they? To provide you with this content. It's Sarah and I. We have a breadth of knowledge and a breadth of expertise and a breadth of qualifications that it's
00:18:58
Speaker
you also don't always find, right? So we have something for you that will give you a taste test of what this program is going to be, which is a free webinar. And the webinar is just basically a workout. The way this workout will work is that you'll show up with whatever equipment you have. So if you have barbells, great. If you just have a broomstick, that's also good. And maybe if you have a couple dumbbells and kettlebells, we're going to take you through the experience of a workout. We're also going to do
00:19:24
Speaker
exactly what we're going to do in the course, which is leave time at the end of the workout for Q&A. We're also going to do exactly what we're going to do in the course, which is provide individuals with form check feedback and take questions. So it's going to be very interactive and basically an exact replica or slash it's going to be an example of how this program
00:19:46
Speaker
will be for you to take in its longer form. This is a free webinar. You get a 30 day replay. It's happening on September 14th. If you want to attend live, if you can't attend live again, you will get emailed the replay.
00:19:58
Speaker
You'll be able to take the class a couple of times, get a feel for what it's going to be like. And then knowing that's the bulk of the content, like you'd be able to make a better decision about whether or not this of course is something that you want to invest in. Absolutely. So alternatives to this are obviously like to get one-on-one personal training sessions, which I will never not recommend. It's a great idea. But in terms of cost, sometimes that can be a major valid objection. Like people just don't have
00:20:24
Speaker
a couple hundred dollars every month lying around to pay their personal trainer and I think that that warrants longer discussion. If you don't have that type of money, the cost of this longer form course that we're presenting to you
00:20:38
Speaker
is a fraction of that cost with a lot of this. It's not the same thing as working with a personal trainer, but it has a lot of the same benefits because there's that live real time personal feedback component to it. So if that's interesting to you, make sure you go to our show notes where you can sign up.
00:20:57
Speaker
to get the Zoom link for our webinar that is taking place on September 14th. I'm really looking forward to it. I'm looking forward to
Yoga and Bone Density: A Critical Look
00:21:04
Speaker
it too. I think it's going to be a lot of fun. And the other thing is, if you have been listening to this podcast, this is who Laurel and I are. This is not like, these people are showing up in that class as well. So just get ready for- They'll be there. These people will be there. By they, we mean we. We'll be there.
00:21:21
Speaker
So this is where my brain might actually finally implode upon itself like a dying star. But this is where we have to talk about, we have to talk about, I'm just trying to calm my internal rage. We have to talk about what I wrote in my notes as that stupid fucking study about yoga and osteoporosis. And yes, that's a bit mean, but I'm just irritated by it at this point.
00:21:43
Speaker
Because one of the biggest and most frustrating myths that are out there that prevail to this day is that yoga can improve your bone density. Now, there's a lot to unpack here. Laurel, will you tell us about this study that was done by Lauren Fishman and why it doesn't actually prove what it claims to prove? Yeah, and you've said it best, Sarah. An email and a social media post you put together was super well researched.
00:22:14
Speaker
So I'm going to refer to that, sure, and just name a couple of the most salient points. So basically, if you don't already know, in 2015, Dr. Lauren Fishman and other researchers published a study called 12 minute daily yoga regimen reverses
00:22:29
Speaker
osteoporotic bone loss, reverses, they said. Okay, the whole world went, woo-hoo, and proceeded to create a lot of classes that were basically like Pilates or yoga for strong bones. And, you know, maybe they should have just pumped the brakes for a second, because we need to take a closer look at like what's inside, what's underneath the title. Yeah. And, you know, before I just, I do want to break in and say, you know, it is, I am glad that in the movement world,
00:22:58
Speaker
People are starting to really try to apply more research or more evidence-based information to their work. And this is not, you know, when I became a yoga teacher, yoga teachers weren't sitting around reading research papers. This is a relatively new development, and I think it's a great one. However,
00:23:15
Speaker
We have to have a critical eye about research just because there's somebody published a paper doesn't make that paper as good as the one sitting next to it, right? We have to be so much more skeptical and critical and not just read the title and the summary, but actually go into the study and if
00:23:36
Speaker
You know, I took a year worth of school in PT school just about learning how to understand research and read it. So if you don't have that under your belt, just, you know, there's lots of people out there who are taking studies and who do have that understanding and summarizing it for you and, you know, creating papers about that.
