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Episode 38: Got Bones? Yoga Asana Isn't Enough.
1.1k Plays1 year ago
Welcome to Episode 38 of the Movement Logic podcast! In this episode about bone density, Sarah and Laurel talk all about what kinds of exercise are indicated by research to improve bone density, and almost more importantly: what isn’t (including yoga).
We also discuss:
- What is bone density and how do we measure it
- Why women are at more risk for fracture than men, especially following menopause
- How to interpret DEXA scan results and its relationship to fracture risk
- What lifestyle and medical factors can contribute to bone density loss (osteopenia and osteoporosis)
- Why so many people believe that yoga can improve or reverse osteoporosis
- How an often-repeated yet very flawed study convinced a lot of people that claim about yoga
- How the media coverage of this study contributed to the problem
- How heavy weight training and impact training are proven to improve bone density
- What other exercises may or may not possess the necessary qualities to improve bone density
12-Minute Daily Yoga Regimen Reverses Bone Loss
Video of women doing LIFTMOR Intervention
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Transcript
00:00:00
Speaker
What are some good ways to bone, bone, boop? To bone-bensity. How about by bone-bensity? I'm bone-bensity. I'm the bone-bensity on my mother. Bone-bensity's all but all density. Don't you blah, blah, blah, blah, blah, stand up, jump down, get some impact, and lift the heavy weight. Bone, I'm bone density.
Introduction to Movement Logic Podcast
00:00:22
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yoga, movement, and physical therapy worlds, we believe in strong opinions loosely held, which means we're not hyping outdated movement concepts.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 Dr. Sarah Court, physical therapist, and I'm here with my co-host, Laurel Beaversdorf, strength coach, and yoga teacher. Now, I really wanted to call this episode Milk Toast Approaches to Bone Density, which you might mistake for a hot new tasting menu item. Mm, toast dipped in milk? Yummy. And it's somehow I started thinking about bone marrow.
00:01:14
Speaker
That seems a bit weird, but milk toast is probably not the best word to put in an episode title, and frankly, it just makes me hungry.
Understanding Bone Density: Measurements and Misconceptions
00:01:20
Speaker
So in this episode, we are going to discuss what is bone density? How do we measure it? What are the causes and the risk factors for bone density loss, also known as osteopenia and osteoporosis?
00:01:34
Speaker
Why do so many people believe that yoga can improve bone density when that claim is highly questionable? How heavyweight training and impact training are proven to improve bone density? And based on this evidence, what other exercises that claim to improve bone density do not possess or do possess the necessary characteristics to do that?
00:01:57
Speaker
Now, I did an Instagram post a few months ago about the two ways that you can improve bone density, which are heavy lifting of external weight and impact training, which is a subset of something called plyometrics. And if you are finding that a bit confusing, you should go back and listen to our episode about plyometrics and you will learn that not all plyometrics are, in fact, bone density building, anyhow.
00:02:21
Speaker
In that post, I did a bit of a callout about a famous, very often repeated study that claimed yoga can reverse osteoporosis. But that study is also known to be extremely flawed. And I'm going to go into those flaws in a little bit. And the response to my post was really interesting, Laurel, because some people were like, yeah, right on. That study was BS. And I was like, yes. And then other people were like, whoa, I didn't know that that study was BS. And I was like, cool. And then one person said,
00:02:52
Speaker
I have to interject here and say one of my favorite things to do is take when somebody says something super iffy to me or you or both of us and just call them out on it anonymously. I'm not naming this person. I don't know this person's name, but I am deeply entertained by it. It's my personal way of processing. Well, that's how you know you've arrived in the land of social media. When it doesn't actually raise your hackles anymore, you just go, ha! Exactly.
00:03:14
Speaker
So someone said, it's so sad. You're spreading misinformation. You should do more research. Osteoporosis is an autoimmune disease. I am going to address this because that's not actually correct, although there is some linkage between autoimmune disease and osteoporosis, but this is where that internet pseudoscientific magical mystery machine of I did my own research drives me up the freaking wall.
00:03:42
Speaker
Okay, so let's also address there are drugs.
The Role of Movement in Bone Health
00:03:47
Speaker
There's medication that you can take for bone density. And there are dietary choices you can make that are going to be more supportive of bone health. But from a movement perspective, and Laurel and I are both movement professionals, so this is our wheelhouse, we need two things. We need heavy load, or we need impact.
00:04:07
Speaker
Okay, so let's start at the beginning. What is bone density and how do we measure it? Well, bone density is a measure of the amount of calcium and phosphorus present in your bones. And throughout our lives, our bones are constantly both breaking down and rebuilding. That's just a natural process. And roughly from birth to about 25, the building phase, the building process is outpacing the breaking down process. And during that time, your bones are getting stronger.
