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Episode 88: Inbeteweenie - Evidence-Based Pilates Podcast
622 Plays3 days ago
In this very special Inbetweenie, we're interviewed by Dr. Adam McAtee, PT, on his Evidence-Based Pilates podcast to talk all things bone density.
You will learn:
· The 3 aspects that make up bone strength: BMD, bone size, and bone architecture
· Catabolism and anabolism across your lifespan
· Why Pilates and yoga aren’t going to cut it long term for bone building
· How weight bearing and weight lifting are not the same thing
· What types of exercise will impact bone density
· How and why intensity is relative
· Why a jumpboard on a reformer does not count as impact training
And more!
Links:
Get our free Bone Density Mini Course by signing up for our mailing list
2-Week Free Trial of the Anatomy & Biomechanics Club: https://www.evidence-basedpilates.com/anatomy-and-biomechanics-club-2-week-free-trial
Adam's Instagram handle: https://www.instagram.com/adammcateepilates/
Recommended
Transcript
Introduction to Movement Logic Podcast
00:00:02
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yoga, movement, and physical therapy worlds, we believe in strong opinions loosely held, which means we're not hyping outdated movement concepts.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.
Tools and Concepts for Modern Movers
00:00:40
Speaker
Welcome to the Movement Logic podcast. I'm Dr. Sarah Court, and I'm here to introduce for you today a very special in-betweenie episode. A little while back, Laurel and I went on the Evidence-Based Pilates podcast, which is hosted by Dr. Adam Mackey.
00:00:57
Speaker
who's a brilliant Pilates instructor and newly minted physical therapist. He's going to be a fantastic addition to the community. And we had a fantastic talk with him about all things bone mineral density, beliefs around what Pilates and yoga can do for your bones, and then the truth about that, which a lot of people don't seem to like to hear, other kind of bone
Special Episode with Dr. Adam Mackey on Bone Density
00:01:20
Speaker
building myths, as well as practical ways that you can start to incorporate bone-building work into your own exercise. And if you find yourself really enjoying him and wanting to study more with him, we've got a link in our show notes for a free two-week trial of his VIP membership so that you can build your skills, knowledge, and confidence as a Pilates instructor. But before we get to that, let's have a listen to the episode. Please do enjoy.
00:01:47
Speaker
are
00:01:52
Speaker
In episode 99 of the evidence-based Pilates podcast, I sit down with Laurel Beaverstorff and Dr. Sarah Court, the founders of Movement Logic, to go ahead and discuss all things bone mineral density. So if you are interested in how you can build bone mineral density in yourself, your loved ones, and your clients, this episode is for you.
00:02:17
Speaker
And if you enjoy the thought process and the education in this podcast, go ahead and use the link in the show notes to get your two week free trial of the VIP membership so you can build your skills, knowledge and confidence as a Pilates instructor. But without further ado, let's get on to this new episode.
00:02:47
Speaker
All right, welcome back to the evidence based Pilates podcast. And I have some special guests today. I have Laurel be restored. I hope I pronounced your name correctly. Please let me know. You did Dr. Sarah core I did. Yeah, it's gold star. and When you are winning you're winning Sarah, you're winning and thank you listeners, you're already winning. Let's win together.
00:03:09
Speaker
um So for those of you that are not aware of your work at Movement Logic as well as other adventures that you go into, um I'd love for you all to listen to um
Evidence-based Methods for Bone Density: Lifting and Impact Training
00:03:20
Speaker
introduce yourself to the listeners. Laurel, would you like to go first? Absolutely. My name is Laurel Beaversdorf, just as Adam pronounced it. And I am a strength coach, CSCS and yoga teacher. I also am deeply into running and love a pickup game of pickleball whenever I can find one.
00:03:38
Speaker
Nice. I love Sarah. Yeah, I'm Sarah. cor I'm a doctor of physical therapy, a former yoga teacher. And together Laurel and I have I always struggle at this part because I'm like, is it a company? Are we a business? It's a partnership. It's definitely a partnership called movement logic. And ah We started it as a way to offer continuing education online tutorials for yoga teachers, Pilates instructors, movement movement teachers of all kinds, some PTs even.
00:04:09
Speaker
But we've taken a ah kind of directional shift in the past year or two where we're really focusing on teaching women how to lift heavy with barbells and to engage in impact training as two of the evidence-based ways to improve your bone density and perhaps even reverse a osteoporosis or osteopenia diagnosis. So that's really been our big focus, our big sort of thrust for the past ah year and a half.
00:04:33
Speaker
which is it that's incredible work. So shout out to both of you, which is exactly why we are talking today because we are here to talk about um improving ah bone density. And we also want to define it for the listeners. So we're all on ah the same page, but most importantly,
Debunking Myths and Misconceptions about Bone-Building
00:04:50
Speaker
I want to know how is your bulky girl summer going?
00:04:54
Speaker
ah It's getting bulkier and bulkier by the minute. that this this bal girl This bulky girl summer t-shirt that I ordered, Sarah, is too small for my bulk. I'm so fantastic bulking out of it. yeah fantasticing That's the goal. We want some Hulk moments where it like just you just you flex and it rips off your body.
00:05:17
Speaker
That's what I'm going for. Yeah, can people get Polky Girl Summer t-shirts on your website? They sure can. They just go to movementlogictutorials.com and they hit the button that says shop, and we've got t-shirts. We got tank tops. We got muscle tanks. We got some in color. We got some in something called Slub that we don't understand what that means, but we're just running with it. I got one, Slub. It's like a heathered texture. I really like it. Nice. Cool. Yeah. Yeah. We've been meaning to create merch forever and just never really happened.
00:05:47
Speaker
I went on just kind of a bit of a tirade about having a hashtag bulky girl summer. And then the the momentum that I had from that like sent me to, I was like, um, two sorts. And then that just kind of like happened. I like how you turned into the incredible Hulk and that was good. yeah Sarah, Sarah, Sarah was, there was no stopping her. She was like, I'm making t-shirts. This is happening. I was like, you fricking go. And I'm very happy with my t-shirts. Very happy.
00:06:14
Speaker
I want a coffee mug, but I want a coffee mug with any of that with everything, which I've been told not to have any more at home. i Oh, yeah. Well, we can send you either a bulky girl summer or a women. We also the other t shirt logo that we have says women belong strong, so we can send you one of those if you would like. All right. And for any listener who didn't write down the ah URL on like a bar napkin, um you can go ahead and get the link is in the show notes. You can get your bulky girl summer t shirt.
00:06:41
Speaker
um i'm ah Yeah, I'm just here it says to do that. Anyways, we're also going to talk about other things than t shirts. So we're going to talk about ah bone mineral density and and improving it, right. And one thing that I found that I found to be helpful is to ensure that every like you like like us three as well as the listener are on the same topic, right. And so when when when I say bone mineral density, what does that mean ah to you to Yeah, okay. So let's we're going to define our terms, right? So bone mineral density is a one of the aspects of what you can think of as an umbrella term, bone strength, right? So the strength of your bone depends on three things. One of them is bone mineral density, one of them is bone size, and one of them is bone architecture. So your bone mineral density
00:07:32
Speaker
is basically how packed with minerals are your bones, right? So the more, the better. Bone size is just about how big your bones are and some of that is going to be genetic, some of that's going to depend on like what you have done in your whole life leading up to this point. And then bone architecture is the sort of design and the layout of the matrix of the scaffolding inside your bones. And it's different in the long part of the bone, separate from the end part of the bones, right different kinds of layout. So all three of these play a role in your bone strength. But bone mineral density is the one that we can really do something about most most effectively. right So ah a lot of people might be familiar with this, but your bone mineral density,
Understanding Bone Mineral Density and Health
00:08:20
Speaker
it's measured by something called a DEXA scan. This is where I always get tripped up.
