Strong Is Ageless: How to Age with Power, Strength & Science with Dr. Vonda Wright

Understanding menopause is key to thriving through it! Dr. Vonda Wright shares insights on musculoskeletal health, strength training, and maintaining vitality. She explores the critical 'mental-essence' period, the importance of strength training, vital nutritional changes, and how these components come together to help women lead vibrant, empowered lives into their 80s and beyond. Discover the essential strategies to prevent osteoporosis, maintain muscle mass, and achieve overall health and wellness through every stage of life. To view full show notes, more information on our guests, resources mentioned in the episode, discount codes, transcripts, and more, visithttps://drmindypelz.com/ep300 Dr. Vonda Wright is a double-board-certified orthopedic surgeon and internationally recognized authority on human performance, longevity, and women's health. The founding director of the Performance and Research Initiative for Masters Athletes (PRIMA), she has served as a physician for athletes at the University of Pittsburgh, Georgia State, the Pittsburgh and Atlanta Ballet, World Rugby, and the PGA. A highly sought-after media expert, she has been featured on the Diary of a CEO, Jay Shetty, and Mel Robbins podcasts as well as the Today show, the Dr. Oz show, and in top publications including The New York Times, USA Today, and the Observer. She has authored five books, including Fitness After 40 and Guide to THRIVE. She lives with her husband, a retired two-time Stanley Cup champion, near Orlando, Florida. Check out our fasting membership at https://esetacademy.drmindypelz.com. Please note our medical disclaimer https://drmindypelz.com/medical-disclaimer/.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:02Mindy Pelz?

  On this episode of the Resetter Podcast, I bring you Dr. Vonda Wright. And we're going to talk about menopause and the musculoskeletal system. And it's a really cool conversation for a variety of reasons. But one of them is you're going to want to get a pen and a pad of paper because has she got some incredible ways that we can keep our musculoskeletal system strong, healthy, and functioning well into our hundreds? So let's talk about who Dr. Wright is. So she is an orthopedic surgeon. She has worked with a lot of elite sports teams.

• 0:46Mindy Pelz?

  She had, this is in her first book, she actually has a book coming out. She's done several books and she has literally been in the trenches with athletes, non-athletes, women, men for years. And what I love about Dr. Wright and why I wanted to bring her to you is she now has mastered a formula for musculoskeletal health and menopause. So what you're going to learn in this conversation is you're going to learn that when estrogen goes down, this is the beginning of things like injuries from our activities, joint replacement, osteoporosis.

• 1:27Mindy Pelz?

  And there are some really simple ways that we can start to prevent this. And it doesn't matter if you're 70 and hearing this, or you're 30 and hearing it. She has some really smart strategies for making sure that we prevent osteoporosis, we prevent hip replacement, and that we stop injuring ourselves. So, so we go through that. We also spent a lot of time talking about nutrition. And what do we need to know about the way we eat for our musculoskeletal system? We broke down every single exercise you could think of. I, we went from Pilates to yoga to rucking to...

• 2:10Mindy Pelz?

  Weightlifting to how often should you be weightlifting to what kind of muscles are you are you trying to activate when you weightlift? So it, you know, a lot of times when I bring you all podcasts, there's a lot of theories and philosophies and mindset. This one is application and I'm really excited to bring it to you. She has a new book coming out called Unbreakable. We will leave links for it. I highly recommend that you grab a copy and sit back and enjoy the her humor, her straightforwardness. I absolutely loved. And it's just a really profound

• 2:54Mindy Pelz?

  and fun discussion that I know is going to help you move your health forward and give you a new vision of what fitness can look like as we age. So Dr. Vonda Wright and Unbreakable. Enjoy.

• 3:10Mindy Pelz?

  Welcome to the Resetter Podcast. This podcast is all about empowering you to believe in yourself again. If you have a passion for learning, if you're looking to be in control of your health and take your power back, this is the podcast for you.

• 3:34Mindy Pelz?

  I am just so excited to have this conversation with you. So, welcome. Thank you. And you know what I have to tell you, like so many of the digital world, I feel like I've known you for years. So I'm finally so happy to sit across a desk from you. Yeah, thank you. I have to tell you that I think the menopausal conversation has been really interesting to watch how it has transpired. And I always say we went from a cultural hush to cultural chaos. And then somewhere along this like emergence, I saw your work and I was like, yes, let's talk about the musculoskeletal system and how it changed. Because not only did I have major injuries as an athlete going through my menopausal experience, but I had

• 4:19Mindy Pelz?

  a practice full of menopausal women that I didn't really understand what was going on until people like you really emerged and taught us. So, so thank you. I'm so happy you wrote this book.

• 4:32Speaker 01

  My pleasure. My pleasure. Yeah.

• 4:35Mindy Pelz?

  Okay, so here's the first heart space. What I want to know is what is it like to be a female orthopedic surgeon? Let's just start off with that.

• 4:43Speaker 01

  Oh, my God. So, you know, we're the fun people in medicine, right? All, everybody going to, all the guys going to orthopedic surgery, 94% are guys. Now, when I trained so, so long ago, there were 3%. So between, you know, then and now, we've doubled, which means it's going to take us 150 years.

• 5:05Mindy Pelz?

  God, I better take, I better, we're fast a little more.

• 5:09Speaker 01

  We're trying really hard, but so 94% guys, and we're the fun guys, right? Because we're all the old athletes, where they're the engineers, but even they're fun engineers. And we get to do fun things by and large, except for this musculoskeletal oncologists and some of the pediatric stuff. Most of what we do is fun and aspirational. Imagine I have spent my life making people walk again.

• 5:35Mindy Pelz?

  Yes, right.

• 5:36Speaker 01

  Or using their shoulders again.

• 5:37Mindy Pelz?

  Yes, well.

• 5:39Speaker 01

  Every time one of my golfers that I fix his shoulder does a hole in one, I'm like, you know, that's mine. I did that. So it's really aspirational.

• 5:48Mindy Pelz?

  It's beautiful.

• 5:50Speaker 01

  But what an honor, you know? I mean, for, for, for doctors, it's such an honor. People trust us with a lot of important things, sometimes the first time they meet us. And that's a, that's an honor, that's sacred. And so, yeah, so we're the fun people, but we take what we do so seriously. Like, you can imagine academic meetings, there are these big debates on where the 2 millimeters, we put the ACL screw. I'm like, you're from an outsider, you're like, it's 2 millimeters.

• 6:24Mindy Pelz?

  Right.

• 6:25Speaker 01

  But it's really.

• 6:26Mindy Pelz?

  Wow. Wow. So were you in practice and, and doing surgeries on both men and women? And then seeing like a trend in menopausal women? Is it like, I would think, you know, my, my husband just had hip replacement surgery. And I was like, I was like, did anybody take a picture of his hip?

• 6:46Speaker 01

  I want to see.

• 6:48Mindy Pelz?

  Like exactly, I would have been in there watching if they would have let me watch because I wanted to like see how, where it had degenerated and all that. So I would think if you had the opportunity to open up a lot of menopausal women's hips and shoulders, that you saw something most of us didn't see.