00:04:34
Speaker
from roughly 25 to 50 those two processes are kind of equal so your bones are not getting weaker or stronger they're staying the same and then generally after about age 50 the bone breakdown process starts to outpace the bone building process if you're not doing anything about it and your bones are becoming weaker. So our bone density is measured by something called a DEXA scan
00:04:55
Speaker
which stands for dual energy x-ray, oh boy. Absorptiometry. Absorbitrometry. Absorptiometry. Absorptiometry. Absorption-metry. Definitely call in with your correct, we don't have a phone line. We don't know how to pronounce that.
00:05:11
Speaker
But it's a hard word. There's an R and a P and a T right up against each other. Anyway, the DEXA scan is what allows doctors to diagnose osteoporosis or osteopenia based on the amount of calcium and phosphorus that is showing up in your bones.
00:05:26
Speaker
And specifically they're not scanning your entire skeleton typically they're looking at areas where bone density loss most often occurs which is the spine the pelvic bones the femoral neck which is the kind of part of the femur where it makes a turn and it aims itself into your hip.
00:05:44
Speaker
and the wrist these are the most common areas of bone density loss. Didn't you have some fact about femoral necks? I think that is the most frequently fractured area of the body that results in
00:05:58
Speaker
becoming bedridden, which is not a great prognosis. No. And actually, that's why a lot of people are so scared of falling, because they know about these kind of risks, and it makes sense very scary. Yeah. Being bedridden can often be life ending in and of itself. If you're old enough, yeah. So I'm going to get into a little bit of statistical analysis here, because your DEXA score is then compared to that of an average, healthy adult using standard deviation.
00:06:26
Speaker
Laurel, what is a standard deviation? It is a numerical distance from the average. So you could be above or below average and that numerical distance is like a fixed amount. Nice. And it's kind of stepwise because you can have one statistical, excuse me, you can have one standard deviation, you could have two standard deviations.
00:06:49
Speaker
So all right, either that just made you wanna like vomit in your mouth a little bit or you're like, I don't know what a standard deviation is, but if you're mildly traumatized from having to learn statistics in school, you can think of a standard deviation like how many degrees away from the norm is this person's bone density score? So the DEXA results are put into a T score and that is the difference between your bone mineral density and that of a average healthy adult using this standard deviation.
00:07:16
Speaker
and they create something called a t-score. So a t-score of greater than or equal to 1 is considered normal. You and the average healthy adult are in that same category.
00:07:29
Speaker
a T-score of 1 to minus 2.5. So 2.5 standard deviations below the norm is considered osteopenia. And then a T-score that is below minus 2.5, meaning it's more than minus 2.5 standard deviations away from the norm, is considered osteoporosis. Now, the relevance of this is that your risk for bone fracture doubles
00:07:56
Speaker
with every standard deviation below norm. So if your T score is minus one, your risk is doubled. If your T score is minus two, it's doubled again, quadrupled, even quadrupled. And then they also do something called a Z score, which is the same thing except it's an age matched norm. So they're looking for somebody who is your same age, your same gender, your height, your weight, right? It's a little more specific. That seems important for bone density as well since
00:08:22
Speaker
I think sex makes a very big difference. Definitely,
Risk Factors for Bone Density Loss
00:08:25
Speaker
definitely. Okay, so what are the causes of bone density? Who's at risk for bone density loss? Laurel, do you want to talk about some of the lifestyle factors? Yeah, so if you are a smoker, if you drink too much alcohol, if you have a dietary deficiency, if you have a history of dietary
00:08:46
Speaker
deficiency, specifically low calcium, potassium, vitamin D, and protein. If you have a history of just being physically inactive, a history of eating disorders, things like anorexia and bulimia, not overeating, but anorexia and bulimia for sure, long-term use of medications I read, including prednisone or other steroids, anti-seizure drugs, and even certain antacids that contain aluminum.
00:09:13
Speaker
Some other non-medical factors include your age. So age 50 and above, if you recall, is when you start to not continue to build bone to the same extent that your bone is breaking down for men and for women.
00:09:26
Speaker
For women, estrogen plays a huge role. And so when you are menopausal or postmenopausal, estrogen is a hormone that bolsters bone density. And during menopausal, our estrogen is decreased and eventually depleted, which then decreases our bone building capacity.
00:09:44
Speaker
Women's bones are also typically smaller and less dense than men's. This is just my opinion. But I would believe that at least some part of the density difference between men and women has to do with the fact that most women are not doing heavy weightlifting throughout their lives.
00:10:06
Speaker
Yeah, definitely that will play a role, but also men have a lot of testosterone in their bodies, which is also really important for bone strength and bone density. And then there's also medical conditions that either the condition itself can impact your bone density or the treatment for the condition can impact your bone density. And these include things like having an overactive thyroid or parathyroid, chronic lung disease,
00:10:32
Speaker
and some forms of cancer because tumors for women that are estrogen and progesterone positive, meaning that the tumor grows when there's estrogen and progesterone around, there's treatment. Part of your treatment is to then take medication for a long period of time that essentially pulls the estrogen out of your body and forces you into menopause like tamoxifen or aromatase inhibitors. I am on tamoxifen myself. I was very aggressively forced through menopause during the past year.