00:08:25
Speaker
DEXA stands for Dual Energy X-Ray Absorbitometry. Okay, that's maybe the first time I've gotten that out without flubbing the absorptometry part. ah But anyway, so what they measure is something called a T-score, and that T-score is what allows doctors to diagnose you with osteoporosis or osteopenia based on how much minerals, in particular calcium and phosphorus, are in your bones. And so a DEXA scan looks at your spine, the bones of your hips, your pelvis,
00:09:00
Speaker
the neck of the femur of your leg bone and your wrists, because these are the most common areas that we experience bone mineral density loss. And so if we talk about these minerals, the calcium and the phosphorus that are present in your bones, over your entire lifetime, bones are constantly breaking down and rebuilding themselves. It's just this natural process that's going on. So the process of building new bone material is called anabolism.
00:09:30
Speaker
And, or anabolism? Anabolism. Yeah. I was suddenly like, cannibalism? And then the the opposite, the breaking down is called catabolism. And that's, so that, that, that anabolism, catabolism is just constantly going on in the background as part of your life.
00:09:48
Speaker
Yeah, you could think of them almost like dials. And the one dial or the other dial, right, anabolism and catabolism are being turned up or down at various amounts depending on where you are in the lifespan. So from birth to about age 25.
00:10:06
Speaker
Your bone rebuilding outpaces your bone breakdown. And it's worth mentioning here that it's in these earlier years leading up to early adulthood that we have the opportunity to build bone size, right? So there's bone density, bone size, and bone architecture. It's really when we're young, we can build bone size, which contributes significantly to bone strength. so I say this because it's just the case that children especially should be engaging in lots of physical activity.
00:10:36
Speaker
so that they can basically make hay while the sun shines. They can build bone size while the building of bone size is you know most likely to happen. In fact, this is really only the only period in our lifespan where we have that opportunity to build bone size. But after early adulthood, we can continue to improve bone density and bone architecture to enhance our bone strength.
00:11:01
Speaker
So we increase bone density pretty easily up to age 25 and then from 25 to 50 it sort of stagnates and there is pretty much no change unless we're doing something about it. Basically, you know we're going to keep saying this, building any tissue, whether it's bone, muscle, tendon, it's really about anabolism outpacing catabolism, right? Turning an metabolism dial up, right? So that it outpaces catabolism. It just so happens that as we get older, it gets harder to outpace tissue breakdown slash catabolism.
00:11:39
Speaker
as we age. And we could also call this tissue breakdown atrophy, right? Atrophy is an increase in that catabolic activity, that tissue breakdown activity where tissues are broken down more rapidly than they are built up. So we are just, as we age, more vulnerable to tissue atrophy.
00:11:59
Speaker
One reason is that the aging process involves a slowing down of anabolic activity, largely due to decreases in anabolic hormone. So for women, which is our target demographic, this is estrogen, right? Estrogen production decreases severely around perimenopause and menopause. Now, another reason we age is due to a speeding up of catabolic activity, that breaks our tissues down. And again, in part due to, there are many things that contribute to catabolism, but in part due to that decrease
Critiquing Misinformation in Movement Communities
00:12:31
Speaker
in anabolic ah hormone production, estrogen, right? so So if we go back to this timeline again, between now 25 to 50, we've sort of reached this equilibrium, um age 25 to 50, we're kind of in this like holding zone, where bone formation and breakdown are kind of
00:12:47
Speaker
you know happening at equal paces, right? and unless we are engaged Unless we are engaged in exercise that allows our tissue buildup to actively outpace tissue breakdown. So here we could just talk about what it means to be an osteogenic exercise or a form of exercise that is osteogenic, which means the genesis of osteo or bone building. Not all exercise is osteogenic. um All exercise is good for something, right? But it doesn't all do the same stuff. And so if we want to make a meaningful positive impact to bone,
00:13:23
Speaker
formation, we need to engage in osteogenic activity. Specifically, we're going to talk about what that looks like. So if we go back to the timeline now and we go from 50 years and up, so 50 years and older, this is where bone breakdown starts to rapidly outpace. Bone building, if we do nothing about it, if we do something about it, if we engage in osteogenic activity,
00:13:49
Speaker
we can actually slow down the process of bone breakdown by increasing bone building. And I think a great analogy for this would be a sink, okay? A sink, like in your kitchen or your bathroom. Visualize a s sink. Visualize water pouring into the sink. This represents bone formation. The fuller your sink is with water, the higher your bone mineral density, for example. Now, the degree to which your drain The drain represents bone breakdown. The degree to which your drain is open represents that pace of bone breakdown. So it gets harder to have a full sink, high bone mineral density, the more open that drain is. So if we go back to before age 25, we're young, right? The tap is fully open, right? The drain is almost totally closed.
00:14:42
Speaker
It's easy to have high bone mil mineral density. We don't actually have to do that much about it. And our bones will get stronger. Of course, if we engage in osteogenic activity, even at a young age, our bone strength will be even better. But bone atrophy is really not a big risk. Then between 25 and 50, the sink is filling at about the same rate as it's draining. Water's going in at about the same rate that it's going out, unless we engage in osteogenic activity. This would just open the tap more.
00:15:09
Speaker
right And then at 50, the drain is more open. Tissue breakdown has sped up even more. The tap is more closed. Tissue buildup has slowed down. We are simply not able to maintain bone mineral density as easily and unless we engage in osteogenic activity. right We need to open that tap.
00:15:35
Speaker
Yeah. And, and I think one of the things that we, we find ourselves, Laura and I find ourselves battling against a lot of in the yoga and Pilates communities is really identifying what activity you're doing. And is it truly osteogenic? Is it really a bone building activity? Because we need that tap wide open, right? We need maximum bone building going on because our drain is wide open, right? So,
00:16:04
Speaker
The thing that we that we ah do a lot of arguing online about is correctly selecting exercises that are bone building. and there is so much It's like a daily frustration for us. There's so much misinformation out there around people selling low-intensity, low-impact exercise,
00:16:23
Speaker
as osteogenic exercise, which it just fucking isn't. It isn't. And there's so many people out there being like, no, but it's good. You know, just walk and it's going to help your bones. Maybe if you've been sitting down for 50 years, but pretty quickly it won't. Right. This is a rampant, rampant problem in the yoga and Pilates communities, massive offenders in both communities. We've got a lot to say about these offenders.
00:16:53
Speaker
yeah Yeah. So that's what bone mineral density is. but You're in in good company with that. And a few things that that highlight for me, if anyone, ah by the way, you know how like like um in any kind of education, you have to learn like weird tricks to understand, to remember words. So if anyone got googly-eyed with anabolism and catabolism,
00:17:15
Speaker
my advice is just to learn one of them and know the other one's the opposite. And I think of um a like anabolism is an A, which is an arrow that goes up. So you're building up. That's how I remember it. If that doesn't work, figure something else out. um But anyway, I hope that's helpful. And in just ah I got can i I got one. I got for cats are murderous creatures. They love to kill. I'm Yes, yes. I was even gonna go with like my initial like how do you even say this word? Catabolism and cannibalism start with the same letters so you can think of it like your bones are getting cannibalized.
00:17:54
Speaker
Yeah, if you if you're like a Halloween person, go with Alan. So I also like just as like, I'm a father, 14 year old girl. And so for for me, like, I like immediately my dad brain turns on to be like, I need to teach her how to lift heavy stuff, which I'm teaching her how to do deadlifts.
00:18:13
Speaker
And so for any parents out there, um this is huge, right? Make lifting heavy shit normal in childhood and sports and all of the things. But just if you normalize it in childhood, it becomes just normal throughout your life, or it's more likely to. And this is the time like to really help out your kids. You know, to have them do their homework and stuff too, but like do a deadlift after. And things of that nature.
00:18:37
Speaker
So now what is like,
Risks and Requirements for Bone Health
00:18:40
Speaker
what's the problem with reduced bone mineral density? Like wouldn't we lose weight? We would be smaller. would like I'm just here for figuring questions.
00:18:52
Speaker
I just want to see the cannibal come out. But seriously, that that could be that could be the way it's sold to women in some horrific like article of misinformation online these days because you won't believe what we've seen, actually. It's it's pretty horrendous.