• 7:04Speaker 01

  So my practice, just to answer the first question and then tell you how I got into where I am now, is, you know, I'm a fellowship trained sports doctor. So my job is not only that sports surgery, but I'm a team doctor. So meaning that I'm the guy on the field and all the football, I was the head football doctor for University of Pittsburgh and all their Olympic sports teams. And so there's the team doctor side of that. And the reality is, most of the teams I took care of were men's athletics. I had a few female teams, I had a few rugby teams, but just the way it worked out. But in 2012, Mindy, I read a statistic that women make 80% of all the healthcare decisions in this country for

• 7:46Speaker 01

  themselves and everyone we touch. And it just a light bulb went off because we're 51% of the population and therefore 50% of my, all my patients, athlete or not, were women. And so when I went through my own menopause more than a decade ago, it hit me, I tell the story, 40 best shape of my life. I had a baby, I'm training for all kinds of things. I've got, God knows, I'll never get back to it, 19% body fat. And then 47 about killed me, right? Very menopausal thing. And I became a scholar, not only of women, but of menopause. And, and really, it's such a deep dive, I consider myself an expert, especially within

• 8:30Speaker 01

  the lane of musculoskeletal. Because here's what women would say to me, once I started listening with menopausal ears, with, I'm sure you've heard this in your own practice, "I don't know what happened."

• 8:43Mindy Pelz?

  Yep.

• 8:43Speaker 01

  "Think I'm falling apart."

• 8:45Mindy Pelz?

  Yep, yep.

• 8:46Speaker 01

  "Do you know what else? I might be going crazy because I talked to my other doctor about it and they said, nothing's wrong with you, you're just getting old."

• 8:54Mindy Pelz?

  Yep.

• 8:55Speaker 01

  Here's the part that killed me, and this is what really keeps me so focused. They say to me without prompting, but you know what? I didn't want to come in today because I have a very high pain tolerance. Like it's a button, right?

• 9:11Mindy Pelz?

  Yep.

• 9:11Speaker 01

  High pain tolerance. But doc, I just can't take it anymore. And in a very defeated way. And I'm a musculoskeletal doctor, but people are weeping because it's so hard. So I decided, once I started listening with those ears, the ears that come with experiencing it.

• 9:31Mindy Pelz?

  Hmm, I love that.

• 9:32Speaker 01

  More than academic, right? It's more than reading it in a stress study. I lived it. And musculoskeletal syndrome of menopause was one of my biggest symptoms, right? I couldn't get out of bed.

• 9:43Mindy Pelz?

  Hmm.

• 9:44Speaker 01

  So painful.

• 9:45Mindy Pelz?

  Wow.

• 9:46Speaker 01

  And we can talk about all those things. That is when I really became committed to exposing what affects 80% of all women. At almost the same rate as hot flashes, night sweats and brain fog is the musculoskeletal syndrome of menopause.

• 10:03Mindy Pelz?

  Yep, yep. Yeah, and so let's launch from there. If as women are listening to this, I feel like there's some like golden rules we need to follow when we go into our peri-menopausal years. Like are there things that we should, we should start doing differently? I can tell you for me, I was a ex-tennis player in college and it turned me into a runner. And all of a sudden at 43, I was injury upon injury upon injury. And it took me several years to figure out, oh, wait, something has shifted as my hormones have shifted. And so I had to change the way I worked out.

• 10:44Speaker 01

  Yeah.

• 10:44Mindy Pelz?

  So what are some of those ground rules that we need to know when you're going into menopause as far as your musculoskeletal system goes?

• 10:52Speaker 01

  Well, I think it's helpful to know that muscle tendon, ligament, bone, fat, satellite stem cells, cartilage.

• 11:02Speaker 01

  Disc annulus in the back, you know, they are all from the same stem cell. So they're all gonna respond in a cousin-like way to estrogen. Every one of those tissues has estrogen alpha and beta receptors on them that keep them healthy. Cartilage, for instance, the matrix is like a mesh, if you will, with estrogen receptors. And without estrogen, sitting there, the matrix starts to fall apart such that here's, men before 50 have more arthritis. Women after 50, without estrogen, have rapid increase in arthritis in the hips, the knees, the hands.

• 11:46Speaker 01

  So the first thing women have to know going through what I call, I call this thing, I like to make up words. So I call this transition the menopause. To be, yeah, to be reminiscent of the chaos of adolescence. Like, people get that, right?

• 12:02Mindy Pelz?

  Oh, that's, that's good. Yeah, menopause is awesome.

• 12:06Speaker 01

  We're exiting our hormones the way we came into them in total chaos. Number one thing to go into is to recognize this is different, right? The same things are not gonna work now that worked then. This is a different life stage to embrace. So, and every tissue in the musculoskeletal system. So it follows that, for instance, if your tendons and ligaments, naturally with age, increase, these are, these are supposed to be collagen fibers. Increase your covalent bonding and get tighter. And then they don't have estrogen to help repair the micro tears. We're gonna have more tendonitis.

• 12:51Mindy Pelz?

  Hmm, okay.

• 12:52Speaker 01

  On top of the fact that estrogen is a huge anti-inflammatory. It works directly on the immune system. It modulates immune cytokines. We're more inflamed.

• 13:04Speaker 01

  So the microenvironment's hot and bothered. We have less regenerative capacity and just the natural aging, we're getting tighter. So we're more prone to things like tennis elbow, Achilles' tendonitis. And so just recognizing, oh, my God, it's not the same. I can't just rest for two days. I have to have a mobility practice to stretch out my tendons, right? To, to keep my joints moving. So the synovial fluid continues to be produced and you don't dry up like a raisin in the sun, right?

• 13:39Mindy Pelz?

  Yep.

• 13:40Speaker 01

  So recognition.

• 13:42Mindy Pelz?

  What age do you think that starts at?

• 13:44Speaker 01

  Yeah, you know what? Perimenopause, on average, in this country, is about 45. However, it can be much earlier. It can be 35, right? I, and it all comes down to, and your listeners know this, to the fact that by about age 40, we have 1 to 3% of our eggs left, right? So we're not producing enough estrogen. And by the time it catches up or people recognize that they're, they're about 45, with complete cessation of our menstruation, on average in this country, about 52.

• 14:19Mindy Pelz?

  Right.

• 14:19Speaker 01

  But I call the decade between 35 and 45, the critical decade to get your shit together. Here's why. Here's why. Because I wish I had done it.

• 14:31Mindy Pelz?

  Yeah, me too. Me too.

• 14:33Speaker 01

  Because I don't know about you. You were an athlete. I was an athlete. If I saw I was gaining a little weight, or I was sore, it was a really quick fix for me.

• 14:43Mindy Pelz?

  Yep.

• 14:44Speaker 01

  And I'm, you know what? This is so ironic. I am a musculoskeletal aging researcher. I don't think I thought it would ever happen to me.

• 14:53Mindy Pelz?

  Oh, yeah, that's interesting.

• 14:55Speaker 01

  But if you're listening, please recognize that between 35 and 45, 35, you still have all your hormones by and large. You've got this youthful vigor. 45, you're going to start to be chaotically perimenopause when things change. Let's make sure.

• 15:15Speaker 01

  We have learned what's coming. Let's make sure we establish a standard of our nutrition. Right? Because when we get to forty five, or even later fifty two, when menopause happens, if we're suddenly having to create six or seven new lifestyle things, it is so hard. Like, people are like, what should I do now, Vonda? And if they're fifty five, I'm like this and this and that.

• 15:44Mindy Pelz?

  Right, right.

• 15:46Speaker 01

  Right. But at thirty five, if we layer in, how are we going to have an anti-inflammatory diet? How are we going to eat enough protein? And what does that even mean? If we think about, okay, at thirty five, how do I start lifting in a way that's going to help me stimulate muscle protein synthesis and not just hold endurance?

• 16:07Mindy Pelz?

  Right.

• 16:08Speaker 01

  I think starting early and layering on the lifestyles, by the time we get to be perimenopausal, when hormones may or may not be helping us at all, our endogenous hormones, it's not such a shock. It's not so hard.

• 16:30Mindy Pelz?

  Yeah.

• 16:31Speaker 01

  So that was a lot.

• 16:33Mindy Pelz?