00:23:57
Speaker
You can find other people to help you understand the research, but the big picture from my perspective is we need to stop just reading the title and being like, oh, well, that's what it proved. Yeah, please. Could we please? All right, so the study has a couple problems. I'm going to name a couple. Sarah kind of did all this research and has read the study so many times that you can see it's having a pretty negative effect on her psyche. The study is not detailed enough to be repeatable. That's a big one, right?
00:24:25
Speaker
You don't, it's real vague. And so it'd be hard to take this study and try to do it again to see if like you get similar results. Yeah. I mean, it's a huge in the world of research, basically the, the gold standard of showing that this research means anything at all is that other researchers can take your paper.
00:24:43
Speaker
and they can replicate it and it can get the same results. And it may well be that this study could be replicable, but the problem is in the paper itself, it leaves out so much detail that you would have no idea how to actually replicate it. I mean, I'm still confused.
00:24:59
Speaker
by how many people actually finished the study, because at some point they're talking about this number, but then another point they're talking about another number of people and it's just very confusing, right? So like a good example, do you remember that power posing stuff where it was like, oh, before an interview, go stand in the bathroom and stick your arms up in the air for 60 seconds and like, you know, that's going to boost your, you know, whatever, all these things. So it was Amy Cuddy did this research and then people were like, cool. And they tried to replicate it and nobody was able to come up with the same
00:25:29
Speaker
And this is the next problem, right? There's no control group. So within the study design, there's not the ability to isolate down one variable, like yoga, and see how yoga as an intervention for bone loss compares to other
00:25:42
Speaker
interventions or no intervention. Also the people were not blinded or double blinded or anything like that. They all were actually yoga practitioners. They liked yoga. And so this means that they're going to want to participate in the study because they get to do yoga. In fact, they got like a free DVD.
00:26:00
Speaker
So that would make me want to sign up for something, right? So do I get something for it? Awesome. There's a strong, strong risk of bias when we don't have a control group. And there's also an inability to draw any type of conclusion about the outcome of the research if we don't have a control group, right? So there's also this mixing up of the idea that what they're looking at is qualitative, but what they're actually
00:26:29
Speaker
looking at is not qualitative, it's quantitative, like the results you get on a DEXA scan quantify to a certain extent your bone.
00:26:36
Speaker
mineral density, but then they claim that the evidence that they're presenting in their research paper is qualitative evidence? What the heck is that about? If you're doing a qualitative study, that would be if I was going around and just interviewing people about, how do you feel about yoga? That's a qualitative study about yoga, right? I like it. Do you like yoga or whatever? That's a dumb question, but something like that versus- How strong do your bones feel? Right.
00:27:03
Speaker
Do you feel like yoga made your bones stronger? It's very hard to read it and understand what the heck was going on and what they actually thought they were studying, the claims that they're making, the title versus the content.
00:27:20
Speaker
Hard to understand and we're gonna link it in the show notes and you know if you're intimidated by the idea of reading research You shouldn't be because you could totally just open up this paper It's not that long now give it a read and like come to your own conclusions about what it is that you understand from what they're sharing Yeah, a couple of other things the the discussion focuses on reducing fall risk and
00:27:40
Speaker
which is a different discussion than reversing bone loss, which is also a different discussion than fracture, right? So it's like, if you have osteoporosis, your bones have a higher likelihood of fracture, but if you don't fall,
00:27:55
Speaker
than do they? And also, you can fall and not fracture your bone when you have osteoporosis. You can also fall and fracture a bone and not have osteoporosis. So we're conflating some things here, and it's not clear that they know what they're measuring. Yeah, it's not. And they also say that this
00:28:20
Speaker
There's no competing interests, but, you know, Fishman himself funded the study. And, you know, yes, okay, maybe if you were in the study and you got a free DVD, I mean, he's not making any money off of the study, but there is the potential for the results of the study to create future income if it proves what he wants it to prove, so then people go and buy his content.
00:28:43
Speaker
Right? He sells the DVD, right? Yeah. It's my understanding. And in the study itself, literally, there's a sentence that says, this study suffers from several problems. So they're well aware that this is not to their credit. To their credit. Listen, and look, if you're out there doing research good on you because it's tough. It's hard as hell. Hell, yeah. It's hard as hell to do. I have a lot of respect for scientists and researchers. I do too. Researchers, it's a lot. It's a very, very tough thing to do well.
00:29:12
Speaker
And it's a pretty thankless task. And you're basically always standing around about to get taken down by the rest of the research world who's like, I really wish you had included a control study. But also, given all of that, what is so frustrating then to us about this paper? I think it's the way that the results have been over interpreted or the way people have read the title and just then not read anything else and run with it.