00:19:07
Speaker
It's pretty outrageous. And frankly, we're so pressured. There's so much pressure for women to lose weight. So if we find another new way for you to lose weight, even better, I mean, I would go one step further, I would say, just go on continuous bed rest, you'll lose all of the weight, eventually, literally all of it.
00:19:24
Speaker
you'll decide But so the problem with having reduced bone mineral density has to do with the increased risk for bone fracture. So this is where we get a little bit into the statistics of that T-score that you get from the DEXA scan. So if your T-score is minus one, your risk for a bone fracture is doubled against what would they would call, like quote unquote, the norm, right? So compared to somebody who has normal bone density,
00:19:55
Speaker
your risk is doubled with every um standard deviation below that norm. So if it's minus if it's one down from normal, you have a doubled risk. If it's two down from normal, it's doubled again. right And the reason why, yeah if you might then continue to say, well, so so what? What does it matter if I'm more at a risk for for fracturing a bone? Well, as we get older, which is as this continuum of cannibalism, catabolism is going on,
00:20:24
Speaker
Falling becomes a really scary idea. First of all, people also, they tend to be losing their natural ability to balance if they're not working on it. So the potential for falling seems higher. And then if you fall and you break a bone, a very common outcome is someone is, you know, they're walking or they're going to the bathroom in the middle of the night, they trip on something, they lose their balance, they're a little lightheaded and they break a hip. That's very common. They go to the hospital.
00:20:53
Speaker
The statistic is that 20% of people who go to the hospital with a broken bone don't leave the hospital. right In other words, they die there. And these are the 20% of people who are deconditioned. They very likely have multiple other comorbidities. Their body can't tolerate ah the, the sort of wasting effects of being bedridden being in your bed without moving for like three days. It's wild how fast all it like the muscle atrophy that they just everything just starts to go downhill. So
00:21:27
Speaker
But if you if you're let's just say you're a healthy 65-year-old, and now you're seeing, well, my balance isn't what it used to be. And maybe you've had like some falls or some near falls. This idea of falling and breaking something is a really scary idea because you've got in your head this this information that like people go into the hospital and ah a bunch of them don't come back out again.
00:21:49
Speaker
But then the horrible irony of this situation is that everything that you need to do to improve your balance and improve your strength are the very things that have now become scary and possibly off limits to you, right? You're you're sort of self-reducing your world. You're making your world smaller, right? Physical challenges in your world, you start to decrease them because you're scared that this physical challenge might lead to a fall, right? So it becomes this kind of self-fulfilling prophecy in this horrible way for a lot of older people.
00:22:21
Speaker
Do you have anything to add to that, Laurel? Yeah, I think that the information widely available out there, like the Googleable stuff is still recommending things like, quote, weight bearing, right? So the problem with that is that everything on planet Earth is weight bearing because of gravity. So standing is weight bearing, sitting is weight bearing, so is walking.
00:22:46
Speaker
When we talk about osteogenic activity though, when we when we understand it, it's actually stuff that involves much more than body weight. after a certain points. If you're coming from a very deep-conditioned state, like Sarah said, right and you start walking, that might be osteogenic, taking you from that very severe level of atrophy to a better baseline. right But after a certain point, that ceiling is very low, that will quickly not be osteogenic anymore. We'll talk about a little bit about like how bones work in terms of when they get bored, basically, they need variety and they need progressive overload, right? They need that load to constantly be keeping pace with their strengths so that they're challenged and they need variety. But if you Google it, unfortunately, the recommendations widely available now on the Google are just walk basically and do weight bearing activity. And the people who love to do yoga are suddenly like a great yoga's weight bearing. I'm bearing my own weight.
00:23:47
Speaker
It's like you're always bearing your own weight, unless you're in outer space. So we need to be more specific about what amount of weight, what magnitude of load is required. And if we're talking about impact,
00:24:03
Speaker
what amount of impact is required to be osteogenic. and it it It is going to be more specific than just, quote, weight bearing. Otherwise, no one would have ah brittle bones. No one would have osteoporosis if all that was required was weight bearing. It's very unclear.
00:24:21
Speaker
Yeah, absolutely. And um with that, like, took off to one of Sarah's points about individuals who fall having a greater risk of mortality. um You know, I was just sharing with you all how I was working in a skilled nursing facility. And I just have this firsthand in three months. and i And there were there are countless people that I worked with.
00:24:41
Speaker
that they didn't have, like, they would fall, they would break a hip, classic, right? But they didn't have the the, like, let's say, it depended on the surgeon and how their their bone density was, if they were if they were what's called weight-bearing, where they were allowed to put weight on their hip, um it could have been a procedure where they had needed to be non-weight-bearing. So they they might not be able to put weight on their leg for six to eight weeks, right? Or maybe 12 weeks, depending on the surgeon, right?
00:25:08
Speaker
And so, and that might have not have been a hip replacement, it might have been like a ORIF, whatever that is. um And so, the point is, is that they- Sorry, I'm just going to stick in and be a nerd. Open reduction internal fixation. Yeah. and so big I was like, I just don't want to do the tongue coaster right now. So, within that, these are different procedures that a surgeon would do for a broken hip or a broken femur.
00:25:33
Speaker
And so they would need to rely on their upper body strength or one leg to get around. And so many people didn't have the strength to do so. So you know what happened? It wasn't just three days that they're in bed. They're in bed for weeks, months.
00:25:50
Speaker
yeah and we're trying to get them out there's a team of therapists like trying to lift you i was getting my workout and so point is is that we want you need to have muscle in reserve. You need bone density in reserve because you don't know when you're gonna need it right or if it's if you're like no i'm thirty two i don't care right now what is i think you should but like your your your um Older people in your life need it, right? You can make a difference. Your clients need it in in reserve. So that's just my my passion um on on this one. But we keep talking about um osteogenic, right? Such a cool word, right? and Osteo for anyone listening means bone and then genic means like to create, right? Or the genesis of it. So we're creating more bone. And so that is that anabolism, right? Not to be confused with ah cannibalism.
Effective Osteogenic Exercises
00:26:40
Speaker
Sorry, I'm a dog person. So with that, what are considered osteogenic or bone building exercises? Cool, yeah. So bone building exercises are exercises that involve either high impact or high magnitude of load.
00:27:06
Speaker
so Let's discuss. Basically, high impact exercise is osteogenic and then conversely, low impact exercise is not. And high intensity resistance training, in other words, heavy resistance training is osteogenic and low intensity resistance training is not according to research.
00:27:30
Speaker
So to understand what we mean by high and low, we have to talk about force characteristics or the characteristics of load. And there are many, but we're going to discuss two main ones, right? So first of all, we have this characteristic of magnitude, which is basically just how much, right? High intensity resistance training usually involves lifting heavier weights, therefore it is higher magnitude.
00:27:54
Speaker
in terms of loading than lighter resistance training and therefore that is why it is osteogenic. um The reason that it is osteogenic is that heavier resistance requires a higher level of recruitment.
00:28:10
Speaker
in terms of the amount of muscle mass being recruited by the brain, you're going to have full recruitment. So all of the fibers of your muscle will engage and generate force against the bone via the tendon, whereas lower resistance training is possible that you're not going to get that full recruitment. In fact, generally speaking, that is what defines high intensity basically as full recruitment.
00:28:34
Speaker
um, in terms of muscle physiology. So we need heavy resistance to get that full recruitment to generate that higher internal load to the bone because the muscles are pulling via the tendon on the bone. And that's what causes that bone. And it's like cascade of signals happening from the brain to lay down more bone. Okay. So, so just to step back in. So you mean, um, so like doing clam shells?
00:29:01
Speaker
Well, if you're severely deconditioned, okay, if you're that person who's in the bed for weeks and weeks and weeks, yeah, maybe, right. But if you're not that person, no, right. What I'm talking about, like in the class, they just make it burn.
00:29:14
Speaker
yeah Yeah, no, no, no, no. and that's that's That's another really um important thing to bring up. Of course, Adam, you're a wonderful educator, so you know the questions to ask, right? Which is that feeling the burn is, yes, eight it's is it's a an experience of fatigue, and it is an experience of muscle fatigue. It's one of the ways we can experience muscle fatigue. But we can actually fatigue a muscle with light resistance if we do enough reps.