  Yeah, no, it's, I really like getting ahead of it. I think that is a really important point. And, and it was interesting, as you were talking, I was thinking, yeah, that, when I was forty three, that's how I found fasting. Because I, like you, anytime I needed to drop a few pounds, I would just put a couple more hours in each week on the, you know, running and it would make it go, yeah. Run a little more, but then the injury kept piling upon injury upon injury. And I was like, what is going on? And so I, that's when I learned about fasting. I was like, oh, wait, I can actually get my weight to drop doing it that way.

• 17:06Speaker 01

  Yeah.

• 17:06Mindy Pelz?

  What's interesting about what you're saying is that you're using nutrition like most people would use supplements, or they would use medication. Like, I love this idea of like bringing it in in the beginning so that you can keep that a good foundation of inflammation down. And then my question is, collagen, is, would it be worth it to, to eat collagen-rich foods, especially in those early, early perimenopausal years?

• 17:37Speaker 01

  Well, I think the best date on collagen, and I'm not an expert, but I think the best date on collagen happens to be surrounding bones and muscle, actually.

• 17:45Mindy Pelz?

  Okay.

• 17:46Speaker 01

  Yeah. And so, you know, there's some data that you can increase bone density 1% to 2% a year by supplementing with the right kind of collagen. Imagine entering the critical decade, maxed out on everything with the best bone density, right?

• 18:05Mindy Pelz?

  Right, right.

• 18:06Speaker 01

  Before you start losing your estrogen with the best muscle.

• 18:09Mindy Pelz?

  Yeah.

• 18:10Speaker 01

  And so, pulling in all the tools, I don't think it's one thing. I think, if I look at the, and I'm, I mean, we're both deep into the longevity community. We both appear at these same things. And I think what happens sometimes is we think one gadget's gonna do it for us.

• 18:24Mindy Pelz?

  Right.

• 18:25Speaker 01

  A bright shiny tool. And that's not my experience as a clinician.

• 18:28Mindy Pelz?

  No.

• 18:29Speaker 01

  It is this constant, it's this ecosystem, as we like to say. It's not one little thing you turn on with a switch. Well, that's why I talk about it like this.

• 18:37Mindy Pelz?

  Yeah. You know, I, I was at all the biohacking and everything for so many years. And one day, it hit me, I don't think you can hack a woman's body. You can't like hack into it. You have to harmonize it. It's not a body that's hackable. And it's a body that needs love and nourishment and needs a rhythm to it. And so, I really

• 19:02Speaker 01

  You work in a rhythmic manner. When you think about, every month, there's a rhythm of our complexity. Hormones up, hormones down, we exchange different versus, you know, men get their testosterone in it, slowly declines. And so, you may be more inclined to hack that.

• 19:18Mindy Pelz?

  Right. That's another topic.

• 19:21Speaker 01

  You know, I've made several comments, I really do love men. I married a man, I have four sons.

• 19:28Mindy Pelz?

  Yeah, right. There you go. Yeah. Well, it's our moment, too. We're having our moment. We're finally, finally getting to stand on our soapbox and scream from the rooftops. So, okay, so, we've got nutrition. You're gonna make some nutrition changes. Okay, what else could I do as I'm going through this transition?

• 19:48Speaker 01

  So, in the critical decade, please, please, please, please, use Pilates and yoga as your movement icing.

• 20:00Speaker 01

  But your meat and potatoes has to be building muscle mass.

• 20:06Mindy Pelz?

  Yeah, yeah.

• 20:07Speaker 01

  While you still have your estrogen. I say, do it while you have estrogen. Do it while you you can do it later. You sure can. And I'm working my butt off to try. And I know you are too.

• 20:17Mindy Pelz?

  Yeah.

• 20:18Speaker 01

  Your endogenous estrogen is is easier to make muscle with as a stimulus. So learn to lift. You don't have to lift heavy when you're 30. You should. It depends what you want. If we want to go into prescription of lifting, people criticize me a lot because I mostly talk about heavy lifting. I don't care how you lift, but it depends why you're lifting. So if you're you're younger and you want to build endurance, then lift for endurance. Do tons of reps with the lightest weight possible, 25 to failure. I would never do that. How boring is that? But anyway, that's a lot of joint motion. That's a lot of joint. If you want hypertrophy,

• 21:02Speaker 01

  which is what people in their 30s and or generally want, well, that's a mid range rep set. But as a solidly postmenopausal woman like me, I am lifting for strength and power, which requires heavier lifts. So in the younger years, which is what you've asked me about, let's build a foundation. So our body knows how to lift. Let's do hypertrophy. So you know the form. So that as you progress and need that strategic stress of lifting heavier, you don't have to start at zero off the couch because that's a long.

• 21:42Mindy Pelz?

  Yes, yes. Yeah, I would definitely say I fell in the camp in the 40s because I love to run. I fell in and I love yoga. So I fell in that camp. And when I went to go lift weights, when I lifted weights in my 20s in college, because we had to, it was like I could look at a barbell and poof, I got like muscle. Now I'm like, I'm like two years ago, I'm 55. Two years ago, I went into the. I hired a trainer. I was like, I need to build muscle. Oh my God, we were working so hard for so many months. And then I would look in the mirror and I'm like, it feels like I'm doing nothing. So, yeah, so I think you're really on to something.

• 22:27Mindy Pelz?

  If you don't, if you, if you, you would say 40s, late 30s, like, switch away from your cardio and, and really look at weightlifting. Is that what you're saying is like the critical time period?

• 22:39Speaker 01

  I think cardio is important. They do two separate things, right? We want a big, we want a strong cardiovascular engine. Listen, disease kills, is the number one killer of men and women. I'm not saying abandon cardio. What I am saying, though, is it cannot be the only thing you do. I'll tell you from a orthopedic doctor's standpoint, and I'm sorry, runners, when I say this. And I was a runner. I've run multiple.

• 23:03Mindy Pelz?

  Yep, yep.

• 23:04Speaker 01

  I get it.

• 23:06Speaker 01

  We get, I, if I hear one more runner telling me they don't lift with their legs because they run.

• 23:12Mindy Pelz?

  Oh, God.

• 23:13Speaker 01

  That is a surefire way to end up in my clinic with some kind of butt pain because your glutes don't fire. Or because you've got pelvic instability and instead of running in a straight line, you're running like a weebel, right? You can't, running is a single leg sport. You have to be able to balance in a, in a, in a mini squat without falling over to run well. Otherwise, you're adjusting all the time. So when I, so when I say cardio is important,

• 23:44Speaker 01

  but if we're looking at it from a, a health span and longevity, I want you to, this is just how I prescribe it. There's many ways to do it, unless you're training for a big race, unless you're a training athlete, again, running a marathon. 80% of the time spend in base training. So we build mitochondrial flexibility. We're burning fat. We're at our lactate threshold. 20% of the time, and I'll tell you, this is not based on my research. It's based on, there's a researcher here in my building that trains Tour de France. It's, yeah.

• 24:17Mindy Pelz?

  Oh, wow.

• 24:18Speaker 01

  So, so 80% of the time base training, 20% of the time. We are gunning it as fast as it's safe for our heart. So that we get, so that we give our bodies that positive stress, working in that high zone to stimulate all the, all the muscle protein synthesis and cardiac function. But we don't do that all the time. And that's what I see. The injured people coming into my office spend a lot of time at the highest, highest zones.

• 24:47Mindy Pelz?

  Yep, yep.

• 24:48Speaker 01

  And they're injured every three weeks and then they have to recover and then their brains angry. No dopamine. So I'm not saying cardiac's not important. It's not the only thing anymore.

• 25:00Mindy Pelz?

  But, and what I hear you saying is, and if you're gonna do it, do some sprints, get the, get the max cardiovascular and then get your butt to the gym and start lifting weights.

• 25:10Speaker 01

  Yeah.

