Rethinking Women’s Health: From Frozen Shoulders To Longevity

We explore how declining estrogen reshapes joint health and recovery, why some midlife pains linger, and how modern chiropractic, smart strength work, and informed medical care can change outcomes. Practical steps, clear resources, and a push to advocate for better midlife care.

• musculoskeletal syndrome of menopause explained
• differences and overlap between chiropractic and physiotherapy
• frozen shoulder, plantar fasciitis and gluteal tendinopathy patterns
• hormones, inflammation and slow recovery links
• HRT as a potential musculoskeletal ally
• strength training with low reps and true sprint intervals
• jumping and bone density for long-term independence
• labs, blood pressure, cholesterol and insulin resistance awareness
• realistic rehab expectations and referrals in a team model
• resources to learn and talk to your doctor confidently

Find Dr. Ashley at burlingtonsportsandspine.com and on Instagram at @ashburlington

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Transcript

Warm Welcome And Backstory

SPEAKER_00 0:32

Hold on. Good morning. Good morning, Tanya. Good morning to our wonderful guest, Dr. Ashley Warback. We have a guest today.

SPEAKER_02 0:45

Good morning.

SPEAKER_00 0:46

I'm happy to be here with you guys. We're excited for this conversation. We are. We were just starting to talk. I'm like, no, we gotta, we gotta stop. So we were just figuring out how Ashley and Tanya met each other, and we think maybe, but they feel like they know each other.

SPEAKER_01 1:00

So that's what we were saying. It's funny. I think in today's day and age, also with um the internet and you just don't know. You meet people and you're like, I feel like I know you. But with you, Ashley, I was just saying that um Anne Marie is always speaking so highly of you, as she does about all of the people. I feel I do the same with the people I love in my in my my group and cohort. So she's like, we need to have my friend Ashley on. We need to have my friend Ashley on. So you were like top of the list is we were like, we need to start bringing on. So we're excited.

SPEAKER_03 1:31

Anne-Marie and I have been friends for a long time. And if you talk to my husband, he would claim that he's the one who set up her and her husband as a couple in university. Yeah.

SPEAKER_00 1:41

So I was thinking about that. I was thinking about it staying in the shower, and I was like, how long have I known Ashley? So here's the story is so so Ashley's husband, Chris, went to Laurier with Michael and I. And so he was a Don. So it was like Smith, Burton, and Warbeck ate dinner or lunch in the residence hall with a bunch of other people, but the three of us like for a year. So it's almost like we lived together. And then Michael graduated, and then Chris and I were in the same building. So I think he was either like the floor above me or the floor below. Anyway, so we we go back to Laurier, and then I throw a party for Michael's 30th birthday, I think. And Chris up with this date.

SPEAKER_03 2:20

This beautiful blonde woman. And I was five years younger. So I was 25, and you guys 30. You were all turning 30, I wasn't sound and old at the time. Like, oh my gosh, I'm going to a 30th birthday party.

SPEAKER_00 2:37

Yeah. But she works up, this like smoke and blonde shows up, and we're all like, who's Chris brought? Like, this is like where he's like batting above his average here. Like, what is this? And then, and then we find out she had run the Toronto Scotia Bank marathon like that day. Oh my god. Or something. Like, you went for your age.

SPEAKER_01 2:56

Actually, you know how to walk into a room and make an entrance.

SPEAKER_00 3:00

Yeah. Yeah. Actually, and it was a 1974 theme, because you know I love a theme. So everyone was dressed like disco-esque. So she had to come in to like a bunch of rowdy people in ridiculous costumes and wigs, not vests, but came in as this marathon champion. And then she stuck around like she married the guy, which is like we were lucky to bring Ashley in. And were you an actual chiropractor by then, or were you just were you in school?

SPEAKER_03 3:26

Like I was a student at that point. It was probably, yeah, probably pretty close though, because I've been in practice 20 years now.

SPEAKER_00 3:32

So yeah.

unknown 3:33

Yeah.

SPEAKER_00 3:34

2004. 2006.

SPEAKER_03 3:37

Okay. This would have I graduated in 2006. So you were a student then.

SPEAKER_00 3:41

Yeah. And so Ashley was a chiropractor when I didn't even really know what a chiropractor was. Like that was a good idea. We didn't talk about that remove first. No, but that's that's another thing. And so Ashley's been an interesting um introduction to kind of, I don't know if you would call that like an all at the time, like an alternative medicine. I don't know how to describe it. Like, but over the years, like this is my go-to person for like that's how I've gotten to know Ashley without actually meeting you.

How Chiropractic Has Evolved

SPEAKER_01 4:12

Is um, and listen, I'm excited about this discussion because I I always like to learn new things through other people. I don't do my own research, I just believe what other people tell me. Um, people I know. And I know little about that. I believe this is probably a generational thing, which is why we'll talk about now 50-year-olds who are like, what is this? Like, would you deem this an alternative? Like that, I I agree, but I could see there was some hesitation. So I'm excited to have this discussion for our listeners who might be. We have I know some people, typically they're younger, who are all over this. And I'm like, I haven't done this once.

SPEAKER_00 4:51

Yeah.

SPEAKER_01 4:51

I mean, so uh, let's get into that.