00:29:38
Speaker
We can also fatigue and muscle with heavy resistance and we don't have to do as many reps. And the irony is that we actually experience less muscle fatigue from heavy resistance training. And this is where it can get really confusing for people, especially if they're used to feeling the burn or people who are into high intensity interval training who are really into getting really sweaty and out of breath.
00:29:57
Speaker
right? Which is that those ways of experiencing fatigue are not necessarily indicative of the degree to which your bone experienced a high magnitude of force. okay they They definitely indicate that you probably reached a threshold to make some change to your body with high intensity interval training is probably going to be changes to muscle endurance and maybe cardio respiratory endurance to a point.
00:30:22
Speaker
And with something like bodybuilding, where we're probably going to work with ah moderate to lightweight and do a lot of reps close to failure, you're definitely making changes to muscle size, muscle strength for sure. But it is just the case that when we look at randomized control trials and compare light resistance training to heavy resistance training, we see that heavy resistance training wins out in terms of making changes to bone mineral density.
00:30:50
Speaker
So that is high and low intensity resistance training, but we also have another really important form of exercise called impact training, which also deals in high and low, but it's high impact and low impact. Impact is kind of what it sounds like. It's the collision or contact between two objects.
00:31:09
Speaker
So impact training could involve jump training where your feet collide with the floor and then the floor collides back up against your feet. And that's the force placed on your body. And then we also have sports like boxing, which has been studied and been shown to be wonderful for improving bone density, actually. And that's where your fists collide with a bag or a face or a body. Like not really like a now you doing a downward dog, your feet are on the floor.
00:31:37
Speaker
Yeah. So they're not colliding with the floor. um here's Here's where we we could talk again about force characteristics to maybe understand why downward facing dog is is a no impact, actually a no impact activity. So impact combined combines force characteristics. Okay. So first and foremost, we have velocity.
00:31:56
Speaker
The speed at which the object collides affects the force on impact, right? Higher velocities, higher force, lower velocities, lower force. So if you take, for example, like jumping off of a two-foot box and landing on the floor, you're going to hit the floor at higher velocity than you had you jump off of a six-inch box, right?
00:32:18
Speaker
um Magnitude is also a characteristic that we can use to understand impact because you can not only increase the velocity to increase the force, but you can also increase the mass of the object colliding. okay So a great example of this would be, again, jump training. If you're jumping on two feet, both of your lower extremities are taking the impact of your entire body. If you jump on one foot, one of your lower extremities is taking the you know the impact of your entire body. And so we're going to have more a higher force. right We're going to have a higher intensity ah jump on one foot than two. We also have duration. okay So the time over which the force is applied it influences whether it's high or low. Impact forces are typically characterized by a short duration.
00:33:11
Speaker
for higher forces and a long duration for lower forces. And so in our bone density course, Lift for Longevity, we encourage our students to land stiffly. and to leave the ground quickly so that there's a short ah amount of time or a short duration in which there're they're on the ground. right So not landing softly, actually landing stiffly, which is kind of the opposite of how we're taught to land. right You're taught to land softly and bend your knees. We're actually ah encouraging them at
00:33:41
Speaker
their particular level and tolerance to land stiffly. And that might even just be stiff heel drops where their feet aren't actually leaving the floor, just their heels are leaving the floor and landing, right? Or it might be stomping, right? Or it might be jumping off of an eight inch box and landing stiffly versus maybe some other students who are jumping off of a 18 inch box and landing stiffly. It really is going to be person dependent because again, high intensity, high is relative. If someone has been in a bed for four days and they get up to do some exercise for the first time and they've been deconditioned before that, like high intensity is going to look really different than the person who's been working out and doing impact training and heavy resistance training. and whatever else they've been doing four or five days a week. right that That person's high is going to be different than the other person's high. right So we're meeting everyone where they are with this, obviously. okay And then direction of force is also important for impact. um Here's where I can say bones love a multidirectional input of forces. So variety is really the spice of life. With bones, they get bored if you do the same thing day in and day out. ah They love, for example, with impact training, multidirectional reactive landings.
00:34:56
Speaker
So if we were going to progress somebody with an exercise like pogos, pogos are basically jumping, but landing with full foot contact, kind of a stiff landing and a fast and a fast um reactive jump, right? So you're gonna hit the floor and immediately leave the floor.
00:35:13
Speaker
It's really very different than so skipping. So if you skip around, it's very prancy and light and you can do it very quietly. Pogos are very loud and slappy and we actually encourage students like make a loud slapping sound with your feet. If we were going to change the direction of the pogos, we would start them off maybe with both feet leaving and landing stationary and then progress to both feet leaving and landing, but like maybe jumping around a kettlebell. And now we've got a multi-directional way in which forces are being sent through the body. Bones love that stimulation. If we're going to progress them further, we're going to make it higher intensity. We'll ask them to do a pogo on one foot. And then if we're going to make that multi-directional, we'll have them jump on one foot, pogo on one foot around a kettlebell. right so the the the The high and the low, I think where we get lost with high and low is that
00:36:05
Speaker
because there's a lack of exercise science education just in general in the general population and there's a dearth of it. In fact, I would say it was totally absent in my yoga teacher training. When people think high intensity interval training, they think of like sean t Like, what are those like boot camp type exercises where people are just... Yeah, Barry's Boot Camp. are like They think of like this this type of high intensity interval training format in these like boutique fitness gyms where people go in and work themselves into a lather.
00:36:42
Speaker
and leave completely wiped out, entrenched in sweat. And there is absolutely nothing wrong with that form of exercise. I'm not here to trash it. In fact, I really love that form of exercise. But that is not necessarily what we mean by high impact or high intensity resistance training. In fact, it's very much not high impact and high high intensity resistance training because what's often prioritized in those bootcamp classes is resting as little as possible. And to truly put a high force through your body, to truly be able to consistently meet high impact, we actually need to be doing quite a bit of rest between those inputs. um So yeah.
00:37:26
Speaker
Something i um that I can imagine a Pilates instructor who's listening would um have a question about, and and this this might be more towards Sarah, because my i understanding is Sarah, you have more of a Pilates background,
Impact of Training Techniques on Joint and Bone Health
00:37:40
Speaker
Pilates and yoga, and then Laurel more yoga. So feel free to chime in, Laurel, but I didn't want to throw a Pilates question at you and be like, what the...
00:37:50
Speaker
What about jump boards? Like we're dumping and there's a board and it's hard impact. sure ah Like, is jump board bone building? Is that the question? Yeah. is is Like, what are your thoughts on on everything that Laurel just mentioned is awesome. I totally agree with that I get it, but like 10 years ago, me would be like jump board, right? Which is different because horizontal instead of vertical, right? So right but exactly I can get nerdy with it, but I would like you to get nerdy with it. Yes, absolutely. so
00:38:22
Speaker
Yeah, so if anyone's listening who doesn't know what it is, a jump board is a piece of equipment that you attach to the end of the reformer, you lie down on the reformer. And basically, like you were saying, Adam, you're doing horizontal jumping. It's what that allows is for and then you change the intensity of it or the various challenges of it with how much spring load you give the person.
00:38:45
Speaker
What that does is it gives your body, I use it all the time in the clinic, to actually teach people how to land or remind their body part, let's say they had an ankle injury or a knee injury, what it feels like to jump up and land. And the great thing about it is it's basically, it can be just really slowed down. So compared to actually jumping, right, compared to the force that gravity is going to pull you back down with as soon as you jump. So it helps people kind of slow the activity down enough in order to actually work on the mechanics of it at a level that their body can tolerate while they're going through rehab. It's also really fun. I really love the jump board. I like to get on the jump board and bounce all over the place and do all kinds of different things. But
00:39:29
Speaker
where you have the the huge part that's missing is like, yes, even though you're landing on something with a little bit of impact, you're not landing stiffly. I have never been in a yoga in a Pilates class where the teacher says, okay, when you hit the jump board, lock your knees out, you know, like, that's just not happening. What? It's bad for your joints.
