Kim (00:01.57)
Hi Rebecca, welcome. Thank you so much for coming and joining me on the show. I'm really, really excited about this conversation because it is such a, it's a hot topic with regards to the perimenopause, menopause people in my community, especially because pelvic health is such a, it can halt people in their tracks with regards to things that we think of as building our bones. And so I've been following your journey and really.
interested in your story and also how you help people from a bone health perspective and how that could potentially help people with pelvic health struggles as well. So thank you so much. Welcome. I would love to hand it over to you and have you start us off with telling us your story. What got you to becoming a bone coach, bone health coach?
Rebekah Rotstein (00:49.085)
Thanks, Kim. Well, I consider myself really a teacher. And I am a teacher at heart because education is, to me, the foundation of everything. And I started out actually as a Pilates teacher.
And my roots come from there. Before that, many years before that, I was actually a ballet dancer. So that's really kind of where the story truly begins, which is that, like many dancers, I stopped menstruating. It's very common with any kind of high performance athletes. So, and this was also during my teenage years. So.
Fast forward to where the next part of the story begins is that when I was teaching other
people how to become Pilates teachers. I used to teach the curriculum that dealt with special injuries and conditions. And one of those was osteoporosis. I already had some knowledge about it. And I decided to take a workshop, an additional workshop for myself, where I learned how you build the majority of your bone density in those teenage years. So remembering back to those dancing years, I thought, ooh, this is probably a little bit of an issue for me because I wasn't menstruating.
that you build the majority of your bone health, or I should say the majority of your bone density. I'll come back to health versus density later. So I thought, oh, you know, I'm probably predisposed to this on top of which it runs in my family and I'm really small boned. And I just wanted to get a baseline. So I was 28 and instead of just finding like a little baseline for, to tuck away for the future, I was told, you know, you have full blown osteoporosis and we're going to put you on medication.
Rebekah Rotstein (02:36.419)
and it took down a whole other, took me down a very different path than I was expecting at that point in my life.
Kim (02:44.498)
I can imagine. So does not having a menstrual cycle predispose you to osteoporosis? Does the menstrual cycle influence our bone health or bone density? Ha ha ha.
Rebekah Rotstein (02:55.345)
Yes. It does, it does, exactly. And so the reason is that during your reproductive years, you are filled with estrogen and that estrogen is also a bone preserver, which is why once we hit menopause and we lose estrogen, we lose that preservation of bone and you have that rapid acceleration of bone loss. So.
To answer your question, yes, those who have, well, there's something called relative energy deficit in sport, which relates one of the elements of that is this female athlete triad where you stop menstruating and you, there may be an eating disorder, there may not be an eating disorder in this whole.
relationship but osteoporosis predisposition then is in effect. So for anybody who has not been menstruating and it has nothing to do with menopause, that does predispose you to either early bone loss or in my case a lack of building up your peak bone mass.
Kim (04:03.462)
it. Okay. So then I want to go right to that distinguishing factor of bone health versus bone density. And yeah, what's the difference?
Rebekah Rotstein (04:09.586)
Mm-hmm.
Rebekah Rotstein (04:16.657)
This is one I feel pretty passionate about because your overall bone strength and the determinant of whether or not you will actually fracture has a number of factors, one of which is the density of your bones. And it's an important factor, but it's not the only factor. And what often happens is...
it becomes the entire overarching discussion when there are actually a number of shortcomings with bone density, both within the findings and epidemiological rates of fracture, as well as with the diagnostic tools for determining your bone density. So bone density is important, but it's not the only factor that will determine whether or not you're gonna break or not.
Kim (05:03.81)
Got it. So what are some of those other factors? What are all the things that would equate to healthy bone? I guess is the best way to ask.