SPEAKER_00 4:53

And there's different methodologies, I think, within the industry, I guess, right?

Chiro vs Physio: What’s Different

SPEAKER_03 4:57

So our profession has changed a lot. So, like I said, I've been in practice 20 years. And when I first graduated, chiropractic was kind of like the the odd duck. Like you were considered not a real doctor, you're a quack, you're on the on the fringe. And I feel like that's really developed over the last, yeah, 20 years. Um, and and that come there's a real divide in my profession. There's some chiropractors who believe in an adjustment only approach, and that's now a little bit more old school. The newer chiropractors graduating are much more evidence-based, and we look at the body as a whole. The cat. Um, there's that. That actually scared me for a second.

SPEAKER_02 5:37

I was like, what is happening? Don't worry, she's no, it's all good. No, there's a cat.

SPEAKER_00 5:41

For those who are listening, a cat just walked by.

SPEAKER_02 5:42

There's a cat just walked by, and it was just interesting because your background is so like, you know, neutral, and then there's this cat.

SPEAKER_00 5:50

I love that. I love that.

SPEAKER_03 5:51

So it's changed over 20 years. It's changed over 20 years. Now, chiropractic, I think, is considered a little bit more mainstream, and most chiropractors are now very evidence-based and look at the whole body, and an adjustment can be part of that if there's a joint problem, but it's not the be all end-all. Like, I think I I get a lot of people who are very confused by what I do versus what a physiotherapist does. And there really is a lot of overlap. Like, my appointment times are 15 to 30 minutes long. I'm giving people exercises, I'm doing muscle work, um, doing acupuncture. Like, there's a lot of overlap between physiotherapy and chiropractic.

SPEAKER_01 6:29

So then what's the divide? So if it's a Venn diagram, my whole life is in Venn diagram. So if it's like there's the overlap. So can you give us a land between those?

SPEAKER_03 6:38

So there's a if it's a musculoskeletal injury, meaning something is wrong with your muscles, um, joints, nerves, either or can usually help. That being said, chiropractors are able to adjust, uh, like manipulate joints. Some physios can, but they need additional training to meet that certification, whereas that is just part of our scope of practice. And um we have a little tiny bit more power in the healthcare system, meaning we can send for x-rays. Um, we can provide patients with an official diagnosis, whereas physiotherapists have to provide an assessment. So just the vernacular of it is a little bit different, but really the nuts and bolts, it overlaps a lot.

SPEAKER_01 7:22

Okay. Yeah.

SPEAKER_03 7:23

Yeah.

Midlife Women And Musculoskeletal Patterns

SPEAKER_00 7:24

So we've as a family with the athletes in our family, like there's a lot of overlap in athletes in your practice as well. It feels like when someone has an injury and it's not about you're coming here for a year, you're coming to fix the circumstance. Yes. And you have a variety of approaches to help fix that circumstance. Like whether it's been like a kid with plant or fascia or me with plant or fascia, or um a kid with a broken bone, and like what? How can we help that bone grow faster? Like, there's been we are regulars in your clinics. I think we're regulars. I don't know.

SPEAKER_03 8:02

I think you guys should have like a punch card, you know, like a like a McDonald's punch card. Yeah, the guys come in. Yeah, yeah, for sure. And we have a lot of families like that. Like, um, we address whole body injuries, and sometimes, like, for example, somebody with a broken bone you mentioned, once they heal from that fracture, they're gonna need some rehab. And that is not my specialty. So I would send them over to one of our physios. Like, I work in a multidisciplinary clinic. Okay. Um, so I don't do it all on my own by any means. But yeah, we, you know, anything like biomechanical in nature, we can help for sure. Right.

SPEAKER_01 8:40

Yeah. Okay. So then as we talk about evolution, and and I know specifically we wanted to get into and get your insights around, you know, a certain age and stage of females, right? When we talk about um what we might be going through. Again, I'm 51, um, perimenopause, there's a lot of kind of soreness, andor more specific, Anne Marie with her frozen shoulder, that sort of thing. So can you give us a I'm just again curious. We have these discussions all the time, what you're seeing and how that aligns with kind of societally all these women kind of being more in tune with their body and saying there's something wrong. Who do I go to? How could this help? And and do you give any insights? Yeah.

SPEAKER_00 9:30

There's a lot of patterns. There's a lot of patterns, I think, in Ms. Midlife. There's a pattern constraint.

Frozen Shoulder, Plantar Fascia, Glute Tendons

SPEAKER_03 9:35

Yes, absolutely. And I am only like all of this information that we're going to talk about today, this is not stuff that I was taught in school 20 years ago. And I'm quite sure this is not stuff that newer chiropractors are being taught now. I'm in the middle of this myself, and that's why this has become a real interest to me. And, you know, you your practice tends to grow based on your age and stage and interest level. And so I have a lot of women in their 40s and 50s, and we end up talking about all things hormones and perimenopause. And um, so then I've dug into the research and you know, listened to the podcasts and read the books and all that. But there's an official term that's just coming to light now called the musculoskeletal syndrome of menopause. So the m estrogen, declining estrogen affects joints, um tendons, ligaments, and there's a few conditions specifically that the research is just starting to catch up with and correlate with menopause. Um, two of those, actually, let's talk about three because there's three that are very prevalent. One is frozen shoulder, also called Ding ding ding. Yep.