00:39:50
Speaker
Right, back for your joints. Land softly. Make it nicer on your joints, right? So you're doing these very ah force-absorbing type of landing. You're doing it without gravity involved at all.
00:40:04
Speaker
The other thing that I love about it is like sometimes people argue that it is kind of cardiovascular. I did some jump board. like a series of I did put my heart rate monitor on. I did like jump board for probably five, 10 minutes straight. I don't think my heart went over 100 BPM. I'm not even in zone one, let alone zone two. right So it's definitely not cardio, even though it feel like it might feel like, ooh, compared to everything else, you're getting your heart rate up a little bit. But jump board is not going to... It does lots of other super great fun things.
00:40:32
Speaker
For people who struggle with even like some motor control, like coordination things, it's a great way. it's a great way to get to I have so many people that had like were on the struggle bus trying to do alternating single leg jump board. and i mean I'm sure you've seen it too. or It's like, I pushed with that one. Oh, shit. And then they're like, you know so so it can be a fun way to improve in coordination.
00:40:53
Speaker
It's not going to do anything for your bone density because the level of impact is nowhere near what it needs to be. And that's just the beginning and the end. You're much better off. If you really want to impact your, sorry, pun intended, your your client's bone density, get them up off the reformer.
00:41:10
Speaker
depending on what they can tolerate, like Laurel is saying, maybe it's just stomping, maybe it's heel drops, or maybe you ah put the box on the ground, you have them get up on the box and then land on the ground without absorbing it, land stiffly, right? That's a drop landing. You can do all of these activities with the reformer equipment, um just in a slightly different off-label use way, maybe. Yeah. Do you have anything to add to that, Laurel?
00:41:35
Speaker
No, I mean, I think that there is the issue of it being gravity neutral, like you're lying down and you're moving in the horizontal plane. And so you're not going to get the weight of your body helping you out to increase the mass, which mass times velocity, right? So yeah, I think we're gonna, we're gonna have some fun. We're gonna rehab. We're gonna work on a cool coordination skill. We're gonna um look cool.
00:42:04
Speaker
and maybe work on mobility, rate of loading, things like that, all all amazing. Like I said, all exercise is good. and Literally any amount of exercise is better than none. And the jump board looks cool as hell. But I don't think we need to oversell it as being bone building when it's not, because why would we do that to our students?
00:42:24
Speaker
Yeah, that it's it's like understanding that gravity's vector is down, which means the force of gravity is down. So if you if you want to so like weight bearing is a thing, but then you have to like double, triple, quadruple check on that. right like How are we weight bearing? What are we doing weight bearing? But it's like like underneath all that is we do need to be weight bearing, which means that you're bearing weight on your joints and weight has gravity or weight has gravity in this definition, which means always going down. So you do need to use, um, use the floor for anyone who teaches jump board classes. You can absolutely get impact in cardio in jump board classes. It's just not on the jump board. You do jump board, right? For me, I'm impressed. He did five to 10 minutes there. I did the same thing, but I did like two minutes. I like for the first two minutes. And then I'm the student who's like, get me out of here now. Um, so you can jump and then you just go next to the reformer. You do your cardio or your impact training and you're like,
00:43:14
Speaker
And then you recover, you go back to the jump board, right? like that's Like you can get in the class just not because of the jump board. But another concern that 10 years ago me would have um is what about and joint health? Now we're jumping. So now we're like, okay, we're getting impact, but we're ruining our knees. What do we do about protecting joints?
00:43:38
Speaker
um The best way to protect your joints is to impact them as much as you can. It is not dangerous. It is not going to break your knees.
00:43:52
Speaker
it's not bad for your cartilage either, right? That's another one that people get. they're Like when people say you have to protect your joints, a lot of the time what they're talking about is like protecting the cartilage, right? So you don't quote unquote end up with arthritis as that's automatically going to happen. But actually a lot of recent research has shown things like running, which is a impact sport helps to, uh, I was going to say tensify, but that's not a word helps to stiffen and build a mass in your, in your cartilage itself. But you know,
00:44:22
Speaker
because we're thinking about this idea that it's going to be dangerous, right? That's the fear for the for the teacher is that and all this like impact stuff is going to hurt people's joints, or it's not safe, especially it's not safe if you already have osteoporosis, right or osteopenia. um But it's just not true. I mean, it's sort of like, we've known for a long time that heavy load and high impact make the biggest difference to bone density. But the medical field has been really conservative about this. And I think they've actually done people a disservice by dissuading them from doing resistance training, in
Insights from the Liftmore Trial on Heavy Lifting
00:45:00
Speaker
particularly the kind of heavy lifting or the kind of impact that promotes
00:45:03
Speaker
No density right they'll often say you know just start climbing stairs or go for longer walks things like that because they're so conservative and they've been so cautious about this idea that like if you already have reduced bone mineral density your risk of fracture is higher so we won't don't wanna have you do activities that possibly increase that risk as well, but when in fact it really doesn't. you know Obviously, it's different person to person, but most people with osteoporosis can very successfully participate in resistance, train heavy weightlifting, and impact training. right They may need to start with something that's a little lighter, work up to moderate, then work up to heavy, but that's still that doesn't mean you can't do it. right It just means the progression has to be really kind of specific.
00:45:48
Speaker
And there's this famous, you know for nerds, famous ah and research trial called the Liftmore trial that they did in Australia, I think it was about five or six years ago now, where they took, I think it was about 100 women. All of them were postmenopausal. Either all or most of them had some sort of osteoporosis or osteopenia diagnosis. And they just put them through a program of heavy lifting, barbells,
00:46:15
Speaker
There's an amazing video on YouTube where you go on, and it's all these women in their 60s and 70s, and they're just like cranking on barbells, and they've all got like super kyphotic upper backs, but who cares? It doesn't actually matter, says science, and they're sorry and they're doing drop landings off of a box. It's so cool. um So they took these women through heavyweight training, impact training for eight months. They did 30 minutes twice a week, and people in that trial, women in that trial, improved and in some cases reversed.
00:46:45
Speaker
their osteoporosis diagnosis. It's so cool. And our course, our bone mineral, no, that's not what it's called, our bone density course. I was like, did we call it bone mineral? That sounds a lot. Our bone density course. So we ran it for the first time starting in last October. We had 90 people sign up, which is amazing. And we just heard from one of those participants that she just had another DEXA scan and she had entered our program with an osteoporosis diagnosis.
00:47:13
Speaker
And she has reversed it using six months of heavy lifting and impact training. And we're we're like over the moon. We're thrilled. This is like so exciting. I'm like, we could start publishing. Like it's going to be so cool. But one of the things that I found really kind of ironic was so I put, I just posted about it on Instagram. And then there was a comment, somebody commented and the comment was basically like, Oh, this is great. Do you think it was the heavy lifting that made the difference?
00:47:41
Speaker
Or like played a factor and I was like No, it didn't it didn't play a factor. It was the difference. It was the factor Right. It's not like heavy lifting plus really changing your nutrition and blah blah blah It it was the lifting it was the impact training. It's just so ingrained in us in a lot of women in particular movement teach Pilates and yoga teachers in particular that it's uh dangerous to lift heavy, it's scary to lift heavy, ah it that we should be doing anything but it to increase bone density. And it's it's this incredibly dangerous and careless and honestly, in my opinion, unethical message. But there are a lot of people that continue to purport it with with abandon. There is one Pilates teacher in particular
00:48:32
Speaker
who plays very fast and loose with the truth around this and leans on fear mongering around heavy lifting and just kind of encourages people to just kind of do what you can, you know, as if your osteoporosis was a disability, right? Which means you can't do certain things, which it's not.
00:48:48
Speaker
you know But then like maybe down in the caption, they'll say something like, oh yes, of course weight training is important. But the the products that this person is selling are not heavy resistance. It's body weight and low impact and maybe some pink dumbbells, and we know that those are not osteogenic activities. And as Laurel likes to say, um this person really talks out of both sides of her mouth, right? So for example, I just checked her account to see what she was posting recently, and there's a video of someone, and they've got one foot in front of the other, and they're rocking backwards and forwards onto their toes, and then onto their heels, and practicing like sort of balancing moments in the center. Cool, great for balancing, I love it. But then she writes own health on it.