00:29:37
Speaker
And while Lauren Fishman is not necessarily responsible for that happening, I don't see him standing out there going, hey, whoa, whoa, everybody needs to pump the brakes here. Right. And in my opinion, that would be the more
00:29:51
Speaker
integrity-rich thing to do. Yeah, absolutely. Absolutely. We've also talked about this study a lot before, so that's about as much as I can tolerate going into it again. But if you want to hear more about it, season one, episode five, Laurel did a solo episode where she asked about yoga and bone density.
00:30:12
Speaker
In season two, episode 38, we talk about how yoga asana, generally speaking, is not going to be enough to improve your bone density. So you can definitely go and listen to more of that. And I do also want to say this, if you are deconditioned, there is going to be some amount that yoga is going to do for your bone density, but that's going to be a very small window of time and that's not going to continue to improve.
00:30:37
Speaker
Right. And it has again to do with this analogy of kindergarten. Right. Okay. So if you are largely sedentary and deconditioned and you start doing yoga, I think maybe many of us can think back if you do have a yoga practice under your belt to when you started doing yoga. And a lot of like my experience was like, damn, this is harder than I thought it would be. Right. Until it wasn't anymore. Right. So your body is constantly adapting to the things you're exposing it to.
00:31:06
Speaker
What this means is that at a certain point, yoga asana is simply not going to be a high enough stimulus for you to continue to make a change. And so as a tool, it's maybe not the best one we have or even remotely close to the best one we have in our tool belt to be able to improve bone density. I would say a far better tool would be resistance training because inherent to something even being resistance training, it has to apply a principle called progressive overload.
00:31:35
Speaker
Progressive overload is systematically and gradually, over the course of weeks and months, increasing the amount of stress we're applying to the body's muscles, bones, soft tissues such that we are constantly pushing the envelope in terms of
00:31:52
Speaker
creating change in the body, right? So if you do a little bit more than you're used to doing, your body will rise to the occasion and adapt to be able to tolerate that little bit more and then you actually have to do a little bit more to continue to create change. I liken this to like yoga is sort of like trying to pound a nail in with a screwdriver. You can do it. I mean when I've been in a pinch before I want to pound a nail into the wall so I can hang a picture and if I use the end of a screwdriver
00:32:18
Speaker
I can get it there, but if I'm trying to build a house, am I really going to use a screwdriver to build my house? I hope not, right? Yoga Asana has its place, but at a certain point and probably really pretty early on because the body is more like a... It's an adaptation machine wonder. It's not a machine, right? Because the very thing that makes it the least like a machine is the fact that it can change.
00:32:43
Speaker
it can adapt, right? So I don't want to say Yoga Asana doesn't play any role in building bone because that would be a statement that lacks a nuance just like the title of Lauren Fishman's research paper, right? And I don't want to swing to the opposite end of the spectrum. I think we have to start having more nuanced conversations and start to better understand
00:33:05
Speaker
how bone builds to prevent osteoporosis, to reduce harm. I think that when we don't have these nuanced conversations and we don't fully understand what it is that we're talking about or what we're doing, we're actually potentially causing more harm. So the other thing I'll say too is there's a difference between slowing down bone loss and building bone. And ultimately, if you have osteoporosis, you want to be building bone because you want to not have osteoporosis anymore or osteopenia, same thing, right?
Strength vs. Yoga for Bone Density
00:33:35
Speaker
So if you're in a boat and there's a hole in your boat, you don't want to drown, so you could try to either take a bucket and bail your boat out. So every time you scoop a bucket of water out and pour it back into the lake, you're going to slow down the inevitability of your boat sinking. The other thing you could do is patch the hole, and then you don't have to
00:33:58
Speaker
be bailing yourself out all the time and you can just keep fishing or whatever it is you're doing out there. And so I like in doing yoga asana as a way to bail your sinking boat out, right? It will slow down, but definitely better than sitting in a chair on a couch. 100%. So is walking, right? Yeah. But if you actually want to build bone, if you want to stimulate your bones to actually lay down more bone,
00:34:20
Speaker
you want to patch the hole. And that is analogous to starting to lift heavy weights, building up progressively to that point, right? And also impact training.