SPEAKER_00 10:46

That was Anne Marie's um recent? No, not even my most recent. It's been going on for a while, Amory. I know. Well, that's a year. It's been a year when I when I thought I just woke up, thought I slept funny. Yeah. And then it took me a month to come in and say, Ash, I think there's this is not going away. Yeah. And you had your insights.

SPEAKER_03 11:05

Yeah, it's a very difficult thing to treat. It comes on insidious onset. Like we don't know why it comes on all of a sudden your shoulder feels tight and sore and hard to move. And there's a very high incidence of that in this age group, as well as plantar fasciitis. We just spoke about that. Yeah. That's another one. That's another one. And and the theory being that um, so plantar fascia is almost like a thickened skin, like it's not a contractile tissue that you can contract consciously, but there are estrogen receptors within all tissues of your body, including your plantar fascia. And for whatever reason, as your estrogen declines and that that can get irritated and not heal well. So that's the second one. And then the third one being glute tendinopathies. So the muscles in your bum, where they attach into the bones, the the tendons of your glutes can become sore and stiff and painful. I don't have that one and hard to resolve.

SPEAKER_01 12:05

Does that show up in it feels like a hip issue, but in fact it's your glute? I might be dinging dinging on that.

SPEAKER_03 12:12

So, yeah, last night at our book club, I was talking with two people out of 12 who had this exact, exact thing going on, and they both happen to be in their late 40s.

unknown 12:22

Wow.

SPEAKER_03 12:23

So yeah, uh, you know, and I would say, you know, up until maybe five, six years ago, we I would just treat these things, and you know, these women are coming in over and over again. We're doing all the things we're supposed to be doing. This should be following the plan, and it's not like the recovery is just not there. Like, what is the missing piece here? And very often it's hormones.

SPEAKER_01 12:45

A hundred percent, which is all in and in the basis of inflammation as being kind of the challenge, right? Like with estrogen playing such an important role. Um, yeah.

Hormones, Inflammation And Care Gaps

SPEAKER_00 12:55

Did I tell you actually about the chiropractor, the parent on one of the kids' hockey teams who saw we were playing cornhole before a hockey game and I I couldn't, or I was I was playing with my non-dominant hand because my other children were not cooperating with me. And he pulled me aside and whispers, Are you on hormones? Oh my god, why he in his practice was seeing tons of frozen shoulders as well. Yeah. And he's like, Have you talked to your doctor about hormones? And I laughed and I said, Oh my God, I'm yes, yes, I am right there with you. I'm in the process of doing this because it had been like four months of coming to see you, and it was getting better, but not nearly at the at the rate. So I think there's lots of people in their practices who are seeing similar patterns and finally layering it with the new evidence.

SPEAKER_03 13:47

Yes, for sure. And that makes me so happy that a male said that to you because that means the word is getting out, right? Like people are hearing about this, and it hopefully that at least to better outcomes and better care.

SPEAKER_00 13:59

Yeah. And it and that we're talking about it. Like my son, he they they hear the word menopause and they're they ever, but he calls it my meningitis shoulder. I don't know why. Meningitis? And I'm like, it's not meningitis, it's menopause, but whatever. The point of it is my middle-aged shoulder. Like, yes, middle-aged female shoulder, like they're talking about it, which I think is whether it's in jest, it's it's like, oh gosh, there's a there's a there's some of these things are happening to our women in our life, and we're even teenagers are like discussing it.

SPEAKER_03 14:33

For sure. And it's it becomes like a bit of a trickle-down effect, like that conversation is out there, so now the research is happening, and then that trickles into the education. So then you can have educated practitioners who then disseminate that info out. Like it's such a systemic problem, and it's been so under-researched, and women's health in general has been so underserved for decades. Uh, so finally, I feel like we're in the shift of it right now. Like it's gonna be a different ballgame for our daughters.

SPEAKER_01 15:00

Yeah, it's nice to see on the cursory kind of um practices, right? Because there's still such a gap when you said, Oh, we weren't taught that. I mean, there's OBGYNs who weren't taught that, even like or or family practitioners, where I do believe that there's been such a shift. So for me, and again, for our daughters, but even it's nice to see that even, you know, across all disciplines, there's an understanding when there's still such a gap at the very basic level. Still, it's getting better. It's getting better, but the conversations still need to be, you have to be, you have to advocate pretty strongly still in a lot of those cases if you're a female going through paramenopause.

SPEAKER_00 15:43

Do you see other things with midlife women? Like, what about vertigo? I feel like you hear about women, a lot of friends having vertigo episodes.

SPEAKER_03 15:51

Yes, I'm not aware of research surrounding that, but anecdotally, absolutely, vertigo is much higher in our population, and it stands to reason that like there would be a hormonal component there too. Like literally, estrogen, well, not just estrogen, our hormones are in every tissue of our body. So when that changes, it's gonna change in how we feel 100%. Yeah, whole thing. Yes, for sure.

Advocacy, Education And Menopause Film

SPEAKER_00 16:19

Um, I would love to talk about so I don't know if I told you about this, Tanya, but Ashley brought a film to Burlington. Was it a year ago?