00:49:33
Speaker
And so bone health implies bone strengthening, but it doesn't outright say it, right? So it's this very, I don't know, I think it's kind of slimy thing to do where you're, you're inferring something, but you're not actually stating the full facts around it, but that way you're keeping people locked into your method.
00:49:54
Speaker
while gatekeeping the actual work that will make a difference to their bones, right? And in a lot of things that a lot of... Sorry, I'm just like on a rant because this drives me nuts, but a lot of things that that people who have courses like this do when either consciously or or not, they they're not providing any sort of osteogenic activity.
00:50:15
Speaker
They will switch focus and they'll say, well, the really important thing to do is improve your balance because if your balance is better, then you won't fall. And so then you won't fracture anything. Because that's what they sell. They sell they sell balance training. Or another one they'll say is it's your posture is important.
00:50:33
Speaker
so Yeah, you need you need a particularly, you know, aligned type of posture, whatever they deem that to be, because they teach posture correction. So of course, they're going to try to spin that as bone building. Here's and a really egregious one, if I can jump in, Sarah. So Yoga You, which is a online yoga course marketplace, and they also have ah articles, they have an article on their website titled two breathing practices for calming inflammation and strengthening bones. And when you read the article, it's amazing how they overstate and oversell this connection between inflammation and bone health. So right they're trying to draw a connection between stress relief, reducing inflammation,
00:51:22
Speaker
strengthening bones. right But we already know that there's something called anabolism, which involves stimulating the body past a minimal effective threshold a minimal effective dose that meets a threshold to make a change. And I'm sorry, sitting down and breathing is not it. Now, if you want to say that reducing inflammation may reduce bone absorption, right the loss of bone, that may be true.
00:51:52
Speaker
The truth is that the mechanisms ah by which inflammation affect bone are really complex and they're not fully understood. And so yoga, sure, it could reduce inflammation, but this claim in the title that it significantly impacts bone strength or reduces the possibility of getting osteoporosis or reverses osteoporosis is just really irresponsible. It's highly speculative, and that is a generous assessment. It's completely unsupported by strong evidence. And the article, if you read it, is written with a very high confidence. The language used is very confident, black and white. While totally misrepresenting the nuance, it basically leaves readers
00:52:41
Speaker
You know, thinking that their breathing exercises are making some significant impact to their bone strength because that's what they want to hear. I'm sorry, that's what they want to hear because it's actually much easier to sit down and breathe than it is to engage in any type of high intensity resistance training or impact training. I will be the first to admit that. But it's so troubling that this is coming from a yoga website, because one of the main ethical tenets of yoga, because yoga is more than just exercise. It's a ancient tradition that is multilingual, multicultural, original from India. and it And there's a whole system of ethics around it. And one of those systems of of those those ethical tenets is do no harm.
00:53:22
Speaker
But health misinformation is actually very harmful, more so now in the digital age, where it spreads like wildfire and causes complete and total what I call thought viruses and misunderstandings around how we can actually be healthy. And they're they're feeding this and and information to an audience that is highly vulnerable to having low bone mineral density.
00:53:46
Speaker
And it should also be noted that they sell a yoga wellness course involving Lauren Fishman, which Sarah can tell you about him, called Yoga for yoga for Bone Health, Strength and of Balance. Yoga for Bone Health, Strength and Balance.
00:54:06
Speaker
Yeah, we're gonna get into that article in just a moment. One thought that I have on this, because this is so parallel in the Pilates industry, I just did um at episode 95 of this podcast, I broke down an article that was very similar, that was talking about doing backbends to hear someone's art like me. It was so wild. Fasha, it was I think was the claim. And then so, um but sorry, I'm sorry, wait, I'm sorry. Backbends,
00:54:31
Speaker
Yeah, via your fascia cures your but your knee pain. Yeah. And did you know we have a lateral cruciate ligament? I did. What?
00:54:41
Speaker
oh I was hoping you'd catch that. Yeah. as I was going to say, yes. And I was like, no. know But it's close, right? But there are these red flags. And then I can imagine in the yoga article, there was a ah lack of um ah references to high quality literature, which is very common in the Pilates industry, which is why conversations like this are so um valuable. And we you can just pull information from outside. And and one thing that I just, you're a listener,
00:55:09
Speaker
try like Watch out for traps that sell mediocrity. They're selling you like you don't have to work that hard and you're gonna get these awesome results. No, like it's fucking hard work. like Lifting heavy shit is hard work. and It is.
00:55:26
Speaker
Okay. You got to show up and you got to get it done. Sorry. My mother's coming out of me of like, just get your shit done. Cleaning up. Your mom's right. It's hard. Cardio is hard, right? You get out of breath. You get uncomfortable. And then but we can change our relationship with that discomfort.
00:55:42
Speaker
right? We can change our relationship with pain and things like that. It gets part of the process. And just you can't like like, just
Critique and Analysis of Yoga and Pilates Studies
00:55:50
Speaker
watch out for claims that talk about building strength, building cardiovascular fitness and all these things with these like very mediocre, very simple or easy um exercises, because it's just it just it just ain't that way. And like Pilates and yoga, they don't get to make up physiology. They don't get to make up anatomy.
00:56:09
Speaker
right like It is what it is regardless of um modality. but Before I go down like that rabbit hole because I'm conscious of the time, we have to talk about this article because you you pointed me to a 2016 article by Dr. Fishman and i just i glance I glanced over it while having a glass of wine.
00:56:25
Speaker
And I couldn't help but notice that Dr. Fitchman also like funded the study, right? So it's like cigarette. And then all of a sudden, yoga is great for bone density. It's all you need is 12 minutes, I believe it was. It's kind of like the cigarette companies funded i'm studying on cigarettes. And they're good. They're good for you. You should have one. right So Dr. Fitchman studied the study ah he did that he that he funded. um What were the findings? what are you What do you think? What do you all think about that? OK.
00:56:56
Speaker
I just start to laugh because i've I've read, there's actually, it's a bit confusing because my understanding is that there have been a few different iterations of this same study over a few years ah because i I think what's happening is they're trying to be like, oh, if we just do it again, we'll get different results. And then that we could, we oh wait, we'll just do it again. We'll get different, wait, no, we'll just do it again. We'll get different. So of whenever I read it, I feel like I've read sort of different you know discussions or different results and things like that. but so The title alone is incredibly deceiving. The title of the study is 12-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss. Sounds great. Not true.
00:57:39
Speaker
ah the There are a lot of, and this is this is where we get into that thing of study quality, research quality. How good was the research? how much which Which translates to how much do we, you know quote unquote, trust it? How much could should we use it as part of our evidence-based learning and teaching?
00:58:02
Speaker
um it the A couple of the problems, they they recruited a bunch of people, I think basically with like flyers at Yoga Studios, being like, hey, do you want to get this free DVD to do these exercises? And so it's a bunch of people already doing yoga, and they're like, totally, of course. um They had a ton of people drop out, because it was a long form study. I think the original one was just one year. So over the course of the year, you're supposed to do this DVD like at twice a week, or I don't know how many times, but, oh, daily, every day. Sorry, it says in the title, daily.
00:58:32
Speaker
But so a lot of people, after a year or whatever, we're not doing it every day. So ah their their results were very confounded by that. um One of my... So there were a couple... i Because I looked at it again and I was like, oh, God, this again. But um in the study itself, it's that it actually says, they admit, this is a study.
00:58:51
Speaker
This study suffers from many drawbacks. And I'm like, yeah, no kidding. So there there were a couple of like really special little chestnuts that i that I picked up on this time that I just wanted to go into a little bit. So this is a quote direct quote from the study. It says, mean rate of improvement in total hip bone mineral density increased from baseline by 50% after a mean 23 plus or minus two months of yoga.