00:34:31
Speaker
Yes. I really want to stop talking about this study, but I do have to say that one of the things that is frustrating about it is that even to this day, I did a Google search because I like to look for things the way I go on PubMed and I know how to put in all the parameters and all that, but your average person is just going to go on Google and look up something like yoga for osteoporosis. When I did that, I had to
00:34:55
Speaker
step away from the computer because I was very likely going to start rage throwing things around the room, including the computer, because here's another website in 2023 citing this study as if it's anywhere close to conclusive, which is the problem. It's just not. And all of these comments, this is what was really upsetting to me because all these comments on this website are saying things like, oh, this is so exciting. I'm going to start doing this 12 minute yoga program right away. I can't wait to improve my bone density with yoga.
00:35:24
Speaker
And I don't think I need to reiterate what Laurel said because she said it very, very succinctly. So then I try to calm myself down and I was like, okay, well, what if I Google Pilates for osteoporosis? What do I get? And there is a study that I found, but it's behind a paywall. So I didn't get to read the whole study. So I can't say anything about it, but I will say that in that study, the conclusion that I read said that physical therapists could use Pilates for bone mineral density building.
00:35:53
Speaker
So that to me just says the findings were probably along the lines of it has potential value in a clinical setting, not just go do some Pilates in a group class and it will make your bones stronger. And the biggest difference to consider, from my opinion, is that a clinical setting, we're in the world of rehab, we're in the world of physical therapists. This is where people are coming in with their half pain or they're deconditioned,
00:36:18
Speaker
or they have maybe osteoporosis that has advanced to a point that their doctor has told them, you need the assistance of a physical therapist for this. Or they have other co-morbidities. We love that word. My least favorite word, right? So there's other things going on medically that make it necessary for them to be under the care of a clinician.
00:36:39
Speaker
And, you know, there is a point at which either your body weight or even very low weights, like the, you know, five pound, two pound dumbbell might improve some bone density, but just like yoga. Exactly. But this is going to be a very short amount of time. And there's another episode we're doing, I believe it's coming up.
00:36:57
Speaker
I can't remember the order of the episodes, but there's another episode that we are doing that is about something called cellular accommodation. Oh, it's the rat research episode. Rat research. We're now calling the rat research episode. We'll go a lot more into what that is in that episode, but essentially, your bones get bored really quickly. If all you're doing is yoga or all you're doing is lifting small weights, or frankly, even if all you're doing is lifting a 30-pound kettlebell, but that's always the weight that you're doing for your squats,
00:37:27
Speaker
Pretty quickly your bones are going to be like meh. I want to say something. You know how you had a favorite injury? Yes. In one of the episodes of season, Sarah's going to share about her favorite injury. I have a favorite connective tissue. Please. Bone. Nice. It's like me. It gets bored easily. It is very much like you. It's like those Buzzfeed studies. Which tissue are you? I have a bone. Carl is definitely a bone. I get bored easily. But she's also very strong.
00:37:53
Speaker
I like to mix it up. Let's just put it that way, right? I like to do different stuff and so do your bones. Right, so your yoga, your Pilates, your light weights, even your medium, any weight, you could be lifting a hundred pound barbell, but if that's the only thing you ever did ever, at some point your bones are not going to be like super excited about it.
Individualized Assessments for Osteoporosis
00:38:10
Speaker
Laurel, let's pause and sort of sum up where we are so far. So what we know is that the quote unquote contraindications that are put out there for people who have osteoporosis are no flexion of your spine, no twisting of your spine, no sudden movements like jumping or any other kind of impact, slow controlled movements only, and these contraindications
00:38:38
Speaker
are not person specific, they're just diagnosis broad. It's the- But wait, aren't diagnoses people specific? Well, in theory, the diagnosis itself, no. The quality of their diagnosis is extremely people specific. Right.
00:38:57
Speaker
Oh, damn that nuance. So we know that this is a very cover your ass approach because we have to imagine the people with osteoporosis are not walking around holding their spine completely still in every part of their lives, right? They're in the car reaching over their shoulder for the seat belt. That's twisting. They're putting their hand down to grab a bag that's on the floor and picking it up. That's bending. I mean, we did a whole episode about how everybody thinks the lower back is neutral in a deadlift when it's like,
00:39:26
Speaker
flexed a lot and so it just speaks again to this topic of like how we know what we know and how do we know we know what we know and it's like you think you are not twisting your spine but let me let me just break it to you. You are all day long. And you know I'm not saying let's you know just flout the common wisdom and go for it. With your 85 year old client who has advanced osteoporosis like you know yeah no your first session maybe don't start them with a rousing round of
00:39:53
Speaker
sit ups to toe touches and then some jumping jacks, right? But I'm also saying, let's not throw out the baby with the bath water. There are ways to safely maintain strength and range of motion while keeping your people within a safe realm of
00:40:10
Speaker
Effort let's say and the other problem is it is really pervasive people think that there's no flexion No rotation is that it can absolute no-go for everybody with osteoporosis across the board and I recently did this rehab Pilates training and I was working in the sort of breakout groups with the woman who was a physical therapist and a Pilates instructor in From what I could tell
00:40:34
Speaker
Yeah, excellent physical condition. Uh, but she was adamant. She herself has osteoporosis and was adamant that flexion and rotation were absolute no goes. And I was just like.
