The 8 Steps Every Woman Over 50 Needs to Build Unbreakable Bones | Dr Vonda Wright

**Dr. Vonda Wright** (0:00)
Hi, and welcome to the Unbreakable Bone Mini Series. I'm Dr. Vonda Wright, your orthopedic sports surgeon and longevity and women's health expert. We have been talking in the prior episodes all about what bone is, what it does, the surprising fact that bone is a master communicator. I shared with you some pretty startling statistics in episode one, and now we're going to spend the entire episode today talking about eight shields that will help you build better bone. Bone strength is highly responsive to the input you put into it, and it's engineered through specific evidence-based inputs. Here are the eight shields. They're all clinically refined and data-based. Number one, you need a mindset mobilization. What did I just say? I'm not starting by telling you to impact your bones. I am, and I'll get there. But the number one thing we have to do, if we are going to look to the future as living longer, living better, doing it as mobile as we can, is a mindset mobilization to quit worshipping our youth. Yes, I know that our 20s and maybe even our early 30s are just so much fun. And we did anything we wanted at any time. And sometimes what happens, especially in this country, is we yearn for that. We think, oh my gosh, I have reached midlife and it's all going to be downhill from here. Nothing could be further from the truth. There are so many examples. And thank goodness, a growing movement in this country that we can live longer, better. And that is the only way by pivoting our mindset from worshipping our youth to understanding that if we put in the work every day, we can live healthy, vital, active, joyful, long into the foreseeable future. So the first shield in building better bone is pivoting our mindset. Number two, I'm going to ask you to consider hormone optimization. We talked in episode one about the fact that one of the primary ways that women have rapid loss of bone is when our estrogen walks out the door and never looks back. And that happens starting in perimenopause. On average, perimenopause starts in our early 40s until we are completely in menopause. On average in this country at 52, when we are no longer producing estrogen, which I've already explained to you, is critical for bone health. I insist that everyone make a hormone optimization decision. And here's how I frame this. I believe that every person is a sentient being with agency, meaning you get to choose. But I insist that you choose whether you go on menopause hormone therapy or what I like to call hormone optimization based on facts, not fear. We cannot just jump on the bandwagon of data that was produced 23 years ago in the Women's Health Initiative that all hormones are bad. No, we must carefully assess and be curious whether they could help you in the way that we know they can. There's a lot of debate out there right now, whether estrogen replacement is good for the brain or good for the heart. But I'm going to tell you, there is no debate that estrogen, progesterone, and even testosterone can help you build better bone. The data is clear, and in fact, estrogen is FDA approved for the prevention of osteoporosis in mid-age women. Here's the deal, I am not telling you that you have to do this, but what I am insisting is that you give yourself the option to make this decision based on facts, not fear. I'm going to give you a resource that changed my life. When I was going through this time of making the decision whether I optimize my hormones, I just knew that I needed to feel better, but I was skeptical, probably in the same way that you may be skeptical, and I read a book by Avram Blooming and Carol Tavris called Estrogen Matters. It is the bringing together of the world's literature on hormone optimization, the safety, the risks in a clear, concise, intelligent way. If you want to change your life and be curious, go read Estrogen Matters. Number one, we're going to mobilize our mindset to believe that the future is worth the work we put in. Number two, we are going to make a hormone optimization decision based on facts, not theory. Number three, here's where the work comes in. You knew you were not going to get away with it. Remember we were talking earlier about the fact that usually bone has a balance between bone breakdown, so that your body can use all the minerals that it contains, and bone building, so that we're not left with holes in our bones or osteoporosis. What makes that balance besides hormone optimization? It's mechanical load. Here's how bones work. There is a guy named Wolf who created an explanation of bone building called Wolf's Law. Basically, it says you need to bash your bones in order for your bones to build themselves. How does that work? Well, here's how it works. There are many cells in a bone. There are osteoclasts, which we've talked about, the bone-eating cells, osteoblasts, the bone-building cells, and then there are mature bone cells called osteocytes that sit within the bone, and they're lonely. The only way they get to talk to other cells is through these little channels of fluid that connect a lonely osteocyte to a lonely osteocyte. But what happens when we give our bones mechanical load? The fluid in those little canals changes, and the body is turning mechanical load into biochemical signals. Isn't that a miracle? By bashing your bone, which we're going to talk about, you are sending chemical signals to the very cells of your bone to build better bone. So it's simple. What is mechanical load? Well, I'm sure you know what it is. Things like jumping, things like lifting weights or resistance training, which we'll get to. Those activities, weight-bearing activities impact and stimulate building of bone, or it's called osteogenesis in science talk. But what is sufficient? What does it mean to bash your bones? I'm asked all the time, well, is walking enough? I walk every day. I want to start out this discussion by saying, you do as much as you can do. I'm going to suggest some things that may sound crazy because your knees hurt or because you haven't done them in years. I want you to start where you are and get to the place that I'm going to point you. Here's the truth of it. Our bones need a mechanical load of approximately four times body weight to stimulate this osteogenesis pathway. Does walking alone get us there? Well, walking generates 1.5 times body weight. So the straight answer is no. How about things like running? Does running get us there? Well, running will generate about 2.5 times body weight. So does running alone get us there? Maybe not. What will get us there? Well, studies have shown that jumping from as low a place as an eight inch step, which is the height of the step at the bottom of your staircase, jumping down and then jumping up. So it's jump down and rebound up, can produce more than four times body weight. But I know what you're saying if you're like so many people who write me on the Internet, I can't jump. I haven't jumped in years. I'm afraid to jump. Start where you are. Maybe you start with some simple heel raises with a thud. Maybe you stomp around your house like you're mad, but you're not. You are trying to create the biomechanical load. You will find that as you progress, you may be able to jump again. And when you can, I want you to jump off the bottom step of your staircase. Or you could do jumping jacks. Or you could jump rope. You get the picture. We just need you to come down hard to turn a biomechanical signal into biochemical stimulation. I did a study once so long ago, published it in 2011, 2008, a long time ago. But studying the Masters Age Athletes of the National Senior Games. When I studied them, we studied 3,000 athletes across all of their sports. And we did bone densities on more than 3,000 of them. And the first question we asked was, can we preserve bone density across the lifespan? And do you know in these Masters Age Athletes, 50 and over, who were chronically active no matter what their sport, they had statistically better bone density than sedentary levels. Even up until their 80s, it was amazing. But then we asked the next question, which sports were most important for maintaining your bone density? We knew what we were going to find, but we needed to document it. Of course, we found that the impact sports like volleyball, basketball, all the running sports produced better bone density across lifespan than the non-weight-bearing sports such as swimming or cycling. But I don't want you to be sad about those data because of the next thing I'm about to say to you.