00:11:01
Speaker
endometriosis is another one, and then also just having a vitamin D deficiency. And actually a lot of people are walking around with a vitamin D deficiency. Yeah, it's actually one of the most common vitamin deficiencies out there. So let's talk about this autoimmune claim because I do want to address it. So osteoporosis is not an autoimmune disease.
00:11:23
Speaker
However, if you have an autoimmune disease, that can then be a risk factor or lead to osteoporosis. So it is a potential contributing factor, but not all autoimmune diseases are going to cause osteoporosis, and not all osteoporosis is caused by autoimmune disease. Cool. All right. So Laurel, why do so many people think that yoga is going to build bone?
00:11:49
Speaker
A couple of reasons. One, in all fairness, a lot of sources, a lot. In fact, if you Google, how do I build bone density, you're going to hear the word weight-bearing. Isn't weight-bearing just being alive?
00:12:09
Speaker
what you get when there's mass and gravity, right? So if you're on earth, you're weight-bearing. And so it's such a vague word that is very vague and unhelpful and so everything is weight-bearing.
00:12:22
Speaker
I think what they're referring to is that your spine should be weight-bearing. You should be upright. In other words, you should be standing upright. At a bare minimum, just get up. Your spine is holding up the weight, bearing the weight of your torso. At the very least, you're not lying on your back. As it turns out, just
00:12:41
Speaker
weight-bearing is not enough even close to enough and it definitely could be but it depends on how much weight are you bearing, it should be a lot and then there was a study in the yoga community it's very very convenient and and and you know maybe comforting to believe that yoga is all you need right and there was a study that came out a very
00:13:02
Speaker
poorly designed study called 12 minute daily yoga regimen reverses osteoporotic bone loss and If it sounds too good to be true, it probably is I'm going to start with that This is a 12 minute series of yoga poses many of which are performed sitting or lying down So not weight bearing quite passive
00:13:22
Speaker
not weight-bearing, that are held up to be sort of cures, I guess, or preventative for bone loss. And unfortunately, not only is that not true, it's potentially harmful for people to believe that. So in season one, I did an episode. The title is, does yoga asana build bone density? Sarah also interviewed Jules Mitchell in season one. She spoke about this study as well.
00:13:50
Speaker
Anyway, I think those are the two big reasons that people think yoga asana is bone building. And I agree that, I mean, I remember as a yoga teacher when I was starting out, there was generally this belief that yoga fixed everything, right? So fixes bone density too, awesome. But unfortunately, that's not true. It's a marketing ploy.
Debunking Myths: Yoga and Bone Density
00:14:10
Speaker
One of my takeaways from reading this study, and we're gonna link to it so you can also read it, but this study says in itself that it is about falls risk. But the title says it's about reversing osteoporosis. Those are different things. Those are completely different things. Yes, having osteoporosis is a bummer because if you fall, you're more likely to break something, but you can also be more likely to fall and not have osteoporosis. Like I'm just incredibly clumsy.
00:14:38
Speaker
The amount of things I bang into on a daily basis is really embarrassing. Yeah. But I don't have osteoporosis. Right. Far as I know. So the other thing is, in the study itself, this is the kind of stuff that makes me absolutely mental. In the study itself, it says, this study suffers from many drawbacks. Hey, you got to give them some credit. They're at least being honest. They're aware. But that's at the very end of the study.
00:15:00
Speaker
And also, who's reading to the very end? Or are you just reading the title? Now, why do so many people believe it? Well, people got very excited about it. It seemed very exciting. There was a lot of media coverage of it. There are still, to this day, courses that people are selling called Yoga for Osteoporosis. Oh, yeah. Entire trademark brands. Also, by the way, Pilates for Osteoporosis. Yes.
00:15:26
Speaker
exercise interventions that actually don't build bone are sold as being bone building. Here's what I want to say. What I've noticed overwhelmingly is that people who do yoga love yoga. They love doing yoga. I can't say the same about everybody who's string trains. I've spoken to a lot of people who string train and they're like, I don't like it, but I do it because I know it's good for me, right? You don't hear that a lot about yoga. So we've got a lot of people really passionate about yoga. They love yoga. It's given them so much benefit. So of course, if we put ourselves
00:15:53
Speaker
in this mentality of having something that's so special that's helped someone in so many different ways that they love so much, of course they're going to want to believe that yoga can prevent osteoporosis or cure anything, right? Because, gosh, that is wonderful because now I'm doing everything that I need to be doing, which is something that I love doing. Right. I mean, how efficient if it did all those things, right? Right. The other big issue is, you know, the way that media covers research is really
00:16:19
Speaker
very often problematic and a lot of publications that frankly should know better write titles and write articles that are very misleading. For example, Harvard Health Publishing, which is put out by the Harvard Medical School
00:16:35
Speaker
has an article titled, Yoga. Another way to reduce osteoporosis? A dozen yoga poses performed daily may increase bone density. So they're literally referencing this study. Yes. In their title. And in the article. And they have a beautiful image of a woman smiling and she looks so happy. And this is Harvard. Right? Great news. But in the article it says, though promising, the study doesn't provide conclusive evidence that yoga can reverse bone loss.