00:40:48
Speaker
Like, that was the noise my brain made because I was tired. And I was also like, I could try to argue this person out of it. They were, you know, it's like, you know, oh honey, wait, somebody's wrong on the internet. Like, there was no way I was gonna convince her. Yeah, especially in that setting. So then, this is the problem. Like, what are we supposed to do?
00:41:06
Speaker
where we are presented with this list of contraindications, and yet we know from research that some of these contraindications are actually useful for improving bone density. It's a pickle. It is a pickle and not a good one. No, it's not pickle ball. I love pickle ball. This is a different type of pickle. I love pickles.
00:41:29
Speaker
It's an impossible situation if you just Google everything, you know what I mean? Yeah, it is an impossible situation. But so if we look at what is actually out there currently in terms of like classes, there's basically two kind of categories. There's classes that are calling themselves osteoporosis safe.
00:41:49
Speaker
And there's classes or courses that are calling themselves, you know, bone building or strong bones or something like that. Laurel, can you talk about the difference between like, what are these two types of classes? What are they doing and not doing? Well, so an osteoporosis safe class would probably avoid all of those movements that were named on the websites, like no flexion, no side bending, no rotation.
00:42:10
Speaker
whatever, no impact, slow controlled movements, right? And so in that case, like we have someone who's teaching the class who basically has a pretty, you know, okay understanding of human movement to know that like they're going to create a class that doesn't involve poses or movements or whatever it is exercises that that involve these spinal positions. All right, so that's fine. And that has its place. And I think that calling your class osteoporosis safe,
00:42:38
Speaker
is slightly misleading to you because it's like, well, we know that we cannot prevent injury. That's not a thing. And so calling anything safe is a suspect, in my opinion. But it's, in my opinion, better to call your class osteoporosis safe than it is to say yoga for strong bones or Pilates for strong bones because what's implied there is that the
Skeptical View on Osteostrong
00:43:08
Speaker
stressors that you're applying to the body in this class, stressors being loads, right? Nothing negative, rather just forces, right? That you're applying to your body in this class are going to reach the threshold they need to reach in order to cause your bones to lay down more bone. And we just don't have any good research showing that these activities actually do that long-term, right? Or even short-term, frankly, but long-term.
00:43:33
Speaker
So we do have quite a bit of research that's pretty good. In fact, one really good study we're going to talk about showing that heavy resistance training, for example, which is something you can do long-term because heavy is relative. You can always be lifting heavy forever. You can start off lifting heavy and then you can be lifting weights that are objectively heavier years down the road and it's still heavy, right? This is a way to build bone long-term and same with impact training.
00:44:02
Speaker
I think that ultimately it's misleading and potentially harmful to suggest that your class that is not an evidence-based way to actually build bone, builds bone, it's false advertising and like all false advertising, it typically creates more problems than it solves. Yeah.
00:44:19
Speaker
So that's what's out there in terms of like taking a movement, a yoga class or a Pilates class or a workshop. But there's another category of, I guess you'd call it a class, workout something. Over the past, I want to say like five, 10 years, we've seen an increase in these, I would call it like medically approved weightlifting machines. And probably the most well-known one of them is called osteostrong.
00:44:47
Speaker
and so if you go on the osteo strong website they claim that it is a or they say that it is a proprietary technology that strengthens bones joints and muscles increases bone density and reduces joint and back pain and in l.a at least and i'm sure in other you know major cities this is a type of sort of specialized rehab that a medical doctor primary care provider might refer their patients
00:45:13
Speaker
who have an osteoporosis diagnosis too. Most likely because, and I would imagine, not because the medical doctors thinks this is necessarily better than anything else, but it's an easier place to refer people to versus saying something like, go start lifting weights, but they know that their patient has osteoporosis. There's no oversight, right? So it's easier to be like, oh, look, there's this place.