00:59:21
Speaker
But wide variation in individual improvement caused the confidence intervals to overlap, thus precluding statistical significance. Okay, so if you're not somebody who reads research regularly, you're going to get ah as far as mean rate of improvement increased from baseline by 50%. And you're like, cool, great, it's good for you. But we actually have to break down what this means, right?
00:59:42
Speaker
so
00:59:45
Speaker
After two years of yoga, 23 months plus or minus two months is two years, unless I don't do the math on that. right So after two years of yoga, not not two months, two years of yoga, they found that the mean improvement was 50%. So if you haven't done math in a while, and why would you have? A mean is when you take all of the results and you find the mathematical average. So I could take the mean of zero and 100 and find that the mean is 50.
01:00:15
Speaker
right So it doesn't mean that everyone was getting 50% improvement right at all. It could be like, if you did it up to people and one person got zero, one person got 100, the mean is 50, but that doesn't mean both people got 50%. And so because of this, it wasn't statistically significant, which is significant. And this is the kind of detail I think is often missed by people. so This phrase, statistically significant, Scott, it's such a, this is where I start to like get nauseous because I, all of this stuff makes me a little like cuckoo. But in, in research, statistical significance means, okay, stay with me. The probability of the null hypothesis being true compared to the acceptable level of uncertainty regarding the true answer. Okay. So if you're like, I don't know what the hell that just meant. I mean, honestly, me neither. So, but here's what it really means. When you do a study,
01:01:11
Speaker
and you get your results back. In order to say something with confidence, in order for something to be statistically significant, you want the results to be true for 95% of the people who took ah were involved in the study. right And if you can't get to that number, if you can't say 95% of the people involved in this study
01:01:36
Speaker
reduce their bone mineral density, then it is not statistically significant. Which means you cannot then go around saying everyone can reduce their osteoporosis with two years of yoga.
01:01:48
Speaker
Excuse the interruption, but I spoke to Dr. Sarah Court right after this podcast, and she was kind of enough to go ahead and correct a little bit of what she was saying about statistical significance, and she wanted to make sure that you got accurate information. In a very simple way, came ah statistical significance is the probability that the result that you found does not do to random chance, which is tied into what's called the confidence interval. You usually get what's called a p-value.
01:02:18
Speaker
in research, which needs to be 5% or under. It'll be like P equals 0.05 or under. And although this is like super nerdy and stuff like that, it's really important that you have statistical significance because what that means is that what you found is not due to random chance. So the standard for statistical significance is that you have a 95% chance that what you found in your data is not due to random chance.
01:02:45
Speaker
And sometimes you'll read papers and stuff like that, or I'll read papers and things like that, where the confidence interval will be like 0.4 or something like that. That means like this data means nothing. And anything they refer to about that data means nothing because it's 40% chance that it was due to complete random data.
01:03:03
Speaker
So with that statistical significance is the probability that the findings within the data are not due to random chance and that needs to be 95% or higher as a general standard. With that, let's ah jump back into this episode.
01:03:20
Speaker
also two years of yoga, two years, right? You can reverse, reduce your osteoporosis in like six to eight months with heavy lifting and also get really and strong.
01:03:35
Speaker
Right? And then, it I mean, it goes it just goes on with this study. It's really, really outrageous. um Another thing that I found weird slash problematic. So here's another quote from the study. It says, people signing up for the study were largely those with already weakened or weakening bones and very often people already doing some yoga. Therefore, the study may have selected the very people for whom yoga does not give maximum benefit.
01:04:03
Speaker
The bone building effects of yoga in younger and in healthier people without the genetic predisposition that is possibly overrepresented in our sample might well be greater and at any rate are unknown. In other words, people who are already doing yoga will have maxed out the tiny, tiny, tiny ah amount of bone benefit like there's they They would have maxed it out a long time ago, and they're not going to see any improvement in their bone density. and The second half of that paragraph that I quoted is is just total world word salad, and it doesn't mean anything. Yeah. and and One thing that is helpful, and I'm a huge advocate for high-impact, high-resistance training for any population, especially um an osteoporotic population or those at risk,
01:04:56
Speaker
It's also, we also have to be in reality and recognize that there are no reliable studies that show that we can change it by 50%. Even the facts are there. Even slowing it down is a victory and then reversing it's like a massive victory. But if we reverse it, it's like, I think the lift more trial was around 10% in that ballpark, like plus or minus five.
01:05:20
Speaker
50%, that's fucking wild. right And then you're you're you're just doing i do maybe warriors. that's that's that That's as far as my yoga terms go. right You're like standing there and then holding shit, right which is healthy for the person. It probably has a better effect on balance than anything.
01:05:40
Speaker
um, you know, then bone density, it's just, it's a huge red flag. And there's actually a systematic, like that, that study is in the show notes. And so is a systematic review on both Pilates and yoga and their ability to build bone density. And they show non-significant effects, which they actually utilize this Fishman study, um, in there. So for anyone looking at like, like research qualities, systematic reviews, meta analysis, and then clinical practice guidelines are at the the top of the list. And the the top of the list, they they say like, you can do it, right? It improves quality of life.
01:06:09
Speaker
So if you can improve quality of life in anyone, I think you should do that. Get dogs. They improve your quality of life. And like, do you know what I'm saying? Sorry, I'm biased. and then you know they it So clinical practice guidelines are also in the show notes. That's the research that I highly recommend um looking at. They recommend um high resistance training, high impact training but you know progressively.
01:06:33
Speaker
um And then also, balance training, which we haven't really touched on, because we're talking about talking about bone mineral density. But if you
Benefits of Balance Training and Movement Principles
01:06:40
Speaker
do want to take a stab at, or if you do want to share your thoughts on balance training for these population for this population, I think deadlifts, you can just get strong and you'll improve your balance. But um what are your thoughts on balance training?
01:06:57
Speaker
Yeah, they want you go yeah balance having better balance will reduce your your risk of falls, which reduces your risk of fractures. So you do want to work on your balance and you can make significant improvements to your balance with yoga. This has actually been studied. Yoga is ah evidence-based way to improve your balance, but it does it through a different mechanism than strength training because strength training is also evidence-based way to improve your balance. so Yoga functions more through the improvement of proprioception as well as mobility and um strength training, the mechanism by which strength training improves your balance is through increases to your strength and power.
01:07:35
Speaker
so I don't think one is actually better than the other in terms of balance improvement. I think they would be a match made in heaven um in combining right your weekly physical activity involving both yoga and ah strength training. i'm sorry i don't have any um information about Pilates and balance training. But I've been in some Pilates classes that involve standing up and balancing. So I'm going to say, you know, if that's the type of Pilates, you're teaching that it involves standing up on your feet and working on balance and not, you know, just lying down the whole time or most of the time, then yes, I would say it's probably very similar to yoga and the way and the
01:08:12
Speaker
mechanism by which it improves balance. um The way I think about it is like, why can't we do both? We should do both because in addition to um balance being important for the prevention of falls, therefore fractures, so is increased bone mineral density, right? And that we get from strength training. So if we can get balance from strength training and strength from strength training,
01:08:34
Speaker
And we can additionally improve our balance through practices like yoga and maybe Pilates. Why not do both, right? the The thing is, if we only do yoga and Pilates, we're missing the strength and power, which is basically recommended that you work on improving your strength and power twice weekly just for the staving off of multiple different types of chronic degenerative diseases and enhancing your longevity by the CDC and the WHO. So like we're already being told by these organizations, these these institutions that compile massive amounts of research to formulate these guidelines that we should be doing strength training whole body twice a week just to not get diseases to live longer.
01:09:18
Speaker
If our whole aim is to reduce the risk of fracture, then we can also say, well, we should definitely be doing strength training to increase bone mineral density, as well as to prevent falls, because we're going to improve our our balance. And then we can also throw in there that we should absolutely be doing yoga and Pilates as well.
01:09:35
Speaker
It's not actually recommended by the CDC and the WHO that we do twice weekly yoga and Pilates, but they're still extremely beneficial in one of the ways they're beneficial is that they can probably enhance your your balance as well. um So I'm a big fan of saying, yes, absolutely do yoga, absolutely do Pilates. They're very good for you beyond just balance training, right? But the I think what's important to just constantly reinforce, because unfortunately we have so much misinformation out there, is that yoga and Pilates are not strength training.