00:17:01
Speaker
And then it says, but if you wanna do the yoga poses, here they are. It's the kind of thing that makes me wanna rip all of the teeth out of my head because it's so irresponsible. They had hundreds of people join this survey, by the way. This study is a survey. It literally was like, do you want a 12-minute yoga video? And a bunch of people were like, hell yeah. And they're like, great, fill out this survey. And a bunch of people did not even submit
00:17:30
Speaker
two DEXA scan scores.
00:17:34
Speaker
So it's really problematic. In fact, 40 people of hundreds of people submitted the second DEXA scan score. And like literally this study, I am angry that Harvard said, a dozen yoga poses performed daily may increase bone density. I think that word may is incredibly misleading because when we say may, we're speaking probably in terms of like loose probability.
00:18:04
Speaker
But there isn't enough information presented in this study to even make a claim that it's loosely probable. It's really irresponsible, Harvard. It's really irresponsible. And the thing is with research that a lot of people don't always realize is that not all research is created equal. And it takes some analysis to tell if the research has value, which is not some, I mean, I didn't learn how to read research in my yoga teacher training. I didn't learn it until I went to PT school.
00:18:31
Speaker
So instead of doing that kind of deeper level analysis, what most people do is they get really excited by titles like this one from the Harvard Medical School, and they don't have the skill set to critically analyze the content. By the way, I did an episode in season one about reading research and how to get better at it if you would like to, but you don't know where to start. So you should give that a lesson. It's very, very easy. Give that a lesson. What did I say? Give it a lesson? Lesson. Fuck. Give that a lesson. There's a lesson in there, and you should give it a lesson. I'll learn you.
Effective Methods to Improve Bone Density
00:19:01
Speaker
All right, so if yoga is not a well-researched and proven way to improve osteoporosis, what is? So here's two ways that are proven in research to improve osteoporosis, heavy weightlifting and impact training. So the most famous study out there is the Liftmore study. Actually, Liftmore is an acronym, I believe that's what it's called.
00:19:26
Speaker
And I can't remember what every letter of LIFTMORE, L-I-F-T-M-O-R, stands for. It's a very clever name. It's open source. So you can just put in LIFTMORE study, osteoporosis will pop right up and you can read it. There are lots of others that back up the findings in various respects of the LIFTMORE study, but what is pretty special about the LIFTMORE study is that it's a very good study.
00:19:49
Speaker
and we're going to talk about it. So these were the parameters for inclusion in the study, meaning who gets to be in the study. They had to be post-menopausal women.
00:19:59
Speaker
By the way, a post-menopausal woman is a woman who has not had her period for more than a year. They have to have low bone mass, so they either have osteopenia or osteoporosis. They had to have been screened for other conditions that may have impacted their bone density, like medications that they're taking, for example, and or other physical limitations
00:20:21
Speaker
that could have stopped them from participating, so that you need to be able to do the protocol of the study. And then no previous strength training experience, so I like that one because we're starting fresh.
00:20:34
Speaker
All right, so this study was also conducted, this is rare, by the way, for a study because it costs a lot of money to run a study, but this one actually was conducted for a total of eight months, which is a long time, and it had to be long because bone mineral density changes. They can happen as quickly as four months, and by the way, that's slow, right, for tissue change, like muscle, you can build muscle much faster than you can build bone, four months, but you can't really see
00:20:59
Speaker
that in a scan until about six months and then they padded that and added two more months to that, gave themselves eight months. The women were, this is really really important, they were randomly assigned to one of two groups.
00:21:15
Speaker
Either they were assigned, and they randomly meaning there was no rhyme or reason, there's literally randomly, you go here, you go here. Two times a week, 30 minutes, supervised, high intensity resistance impact training. We're gonna talk about the parameters of that in a minute.
00:21:34
Speaker
or they were assigned to the control the control is really important the control was a home-based low intensity exercise program so think yoga right yoga is low intensity this is a huge part of why this is a good study because if we're just putting everyone in the two times a week 30 minute supervised high intensity resistance impact training group we're not actually going to know if it was just exercise that helped
00:21:59
Speaker
or if it was that kind of exercise that helps we got to compare it against another kind of exercise.
00:22:05
Speaker
The last thing that made this a really good study is that it had a very high compliance. So people who were in the study stuck with it. The vast majority stuck with it for the full eight months. There was not a lot of drop-off. And so what they measured were DEXA scans taken before the training period and then after eight months another DEXA scan. They also did some very standard
00:22:31
Speaker
well-researched PT tests before and after, things that are more functional based, things like the timed up and go, which is a test where you see how long it takes someone to stand up from a chair and walk a certain distance, or the functional reach test, which is how far can you reach while standing past your center of mass. And so the results.