• 25:10Mindy Pelz?

  Yeah. So with lifting weights, what, are you a fan of like max amount of weight for eight reps? Or is there like, and is there like a formula you follow?

• 25:22Speaker 01

  So when we're lifting for strength and power, the strength, and again,

• 25:31Speaker 01

  I'm about to, I'm framing what I'm saying, because now I'm-

• 25:35Mindy Pelz?

  You can say, no, let it go, let it out, let it out.

• 25:38Speaker 01

  All the bros hopping out of the woodwork and telling me that, that I don't know what I'm talking about because, but listen, I've been, I've been in the locker rooms of the best athletes, training with their trainers.

• 25:49Mindy Pelz?

  Yeah.

• 25:50Speaker 01

  Writing my own things, reading, I know what I'm talking, so.

• 25:53Mindy Pelz?

  Yep.

• 25:53Speaker 01

  I'm just, I'm just responding in my own head, this internal-

• 25:56Mindy Pelz?

  Of course. I love it. I'm watching what you're doing. I think it's beautiful.

• 25:59Speaker 01

  So listen, I prescribe powerlifting, upper body push, upper body pull, lower body push and pull. For the four power lifts, so bench press, some kind of pull, deadlift and squat, those are the lifts that I want you to lift to failure, but to get to failure-

• 26:22Speaker 01

  In a lift range of three to six. Now.

• 26:25Mindy Pelz?

  Oh, nice.

• 26:26Speaker 01

  I've been do, I've been taking care of people so long that I know for sure. They want to be, they want a specific instruction. So I have chosen four. It's what I do. It's what my strength and conditioning coach taught me to do. Four reps to failure. So what does that mean? I can pound out four reps. I can, if I'm bench pressing, I can do five like this. But if I try six, one arm's coming down and I'm dumping the weight off, right?

• 26:56Speaker 01

  Four reps, four sets. For each of the power lifts. Now, that's not the whole story, but power lifts are complex. They do multiple joints. They involve your core, everything, right? To support that lift, I then, on bench day, will do the supportive lifts. Biceps, triceps, lats, delts. Eight to 10 reps. I'm not trying.

• 27:19Mindy Pelz?

  I love that.

• 27:19Speaker 01

  Until I, yeah. So that is the framework that.

• 27:23Mindy Pelz?

  Okay.

• 27:23Speaker 01

  That I use for midlife women, plus the core. So that basic framework builds strength.

• 27:30Mindy Pelz?

  Okay. How many days a week are we talking? Cause you're doing the main muscles?

• 27:34Speaker 01

  Minimum of two. I'd love people to carve out four days, but minimum of two.

• 27:41Mindy Pelz?

  And what, would it, would it look like two days of the power lifting and two days of the supportive lifting?

• 27:47Speaker 01

  No, so it's one power lift a day. If you're doing four days a week, one power lift a day. And the supportive lifts to go. And there's some overlap. For instance, on a deadlifts, deadlift supports might be some plyometrics, might be some step, step ups with a weight. Might be some goblet squats, might be some hamstrings. And her muscles love varieties, so it's, it's usually not the same thing for six weeks or.

• 28:13Speaker 01

  So, but, but it's, so that's how I do strength. Now, when you, that may take six months to build up through from nothing. It may take nine months to get this form down. I had to expect nobody to go from couch to heavy lifting. It's a progression. But, once we're solid in that, once we've been doing it for a while, if we want power, which is strength over time, then we add in some tempo lifting, meaning I hate this when my strength guy makes me do it. One, two, three, down.

• 28:47Mindy Pelz?

  Oh, yeah, I hate that.

• 28:48Speaker 01

  Closing up, I'm like, this is torture. But, that's gonna get me off the floor when I'm on the floor. That power is gonna keep me safe, right? Because we lose our type 2 muscle fibers with age. And so, building power, the plyometric type things, that's what that's all for, not to torture us.

• 29:09Mindy Pelz?

  Well, you also bring up a really good point and something that my athletic brain had to think about in my 40s is that the purpose of working out became very different. And, right? Like, I, like, you, you mentioned dopamine earlier, like, the, the pushing myself out of breath gave me the dopamine high. And I started not running as much because I kept getting injured. And so then, all of a sudden, I had to call it forward movement exercise because I thought if I called it, if I called it walking, I was criticizing myself. I was like, are you seriously walking? And then, the other part of my brain was like, no, I'm moving forward. It's a forward movement exercise. But then I realized that right, left, right, left movement was really calming to the nervous system.

• 29:52Mindy Pelz?

  So, all of a sudden, forward movement became my, like, you know, Xanax. And so, I, I really repatterred everything. But, strength training.

• 30:03Mindy Pelz?

  What's interesting about strength training for most, not maybe in your 40s, but if you start, if you're listening to this and you're in your 50s or 55, it's not like you're gonna do all this heavy lifting and look in the mirror and have bulging muscles. You're gonna have security as you continue, and maybe you will, but it does, for me, I've noticed it doesn't have the same visual effect. But where I notice it is when I'm standing in line and all of a sudden my posture feels better. Or you brought up the point, I reach down to pick something off the ground and I'm like, oh wow, I can pop back up. So can you, can you talk a little bit about what we could expect?

• 30:43Mindy Pelz?

  If we follow a strength training protocol that might be as satisfying as looking in the mirror and seeing a muscle?

• 30:51Speaker 01

  Well, so here's what happens. The only people who pop out muscles like you're thinking are, I mean, some, some people are genetically that way. You may work out forever and it's just part of your cytoplasm. People with very low body fat.

• 31:08Mindy Pelz?

  Right.

• 31:09Speaker 01

  Will expose their muscles, right? You may have, look at discus throwers or shot put throwers. Those are really muscular people, but they also have a lot of body fat. So they don't, you don't see the definition. But what you will feel if you're a midlife woman is your clothes will fit better. You will have a leaner profile because you know, you'll, you'll burn some of the visceral fat. And I wrongly say, but I, just for ease, I say we're exchanging fat for muscle. But this is leaner, when we get on a body composition, we're leaner. Makes our clothes fit better, because I say muscle is nature's Spanx.

• 31:50Mindy Pelz?

  Hmm, that's beautiful.

• 31:52Speaker 01

  It really goes away a little bit. And so those are still satisfying, right?

• 31:56Mindy Pelz?

  Yes, agreed.

• 31:57Speaker 01

  If I want to be really cut and lean, that is hard bodybuilder work. You gotta build by eating more calories to build the muscle. And then you don't look like you're lean at all. And then you gotta suck all that off. And unless you're trying to do that.

• 32:14Mindy Pelz?

  Yep.

• 32:15Speaker 01

  What's the goal? I always return to, what are we working for?

• 32:19Mindy Pelz?

  Right.

• 32:19Speaker 01

  I am working for strength and power. Along the way, my clothes fit better.

• 32:25Speaker 01

  I'm leaner. I'm not quite as jiggly. I don't have to wear Spanx, right? So, not that I don't like Sara Blakely, I sure do.

• 32:34Mindy Pelz?

  I was gonna say, you know, hopefully Sarah's not listening.

• 32:37Speaker 01

  I'm not agreeing with you, Sarah. I'm just trying to build some muscle.

• 32:41Mindy Pelz?

  Yeah.

• 32:44Mindy Pelz?

  Yeah, so you bring up a really important point because when I was in my 20s, I think most of us when we were in our 20s and 30s used cardio to get the same effect. You're saying, hey, when you go into menopause, use weightlifting to get the same effect you were trying to get in cardio in your 20s and 30s. Is that, is that accurate?

• 33:03Speaker 01

  And the fact of the matter is that you can have a big cardio engine and still not be strong in old age. Can't, still can't open the pickle jar.