SPEAKER_01 16:28

About or yeah, it was almost I wasn't able to go see the film, which I'm I'm sad about, but um factor the M factor.

SPEAKER_00 16:37

And uh you were instrumental to bringing like a screening, an actual screening to Burlington around this menopause movie.

SPEAKER_03 16:45

Yeah, so yeah, it was. It was about a year ago. It was it's a documentary film put out by a number of doctors in the U.S. Tams and Fidel is the main producer, and at that time it was only available to host through private screenings, and I just thought, like, I need to spread the word to my community just as a just as a community member. I was not doing this as a practitioner at all. And we filled up a room of 200 women in like three days. I put this out on social media, like the interest level is out there so high. Since that time, my clinic has picked this up and hosted three other private screenings, again, selling out the room like three times over. So almost a thousand women have seen this film just from like my perspective, just from my, you know, getting this out there. So the word is like the knowledge people want this information, it's there, but yeah, you have to you have to actively go out and get it, which is crazy.

SPEAKER_00 17:48

I remember sitting there watching it, so it's called M Factor, right? That's the title of it.

SPEAKER_03 17:52

And yes, and they actually have are just in the process of releasing the M Factor 2. So we're working on getting a screening of that going, but that's the M factor is like the worst news.

SPEAKER_00 18:03

What comes in M Factor 2? Like 2.0, there's another bunch of symptoms. And it doesn't get better. I think in the audience I might have yelled, no, when they said your teeth start to fall out. I was like, Your teeth start to fall out?

SPEAKER_03 18:17

Yes, within within five years of the onset of menopause. What was the number? Something like 80% of women outrageous.

HRT Fears, Research And Reality

SPEAKER_00 18:24

I was like, Can I just keep my teeth? But it all has to do with your gums, and your gums recede because of the hormones, and so your gum health is more important. It's just it's exhausting to keep up with all the things that could go wrong. And then on the flip side, I'm like, actually, what I like about it is you're talking now that there's ways to avoid it. So versus just thinking it had to be like a creaky old grandma who sat there and her life is kind of slowed down because it must. At least we're discussing these things and saying, well, maybe the older generation, she had to slow down because there was no solutions, but there are some solutions available. The next challenge is making those solutions widely known and available. Yes. And that's a whole other thing. Like our book club, where Ash and I are in the same book club, has now jokingly been called the Menopause Club because somebody's always coming in every month to say they just started HRT, or this is going on, and how many pumps do you take and what's going on? Like, there's a whole it's and it's and it's because of that group, I think too. Like I have gone through menopause sooner than most people. And I and because of that that movie, that's when it said in the movie that you should that it's recommended of HRT 10 years before menopause and 10 years after. I had just thought, oh, I it's done.

SPEAKER_01 19:51

Too late for me because you're on that movie, which is not the case.

SPEAKER_00 19:56

Yeah. To say, oh shoot, no, I still could benefit from some of this insurance.

Blood Pressure, Cholesterol And Insulin Resistance

SPEAKER_03 20:03

Yeah. And how crazy is that that you had to be the one to approach your doctor? Like, yes, if the education was there, you know, the the doctor should be the one telling you. Like, really, but yeah, you're you have to lead your own healthcare at this point because there's such a gap in knowledge. So, yeah, I mean I'm so I'm forty six. I started HRT about a year ago and my symptoms weren't that severe. Like I had some heat intolerance. But I was just kind of feeling meh. And then all of a sudden I developed hypertension, high blood pressure. So I'm a super fit person. I have been my whole life. And I just happened to be at my parents' visiting, and my mom has high blood pressure, so it does run in my family. And I put on the cuff, and I was like 170 over 120, which is off the charts crazy. And so um it makes no sense. Makes no sense for the long distance runner that you are. That makes no sense. Right. This hormonal shift caused that, you know, to come. Yes, I do have a family history, but I there's no doubt in my mind it was the hormonal shift that drove that factor to happen, you know. And so I went on blood pressure medication, but I also went on HRT because I I know that's protective for my cardiovascular system. And I want to get ahead of this. So, you know, my body doesn't make those hormones as much anymore. So I'm taking them.

SPEAKER_01 21:29

I think that's the biggest I'm following some of again. Um, one of the biggest things that's interesting is uh women our age too, we have to get our labs done more frequently than maybe we did before, and they do change. So similarly, I was just in because I go on an annual uh, I do an annual doctor's appointment, and um my labs are out of whack. And she's like, What is this? And I know what it is. Like I know it is the hormones. So mine isn't, mine was cholesterol. And there's no way that there was such a change. Like I eat very consistently, like there, and same, I'm very determined. And in fact, I've decreased things that would elevate it. And she's telling me I have to eat stop eating cheese. And I said, you know, lady, I'm gonna, sure, I'll stop eating cheese and we'll see. But it's it's my my hormones. I know 100%, there's no way that there's that level of elevation so quickly. So I do think that's an important as you mentioned, right? Like before, or I mean, you have to do what you need to do to manage it, but just keep that in the back of your mind instead of going into the thing that is treating that symptom right in front of you, like zoom out and HRT, and sure, you have to watch what you're eating and but you're exercising. I watch, you know, there's no way, it's your hormones. So labs, I think, and now, of course, your feed and all of this stuff you start hearing more and more. And I'm like, oh, lab outliers is not uncommon, uncommon as you're kind of going through perimenopause. So you're like, oh my god.