00:22:52
Speaker
found there was improved bone density for lumbar spine, for the femoral neck, that common fracture location, and also increased cortical thickness at the femoral neck, which is the cortical aspect is the outer layer of the bone. Also, all of the scores on these functional test measures were improved.
00:23:16
Speaker
That's pretty awesome. That's really awesome. Right. And Laura found this really fun video on YouTube where they show people taking part in the study and it's all these, I mean, I don't, I don't mean this in a condescending way, but it's, I do find them adorable. These adorable women that are like, I am stronger and my friends tell me I'm standing up taller. Freaking strong. They're deadlifting 150 pounds. Yeah. Some of them. Yeah. And cute while they're doing it. Yeah.
00:23:42
Speaker
Anyway, it's really cool. So you can definitely go on YouTube and watch some of these women kick an ass. So one of the things that the study discusses is how for bone density, most prescribed exercise is only moderate intensity and it's only for individual muscle groups like a biceps curl. By the way, yoga is rarely even moderate intensity.
00:24:06
Speaker
And that doesn't create enough strain on the bone to induce bone growth. And so it doesn't, these studies don't show significant improvement for bone density. Partly because a biceps curl works a very limited amount of muscle mass where something like a squat or a deadlift works a lot of muscle mass. And a lot more connections to bones, which is what we need to stimulate that bone growth.
00:24:29
Speaker
Right, so we need higher intensity, moderate is not enough, and we want compound movements like a squat or a deadlift. So let's talk about these two requirements, the load and the impact. So how much load is enough load for bone density? Well,
00:24:44
Speaker
They say that it is over 85% of a one rep max. Now, Laurel, you and I throw around this one RM term a lot, and every time we do, inside my head, there's a little voice that goes, does everyone know what this is? And we've definitely explained it sometimes, but not every time. So just so it's super, super crystal clear, can you explain to our listeners what a one rep max is and how you measure it?
00:25:07
Speaker
Yeah, so a one rep max is usually an estimated one RM, right? Because it's theoretical. In other words, it's hard to create the conditions in which it would be practical or safe for someone to walk over to an object and try to lift it up one time and one time only because that's a heavy, really super heavy object. It's one where you would lift it up once, set it down and have to rest for three to five minutes.
00:25:32
Speaker
before being able to lift it up again. And so this is usually an estimated 1RM. And the way you figure out what that might be is that you pick up a weight that's actually significantly smaller, a good percentage smaller than 100%, but you get to that place at the end of the set where you really can't lift it one more time. You go, okay, I did 10 reps or 8 reps.
00:25:56
Speaker
of 20 pounds, what is that extrapolate to? What could that mean for my estimated 1RM? And you can look at charts online that tell you, right? It's called a 1RM chart. There you can go, okay, so now I'm going to lift
00:26:12
Speaker
95%, or I'm going to lift 85%, or maybe you know what, you're just getting started with strength training, you're not ready to go heavy, you're going to spend a couple months lifting something significantly lighter than that, I'm going to lift 50% of that, or I'm going to lift 70 or 80% of that.
00:26:27
Speaker
You don't necessarily use 1RM charts to reach 1RMs. You use 1RM charts to decide what intensity you're going to work at. And this is super, super important for women trying to build bone density because we're often encouraged to go low intensity. We're rarely even encouraged to go moderate intensity, which is what we need to be doing to even get stronger to begin with.
00:26:48
Speaker
And we're very, very rarely, in fact, we're often encouraged not to go high intensity because, oh, you get to hurt yourself, right? But as it turns out, that's the intensity level we need to be lifting weights at to build bone.
00:27:02
Speaker
This is something that I get frustrated with in the clinic all the time, because especially for my older female patients where I know like, okay, maybe we need to, to your point, work up to something that is a heavy load, a high intensity. Maybe they're not yet ready to do that. And that's absolutely fair. But what I see over and over again for my older female patients is they are
00:27:24
Speaker
sort of just left in the wasteland of the yellow TheraBand and the pink dumbbell and nobody's progressing. And not only that, I've seen patients where they've gotten weaker because there wasn't any effort for them to do that work. So starting to understand this and starting to normalize the idea of lifting heavy is one of my kind of like work goals in a way.
00:27:51
Speaker
Is to really start to normalize this for women and normalize being strong for women and and taking the fear out of it It's definitely one of our movement logic goals. Yes, absolutely Now Laurel, I have a question. Yeah
00:28:03
Speaker
Let's say you've been working out for a while and you've got some equipment that you've got at home, you've got a bunch of dumbbells, you've got some kettlebells, you've been doing some strength training, and you're saying to yourself, okay, well, maybe I should start to get into this heavier, higher level of workout and you did this where you figured out your 1RM. Turns out that for your high intensity, like an 85%, 90% of your 1RM,
00:28:29
Speaker
you would have to use a weight that you don't actually have. Like you've got your 35 and maybe your 40 pound kettlebells maybe, but they were expensive. And now what you're saying that I have to go buy two 60 pound kettlebells? I'm not even sure that I have the grip strength or the arm strength to pick up two 60 pound dumbbells and bring them all the way up to my shoulders to do a squat with.