• 33:15Mindy Pelz?

  Right.

• 33:15Speaker 01

  Maybe a lifelong runner and still become frail because you can't, because you can't get up out of a chair. Because running doesn't build the same kind of muscle that lifting does in the lower body.

• 33:27Mindy Pelz?

  No. And what about grip strength? You know, we have all these studies on how grip strength is a predictor of longevity.

• 33:36Speaker 01

  Yeah.

• 33:36Mindy Pelz?

  And what I've noticed in the weightlifting was that you're, there's, you have to hold the bar, you have to pull yourself up. Like, there's a natural increase in your hand strength. And that has to be beneficial. Do we, what do we know about grip strength and, and its purpose through menopause?

• 33:55Speaker 01

  Yeah, you know what, there's a, and those studies are population studies. They're not done in, it's not particularly in women, per se. But what it showed is people who have had a better grip strength, I think the number in women is over 30 pounds of grip strength. Men over 50, I believe, if I'm remembering my numbers well. It just infers, oh, better overall strength. It's not saying that you can bench a certain amount of pounds. It just means, in general, you have upper body strength, which is always less than lower body strength. Remember, those are in populations, those are population studies. What do we know about our population in the United States at least? 70% of people do no form of organized exercise at any time.

• 34:39Speaker 01

  So, I think it's a predictor of longevity and frailty.

• 34:44Speaker 01

  Kind of a party trick, if you ask me.

• 34:46Mindy Pelz?

  Yep.

• 34:47Speaker 01

  I wouldn't be satisfied. I have a grip strength of whatever, over thirty-five. That's not the end all be all. It doesn't mean I can stop working.

• 34:55Mindy Pelz?

  Right. So I I shouldn't buy one of those grip strength or like.

• 35:01Speaker 01

  And I show people, I'm like, let's see what you can do. But it's it's an awareness.

• 35:06Mindy Pelz?

  Mm hmm.

• 35:06Speaker 01

  Because if you've got a grip strength of twenty and you think you're okay, you're not.

• 35:11Mindy Pelz?

  Yep. Yep. Okay, so we've got nutrition. We've got strength training.

• 35:17Speaker 01

  Mm hmm.

• 35:18Mindy Pelz?

  Are and we I I think we've said it, but you know, I'm curious if you strongly feel we should stop the long distance running, the Spartan racing, the CrossFitting. Like, is all of that off the table as we go through this?

• 35:32Speaker 01

  No, I don't think I am not the orthopedic surgeon that is ever going to tell you to stop running because it's going to give you arthritis. Number one, there's no data, no data at all.

• 35:44Speaker 01

  I am never going to stop you from

• 35:49Speaker 01

  from wanting to achieve a goal. I do Spartan races. I mean, I still I mean, one of my my first Spartan race was several years ago, I was at that time, I was fifty-six and someone actually said that I was giving a speech and as I walked on, the introducers like, and she ran her first Spartan race at fifty-six. And I started thinking, what does that have to do with it?

• 36:09Mindy Pelz?

  Right.

• 36:11Speaker 01

  I'm capable. I believe that I'm going to try to not die. So, no, I am not saying, but what I'm saying is you need to train differently and you need to harness the wisdom of your age, not to be a jackass out there and just think that because you were twenty and could do it, you can do it now. Right?

• 36:28Mindy Pelz?

  Right.

• 36:29Speaker 01

  You unless you've been kept training for that, keeping your tendons and ligaments springy, building muscle mass, feeding your body, don't expect it to respond like it did the morning you woke up from parting the night before and you ran a race. That doesn't happen at our age.

• 36:45Mindy Pelz?

  No.

• 36:46Speaker 01

  Right? So.

• 36:47Mindy Pelz?

  Yeah. What about rucking? Rucking is making quite, I'm sure you're getting asked this all the time. And I'll, I'll tell you my behind the scenes. I, I watched all the rucking and I watched all the women that were rucking and I, the first thing I thought is, are you fucking kidding me? I can't just go for a run. I can't just go for a hike. Now I gotta put a goddamn weighted vest on. Like, I, I was like, I'm rebelling against this.

• 37:15Speaker 01

  You are.

• 37:16Mindy Pelz?

  And then I put, and then I put one on.

• 37:18Speaker 01

  Whoa, you loved it.

• 37:20Mindy Pelz?

  I loved it.

• 37:22Speaker 01

  What did you love about it?

• 37:24Mindy Pelz?

  Well, so at the time I was living in LA and our neighborhood had a really like a steep hill. And so if I put it on and I walked up the hill, I had the same cardiovascular impact that I did as if I was running a sprint on a, on a track.

• 37:41Speaker 01

  Yes.

• 37:42Mindy Pelz?

  So, but I didn't have the joint jamming and I got the high and I got all of it. So then I, then I was addicted.

• 37:49Speaker 01

  So I am so glad you said that because the data are, you know, come on, the data on whether it builds bone density are kind of plus minus, really small study. It's a big in the, it's really big in the menopause circles. And I am never going to encourage women not to do it if it makes them feel like they're achieving something. But if it's the end all and cure all weighted vest, maybe they increase your bone density one to three percent consistently. But you know why I like it?

• 38:17Mindy Pelz?

  Yeah, tell me.

• 38:19Speaker 01

  So I have a 20 pound weighted vest. Exactly what you found. I can get the same workout at less intensity. My heart rate goes, it's about 10 extra beats per minute with this.

• 38:34Mindy Pelz?

  Yep.

• 38:34Speaker 01

  With this, I wear a full vest, 10 extra beats per minute. I'm feeling all like badassery because I'm wearing this vest. But you know what? The vest I have, I wear a rucksack vest. It has these little ties on the side. It does something to my nervous system.

• 38:52Mindy Pelz?

  Oh, oh.

• 38:53Speaker 01

  So, it's like a hug. It's like, like a, it's like, you know, you're upset. Okay, hug from behind.

• 39:00Mindy Pelz?

  Yes.

• 39:00Speaker 01

  Calming my nervous. I don't know if that's real.

• 39:04Mindy Pelz?

  Yes.

• 39:05Speaker 01

  But I feel that so it's a calming of my nervous system now.

• 39:10Mindy Pelz?

  It's I'm so happy you said that because I thought the same thing. I came back and I was like, I am so happy and so calm. And I don't know what's going on. And I thought I I it reminded me when my kids were in kindergarten. I remember there was a kid that was would act up in the in class all the time. Well, actually, what the mom did is she brought in a bunch of weighted frogs, like those like like frogs, like stuffy frogs, but they were heavy like a beanbag. And it was a parent participation class. And she said, if Joey acts up, put a frog on his shoulder. And I remember at the time thinking that really like that's really going to help Joey in his in his tantrum.

• 39:52Mindy Pelz?

  And then one day I was in class and Joey acted up and I pulled a frog out and I put it on his back. And sure enough, he quieted. And then I started putting frogs on my these weighted frogs on my kids and on the I'm like, let's calm everybody down. And so when I put the rucking vest on, I thought the same thing. It's like a weighted blanket. It's like a and at a time when our nervous system is so frazzled.

• 40:16Speaker 01

  Yes.

• 40:16Mindy Pelz?

  It gives you that added sense of security.

• 40:20Speaker 01

  Yes. Some and you know what? One day I was just wearing it around the house, cleaning the house.

• 40:25Mindy Pelz?

  Oh.

• 40:26Speaker 01

  My daughter's like, oh, you're wearing your vest. I'm like, it just does something to calm me.

• 40:31Mindy Pelz?