SPEAKER_03 23:07

Absolutely, absolutely. So hypertension is a very common finding, increased cholesterol, like mentioned, yeah, and insulin resistance. And that's where I'm starting to really read a lot more on these GLP ones because insulin resistance in perimenopausal women is a huge thing and it's linked to estrogen. So, you know, if we're willing to take estrogen and progesterone and these things to help us, I am in that boat of insulin resistance 100%, and I'm starting to research GLP to help me manage what my body has done for 46 years on its own. It can't do that anymore.

SPEAKER_01 23:46

100%.

Strength Training And Sprint Protocols

SPEAKER_00 23:47

I'm right with you. What if you were insulin resistant always? Like I've so it's so interesting listening to all this because these have been check marks on my list as a younger person. Yeah, like insulin resistance since my 20s. Like that. Okay. And so I think I think menopause made it has made it worse. Yeah, all that's worse. So it was like manageable until it was not manageable.

SPEAKER_04 24:14

Yeah.

SPEAKER_00 24:14

But I never medicated or like, but it's just I think menopause has blown up all these, all these things that you could kind of hang around with and be like, that's fine, that's fine. You can manage it. It's not cholesterol, too. Same.

SPEAKER_03 24:29

I didn't even know 10 years ago that that was well, and it's it's kind of like your shoulder emory, or you guys are talking about your plantar fascia. Like, you know, yeah, you could have gotten plantar fascia pain in your 20s, but your recovery was there. Your body was able to cope with that, and now your body doesn't have that coping capacity and healing capacity that it did.

SPEAKER_00 24:50

Or this and the and the inflammation. Like, yeah, like, yeah, I've seen you for plantar fascia. Then there was my ankle that I rolled or via COVID, and then it just would not come down. Like it was three years of like a bowling ball attached to my ankle, almost felt like it would just swell up, like, and now it's better, which is hooray. But then you just take it for the shoulder. Like I feel like uh six years old.

SPEAKER_03 25:15

The day after that, the day after that M factor screening, I got a message from one of the women who had attended, and she said, I've had my HRT sitting on my bedside table. I got it a few weeks ago. I haven't taken it yet, and that movie drove it home. I took the first dose last night and I woke up pain free this morning for the first time. Oh, did that? Now, like that is the so that's an extreme. That's an outlier for sure, but like remarkable what this can do. This can help so much.

SPEAKER_01 25:46

And so interesting in, you know, I think we all can feel the fear that she had, right? It was sitting on the bedside table. I mean, I think that is the thing that frustrates me the most and and and surprises me the most. It frustrates me from, you know, those who know better who are still cautious because you're feeding um this perceived fear and this still this perception that we shouldn't be doing that. There's something bad, something wrong if you have to take that. It's it's not proven it could cause cancer, whatever the fear is. And we need to help people realize just by talking about it, that there you shouldn't, you are gonna feel better. You need to this our our daughters will not deal with this, right? And and I'm glad you brought up GLP1s. I think that is a huge in addition to this, where there's this stigma, and more and more, especially women our age, that is going to be and should be mainstream access across the board for so many people. But we need to start talking about that. So it's so when I feel that woman who was sitting there and she didn't want to take it. So thank goodness. Like that's the impact you had, which was amazing by bringing that. But more and more, and even if you have a prescription, ladies, yeah. For sure, for sure.

Jumping, Bone Density And Aging Well

SPEAKER_03 27:08

And I mean, that that fear is interesting, right? Because we grew up in a time where our moms were told not to take it because of that one study that was shown to be not applicable, like it it just screwed up generations of women. 100%.

SPEAKER_01 27:25

My mother is still very cautious when I tell her I'm on it. She's like, oh Daniel. Like, um, trust me, this is good. Yeah. Um, so what are the key, just I guess before we kind of wrap wrap this up? So in in everything you've seen, Ashley, like what would you um what would be kind of your key takeaways for women, not only in how you can help, but I think I'd like to hit home more from a chiropractic standpoint, where in the stage of let's say awareness into education, into action that women are going through and where they should seriously consider this. And I'm asking more as much for myself as for anyone else.