01:10:05
Speaker
They don't apply the principle of progressive overload, and they don't ah involve external loading beyond body weight or light resistance, typically. So we are actually not going to be and be able to make the types of changes we want to be able to make to bone or muscle with Pilates and yoga alone. But Pilates plus strength training, yoga plus strength training, it's like peanut butter and chocolate right there, like a match made in heaven, in my opinion.
01:10:31
Speaker
I want to add just the yeah just the the sort of Pilates specific balance stuff that I think is is really cool is there's a lot of dynamic balancing with a little bit of sort of load that you have to manage. right So in a lot of ways, like I always used to joke when I was a yoga teacher that you know you don't trip off a curb and land in triangle pose.
01:10:52
Speaker
right you I mean, I do. I don't know about you. Oh, sorry. Well, I'll just speak only for myself. I don't trip off a curb and land in triangle bows. I'm also very klutzy, so I constantly trip off of things and I'm banging into stuff all the time. But what I like what i think is sort of like an additional challenge that you can play around within Pilates different from yoga is that you can do all kinds of really fun standing balance plus ah you know low resistance work on the reformer. um I'm a big fan of all the Pilates equipment more than I'm a fan of Matt Pilates just because my personal body doesn't love it as much because I'm a hypermobile monkey and I like having everything touching something. It just makes me feel more secure.
01:11:33
Speaker
But yeah, there's all kinds of like dynamic balance stuff. And that's, you know, I take it back, you can you can put some dynamic work into like a vinyasa flow or something by connecting different poses and having you come into balance with one pose and then coming out of your balance into something else. But I don't know, I think the reformer is really fun. I mean, I, for me, and in terms of what I do as my weekly kind of workout,
01:11:53
Speaker
um I try to get some reformer work in but once a week, but I see it much more as ah kind of recovery work, or I use it for a very specific things that my body needs to stay happy because I have, as my PT says, a Rubik's Cube of a body. um There's a lot of lot of little funky things that are all kind of fighting each other, so I just have to make everybody happy.
01:12:19
Speaker
ah but I mean, I love Pilates. I really, really do. I love yoga. I started in yoga. But for me, again, as a hypermobile person, working
Encouragement for Evidence-based Practices and Resources
01:12:30
Speaker
with a reformer just feels so kind of right on my body. So I do cardio exercise, I lift weights, and I get on the reformer, and then I do some other little rehabby things. but ah I very specifically don't look at the work on the reformer as something that's building bone or even really building muscle mass for me at this point, for someone else early on maybe. But that's another thing that like you're going to run out of springs at some point, right? Yeah, especially with the with the lower extremities. And one of the things I love so much about the reformer are for those um out there speaking with like, how do you say this more apparatus?
01:13:09
Speaker
ah like the chair or the Cadillac and these other things that we have to offer is that they're so versatile. And in it's as as anyone listening, I would highly encourage you to focus on the movement principles behind the exercises and then apply that to any movement that you feel is appropriate for the client in in front of you. And I think that's what happens as we grow as practitioners, whether it be yoga, Pilates or anything else, is that we become less attached to the exercises that we learned and more attached to um the principles behind it and then being able to apply it to then get a specific effect ah for an individual, in this case, building bone density, muscle mass, and potentially balance um as well.
01:13:54
Speaker
Now, with that said, um if there was I'd like to ask each of you individually, um if there is one thing that a listener took from this episode, what would you want it to be? i'm Sarah, do you want to go first on this one? Yeah, when I was thinking about this, I was thinking about the teachers who listen to this podcast. So I think as a in your role as a teacher, whatever kind of a movement teacher you are, the most important thing that you can do is make sure you're not accidentally spreading misinformation by making sure that you are the most informed about all of this stuff that you can be. And so one of the ways you can do that is follow accounts that are evidence-based and that quote research like Adams.
01:14:43
Speaker
like ours, movement logic, like sports physio, like E3 rehab. These are just a few of our personal favorites. And then it sort of depends on your comfort level. But if you encounter a colleague who is spouting untruths, whether it's conscious or whether they're just parroting what they were told and haven't had a chance to really think it through or don't know that it might not be right,
01:15:05
Speaker
depending on how comfortable you are with like challenging people, you can you know either maybe call them out or you can maybe like pull someone inside and just say, hey, you know have you seen this research? Or did you know that this is actually what is the you know understood best practices nowadays? And I'll send you this link. and you know I mean, i i've I've done this kind of thing and Laurel has as well. And you know the the calling out factor in particular can go you know, good or not so or not so well. But one time I i i called someone out who was a ah physio. I can't remember. what Oh, it was about this study. He was claiming something from this study and I had that direct message to him and I was like, that's not what this study shows.
01:15:50
Speaker
And I think I said it about as nicely as that. like I think I was very like, I'm in a hurry. That's wrong. and this And then he responded by actually inviting me on his podcast. So it worked out well in that instance. He was able to hear it, but um you know maybe a ah gentler touch.
01:16:05
Speaker
would be appropriate. But I do think it's important to make sure, you know, make sure you we ourselves, to the best of our abilities, are not spreading misinformation, aren't saying things like this exercise is good for toning your abs or whatever, or like, you know, making sure that you're just as much scientifically based as you possibly can be. That's the best possible thing you could do as a teacher. Well, I can't argue with that. Go, go, Laurel.
01:16:32
Speaker
Sorry, i I was going to say mine is more pertaining to the individual. Listeners, if you are interested in doing something extremely powerful and potent for your current health and longevity, especially if you are a female and or ah older approaching perimenopause, menopause, one of the best, most longevity enhancing things you could do for yourself to prevent the onset of diseases like osteoporosis is to put as much muscle on your body as possible and to get as strong as possible. And therefore it is in your best interest to stop fucking around with modalities and formats that are not the best tools for that job and to start taking it seriously and engaging in activities like heavy strength training,
01:17:23
Speaker
and impact training that applies a programmatically progressive overload, taking you from where you are now, wherever that is. If you've never touched a weight or even looked at a weight, you too can strength train and to gradually over the course of the rest of your life, systematically and progressively improve your ability to produce force, to build bone, to build muscle, just get strong as fuck. That's my recommendation to you.
01:17:52
Speaker
Get strong AF. With that, Laurel and Sarah, Movement Logic team, it has been an absolute pleasure ah to hang out with you all. If anyone wants to get in touch with you, um with you all individually and collectively, how can they do so? You're cool.
01:18:13
Speaker
Thank you. So our, what did I call it? is Our partnership, there we go, is Movement Logic, right? So our website for that is movementlogictutorials dot.com. That's where you can get yourself a cool t-shirt. And that's also where you can get on the wait list for our bone density course, Lift for Longevity, which is our six month live online programmed, progressively overload, taught by a strength coach and a physical therapist, ah heavy lifting program that people are making changes to their bone density and massive changes to their strength. So you can sign up for that course. We're starting it again in October. Sorry, you can sign up to be on the waitlist so that you hear about the course. You're not just signing up for the course. You're getting a discount. You're going to get a ah waitlist only discount. We don't get the discount anywhere else.
01:19:03
Speaker
And you get some fun mailing list freebies because once a month we're just sending out like, here's a cool thing, do this. So that's if you're interested in that. And then if you're just social and you want to be social with us on social media, our handle is movement logic tutorials. And then my mine is Sarah Court DPT and Laurel's is Laurel Beaverstorf. So you can come follow us online as well. That's on Instagram only. We are on yeah Instagram.
01:19:29
Speaker
We don't, we don't, we're too old for TikTok. We don't understand it. yeah Yeah, I'm getting younger every year. So eventually we'll be on TikTok. Cool. we All right. Well, all of those links are in the show notes. So anyone interested in hanging out with Laurel and Sarah and getting strong AF, go ahead and go to the show notes and click on the link. But with that, it was an awesome episode and we'll see you in the next one.