00:45:42
Speaker
It's like a gym or a studio or something. They've got a bunch of doctors on the board. Looks good to me. Go there. It probably feels like the most cover your ass kind of a place to send your patients. Can I add a question? Are you working with a doctor when you go there? Are you working with a clinician when you go there?
00:46:01
Speaker
at the place? Yeah. I don't know. But when I'm saying, if you go on the web, there's a lot of doctors involved in osteostronchitis. I don't think they're concerned that is there an actual doctor overseeing your movements on the machines.
00:46:17
Speaker
Just the sense that there's a lot of you know, I'm not just tossing you out in the wild and say go to a gym join CrossFit You know what I mean? They're sending you to a highly controlled environment versus the wild wild west. That's what I was trying to say Thank you for saying it much better than that. So the treatment itself and to be fair I've never done it so I don't know but my understanding from the site and also from other people who have done it is that it's really short like
00:46:41
Speaker
The number of people that have said to me, like, yeah, I do this Osteostrong and it's like 15 minutes or 10 minutes. And I'm like, is that it? Is that going to be enough? People have literally said to me, is that going to be enough? And I did my like, because I don't know. But so the treatment, it's about 10 minutes of work on machines. And I think there's only four machines.
00:47:01
Speaker
And so it's this thing that they call the spectrum system that's their name for it and each machine loads your bones axially meaning in the direction of the length of the bone and you do each of these four movements only once.
00:47:16
Speaker
We do have to talk about this axial loading a little bit because axial loading is what happens when you do something like impact training or like jumping. Like you imagine landing for a jump, your tibia and your femur, those long bones of your legs are being loaded along the length of the bone versus something coming in and squeezing your bone. That's a different direction of load. The squeezing the bone is actually what happens more when a weight lifting capacity.
00:47:44
Speaker
Because muscles around the bone attaching to the bone are all co-contracting and creating what's called compression, right? Compression forces, whereas impact creates a bending force or a bending moment, maybe is the better word. And then your bone resists bending, and that's how it knows to get stronger. Right.
00:48:01
Speaker
So the reason we went into that, that's going to be relevant in a moment, but Laurel, what's up with osteostrong? Is there something funky going on here? Do their claims actually match up with what research has found so far? Okay. So osteostrong's bone mineral density claim is that you can do their exercises for 12 months, 10 minutes a week and increase bone mineral density by 14%. However,
00:48:31
Speaker
None of the studies they post on their website about increasing bone mineral density show osteo strong works compared to a control. There's no control group and so when there's no control group, there's really strong risk of bias. Some case studies using osteo strong didn't show improvement in scans. Another one took 55 people and it was missing a ton of data.
00:48:53
Speaker
It only showed data for nine people. Scan's done after 60 days. They're doing these DEXA scans after 60 days, but a really long history of research shows that we usually don't see change to bone until six months on a scan, on a DEXA scan. Why is it so different for osteostrong? There are no studies to prove osteostrong is safe, despite their claims that it is safe.
00:49:22
Speaker
There is a study comparing it to typical high-intensity strength and impact training, and that study showed that osteostrong did not increase bone mineral density of the people participating, but the typical high-intensity strength and impact study did. Given all of that information, we also have to take into account a couple of other things that raise red flags for me personally.
00:49:53
Speaker
There are a couple of people promoting osteostrong who have a pretty bad track record with regards to integrity and honesty and criminal records. So there is Tony Robbins, who is, I'm going to, I'm going to, like, basically I'm not going to cover up my bias here. He's shilling for osteostrong. And so is David Asprey. These individuals, in my opinion, have shown themselves time and time again to be potentially
00:50:21
Speaker
Let's just put it this way. I don't trust them and I feel like they are operating usually from a very shaky moral compass. And so you can do your own, you can draw your own conclusions. I think that we should link that University of Waterloo video, YouTube video in the show notes if you want to hear what some academics at the Bone Lab at University of Waterloo
00:50:49
Speaker
in Canada, I have to say, about OsteoStrong. And then you can also, maybe we should link a couple of other videos that are raising from experts on reading DEXA scans, for example, on why OsteoStrong, why you may want to think twice before you fall hook, line, and sinker for the promises made by OsteoStrong.
Strength Training for Lifelong Bone Health
00:51:15
Speaker
Yeah. Part of what's really actually quite weird
00:51:17
Speaker
about osteostrong's claims about building bone density is they're talking about this axial loading, but there's no impact in what they're doing. So the axial loading that they're claiming is not what happens when you
00:51:34
Speaker
press or push or pull or anything, a weight with your body. Also, axial loading, not all axial loading involves a high rate of loading. We know that bones get stronger from high magnitude and high rate of loading, but if there's no impact, the rate of loading along that axis of the bone is not a high rate of loading. Right.