00:28:57
Speaker
Yeah, that's a separate movement that's actually very technically challenging called a clean. Yeah, and that you would want to work on. Right. But I don't want to work on that. I just want to- Definitely not with a load you can squat. No, that's not a good idea. No, right? So what does that mean? Well, what it means is that you are going to have to start to change the equipment you're using. Yeah. And more specifically, you're going to have to start using a barbell.
00:29:20
Speaker
I think that is the very, very most logical advice you could give someone who's trying to build bone density.
The Benefits of Barbells for Bone Density
00:29:27
Speaker
And you know what? It's not a surprise that these ladies in the lift more trial were lifting barbells. Yeah. Yeah. No brainer. And also barbells are often touted as being this advanced piece of equipment that you have to be super advanced to use. They're actually much simpler to use in many respects and many exercises than kettlebells. Yeah. A lot.
00:29:43
Speaker
simpler kettlebells have this whole other set of like considerations with the wrist and the grip and where to hold it and they make them in all different sizes that are vastly vastly different and you can do different stuff with them and not do different stuff with them and the barbells are much more standard and they're simpler and they're actually much more stable because it's one piece of equipment with a central handle that's balanced versus an offset
00:30:06
Speaker
center of mass with a handle that's various shapes depending on who you buy it from. It's actually much simpler to just lift a barbell. Well, but I have a question. Okay. Because you're telling me it's much more simple and yet it's, I'm kind of confused and it's very overwhelming to try to figure out what the heck I should even be getting. Also, I don't have a lot of space. Don't I have to get one of those like huge cage things? Yeah, a lot of people think they need a lot of space and they need a lot of money to own a set of barbells. Neither are true.
00:30:33
Speaker
and we show you that that's not true in our barbell free by the way free barbell equipment guide that you can get via the link in our show notes where we basically share with you a pdf it'll arrive right in your inbox like magic you open it up and it's hyperlinked so you're going to see pictures and words i love pictures and words pictures and words are the different products that we found that would potentially meet a variety of space needs financial needs
00:30:57
Speaker
And also, depending on things like how big are your hands, right? Maybe you want this diameter bar versus this diameter bar. Or how much weight do you want to start with at baseline? Maybe starting with a 35-pound barbell doesn't feel appropriate for you. Well, we've got some options for 25-pound barbells and 15-pound barbells. So check out this guide because we want to get this information into your hands in a way that doesn't turn you off, that doesn't cause you to become overwhelmed with all the choices, not knowing who to trust.
00:31:26
Speaker
This piece of equipment, these pieces of equipment we're gonna recommend are ones also that you're gonna have to buy one time and one time only that you'll own forever. And then ultimately it will save you a ton of money while adding years of quality living potentially to your life.
00:31:39
Speaker
Amen. This is actually a big part of my desire, our desire to empower women to get into this level of lifting that actually is going to be protective and preventative for them is getting over the fear or the confusion around using a barbell and making it seem much and making it much more approachable.
00:32:05
Speaker
And honestly, it is a lot easier than kettlebells. It really is. So if you can do kettlebells, you're going to have no problem with a barbell. You're going to be like, why have I resisted this for so long? Because this is so easy. OK, so the other component in this trial is something called impact training. Here's how they incorporated it. So they had women holding on to a bar.
00:32:29
Speaker
Their elbows were already a little bit bent and they had these women jump up or they were assisted in jumping up to get themselves into what would be like the top of a pull up. And then from that position, they dropped to land as stiffly as possible. And the drop was, it looked like roughly about a foot. Yeah, it wasn't actually that big of a drop. They were also holding onto the bar when they dropped to prevent them from losing their balance, falling over. There was also someone standing right next to them, but they were landing from about a foot. I would say that's about right.
00:32:59
Speaker
And the reason why this gets harder to measure is because it's not as simple as it's you know 90% of my one RM now We're talking about G forces and how many G forces and how do we measure and so it's a little bit more difficult to? Quantify yeah, because it depends on the weight of the person actually Yeah, or actually the mass of the person it requires also It also depends on the surface that you're jumping on to there's lots of things factor into it. Yeah
00:33:23
Speaker
But we know that this impact training is useful and you can certainly start, if that seems like a too difficult thing to start with, you can start with something as easy as stomping your foot or heel drops where you go up on your toes and you just land down on your heels. There's lots of inroads to impact training. By the way, one of the best inroads to impact training is heavy strength training. Hey. Yeah. You look at athletic programs that are training athletes to perform at high levels and
00:33:51
Speaker
they don't typically start athletes with plyometrics. They start athletes with moderate, then move them to high intensity string training, and then they add in those plyometrics. So heavy string training is gonna prepare you to do plyometrics in some wonderful ways. Also, the idea of stomping around and dropping your heels on the ground as stiffly as possible, if you try that and you're like, that sucked, that didn't feel good, that's no fun, I don't wanna do that. You can also just start doing some plyometrics, some low intensity plyometrics.