Fasting, Cortisol And What Works

SPEAKER_03 28:10

So if some if somebody is a perimenopausal or menopausal woman and has a mechanical injury in their body that is not healing, and you're not on hormonal therapy, I think that you need to have that conversation with your healthcare provider. That's not within my scope of practice, and I don't know the ins and outs of HRT, but certainly there is a link between that and musculoskeletal inflammation and problems. So for sure that's one thing you can do for yourself. Um, another thing is muscle building. So I know we hear a lot about protein and muscle building. One resource that is fantastic for women our age, her name is Dr. Stacey Sims. You can find her on Instagram. She recently wrote a book called Roar, and she's an exercise physiologist. Her catchphrase is that women are not small men. So just like women are not yeah, just like women have been under-researched in the healthcare realm, the same thing has happened in the fitness realm. And all of these studies on health and fitness have been based on male bodies, and we are not small men. So she speaks a lot about what you should be doing in the gym. It's not walking on a treadmill for 45 minutes, you know, like heavy. Strength training, heavy lifting, lifting. Like we're talking less than five reps, not the 15 rep bicep curls that we were told growing up, you know. You're you should be doing three to five reps of heavy, heavy sets. Um, sprint training is also very effective. And when I say sprint training, I don't mean like literally running sprints on a field. You can do sprint training with a kettlebell on a bike, it's a max effort. That's what I mean when I say sprint training. So, like you get onto a spin bike and you're giving max effort for 30 seconds, like so much effort that you think you're gonna puke, and then you're fully recovering. So two to three minutes of recovery and 30 seconds of hard work, which is the opposite of what most of us do. Like we go to the onto the spin bike for 30 minutes, just steady state. And that's not for perimenopausal women, that is not the way to go. So, those are the two things I've really tried to change in my training. Things to do.

SPEAKER_01 30:29

Yeah. Yeah, that's I love that, Ashley, because like I you saw me, I was writing notes because uh people are in different stages of their journey, and um, I think you've hit something that I I know I haven't really heard. Um, and I I look for this stuff when it comes to exercising, strength training, yeah, get it. But when you said this sprint training, which I have heard a little bit in you can do that in walking, but when you said kettlebell or that totally makes sense, I don't think that that's talked about enough. So, Dr. Stacey Sims, I'm gonna follow her because I think, you know, as we we are disciplined in ensuring, I I'm sure not a lot of people are doing that for sure. Um three to five reps, that's interesting too.

SPEAKER_03 31:16

Like I definitely go heavy, but I don't know that I'm going heavy enough when you say you want it to be so you can do three to five reps with about two reps in reserve. So you're not going to failure, yeah, but you're not doing sets of 10 or 12. You know, it's three to five reps.

SPEAKER_01 31:33

Yeah. Changes everything for us. And and this is, I think the beauty within if we just talk about down that to that exercise, because I I've I've figured a little bit of this out, um, but this proves it is you do not need to be going to the gym for an hour. Like again, as you have busy women, it's if you have small kids and you're running, listen, it's hard to do a lot of things, but like 20 minutes of a day of just really focused intensity um is the new game for women going through perimenopause versus like, you know, always moving and staying active. But I think most 40-something to 50-year-old women like if aren't sitting down that much.

SPEAKER_04 32:13

Yeah.

Resources, Referrals And Taking Action

SPEAKER_01 32:13

Um but it's it's that intentional kind of 20 minutes, 30 minutes a day to find time for yourself to kind of hit that that will save you in the long run. It's all for our 70, 75-year-old selves, right?

SPEAKER_03 32:27

That is 100% true. Like if a lot of women in our demographic, like they they put the strength training aside because it's not something that they're familiar with, they don't know how. But if you are not strength training now as a 40 and 50-year-old woman, you are not going to be able to live independently in your 70s and 80s and 90s. Like, this is this is about longevity. This is not about, you know, fitting into your genes.

SPEAKER_01 32:54

Like, we need to not become our grandmothers who are falling down and breaking hips, and you know, like and even I was just having dinner with my parents yesterday, and we were talking about travel, and they just came back from uh Cancun. They were there for a little bit, and they are um mid-70s, 70, I want to say 76, 77. Um, and it hit home because I like I just hear this stuff really hard when I hear it. Anyway, they're like, we don't think we can really, we don't want to do that as much anymore because we don't enjoy the ocean as much anymore. I'm like, what do you mean? They're like, because getting in and out of the ocean is an issue now. And my dad was like, I remember my sister, my aunt, who's 10 years older than him, watching her getting like, you know, in most oceans there's a little dip. And so it's not getting into the out of the ocean, it's coming back in. And I used to go and she said, I used to ask her and watch her and go, why is she having such a hard time? She goes, that was me. My mom couldn't even go in for fear that she would fall. And that is young, in my view, that is not far off as I'm 51 to look at my 70-year-old self. So that's what I say, ladies. You're right. It's the falling for sure. We think about that. But it's that story last night. I was like, oh my gosh, that's not those little things that you take for granted that if you're not doing this now, you're not gonna be, you're not gonna feel confident or comfortable enough. Imagine going to the ocean and knowing that you can't enjoy it to the degree, I mean, we're all gonna get there at some point, but let's extend that as much as possible for fear that I'm sitting in Cancun and I'm watching it from the balcony because gosh, I'm worried that I'm gonna fall getting out of the beautiful water. No, thank you.

SPEAKER_00 34:44

So, and that was. Well, of course, yes. So we did, right? Yeah, I think 76 to be in the water is a pretty wicked high five. But I think I saw six-year-olds that couldn't get out of the water.

SPEAKER_01 34:59

100%. 100%. Um, I mean, listen, what I think I saw a meme or something, someone said this about running. When's the last time you've you've just decided? I know you did. So if you're not a runner like me, I'm not a runner, I'm a walker, I'm a I lift weights, I do that. But when I do every so often, if on my walk or something, I'll just run for a little bit. Because when do you do that? Like sprint run. There's people who cannot.