Rebekah Rotstein (05:13.653)
Sure. So the bone density is a quantitative measurement of a given area of bone. And it's measured, the gold standard is considered to be a DEXA. You've heard of a DEXA scan, which is basically a bone density scan, which is very simple, painless, and very low radiation. But that's a measurement. There's other qualitative elements that determine whether or not that bone can withstand different thresholds. So it has to do with the microarchitecture of
It has to do with the mineralization of the bone. It has to do with the turnover rate of your bones. And the metabolic rate of your bone, we're constantly building and destroying bone throughout your life. No matter how old you are, it just changes the pace. So you're building more bone than you're destroying when you're younger. And then especially at menopause, and it actually levels out in our 30s. We all start to lose bone mass. But then at menopause, we start to have a rapid deceleration
or I should say acceleration of the bone breakdown. And so that's happening throughout, but again, that metabolic turnover process is another indicator of the health of your bones. And another way that you can determine that is by blood tests. And there's also a urine test, there's a couple of urine tests that you can use. So there's a number of different diagnostic tools to identify what's happening in the state of your bones.
bones. So, you know, somebody like myself who's very, very small, I'm like five feet, a hundred pounds, I have really tiny bones. So I'm automatically can have less bone mass than somebody who's larger framed, let alone larger sized. So there's a number of different things, the shape of your bone, and then also the muscle mass is going to determine whether or not, I shouldn't say whether or not, but can
Rebekah Rotstein (07:13.367)
fracturing. So there's a number of different nuances. And I think the biggest shortcoming that we have is trying to reduce and oversimplify what's really a very complex process.
Kim (07:31.01)
That's interesting. I had no idea that there were blood and urine tests that could help understand bones. So I know of the DEXA. I've had a DEXA scan and that's I think what not everybody would know about. But if you do know something about it, maybe even have been diagnosed with osteopenia, you probably have had a DEXA scan. Would that be what you would recommend as a first step or would you recommend those other tests as a first step? Or should we be doing all of them?
Rebekah Rotstein (07:38.718)
Mm-hmm.
Kim (08:01.054)
I guess to get a good understanding of what our bone health is currently.
Rebekah Rotstein (08:06.681)
No, I would recommend ADDECSA first, but at the same time, what's interesting, I don't know the Canadian recommendations, the United States, it's not on, it's not typically recommended till age 65, which is really late.
Kim (08:20.822)
same pair. Yeah.
Rebekah Rotstein (08:22.257)
you lose up to 20% of your bone mass in the first five to seven years after a menopause. So if you think about it, by the time you're 65, you're, for most people, they're going to, for most women, they're going to be more than decade into that. So you have no idea where you were previously. So I recommend having a baseline DEXA sooner, and I'm part of organizations that are starting to advocate for that as well, which is exciting to see because at least, you know,
to compare to because a single DEXA doesn't necessarily give you that much information, but when you have a comparative then you can see, oh am I losing, am I not losing, and then there's also additional variables that get complicated in there. So you know, you want to ideally be using the same facility, the same machine, same technician if possible, because all of those add in different factors that can really make a difference.
Kim (09:18.806)
Interesting. And so with your story, you said, you know, you said like, well, I might as well go check out, I might be predisposed, and then you find out it's full-blown osteoporosis. And as I understand, the kind of the precursor or the stage before is osteopenia. Is that correct? And are there other stages or other maybe things we should be looking out for ahead of full-blown osteoporosis?
Rebekah Rotstein (09:38.325)
Yes.
Rebekah Rotstein (09:48.373)
So osteoporosis is the actual condition and it's actually considered a disease. And it's based on, this is the interesting part as well, it's based on your scoring from the DEXA. And then...
osteopenia that you're referring to as the precursor that is from a different score, from minus 1 to minus 2.5, and then minus 2.5 and below is considered osteoporosis. But osteopenia is not actually recognized as a true condition in that way. So it's really just low bone mass. There is no other classification beyond those to answer your question, but are there things you can do?
The interesting point though is that in terms of fracture rates, there have been more...
actual fractures that have been identified in the osteopenia range than in the osteoporosis range, which is odd. At the same time, it's about the number of fractures versus the rates. So epidemiologically, they look at rates, and it's almost like a percentage. It's out of, let's say, 1,000 people. So you could say, well, there's more actual fractures in osteopenia than osteoporosis because
Kim (10:50.198)
Interesting.
Rebekah Rotstein (11:11.287)
people with it. In the US it's estimated to be
let's see, 44 million with osteopenia and then 10 million with osteoporosis. So you could say, oh, well, just because there's more people. But at the same time, there's other concerns about, well, people are still fracturing. We're having more fractures, even though the bone density is not as low as it is in the classification of osteoporosis. So it just goes back to a little bit of what I was saying before.