  That is somebody needs to come up with like a funny meme where like a menopausal woman is like highly agitated. Then she puts a rucking vest on is like, yeah, it's really, I don't think it gets enough credit for that. And and I went back to go look at the evolutionary explanation for why rucking might be helpful to menopausal women. And if you go and you look at like, you know, people like Kristin Hawks, who's the champion of the grandmother hypothesis and has studied the Hadza tribe, what they grand the post menopausal women do in the Hadza tribe is they go for a walk every day to go forage for food, but they take the kids, like the toddlers,

• 41:16Mindy Pelz?

  like the four and five year olds that couldn't go out and hunt and aren't really staying at home with the women who are nursing and pregnant, and they would put them on their back. And they would walk with them. Yeah, they're talk. I mean, it when you study the grandmother hypothesis, you realize that we are fitness wise, not meant to perish. We're actually meant to be even better than ever.

• 41:39Speaker 01

  Yeah.

• 41:39Mindy Pelz?

  But it is. And then she would get a bunch of tubers. She would put them on her head. So she was constantly waiting herself, which is an evolutionary design.

• 41:49Speaker 01

  Interesting. It makes sense. You know, it really makes sense. And it makes I just he made me think I have this gorgeous 40 pound grandson.

• 41:59Mindy Pelz?

  Put them on your back.

• 42:01Speaker 01

  Put them on my back. I lift them up to the

• 42:03Mindy Pelz?

  Yeah.

• 42:03Speaker 01

  Swing sets. So it makes so much sense, doesn't it?

• 42:06Mindy Pelz?

  Yeah, yeah, he's he can go. He can be your strength training and then you're getting oxytocin with him. Like the whole thing is amazing.

• 42:13Speaker 01

  It's all good.

• 42:14Mindy Pelz?

  Okay, anything else we need to know about?

• 42:17Speaker 01

  Yes.

• 42:17Mindy Pelz?

  Yeah. Okay, please tell me.

• 42:18Speaker 01

  Fill it out. So when I prescribe exercise to midlife people, we talked about I the acronym I use is FACE. Again, I find people like

• 42:27Mindy Pelz?

  Yeah, it's great.

• 42:28Speaker 01

  F is flexibility and joint mobility. I know this will ring with you because we have to keep our tendons and ligaments long and we have to keep our joints moving through a full range of motion. Otherwise, they get dried out, all rusted out, and we become the hunched over shuffling people. So that's F. A is aerobics. C is carrying a load. We talked about, but E, we've got to spend time on equilibrium and foot speed. I physically teach the women that come to here to be with me physically. Foot speed. I have this. I have this Olympic track and field at speed coach here in this place where I work. We teach our women the same

• 43:12Speaker 01

  methods that we teach Olympic athletes to move our feet fast. And why do we need to do that? So when we're trying to trip, We don't fall down. We have enough foot speed to get over the bag that I trip on nearly every day by my desk, or not to fall off the curb, so that we do not have the fatal fall.

• 43:35Mindy Pelz?

  Yep.

• 43:35Speaker 01

  We're alive and well. We trip over something.

• 43:39Mindy Pelz?

  Yep.

• 43:39Speaker 01

  We break our hip and we have a 30% chance of dying in one year. It's foot speed. It's balance.

• 43:46Mindy Pelz?

  So what does that, you know, that just happened to my 85 year old mom. She fell over on a box and, and fracture, and osteoporotic fractured her shoulder, had to have reverse shoulder surgery. And I, I, you know, you, your parents can be really good models of what you don't want to age like. And I thought about that. Her balance can be really off. So what does foot speed look like? Like, is it, like, do I, do I need to take up like salsa dancing or, or can I?

• 44:13Speaker 01

  Salsa is a very good way to work on all of this, including your brain. Salsa, pickle. But foot speed looks like, imagine, imagine sitting on a box, sitting on a, a plyo box, and just on the ground going like this real fast.

• 44:31Mindy Pelz?

  Oh, just like, in, it, we call it, you know, I used to do P90X forever. And he called it football sprints. We were like.

• 44:40Speaker 01

  Exactly. Agility. Or sometimes we use hexagons and we just go foot out, foot in, foot in.

• 44:46Mindy Pelz?

  Oh, yeah.

• 44:47Speaker 01

  You know what I'm going to introduce back? I just made a reel about this. I am going to introduce hopscotch back to this.

• 44:52Mindy Pelz?

  Oh, hopscotch is so fun. Yes.

• 44:56Speaker 01

  It's jumping, it's lateral motion and play. Play is so good for us. Yes, I want to, when I post that, I want to see you hopscotching because it's all in. Yes.

• 45:08Mindy Pelz?

  Oh, my God. And, and then you get to act like a kid, which is going to now bring in like dopamine and serotonin. So wait, but, but you could do even more. Like you could do, everything on the play yard was great. So we had hopscotch and then we had monkey bars. Have you ever tried doing the monkey bars as an adult?

• 45:25Speaker 01

  It's, yes, because it's hard and race and it's very hard.

• 45:29Mindy Pelz?

  Okay.

• 45:30Speaker 01

  Very hard, but that's grip strength, that's upper body strength. Yeah, I'm not gonna doing a rope, but I can do the rings.

• 45:37Mindy Pelz?

  Yeah, it's so it's and what about jump rope? Would jump rope be good?

• 45:40Speaker 01

  Jump rope.

• 45:42Mindy Pelz?

  Yeah.

• 45:42Speaker 01

  Good for foot speed and jumping because for those of you listeners that don't know bone builds, when we translate biomechanical impact, literally bashing your bones to biochemical signals that, oh, we need to build some bone osteoblasts, jump roping, jumping up and down, plyo boxes, a mini tramp can work. NASA uses mini tramps. If your knees are killing you, get in a pool and jump in a pool, right? I'll take anything to build your bones. But, but four times body weight jumping is, is what the papers say that.

• 46:22Mindy Pelz?

  Interesting.

• 46:23Speaker 01

  Yeah, so.

• 46:24Mindy Pelz?

  What about vibration plates?

• 46:26Speaker 01

  Yeah, like power plates have some research that shows that the small vibrations, I forget the hertz, 50 hertz, can that going up your bones can stimulate osteo, the osteoblast to build bone.

• 46:40Mindy Pelz?

  Mm hmm. And so if we, I love your acronym of FACE. So if we follow the FACE strategy that if we've, if we've, is that what we, if we've, I was gonna say face ourselves, we face ourselves.

• 46:52Speaker 01

  Yeah.

• 46:53Mindy Pelz?

  Is, is that a recipe not just for keeping your posture strong and your moods good, but is it a recipe for preventing osteoporosis?

• 47:03Speaker 01

  Impact in the form of cardio can prevent osteoporosis. Lifting definitely. We can increase our bone density up to 13% a year by a consistent, heavy lifting program because of the, again, the mechanical pull on bones. And then the way equilibrium and foot speed works is to prevent the fatal fall. So all the face is how I encompass all the, all the types of mobility that we need in midlife. Cause listen, when I was 20, I got away with cardio and I didn't lift that much, but like you did, I, my balance was good, my flexibility was good, but now.

• 47:46Speaker 01

  We need to pay attention to those four things.

• 47:49Mindy Pelz?

  Yeah, I think, I think that's so beautiful. Okay, what, I want to come back to collagen and creatine because I do know the connection that as estrogen goes down, those two go down as well. Are, you, you had mentioned, you, my sense in what you said before is you're not a huge supplement fan. Is that, did I misread you?

• 48:09Speaker 01

  I have a short stack. I don't have sixty-two things.

• 48:12Mindy Pelz?

  Excellent, tell me.

• 48:13Speaker 01

  I have a short stack. We must have enough calcium, but I prefer calcium be taken in food. I prefer.

• 48:20Mindy Pelz?

  Okay, such as?