SPEAKER_03 35:30

Or jumping, jumping or jumping as well. When when do you jump, right? Like the only time I jump, I do go to the gym, so I do like box jumps and stuff, but yeah, the research on jumping and bone density, the correlation there, if you're not jumping, jumping, like you're doing a disservice to your bone density.

SPEAKER_00 35:48

What about those new things that are like those jiggly pad things? The vibration plates, yeah.

SPEAKER_03 35:53

So as far as I know, as far as I know, the research is still out. It's it's a vibration plate, it's all over the tick tock. Yeah, it's all over you stand on it and it promotes blood flow.

SPEAKER_02 36:05

And but I my phone's listening and I'm gonna get served ads now. Yeah, I don't know that that's proven just yet, but a lot of people.

SPEAKER_00 36:14

But if you jump on a little trampoline, that would also that would count. That would be the same thing. I think the little jiggly thing is meant to be like to um kind of blood flow and like the your lymph nodes, like to kind of that seems to be what they're saying. But whatever.

SPEAKER_01 36:31

Like, yeah, feels like a little bit of a commercialization. Could be, could be, but I agree with you in the running and the jumping. That's a good point. So that's always like my cue as to how am I doing. I can do those things, because yeah, a lot of people, even in their 50s, can't do that. Like a lot of 60s. So it's it's just being mindful. Again, it's uh like how you said it is beyond bone density, which is a big factor.

SPEAKER_00 36:57

And if you have an injury, like my jumping monkey ankle, which is now fine, but that I there's hesitancy that comes from, and then there's fear of I don't want to jump across the creek on my walk because it's just gonna Yeah, a hype. Like, and then I'm gonna be injured again because I think that all the things you're talking about, Ash, like if our tendons are like extra stretched or whatever and inflamed, there's hesitancy. Like I can totally relate to not wanting like that ocean example or something, being like, I want to go there, but it's not worth it because I want to walk around later.

SPEAKER_03 37:34

Yeah, yeah, for sure. And that I mean, that's where proper training techniques Stacey Sims does talk a lot about this, honestly. She's a great follow. So look her up. But you know, proper warm-ups are very important and easing into these things. Like if you're not into strength training, you're not just gonna go and like deadlift 200 pounds, right?

SPEAKER_01 37:51

You gotta ease into it and make yourself doing jumping jacks, like it's not, you know, in the I do the Apple workouts, and there's always some level that's the extent of my jumping. I'm not even, but at least I'm like making sure I'm doing those jumping jacks because like, and it's just keeping maintained. Um okay, last question I have for you, and I don't even know if you can answer this, but I'm just because I'm on I go on like little tangents. So, in support of in your chiropractic, like in your um, if we talk about food and nutrition, I know you're not a nutritionist, but I love your just point of view on fasting. Do you have yes?

SPEAKER_03 38:30

This is this is not my background. However, my friend Stacy Sims tells me yes, yes, hormonal, like perimenopausal women, intermittent fasting is not the approach that we want to be doing. Um, I'm trying to think of her reasoning. It it's surrounding hormones and cortisol. And again, women are not small men, like the right the intermittent fasting studies are typically performed on 20 to 30-year-old.

SPEAKER_01 38:56

No, yes.

SPEAKER_03 38:57

That's not that's not us. So I need to look at it. I'm with you.

SPEAKER_01 39:02

Yeah, that's what I'm wondering because I'm going down this path now. I have a lot of, not a lot of, I have a few of now my women friends who are have done all of the eating throughout, et cetera, but now they've gone down a fasting and maybe not a regular intermittent fasting, but we're gonna do a two to three day fast in a period of time from an inflammation healing standpoint. Um, so I ask everyone I know now because I'm just genuinely curious about it. Um, I'm gonna follow Stacey Sims. I think I know her.

SPEAKER_00 39:31

Stacey, Tanya, Tanya didn't love the Gina Livy as much as I love Gina Livy. And I know you gave it a go, Ashley. I did. Yeah. No, I love the opposite of fasting. I know.

SPEAKER_01 39:42

I I'm a disciplined, I love to eat, but I'm also a disciplined eater. And I just, I think your body also reacts. So I perform, I feel better with less food. I just always have. I just, but I eat a lot of protein. Like I'm very intentional about my protein. So the problem with that's the challenge I had, which I know with Gene Olivia, you eventually peter out. So it is your body gets used to that. I just never made it that far. I'm like that person. Um, but the fasting, I've done it for years and then stopped doing it because of cortisol levels. And now I'm hearing a slightly opposite if it's managed. And I'm curious because I do feel better if I wait a 14 to 17 hour window. I just do. I have more energy. It's weird. So I'm just curious. I'm following Stacey. I'm that okay. Yeah. No, no, it's okay. I just it was more I was asking you, probably more as a woman. Like have you heard? Like what like I'm just always like like I said, I don't do research, it's through conversation. Oh, what are you doing? Yes, what's that? And then I take that verbatim and try it.

SPEAKER_00 40:46

It's well, Ash, you probably how many clients do you see in a day, approximately?

SPEAKER_03 40:50

Ah, so I see maybe a hundred a week, say.

SPEAKER_00 40:53

And how many of them would be at women our age? Oh, yeah, probably half. Yeah, so like you're you find it's like really cool opportunity. Like you you're like an ongoing focus group where you see 50 random women in a week who are in that age and stage, like the patterns you're seeing, oh yeah, are gonna be all the things.