But that shouldn't be the only thing that we look at. And what's really interesting is that the original World Health Organization definition in, I think it was 1984, I acknowledge that. But we don't really talk about that now. The original definition said, it's a loss of bone mass as well as structural deterioration or changes in the structure architecture, basically, of the bone.
But the diagnosis right now usually is just, oh, this is your T score, so you have osteoporosis. Without identifying, well, are there actual changes? And that's where some of the blood tests that I was mentioning can tell you, oh, you are having, say, excessive bone turnover, like a lot of loss.
Kim (12:34.762)
Interesting. So I guess if I'm looking at this thing and okay, I've trying to be proactive and I wanted to have a baseline. I went and had a DEXA. Thankfully, I'm in a healthy, I'm not in the osteopenia category. Now, I don't know if I would like should I be doing that scan every year or and as you said, it's ideally go back to the same person in the same clinic. And but should I do it every year every two years and like and then if I did have the osteopenia creep in there?
At that point, then potentially that would trigger me to go and have the other investigative test to kind of get a bigger picture. Is that fair to say?
Rebekah Rotstein (13:13.141)
In general, yes. So first of all, it's recommended every two years. So usually they're saying, you don't need to do it every single year. Give yourself a little bit of space in between. But I'm seeing more physicians now that are aware of these blood tests. Endocrinologists are aware of them. But there's a lot of endocrinologists who specialize more in diabetes or obesity and not so much specializing in the bone metabolism side. So...
I see so many people for consults that are educating the physicians that they're working with. So really making sure that you're seeing a physician who's familiar with osteoporosis, everybody's going to be familiar with osteoporosis, but really has in-depth experience with it.
Kim (14:00.814)
Interesting. So what we talked earlier about, you know, menopause and the loss of the menstrual cycle. So that's an, has an estrogen component to predisposing us to osteopenia, osteoporosis. What are other reasons why somebody may have poor bone health, may have low bone density? I'm trying to use the right terminology. I think I'm, those two were good. I'm not sure about how to carry forward, but.
But what else, what are other things that can cause deterioration within our bones?
Rebekah Rotstein (14:36.265)
So first of all, what's considered primary osteoporosis is age and sex hormone, so what we were talking about. But then secondary osteoporosis is osteoporosis that comes from medical conditions or certain medications. So for instance, cancer therapies, chemo and radiation have a negative effect on your bone and on the bone quality itself as well. The use of glucocortico steroids.
on long-term use of prednisone for like colitis. And speaking of GI, those with celiac disease, again, malabsorption issues. Rheumatoid arthritis, another example. And then there's also the whole element I was mentioning before. If you've had a history of disordered eating, that also predisposes you to poor bone health. And then the one that I think that is very interesting for you and myself, which has to do
with an exercise history and moving. So it's not to say that if you've not been working out your whole life that you're going to have osteoporosis, but there's certainly a relationship to the mechanical effects of exercise and loading your bones that helps strengthen them and is basically can be prophylactic, like helpful and protective for them.
Kim (15:59.202)
And you had also mentioned that muscle mass can influence our bone health as well and people who have low muscle mass, for again, there could be a number of different reasons that could also be, you know, sarcopenia as we're aging, we're losing muscle mass, which can kind of play a role in there as well.
Rebekah Rotstein (16:20.677)
Absolutely. And I think, not I think, that is one of the big concerns, not so much for midlife, but for us in 20 to 30 years. That natural decline of, again, not just of bone mass, but also of muscle mass and muscle power. And so not only preserving it, but trying to even increase, if possible, is going to be helpful.
Rebekah Rotstein (16:50.913)
building muscle mass right now. And also, you know, there's more and more research that's been coming out about estrogen and why estrogen matters, et cetera, and how it's also protective to muscle mass. So we'll start to lose some of that muscle mass at this point in life. So it's really important for us to maintain and build as much as we can, because it does directly relate to the bones. And in large part, because the muscles in a very,
simplified manner, the muscles become tendon, the tendon then turns into bone. And so that pull is a mechanical stress and that stress on the bones is different from the kind of stress we think of in life. It's a good stress and you want those strains on your bones because that's how they strengthen.