00:34:20
Speaker
low begets medium, begets high. You progress plyometrics, you progress impact training just like you progress anything. You overload systematically over time and we have a whole episode on plyometrics for you to go back and listen to if you want to hear the specifics on what's an appropriate volume for beginners and what are some low intensity plyometrics to even begin with. That's right.
00:34:47
Speaker
So I think that I, and I don't, this is just my own ignorance. I don't know if anyone's done this, but I do think it would be an interesting followup to this study to do something where the cohort of people in a study were actually split and some of them were doing the weightlifting strength training and some of them were just doing the impact training and what amount of their bone density
00:35:07
Speaker
Improvement came from which category I hope someone who conducts researcher has a lot of money is listening to fund that study, please Thank you. It'll be cool. It will be cool Okay, so we've already established that while yoga is a wonderful thing and I'm never out here trying to slam it as a as a medium of movement and
00:35:28
Speaker
It's not a bone density building activity. Now, if you go on the internet and you look up what are some good exercises to build bone density, you'll see a whole bunch of things. And what I'd like to do here, Laurel, is talk about some of them and why they may or may not actually be that useful. Let's do it. Okay, so walking. Not even close. That's like barely more than standing.
00:35:53
Speaker
It's very low intensity. Yeah. And it's actually too many repetitions. Like after 100 cycles of a movement, your bones actually get bored. It's called cellular accommodation, which corresponds to with this idea of intensity. Like if you can do something 100 times in a row, it's actually pretty low intensity. It's not hard enough. Yeah, no. What about climbing stairs? Same. Not hard enough. Also, it's just your body weight. Right. It's your body weight. You're not at no impact. I mean, it's not strength training. No. What about I saw dancing?
00:36:23
Speaker
It depends on the dance style. I mean, we were just watching a video of tap dancing. Your nephews were tap dancing. And I was like, you know what? I bet tap dancing could be something that might be bone building because of all the stomping happening. But also ballet. I mean, there's quite a bit of jumping, leaping, landing in ballet. The idea is to land really gracefully, though. So I don't know. More studies are needed. Some dance is also incredibly repetitive and rather low intensity, so I wonder.
00:36:49
Speaker
Yeah, I mean, are you dancing the way that my dad dances, which is to occasionally pick up one foot and then the other and then stick his elbows out to the side and do the white man overbite? It's really, it's quite a sight, but I don't think anything that he's doing. Remember Elaine's dance on Seinfeld? That's basically how my dad dances. It's deeply entertaining, but I do not think it is a bone density building exercise.
00:37:14
Speaker
I'm gonna do a live version of it for Laurel after we're done recording.
00:37:19
Speaker
Okay, so what about running or sports that include running like soccer or basketball? Again, I'm gonna ask you to consider intensity of running. So something like sprinting is, it has been shown to be, first of all, sprinting is plyometric, deeply plyometric, and also, or extremely plyometric, but also sprinting is something that you could probably only sustain, right? That's a max velocity sprint. For about 20 seconds,
00:37:47
Speaker
And yes, sprinting is bone building. Jogging, stuff that's slower than sprinting, a lot slower than sprinting, like jogging, probably not. And also, how many cycles are you taking, how many steps are you taking in a row? It's probably gonna be one of those like bones getting bored cellular accommodation things meets too low intensity. Also, you're not probably gonna start someone who rarely runs it all with sprinting.
00:38:17
Speaker
not not no and also not as a way to build bone yeah yeah okay how about jumping rope it depends so if the challenges of the technique of jumping rope prevent you from jumping over the rope like me are you thinking about me that's something to think about um you could mime it but again
00:38:40
Speaker
When you jump rope, you actually have to jump quickly, which means you're not going to leave the ground for very long and you're not going to jump very high because you're jumping over the rope every time you flick it with your wrist.
00:38:52
Speaker
In CrossFit, I am trying to not hate double unders, but every time that rope hits me in the shin, because again, the technique of double unders is actually something I curse. And double unders though requires that you're going to jump up really quite high, flick the rope under your feet twice per jump.
00:39:16
Speaker
So that's gonna be, again, the height of the drill is higher. You're gonna land from a higher height. You're gonna meet more impact on landing.
00:39:25
Speaker
The intensity is much higher. I definitely can't do 100 double unders in a row. Some folks can though, right? So that's another thing about bones is that you actually have to continue to progressively overload bones. It's gonna come a point where what was heavy is no longer heavy. What was intense is no longer intense. If you wanna keep making changes, you gotta keep pushing the envelope. But double unders I would say, yeah, and potentially jumping rope depending on how you're jumping rope. It certainly involves impact. So that's a good thing.