SPEAKER_03 41:14

And and it's it is interesting to see. I would say about half of them have looked into hormone therapy or are on hormone therapy. The other half have no idea that that's even an option for them, yes, or that it's related to their feeling. I'm shocked by that.

SPEAKER_01 41:32

So I said this and I disagreed with her. I said, Are you kidding me? People don't know, so you just validated that.

SPEAKER_00 41:39

So your focus group is too small if you think everybody knows about it. Like obviously, yeah. That's but that's why that's why Ashley's if she's women a day, most of them have no idea. I owe you a beer. No, she's like, I won.

SPEAKER_03 41:56

Yeah, half half and half for sure.

SPEAKER_00 41:58

Yeah, and they don't know sad. And they don't know because I also think some people I know that didn't know about it, maybe they were they had an IUD or something. So really they have HRT. They've they just didn't know because it was part of the buttons and it's fascinating. And I think, and so they don't know, so they're so they're coming to you actually. Are they coming for an injury or reason? And then you're suggesting it's maybe part of perimenopause, so they're not coming to that conclusion on their own. Correct.

SPEAKER_03 42:29

No, it's me who's talking about it, and then uh I'm sending them to their doctor for a discussion. Yeah, or or I give them, I now have like a handout of resources that I send them to various podcasts and books and things like that, so they can kind of see the background of it.

SPEAKER_01 42:44

Thank you for doing that. Yeah, there needs to be more people who are doing that, yeah, right.

SPEAKER_00 42:49

And that's what I think is so so interesting. And even in that you're really seeing in the last couple of years. Like we did in our couple podcasts ago, we were talking about like our own menopause journeys, and I now look at the decade plus like 12 years prior. And I'm like, if I look at that through the lens, yeah, in today, there's so many markers that say that's what this is, but none of us knew. Like I didn't know, the doctor didn't know, you didn't know, like, so it's really so yeah, thank you for doing that service because people are coming in because their shoulder is sore and you're highlighting. So that's another thing, maybe before we kind of log off here, is to say if you are having an unusual thing, like I really just thought I slept, I honestly just thought I slept weird, and I just thought, oh, that's funny, it's gonna go away. It's just and it didn't. And if I wasn't already a patient and wasn't already a friend, I probably wouldn't even, I would just be like, it's fine, it's gonna go away. I'll just keep taking more advil. But I go to see you and you're like, no, this is actually a this is what it is. And so encourage people to go to their practitioners with a problem, not just think it's gonna go away in this age because it doesn't always just go away.

SPEAKER_03 44:03

And manual therapy can still hate help these aches and pains. Don't get me wrong. It's just that the hormonal component is a component of it as well and shouldn't should not be overlooked.

SPEAKER_00 44:14

And you have so many things to make it get better, like yeah, we're bringing more blood flow or whatever, doing the fancy machines.

SPEAKER_01 44:23

That's right. Yeah, or the I definitely need to go see you.

SPEAKER_00 44:26

Oh, the tape. Or even just those component of I'm actually doing something on the right track. Like it's it, you don't have to be in pain.

SPEAKER_01 44:38

Taking control. I think sometimes you can feel out of control of your bodies doing these things. So as soon as you just start to build certain things that you do for yourself, uh mind is an amazing thing too, right? Like down to that that woman who knows undoubtedly she did feel better after taking the one HRT. But a lot of it too is just the peace of mind, like her cortisol, like she feels like she's helping, and that can just immediately change the way you feel, right? While the long term takes effect. So I do think it's important for people to to take control of their own scenario. Like to your point, like there's there's things you can do. So Ashley, this was wonderful. I like could just be talking about sessions, but I loved this.

SPEAKER_00 45:28

This is why Ash is one of my favorite people.

SPEAKER_01 45:30

I could see why.

SPEAKER_00 45:31

Yeah, this looks great, you guys. Thank you.

SPEAKER_03 45:34

Well, thank you.

SPEAKER_00 45:35

Yeah, we'll see, we'll see where this goes. But Ashley is located in Burlington at Sport and Spine Clinic. Burlington Sports and Spine, that's right. Yeah, Burlington Sport. Should you need to find out, but you know, don't take my appointment spot.

Where To Find Dr. Ashley Warback

SPEAKER_01 45:49

Yeah, is that is that the email? Like, what's the website? Where do they find you?

SPEAKER_03 45:54

Yes, burlington sportsandspine.com. That's where I am.

SPEAKER_00 45:57

So and then Ash has her own Instagram. What's the Instagram? Like you kind of showcase your athletic life and your neat. That's true.

SPEAKER_03 46:04

My Instagram is Ash Burlington, so you can find me there. I I share a lot of Stacey Sims stuff on that occasion.

SPEAKER_01 46:11

I know who she is. Now I just looked her up and I was like, oh yeah. I don't follow you, Ashley. Now I do. Oh, get on there. There you go. It's terrible. Yeah, okay. Now I feel better. Thank you. Okay, thanks, guys.

SPEAKER_00 46:23

Thanks, Ash. Have a great day. Thanks, you too. Bye.