00:52:02
Speaker
Whenever you have a group of people showing results that seem too good to be true and also are showing results that no other group of people like no other group of researchers or medical doctors have been able to find, I think you should think twice. You should put on your skeptics hat and wear it proudly. Maybe that's also in our merch store, a hat that just says skeptical.
00:52:32
Speaker
I love that. So here's what the National Osteoporosis Foundation says, and we'll link to this as well, about OsteoStrong. The scientific community has long known the benefits of high intensity resistance and impact training exercise on bone mineral density.
00:52:50
Speaker
While the High Intensity Biodensity Exercise Program, that's what osteostrong is, may be beneficial for increasing bone mineral density in adults, the evidence presented does not demonstrate efficacy of the osteostrong program on bone mineral density outcomes. Furthermore, we do not know how it compares to the benefits of the current recommendations for weight-bearing and resistance exercise. Further research is warranted.
00:53:18
Speaker
before the benefits of osteostrong program can be determined, which is the research way of saying more studies are needed. And there is no clear evidence that osteostrong is an effective method of increasing bone mineral density, but it is high intensity. So in
00:53:39
Speaker
theory, it might. And this is something that Laurel and I were also talking about separately. If the only way you're going to work on your bone density is by every week going to osteostrong, that's better than not doing anything, perhaps. But it's a lot cheaper.
00:53:56
Speaker
And long term, it's a lot more effective to start strength training and impact training. Strength training and impact training are kind of in the same category in my mind as eating and sleeping. It's something that if you are a human in a human body as opposed to human in a dog body or what, no. Alien in a human body. Say it with me. If you are a human being, these are habits. These are just good habits to be in. So the idea that I'm now going to go to a clinic
00:54:25
Speaker
to do my good habit of being a human being is i'm a little bit confused about why we've now moved exercise into the context of clinical intervention i guess i understand like
00:54:38
Speaker
Sarah lives in between those worlds as a PT, right? Obviously, she provides exercise as a means by which to intervene clinically in someone's something that they're trying to recover from or rehab. But is that something that people then do for the rest of their lives? Right. Eventually, we want to
00:55:00
Speaker
take people and put them back into the realms of being a human being and going about doing their good habits. So I guess if osteostrong, I'm going to suspend my disbelief and give osteostrong the benefit of the doubt to an extent. My red flags are up and my hackles are way the heck up when I see how they market themselves and the claims they're making and the lack of evidence. They're good evidence to support what they're saying. I mean, it sounds a lot like good marketing to me.
00:55:29
Speaker
All of that aside, if osteostrong is a bridge to get people feeling confident, to build enough bone density where people are safe to go back into the gym and start doing these activities of healthy human living, like strength training, then okay, cool. I just wonder if because they're not held accountable in the same way that Sarah is as a physical therapist,
00:55:55
Speaker
and they are for profit and there's nothing wrong with being for profit, I wonder if what they're actually trying to create is like some level also of dependency. Absolutely. I mean, you know...
00:56:05
Speaker
There are, in all kinds of worlds, in the PT world, I see this. In the chiropractic world, you see this. I think you see it a lot in the chiropractic world. You do, but sort of secretly, you also see it in the PT world without knowing about it. Of course. In the chiropractic world, you see it where people become dependent on their... I have people come into the clinic and then tell me, well, I have to go to the chiropractor every week because otherwise, I'm out of alignment or the chiropractor resets me or whatever the language is.
00:56:31
Speaker
There's also plenty of people who, there's plenty of physical therapists who never discharge their patients where they're essentially just, you know, draining them at that point, you know, or anyway, as a whole separate conversation.
Impact Training vs. Osteostrong
00:56:43
Speaker
But the bigger picture is we want to normalize lifting weight, doing impact training within the parameters of what is appropriate for each person across your lifespan and something like an osteo strong or something like a Pilates class that's claiming bone density increase or yoga.
00:57:01
Speaker
They have limitations. That's the big picture here, is that they are limited in their capacity to do what we need them to do. And when we know that what exists out there that is relatively easy, not super expensive,
00:57:17
Speaker
Right? Because what's interesting to me is a lot of the newer research is really much more about the impact training and it's less about the weight training and it's really showing how impact training is so, so effective for bone density, right? So sitting in your chair and stomping your feet as far as I know is free, right? And I can then progress that all the way up to, you know,
00:57:39
Speaker
whatever, jumping with impact and doing pogos, right? Another thing I'll say too is like, strength training supports your comfort in doing impact training. Absolutely. The stronger you get, the more you might actually enjoy impact training. So now that we're talking about it, let's talk about the lift more trial.