• 48:21Speaker 01

  Such as, believe it or not, salmon poached with the bones. Like in a can, like fresh, fresh canned salmon, or sardines, mushrooms, prunes and figs, all dairy. I mean, when you add those up, you can get eighteen milli-, eighteen hundred milligrams of calcium pretty well, if you're eating.

• 48:42Mindy Pelz?

  Amazing.

• 48:43Speaker 01

  Right, yeah. Supplement, vitamin D3, obviously. Magnesium, five hundred milligrams in the form of L-3-nate or glycinate, not citrate, people, unless you want diarrhea, because that's what we give in the hospital to relieve

• 48:59Speaker 01

  constipation. Yeah. Magnesium citrate, a little green bottle, does the trick. Creatine, I take ten grams of creatine a day. Five is what we started with, and then that paper recently came out with Alzheimer's cognitive function with twenty, so I'm like, okay, I'll just up it to ten.

• 49:16Mindy Pelz?

  Yeah.

• 49:17Speaker 01

  So ten of creatine, really good, really good research with muscle and brain. What else? Lots of protein. I take a few longevity-type supplements. I don't take the whole stack that people can. I take a form of NMN, so that my body will build NAD+

• 49:36Mindy Pelz?

  Okay.

• 49:36Speaker 01

  Measure my intracellular NAD+ with a, there's a, there's a lab called Gynfinity, owned by a science of my, scientist, a friend of mine, so that. I also take Ficitin, because I am really interested in senescent cells.

• 49:53Speaker 01

  Increasing the load of senescent cells, which for your listeners are those cells which are neither living nor dying, they're just too damaged to die. So they're spewing out all kinds of cytokines. So Fisatine comes from berries, strawberries. You can't get enough by eating strawberries. But a lab out of Vail led by Johnny Huard has done tons of research showing we can do senescent cell load with these.

• 50:19Mindy Pelz?

  Beautiful.

• 50:20Speaker 01

  Yeah, these simple supplements. Thinking what else I tell, I'm, I'm visualizing my.

• 50:26Mindy Pelz?

  Are you, yeah. Are you a big fan of, oh, count your, your, like, do I need to get 30 grams at every single meal? Or are you just like, hey, just eat protein?

• 50:35Speaker 01

  Well, eat protein. I'm a big fan of a gram per pound. Here's why. Here's why. Uh, I can support with research up to point seven three to point eight six grams per pound. But I'm a clinician and I'm telling you, nobody's doing that math.

• 50:54Mindy Pelz?

  Right. Yes, thank you.

• 50:56Speaker 01

  Yeah, nobody's doing it. And number two, we don't absorb it all.

• 51:00Mindy Pelz?

  Yes.

• 51:00Speaker 01

  So, so, but I think we need enough protein. I find most women are under protein. They eat a salad with nothing, dressing soup. I call it dressing soup.

• 51:12Speaker 01

  The box and the lettuce is all.

• 51:14Mindy Pelz?

  I love that. Would you, would you, what would you say to a vegetarian?

• 51:19Speaker 01

  You know what? Here's what I say to you. Think about bulls. Bulls are bovine, are completely made of muscle. It is possible to build muscle eating only vegetables. You just have to eat all the frigging time.

• 51:35Mindy Pelz?

  Right. Oh, yeah.

• 51:37Speaker 01

  So many calories. Three and a half cups of northern white beans to get the same protein in a little cup of yogurt. It can be done. Number one. That being said, you have to be mindful of your essential amino acids. You're probably not going to get the branched chains, the, the other six amino.

• 51:56Speaker 01

  There are nine essential amino acids, but you know, you know this. You gotta be very careful if you're only eating plants.

• 52:02Mindy Pelz?

  Yeah, yeah, you have to be really intentional. That's, that is, I mean, I, I was a vegetarian in my twenties.

• 52:10Speaker 01

  Yeah.

• 52:11Mindy Pelz?

  Oh, horrible. I, I was injured all the time. I was a competitive athlete. I gained a bunch of weight because I was just doing carbs all the time. And I didn't, it took me a long time because I had read Diet for a New America by John Robbins. And I was like, oh my God, we're hurting the animals. And so then I decided, and then I just became sicker and sicker until about 25. I was like, I'm done. I need to go back to eating meat. And things, things got a lot better. So, but I, I have a lot of empathy for people who are like, well, I don't want to eat animals. I, and I, and, and we do need plants. We need to eat plants. But at the end of the day, I think if you're looking at muscle in general, it needs a lot of protein and it's hard to get. Yeah. So, and do you think

• 52:56Mindy Pelz?

  osteoporosis is preventable?

• 52:59Speaker 01

  So here's my take on it. The short answer is yes, but it doesn't start in midlife. We lay down maximum bone density between about 15 and 25. Some will extend it to 30. I do bone densities on everybody, either by DEXA scans or REMS, which is ultrasound. And I have 22 year olds and 30 year olds with terrible bone density. So either we, so number one, we can prevent it if we lay down enough bone initially and get a high peak bone mass.

• 53:29Mindy Pelz?

  I like that.

• 53:30Speaker 01

  And don't because we are taught to be small and not eat. Or maybe we are athletes and we're not refeeding enough. So we, we're not having periods for nine months. I used to not have periods for months because I was a ballet dancer.

• 53:46Mindy Pelz?

  Oh, wow. Oh, yeah, that's the worst.

• 53:49Speaker 01

  That's the worst. And then. So we need to lay down bone to prevent. Then what happens when we're making babies? We take 500 milligrams of calcium from our bones a day to make a baby. And now we're programmed to rebuild that, but only if we're eating well enough. Only if we have time to rebuild and don't have a baby every year first. So that's the, that's the motherhood loss of, of calcium. And then at 45, we start losing our estrogen. There is a normal aging decline in bone density that happens in men and women.

• 54:28Speaker 01

  But for women without the stimulation of estrogen, which balances bone breakdown and bone damage, we precipitously will lose 15 to 20%. So that's why, Mindy, I want people to start in the critical decade.

• 54:45Mindy Pelz?

  So smart.

• 54:47Speaker 01

  Because to prevent osteoporosis in women who have already lost 20%.

• 54:53Mindy Pelz?

  Mm hmm.

• 54:55Speaker 01

  Rolling a boulder up a hill, it's much harder than knowing it's going to happen, getting in front of it, putting all the things in place and never losing it in the first place. Now, if you have lost it, like if you're osteopenic, your, your T score is down to below minus one, but not yet osteoporotic, you can rebuild that. We jump, we eat protein.

• 55:19Mindy Pelz?

  Yeah.

• 55:20Speaker 01

  We lift weights heavy, we do all the things. You can reverse osteopenia. And then osteoporosis. Yeah, you have to think about whether you want to use medications.

• 55:33Mindy Pelz?

  Yeah. It's interesting because my 85 year old mom has had two hip replacements, a shoulder replacement, and she's awesome. Yeah, she's bionic and she's osteoporotic. And so my sister, my sister's in like 58. We, we spend a lot of time like talking about how do we not end up like mom? And, and so it is, it is interesting. I love this idea of doing it early, even though I'm out of that critical period.

• 56:01Speaker 01

  Yeah.

• 56:01Mindy Pelz?

  I do, I just am curious. I mean, for me, the rucking, one of the things that inspired me was what I had seen in the research on rucking and osteoporosis.

• 56:12Speaker 01

  I don't want to give your people the thought that it's too late ever.

• 56:16Mindy Pelz?

  Right.

• 56:16Speaker 01

  Too late. Your body will always respond, always, you know? Even, my mother's eighty-six and she's building muscle, you know?

• 56:25Mindy Pelz?

  That's amazing. That's amazing. You need to do a reel with her.

• 56:28Speaker 01

  Oh, she's amazing. Yeah.

• 56:30Mindy Pelz?