Kim (17:40.81)
Yeah. And that's a perfect segue into the question of we've talked about, you know, what's contributing to the degradation. Now, how can we preserve or build back? How do we build bone? And I have lots of questions, but I'm going to just open topic there and then I'll bring in my specific questions afterwards in terms of things that I've heard, you know, will help strengthen bones and you can help dispel those myths or affirm them.
Rebekah Rotstein (18:07.821)
love to. So let's take our age group or let's say let's take menopause out of the picture just in general. The way that bone is built and mineralized also is through food so nutrition and movement. That's it.
And then in terms of the exercise element, it's from weight bearing as well as resistance and impact. Those are the three ways that you strengthen bone. Weight bearing meaning, I mean, you know, but just for all of the listeners, being upright, standing is a weight bearing activity. Being on your hands crawling, that's weight bearing for your wrists. Resistance is anytime you're using the bone, or to me, you're using your muscles, they pull inadvertently against the bone,
And then impact on top of that is the pounding, say from running and jumping, which is really important in childhood, in adolescence. It's why we want kids to be outside and not sitting on their computers all day. It's actually literally protecting their bones for the rest of their lives. Now once we've hit menopause and we don't have that protective agent of estrogen, we're not...
AI should say, generally the goal has been stated that we want to maintain the bone mass that we have. We want to just prevent bone loss.
But, and through exercise. However, a handful of years ago, 2018, a randomized controlled trial came out of Australia talking about how you, or not talking about, but showing that you can actually build or increase, let's say, bone density in postmenopausal women with exercise alone, which pre, in short bouts, which previously had been not thought, or had been thought to be dangerous, if anything. So that was exciting.
Rebekah Rotstein (20:07.639)
The challenge though is that we're not talking about lifting some weights at home. We're talking about 80 to 85% of one rep max. We're talking really heavy lifting. So say the most that you can do in a single repetition with one with your weight, you go up, you know, say that's a hundred pounds of a deadlift, you're doing about 80 pounds of your deadlifts. So if you can do that, that's great.
Rebekah Rotstein (20:38.139)
is that's something that you would want to work up to, and that's wonderful. But that's not where you're gonna start. A lot of people also are never gonna get to that point. And part of that may be because of just desire. We'd like to change that perception about lifting and lifting heavy, but there's still a lot of people who are not gonna ever do that.
And then there's also people who, like myself, I mean, I actually do lift heavy, but I have to be very cautious. I have a great deal of hypermobility and joint disorders that are from that. So gotta watch out. You have people that have...
autoimmune disorders, people with other conditions where that's not an option for them. And then you have people for whom, you know, there's a financial barrier that maybe you can't afford a personal trainer or a gym membership because this must be supervised for it to be safe. So that's ideal if you can do that. That's how you can actually build bone density, even in post-menopause.
Otherwise, outside of that, you want to just try and maintain what you have. Because at the end of the day, do you really care what your bone density is? No. You really care that you don't fracture. And that's the big message that I'm trying to get across. That yes, we care about bone density, but bone density is part of the picture. And what's your really, what's your ultimate goal down the road? So what I advocate for is a complete method of body conditioning.
And that's really what we do with buff bones is thinking of it as the exercise hub, the center for everything else you do to have really solid foundational movements that are affecting your mobility, your strength, your function, your balance, everything that relates to the health and protection of your bones. And yes, you do want to lift weights. And ideally, you want to lift heavy.
Rebekah Rotstein (22:37.861)
not everybody's gonna do that. So I want people to be doing something is the key.
Kim (22:44.722)
Yeah, and I was reading that study and in my mind, I go to many people who have been told they can't lift anything over X pounds because of a prolapse or because of their pelvic floor. People who have a levator avulsion, which is a specific birth injury in the pelvic floor, it will halt them in their tracks to some extent.
or people who just symptomatically don't like the feeling when they do lift heavy or do some sort of high impact activity, they may feel more heaviness or become more symptomatic. So when I think of that population, now I come back to saying, okay, if we take that, like if we have that RCT study that says heavy lifting, but if we take heavy lifting off and we go okay to impact, well, what...