00:39:54
Speaker
Okay, what about riding a bicycle? Not at all. In fact, there's been studies done comparing road runners, not road sprinters, really just road runners. People have been doing a lot of running throughout their life, and cyclists, and they found actually that lower limb bone density was much, well, I will just say significantly higher in the runners.
00:40:13
Speaker
than it was in the cycle. So here, what we're seeing here is like lifestyle choices could include the habit of doing something often and the habit of running on a road often is gonna land you probably with better bone density than the habit of cycling. There's no impact in cycling at all.
00:40:29
Speaker
I mean, this is just anecdotal, this is not evidence, but a client of mine told me about a friend of his who was his age, so 60s, avid cyclist, and actually fractured his wrist going to open a car door because he slightly missed.
00:40:45
Speaker
Right? So nothing about that cycling was preparing his wrist for the impact of the car door. We could say the same about running if that's all you're doing. Yeah. Laura, what about resistance bands? It says resistance right in the title. What about the black one or the silver one? That one's really hard. Well, we can't just make a blanket statement about a piece of equipment and go, nope, that piece of equipment
00:41:07
Speaker
because that's very different than saying this mode of exercise doesn't build bone density because it's a resistance band. I would say it depends on how you're using the band. For example, if I use a red, which is a lighter band, to do a banded pull-up,
00:41:23
Speaker
I can maybe still only do five pull-ups with that band. That's heavy strength training and that's potentially gonna be really helpful for my wrists. But if I'm using that red band to do, I don't know, some kind of row action or clams, exactly clams. We always like to equate bands with clams or monster walks. Yeah, that's probably not gonna cut it. And so it depends.
00:41:50
Speaker
And here's the thing, force if somebody's extremely deconditioned, the resistance bands may be an entry point to starting to build enough strength to make their way up to using weight, but it's very quickly going to become redundant. And I would say that that's a very good point, which is that nobody, well, I won't say nobody, but very few people should or do start strength training by lifting heavy weights. They start by lifting moderate.
00:42:18
Speaker
weights and sometimes even light weights just to get used to the feeling of lifting a weight and to learn the technique of the exercise. In fact, in the lift more trial, they spent a whole month just lifting the bar, right? Or something very light like a PVC pipe just to learn technique and they got a lot of instruction around technique. So good point, right? Bands, lighter weights can be a wonderful, not only entry point to getting used to lifting weight, but a great way to learn the technique of the exercises that you're going to be performing under
00:42:47
Speaker
more significant load. And then so finally, I also saw body weight exercises, which doesn't mean anything.
00:42:55
Speaker
Yeah, same thing with resistance bands. So for example, a bodyweight pull-up is still heavy for me. And it used to be that bodyweight push-ups were, but now I can do many more than 10 in a row actually. So bodyweight push-ups are no longer going to be bone building for me, but they could very well be right in that sweet spot for somebody else. And they might actually be
00:43:17
Speaker
way too much load for this other person over here. So it really depends on the exercise. Definitely lower body. It's going to be really hard to make body weight last long for lower body. Strength training and you know when we're looking at bone building, we want to look at these compound lifts where it's lower body but it's also spine. So deadlift is lower body and spine.
00:43:43
Speaker
Squat is lower body and spine. So yeah, body weight's not going to cut it for that kind of stuff. All right. Well, I hope you enjoyed this episode and that it's helped you to understand what parameters you need to be working at in order to make an impact on your bone density. And I would say as well, it's never too soon to start. People think about bone density as an older person's problem, but how about we just work on it so that it never becomes a problem? Exactly.
00:44:10
Speaker
Check out our references, all those studies that we mentioned, but also how to get your hands on our barbell equipment guide that's in our show notes. You can also visit the Movement Logic website, which is another place you can get our equipment guide, or also just like take a look around, see what you see, write us a little message, or I don't know.
00:44:30
Speaker
Spend your life the way you want, but maybe you want to go on our website and just check out how cool we are. Thank you so much for joining us on the Movement Logic Podcast. Finally, it helps us out if you liked this episode to subscribe because we put a lot of work into this. Really, we do.
00:44:48
Speaker
We do it. It's an act of love, right? It's a labor of love. This is something that we're both very interested in. This is something we feel passionately about, that we're excited to share with you, that we want to help encourage people to get into the level of activity that's really going to be meaningful for their body to make changes happen, to get back to the things they want to do. These are all things that I care a lot about, Laurel cares a lot about. And so I was about to say, I would do this for free. I am doing this for free.
00:45:14
Speaker
But we want to get it out there. We want as many people as possible to hear about it. And one of the ways that you can help us make that happen is you subscribe, you can rate, and you can even review on Apple Podcasts or wherever you listen to podcasts.