  What about hip replacements? You think, I mean, that's a pretty in vogue surgery right now. Is it, is it preventable?

• 56:38Speaker 01

  So, listen, I, I think I've already said that ar- arthritis rapidly progresses in women over fifty because of the loss of estrogen. It's preventable if we get in front of the estrogen problem. It's preventable if we don't develop the arthritis that comes by carrying around an extra fifty or a hundred pounds.

• 56:57Mindy Pelz?

  Hmm, hmm, interesting.

• 56:59Speaker 01

  Because cartilage is very sensitive to load. In fact, in our cartilage lab at, I was at the University of Pittsburgh, we used to kill cartilage by just dropping a weight on it, right? It's very sensitive. That sense, it's preventable. But

• 57:15Speaker 01

  in my career lifetime, the attitude on total joints has changed completely.

• 57:20Mindy Pelz?

  Oh, yeah.

• 57:21Speaker 01

  We used to wait until the last minute, get it, get it at the last very minute, suffer for twenty years, lose all your muscle mass because you only get one set. Now, we know that by sentencing people to sitting around for twenty years until they're old enough, we're sentencing, we're sentencing them to sedentary death syndrome. So I am much more apt to send a fifty-year-old who have destroyed their knees due to trauma or sports or something like football, to get knee replacements?

• 57:54Mindy Pelz?

  Mm-hmm.

• 57:54Speaker 01

  Knowing that we might have to revise them in twenty years.

• 57:58Mindy Pelz?

  Yeah.

• 57:58Speaker 01

  But I've given him or her twenty years of active life. Does that make sense?

• 58:03Mindy Pelz?

  Yeah. Oh, yeah, yeah. And I've totally changed my opinion on, on joint replacement after just having so many people in my life go through it and watching them and going, wait, that, that really looks like it kind of worked. So, yeah, so you're right, the technology has changed. Where, where do you think HRT fits into the musculoskeletal profile of, of a menopausal woman? Like, would you sit with every forty-year-old and just say, yes, you have to get on HRT? Like, is it a must in order, from a musculoskeletal lens?

• 58:37Speaker 01

  So.

• 58:40Speaker 01

  My statement is every woman is a sentient being with agency to decide.

• 58:45Mindy Pelz?

  Yeah.

• 58:46Speaker 01

  But I insist, yes, I insist however, your decision be made based on facts, not fear. Not fear of the W H I, but the facts of what we know from reanalysis of data. That's where I stand on that. That being said, every musculoskeletal tissue has estrogen receptors.

• 59:05Mindy Pelz?

  Right.

• 59:06Speaker 01

  So if I want to maintain muscle and bone and tendon and ligament and cartilage, I want enough of it around. And I'm going to tell you for sure, Mindy, in my patients and in my own life, the minute or the, the month that I started with hormone optimization, my arthralgia went away.

• 59:26Mindy Pelz?

  Hmm.

• 59:27Speaker 01

  My body didn't hurt anymore and I could get out of bed. And for the women out there that suffer from frozen shoulder, which is infla- like just everybody.

• 59:36Mindy Pelz?

  Yeah.

• 59:36Speaker 01

  Inflammation of the shoulder capsule. That's a critical part of decreasing that, that inflammation that just takes over your, your shoulder joint. So is it mandatory? Hormones are never mandatory. Do I demand people make the decision based on facts and make an intelligent decision? Yeah. And if you decide that you just want no part of it, like 90% of women do, well, that's your decision. There are consequences to every decision that you make with agency.

• 1:00:07Mindy Pelz?

  Yeah, that's, that's really well said. Though, one of the ways I always explain it is that it's definitely a personal, personal choice. And, but it doesn't give you a free pass from lifestyle changes. And yeah, I think, I think a lot of women were like, oh, okay. Well, I can just stop suffering and eating my Big Mac and skimping on sleep and not working out. And I'll rub some cream on me and I'll be fine. And I think, I think hopefully as a collective world, we're starting to see that different.

• 1:00:37Speaker 01

  Yeah, it's not one thing.

• 1:00:39Mindy Pelz?

  Right.

• 1:00:39Speaker 01

  It takes an ecosystem.

• 1:00:41Mindy Pelz?

  Yeah, yeah. So, so dream with me as we finish this up. Dream with me for a moment. If, if people hear. Conversations like this, they read your book. They start to approach menopause from such a different angle than our mothers did and our grandmothers did. What, the piece that I haven't visually been able to master in my mind is where do you think we'll be at 80? What do you think 80 will look like aging if we follow your formula?

• 1:01:12Speaker 01

  Eighty will be, we get to do what we want to do, when we want to do it, without having to ask somebody to help us unless we want to. That, that's my 80, 97, whatever I live to goal. I may choose to ask for help, but I don't want to have to.

• 1:01:33Mindy Pelz?

  Beautiful. That's beautiful. How long do you think, I just have to add this extra thing, how long do you think the musculoskeletal system can thrive? Like the human body, they say is you can live to 120. Do you think you can, if you follow regimens like what you're teaching, do you think you can physically thrive well into your hundreds?

• 1:01:53Speaker 01

  I think so, as long as you haven't traumatized your joints as a young person. I had, I, you know, I was a football doctor. I had very young men with very old knees from the trauma. So if we do constant maintenance, we're reinvesting, we're feeding this vessel. I think our, our bodies are meant to last.

• 1:02:15Mindy Pelz?

  Yeah, I love that. And I think that, I mean, that is the message that needs to get out because we need to re-pattern in our brains how we see aging. And the only model, visual model we have right now is our mothers. And then we of course have our grandmothers. But there's this whole new wave of, of aging that's coming. And I think we need more to point out that more and more about just how the body was built to thrive even into our hundreds.

• 1:02:43Speaker 01

  And you know, I can tell you for sure, that has been the guiding light of my career to change the way we age in this country.

• 1:02:49Mindy Pelz?

  I just love that. Well, I'm excited for your book. How do people get it? Where do, where, where do they go buy it?

• 1:02:55Speaker 01

  It's available everywhere now for sale. There's a website, theunbreakablebook.com. So it has all the goodies on it, The Unbreakable Book. I hope everybody loves it.

• 1:03:07Mindy Pelz?

  Yeah, it is a great name. When I first saw it come through my socials, I was like, "Ooh, that's a good name for a book." So, well done on that. And we'll leave links for everybody. And I have to ask you, what's your favorite chapter? Do you have a favorite chapter or section of the book?

• 1:03:27Speaker 01

  I like the stories I tell throughout. But you know what I love? I just got done recording it on audiobook. I really love. There's one chapter that's all about this conversation. It pulls everything about aging into the menopause conversation.

• 1:03:45Mindy Pelz?

  Amazing. Amazing.

• 1:03:46Speaker 01

  I love that chapter.

• 1:03:47Mindy Pelz?

  Well, I can't wait to read it. And I'm just so happy that you're like bringing your information out. I think it's so easy as doctors for us to just get stuck in our little clinics. And the benefit of social media and books is that you get your knowledge, but they aren't necessarily in your clinic. So.

• 1:04:07Speaker 01

  Well, thank you.

• 1:04:08Mindy Pelz?

  Yeah. Yeah, thank you. I've really enjoyed this. And good luck with the book. And everybody go get it. We should have like one bookcase that just has all the menopausal books. Yeah, because you can't have too many. So, yeah, so thank you. Cheering you on, Vonda. Thank you for this conversation.

• 1:04:27Speaker 01

  My pleasure.

• 1:04:29Mindy Pelz?

  Thank you so much for joining me in today's episode. I love bringing thoughtful discussions about all things health to you. If you enjoyed it, we'd love to know about it. So please leave us a review, share it with your friends, and let me know what your biggest takeaway is.