00:57:54
Speaker
So we have talked about the lift more trial quite a bit, especially in multiple episodes in season two, but especially episode 38. But in case somebody's listening for the first time, Laurel, could you give us just kind of like an overview of what the trial was and then what the results showed? Right. So they had a control group doing low intensity at home workouts and then they had
00:58:18
Speaker
the, what would you call it? The research group doing high intensity strength training and impact training in the clinic with physical therapists. And this was a group of women who were all postmenopausal. I think a large percentage of them, they all had osteoporosis and a large percentage of them had even sustained fractures from their osteoporosis from probably falling, right? So these were, these were
00:58:46
Speaker
post-menopausal osteoporotic women, many of whom had a history of fracture, doing high intensity strength training and impact training over the course of six months. Was it eight months? Actually, it was eight months, which is an incredibly long time to run a study, which is why you don't see a lot of studies that go on for that long.
00:59:05
Speaker
because it's very expensive. But they gave the subjects time to actually build bone, which is really very necessary to be able to study bone. And it turned out there were just really positive results. People were, in a statistically significant way, able to increase their bone mineral density far more effectively than the control group.
00:59:32
Speaker
Uh, and so, you know, the lift more trial is really the gold standard that's out there showing that how to run a good study. Well, how to run a good study, but also it really does show how progressive overload of weight training and impact training does positively benefit your bone mineral density. And we have modeled our program to a large extent off of our understanding of how this, how this program was run. Yeah.
00:59:59
Speaker
So I think at this point we've kind of covered a lot of different things. Let's take a moment and just kind of summarize what we know works or doesn't work in terms of improving your bone mineral density or your osteoporosis. So we know that a high load is important, especially the older you get. And the older you get is because so if you take that like
01:00:27
Speaker
analogy of a sinking boat, right? Your boat is sinking faster than a younger person, right? So you actually need to ensure that you're patching the hole well. Whereas people who are younger, their bone growth is outpacing their bone loss. It's the opposite of when you're older. So they maybe don't need quite as high of a stimulus. In fact, just like moderate strength training is probably more than enough. But at a certain point, because bone loss then starts to outpace bone growth,
01:00:57
Speaker
You're going to potentially have to step it up and give your bones a better reason, right? Just give them a better reason to grow. Exactly. And that higher load, let's be clear for a moment. We're talking about something that you could lift maximally five times. Five or six times, yeah. So this is not your three sets of 10 weight. And we'll talk about that all over the place. So we know that strength training is
01:01:22
Speaker
a positive influence on your bones. We know that impact training is a positive influence on your bones. Do you need to avoid flexion and rotation? This is kind of a, it's tough. I mean, we cannot say conclusively one way or another right here, right now on this podcast because so much of it depends on the diagnosis, the individual, the comorbidities, the age, all of it.
01:01:45
Speaker
But the reality is everyone is probably doing some amount of flexion and rotation in their day-to-day life and all the time and nothing's happening. So, you know, we take it with a grain of salt.
Conclusion and Critical Thinking Encouragement
01:01:58
Speaker
I hope you've enjoyed this episode. Well, I hope at least that this episode has
01:02:04
Speaker
helped you navigate the mythscape of osteoporosis in maybe a more nuanced and intelligent way for yourself, for your clients that you may be working with, for your patients if you're a clinician, and that maybe it's helped you take a more squinty, skeptical look, which is a clinical scientific look at things like claims around yoga and osteoporosis. And osteo-strong.
01:02:30
Speaker
and osteo strong claims around Pilates and osteoporosis, any kind of program that's claiming big improvement in small amounts of time that's wildly different than what the research is currently showing should make you run for the hills. It should make you at least go wait. Whoa.
01:02:48
Speaker
So you can check out our show notes for links, there's gonna be a lot of links in these show notes. I'm already like, oh boy, writing these show notes. Where's our assistant? You can also visit the Movement Logic website where you can get on our mailing list and you can also get on that list to get our free class, our free weightlifting class that's happening on September 14th, 2023. Thank you so much for joining us on the Movement Logic podcast. It helps us out if you liked this episode to subscribe,
01:03:17
Speaker
Rate review on Apple podcasts or wherever you listen to podcasts and we will see you next week