Is walking enough impact or how much impact? Do we have to jump? Does it have to be the multi-directional? And then I come to yoga, which a lot of people interpret yoga as being better, safer, quote unquote, air quotes for the pelvic floor. There's still a lot of creation of intra-abdominal pressure and is the pull on the bones from stretching into those various poses and moving throughout a yoga practice enough of a...
enough of a stimulus or will all of those maybe just kind of be playing a role in the maintaining not so much the building.
Rebekah Rotstein (24:16.537)
Right? And so these are all really valid questions, and especially with what you're asking about is we call it osteogenic, like is it enough for that stimulus? So this brings a couple interesting points. So going back to that study, you know, one of the challenges with this study is that they put three...
weight training, traditional weight training exercises, along with an impact, a fourth exercise, it's an impact. So really, if we really wanna get granular, we gotta take those apart to see, are they still okay without the impact one? Nobody's talking about that part. And it's interesting, they did a follow-up study that was published in 2021 comparing our Buff Bones program to theirs. And...
it's interesting again to see looking both with medication and without medication what the results are. So there's a whole other element with that. So going back to with your impact, we don't really know.
Is it, you know, were the results that were so promising because of the heavy lifting or because of the jump drop where you basically are pulling yourself up on a bar that is higher than your standing height, which increases the velocity of your drop and therefore the impact, right? And so, which is the most important part. We know that walking itself is not enough.
Running can be great, but at the same time, if you have osteoporosis and you're really prone to fractures, it's probably not the best thing for you. Low impact can be helpful. We don't know necessarily of its relationship to, quote, increasing bone density. And that's where something I do advocate people do. You're standing at the stoplight.
Rebekah Rotstein (26:03.109)
just drop your heels, like up to 50 times, slowly build up to that, but keeping your knees straight so that your knees and your muscles aren't absorbing that impact. But we don't really know, so you bring up a really good question.
On top of which, you know, for myself, I have some ankle injuries and some pretty severe arthritis in them. I stopped doing my running and I have some issues with them. So I'm limited on that kind of big jump drop in the plyometrics, which are amazing, like really good for your bones. Again, if you can sustain it. And then you bring some of these pelvic floor issues that are really valid questions that I don't think are often answered.
And you know more than anybody about the prevalence in this population of pelvic floor dysfunction. And so we have to acknowledge that, again, heavy lifting might not be the option for everybody. What are the things, or the jumping? What are options that we can offer them that are safe and protective?
Kim (27:10.419)
Yeah, it's interesting as I go through these stages of life myself, it opens up more awareness. And all the people that I work with and even changes in my own body and I think just entering this phase, even if I have had no pelvic floor issues, even if everything's been fine, just entering this phase of life, I have increased risk of...
cardiovascular disease, I have increased risk of bone density loss, bone mineral loss. And then when you factor in the people who now are not doing these things because of their pelvic floor, those risks become ever increased. And with the hormone conversation that's happening and the recommendations of estrogen being indicated for the prevention of bone loss, and then those that don't want to...
aren't able to take hormone therapy. So then, you know what I mean? Like there's just, there's so many things to navigate and I just find it so disheartening in a sense. I mean, I've always felt disheartened by the fact that there's so many people struggling with pelvic health. And then now when I'm learning again, all of this other stuff, I just feel like, gosh, like we just can't, no pun intended, we can't catch a break, right? Yeah.
Rebekah Rotstein (28:34.498)
It's true. It's true. And, you know, beyond the disheartening side, it's confusing.
And I think it's confusing even inside the field. So you're not alone. People listening are not alone. But I think the biggest, one of the most important things that we can do is encourage people to recognize no matter what, there are things that you can be doing. And beyond lifting heavy, you know, the big elephant in the room we haven't talked about is balance, right? How do most fractures actually occur is from falls. And at our point in life,
Kim (29:02.798)
That was one of my questions.
Rebekah Rotstein (29:09.827)
common side of fracture is the wrists because think of how many people you've known who've tripped, fallen, and fractured a wrist. We're not, you're probably, probably not having too many friends of your age that are having hip fractures. That's really much more in the elderly and down the road which is the thing that gets talked about the most because it has this direct correlation, not even causation, but like correlation to mortality. So that is what our
the most. But balance, you know, we can prevent a lot of fractures just by improving balance. And so that's another thing that you can do no matter what. But, you know, there's so many other elements in here, you know, different ways that you can strengthen and the things that you do already, you know, with finding pelvic floor integrity and throughout the entire, entire lumbopelvic abdominal cavity of strength. If we use the word core, we don't use the word core,
is but all of that let's call it core control though that has a direct relationship to fall prevention back extensor strength so how strong your back is again has been shown in research relationship to falls as well as spine fractures and you know there's so many other elements of how ways that you can work on strengthening your hips you can be strengthening your
Rebekah Rotstein (30:39.567)
working through the feet, feet and ankles, addressing upper body, neck and shoulder capacity. I mean, there's so many things that we can be doing. So rather than us trying to find the one thing, there is no, I should say. I think that's a great question.
just acknowledging there's not one thing and I think that's where we often get disheartened as well thinking well, what's the one activity I should be doing and what I think is really encouraging is a paper came out Adelphi consensus 2014 saying oh, you know what for osteoporosis treatment it came out of Canada Actually, what we should be doing is a multimodal approach and that's wonderful. You know, there's not one thing There's so many things that we should be doing
It's just like there's not one food you should eat, right? You should eat. You're so amazing.
Kim (31:31.286)
Yeah, I was going to say diversity for our gut health, diversity for our bone health. Yeah, yeah. What about whole body vibration? This is something that I've been very intrigued by vibration for several years. A colleague of mine uses it a lot in her practice. And I've been more and more again, as I'm kind of entering this phase now, I'm paying more attention to bone health and...
Rebekah Rotstein (31:36.927)
Exactly.
Kim (31:57.91)
you know, as it pertains to people with pelvic health, they look at vibration and say, okay, there's something that, could that be a way that we eliminate some of the symptoms, the symptom creation from the heavy lifting or the heavy pounding, and we can still get some benefit with some resistance training or even just standing or moving on the platform. So what's your take? What does the evidence say? What do you think from a whole body vibration perspective?
Rebekah Rotstein (31:58.11)
Yeah.
Rebekah Rotstein (32:24.213)
So I'll give you the evidence first before my opinion. The evidence shows that more research is needed. So the evidence says, you know, we cannot say yet that this should be a treatment for osteoporosis or even osteoporosis therapy. So the claims that are made about that really are not backed. So there have been studies. And so one of the interesting things also
So I'm going to be very specific in how I'm saying this because
There are a lot of benefits that I've seen with other research from whole body vibration and from something like the power plate where we're talking very high G-force, meaning it's high intensity. However, that has not been recommended for osteoporosis itself. And unfortunately, even what you see is a single paper that was put out on that, that was stating that there was bone density,
improvement from it. But the exclusion criteria removed people with osteoporosis. So we have to really look at this very specifically. So what has been looked at is
whole body vibration with low intensity. That a position paper came out a handful of years ago saying that there's concerns about the high intensity, like what we were just talking about, low intensity may be safer. So for somebody with osteoporosis, I would feel much more comfortable with them doing a low intensity vibration plate, which basically these low intensity vibration plates,
Rebekah Rotstein (34:10.629)
tend to look like a scale in your bathroom. They're really small as opposed to the mega kind that you see at the gym. That said...
It's interesting because there's there've been studies on mice and there have been initial studies looking at humans That again don't always translate but you know It's it's promising that could be good and especially when we're talking about people Say like the elderly who are going to be limited in how much they can actually load their bones with external weights
or for instance in some of the scenarios that you were talking about with some of the clients or patients that you work with. So I think it can be promising, but also I think there's also certain contraindications people have to be aware of. There's possibilities, especially with the high intensity ones, there's dangers of retinal detachment and such. So I think you wanna talk to your physician about it, just to make sure that there's no other underlying conditions that could be problematic for you.
But the key has really been, it seems to be going toward low intensity. And that's really going to be the key to what you're looking at. Because we're
Kim (35:23.454)
And maybe more prevention as opposed to treatment as well. Would you agree with that? Yeah, yeah.
Rebekah Rotstein (35:28.381)
probably, probably. So you know the it just has to do that with that concern or with the really high magnitude. But you know what's also interesting is that you know if when somebody's healing from a surgery they're often given some kind of little home bone stimulator to take which will help basically stimulate the healing process. So I do think there is something
Kim (35:37.826)
Yep, yep, interesting.
Rebekah Rotstein (35:56.261)
to be said for the vibration. It's just identifying that sweet spot and for actual safety guidelines and true recommendations to be made, the consensus is we just need more research.
Kim (36:09.758)
Yeah, fair enough. Just before we go, one thing I have a question about was I was recently in Indonesia. And in Indonesia, we always in Bali and a lot of the women will carry baskets of like very heavy loads on their head. And they and it's fascinating to watch them because they lift up this basket often full sometimes of jars or fruits and vegetables or whatever, whatever it is and they have
almost like fabric that's sort of creating a little platform or nest on their head. They lift up this basket, they place it on top of their head and they will often walk sometimes without even holding this basket or sometimes maybe with one. And I don't remember where I read this, but it was the importance of loading bone from the top down. And so when I was watching these women, I was thinking it would be interesting to look at the bone density of these women who are often, you know, in their sixties, sometimes even into their seventies.
compared with those that aren't practicing that type of daily movement or bone loading. So is that true that loading from the top down, so maybe even with a deadlift with some weight on your shoulders, would that translate into better bone building?
Rebekah Rotstein (37:29.634)
Well...
I would love to see the same study you're thinking of. It would be amazing. I think, I mean, you can make a little bit of a correlative to weighted vests. So that is something that has been used to try and, especially for somebody like myself, who I'm just tiny, I don't have enough mass to stimulate without external support, essentially. So you put on a weighted vest and that has been looked at to perhaps be osteogenic.
Kim (37:33.516)
Hahaha
Kim (37:40.366)
Mm.
Rebekah Rotstein (38:01.003)
pointing out is that axial loading like directly through the skeleton and what I think you can maybe extrapolate a little bit is so as opposed to a deadlift so for everybody listening you're hinging at the hips so you basically don't you you're holding something in your hands straight elbows and you just hinge forward at your hips basically keeping your back straight and then you come back up
So that's gonna be less, it's gonna be loading more for your hips than it is for your spine, as opposed to say a back squat or a goblet squat where your trunk is more upright as you squat. So there you are having more of an axial load or say like an overhead press where you're pushing stuff directly up overhead. That's gonna transmit more through your spine. Now, you know, those women that you've seen in Bali, I'm sure, you know, they've learned to do that
teenagers, right? So it's all like that progressive overload and conditioning. Yeah, so you know, nobody please go just try and you know, put
Kim (38:56.927)
Mm-hmm.
Kim (39:00.618)
See adaptation exactly, yeah.
Rebekah Rotstein (39:07.053)
80 pounds on your head and start walking. There's obviously a great amount of coordination that comes into play there. But I think, you know, as much as it would be fascinating to look at a study with that, the other elements would be, you know, do they spend most of their life not sedentary at a desk? How much sun are they getting? And then there's a genetic predisposition as well. But I think it's a great idea because, yeah, the more we can actually get of a load directly
Kim (39:23.498)
Mm-hmm, mm-hmm, exactly.
Kim (39:28.79)
Yeah.
Rebekah Rotstein (39:37.047)
upright position through the skeleton the better it is going to be for the spine. Yeah.
Kim (39:41.374)
Yeah, interesting. Alrighty, well thank you. That was fascinating. I really, really appreciate you sharing your knowledge and for spending the time. Where can people find more? You mentioned your program Buff Bones. Where can people come and find you and learn more?
Rebekah Rotstein (39:56.481)
Yes, so the website is buff-bones.com, so a hyphen between the two, and we offer exercise certifications and programming for exercise professionals along with products online directly for consumers. And you can also find us on Instagram, which the handle is gotbuffbones, all one word essentially, and then on Facebook we're just buffbones.
Kim (40:26.186)
Awesome, amazing. Well, thank you so much for your work and I'm gonna look into your certification. I always love getting more informed and more trained. So thank you for your work, thank you for your time. I really appreciate having you.
Rebekah Rotstein (40:37.277)
Thank you, Kim, and thanks for all you do. Appreciate it.
