Strong Bones, Strong Women: Why Lifting Weights Isn’t Optional with Professor Belinda Beck

For years, women have been taught to be careful with their bodies as they age — to avoid risk, lift lightly, and accept a level of fragility.

But what if that narrative is wrong?

In this episode of Inside-Out Connections, I sit down with Professor Belinda Beck, a leading researcher in osteoporosis and exercise science, whose work has helped challenge long-held beliefs around bone health and strength training.

We explore what’s actually happening to women’s bones through menopause and beyond, why lifting heavy weights is not only safe when done correctly but essential, and how strength training can shift not just our physical health, but our confidence, independence, and sense of self.

This is a powerful conversation about moving from fear to capability — and understanding that it is never too late to start.

What We Cover

• Why the narrative of fragility in women needs to change
• What really happens to bone density during menopause
• The truth about lifting weights and the fear of “bulking up”
• Inside the LIFTMOR research and what it proved
• How the ONERO program is helping women build bone safely
• Can you rebuild or reverse bone loss
• How often to check your bone density and what to look for
• The impact of GLP-1 medications on muscle and bone health
• Why balance, impact, and reaction training matter
• The role of Pilates, yoga, and where they may fall short
• How to start if you feel overwhelmed or unsure
• Why strength equals independence as we age

Where to Find Professor Belinda Beck
The Bone Clinic
https://theboneclinic.com.au

ONERO Program
https://theboneclinic.com.au/onero/

Find ONERO locations
https://theboneclinic.com.au/locations

ONERO Academy
https://onero.academy/

Additional Resource
As mentioned in this episode, Professor Belinda Beck will be featured in May on 7 News Spotlight with Liz Hayes, offering a deeper look into her work and research.

Share the Episode
If this episode resonated, share it with a woman in your life — a friend, a sister, your mum.

Because this is a conversation more women need to be part of.

Transcript

SPEAKER_01 0:03

Welcome to Inside Out Connections, where we explore the link between your skin, your gut, emotional health, and your deeper sense of self. I'm your host, Tracy Ann, a wellness coach exploring what it really means to reconnect from the inside out. Today's conversation I've really been looking forward to, and one I feel is so important for women, particularly through midlife and beyond. For a long time we've been taught to be careful with our bodies as we age, to protect, to avoid risk, to almost expect a level of fragility. But what if that narrative isn't serving us? What if the real conversation we should be having is about strength? I'm joined by Professor Belinda Beck, a leading researcher in osteoporosis and exercise science, and someone who's been at the forefront of changing the way we think about strength training for women, particularly when it comes to bone health. Her work has challenged long-held beliefs that lifting heavy is unsafe and instead shown that when done correctly, it can be one of the most powerful tools we have for building stronger bones and preventing fracture. This is a conversation about shifting perspective from fragility to resilience, from fear to confidence, and reconnecting to the strength that is available to every one of us at every stage of life. Professor Beck, welcome. I'm so excited to have you on today. My pleasure.

SPEAKER_00 1:32

I'm happy to be here.

SPEAKER_01 1:34

What first drew you into the space of bone health and osteoporosis, and what was it about this area that really captured your attention earlier on?

SPEAKER_00 1:45

Well, as is often the case with researchers, it was a personal problem, and I constantly had sore shins when I was run a runner when I was younger, and nobody seemed to be able to help me. So I just in in my head it was always a problem that had to be solved, and I luckily went into an area where I was able to begin to study it. So I was looking at tibial stress injuries, and that led, which people always used to think was a muscle problem. And it quickly became evident to me that it was actually a bone problem. And that just led me down the path of bone response to loading and its amazing ability to adapt to loads and the application of that for not just athletes, but also for people with osteoporosis. And the more you learn about bone, the more you realize it is just the most phenomenal tissue. And it's fascinating to me. So I I'm hooked.

SPEAKER_01 2:49

Well, you just got my attention because my daughter uh likes to run, hadn't for a while, and she's got severe shin splints right now. So that's interesting.

SPEAKER_00 3:01

It is your classic bone reaction, and it is for after years of studying and trying to figure out what how to how to he heal them. Actually, it's not a it's not a therapy problem, it's a prevention problem. It's always too much too soon. Because bone will actually adapt to her running, but she's come back too quickly, and so the bone has got some injuries and hasn't been able to heal itself, and she's kept loading. So she needs to, you know, scale it back and come back slower, and she'll be fine.

SPEAKER_01 3:35

Interesting. Okay, great. I've taken note. So, what was the defining moment when you realized the way we approach bone health, particularly for women, needed to change?

SPEAKER_00 3:48

I think it was the the junction between my experience with animal research, where we knew that if you loaded bone in a certain way, it would adapt. It did, you know, we could see that if you could have in this highly controlled animal experience, you can cause bone to adapt. And yet the translation of that into exercise prescription for osteoporosis just hadn't been successful. And so what caught my attention is the fact that we hadn't actually been applying the principles we learnt from animal research into the human situation because we were scared of hurting people. The minute somebody has osteoporosis, a doctor is always much more conservative with their recommendations for exercise. And the problem is conservative exercise is not going to improve bone mass. So it was it was that nexus between animal and human research that made me think, wait on, we're not doing it right.

SPEAKER_01 4:48

And it's interesting, just like you said, that approach, there's almost this fragility when somebody has osteoporosis that you have to approach it with care. But with weight training, it's it feels like the opposite.

SPEAKER_00 5:04

Yeah, and look, I'm not a cowboy in any sense. I would never say, for example, somebody's 80-year-old grandmother who has never done any exercise in their life and they've just had a diagnosis of osteoporosis and they have severe osteoporosis. That is not a person that I'm going to put straight into the gym and load heavy. I mean, it bone will adapt, but you have to introduce it gradually. So that's somebody that I would start with very lightweights and build up. But if we want grandma to build bone, you do have to build up. There are other people who have a diagnosis of osteoporosis or perhaps osteopenia, who are younger, more robust, they're quite fit, maybe they're a runner. Um, and you don't have to be as conservative. You can actually get them loading pretty heavy quickly. So definitely, horses for courses, you have to treat the person, not the condition.

SPEAKER_01 5:58

So, why do you think so many women have been conditioned to be careful rather than strong as they age? And where do you think that messaging comes from?

SPEAKER_00 6:09

Well, we're going down a bit of a psychosocial path here, aren't we? Just a little bit. Um so I was a young woman in the 80s, and so I was right on the border of feminism in the 60s and 70s really took hold, and so people, women started to have more of a uh a voice, an opinion, and entrance into the workplace and so on, but it was a very, very slow process. And the fact that my father, of course, was brought up where women were in the kitchen and they looked after children and they didn't go to work and and you opened doors for women and you treated them with kid gloves and you let me get that for you, dear, I will lift that heavy suitcase. And everything about it was treating women as if they were fragile and weak. Now we are weaker than men. There's no two ways about it. We have less bu uh less muscle and no a very little testosterone. So I'm not saying we're as strong as men, but the less you do, the less you're going to be able to do. So even though it's very sweet that my father always did all the heavy lifting for my mum, it actually did her a great disservice.

SPEAKER_01 7:24

Yeah. And you feel like you're not capable. There's that feeling or notion that you're not capable, that a man can only lift and women can't because we're fragile, right? It's an undercurrent.

SPEAKER_00 7:36

It's good to know your limitations, but it's also good to know that those limitations are not as limited as you think. So you're never gonna know what you can do unless you try. And I I some if I'm working in the garden, I sometimes do get to a point where that pot plant, I can't lift. So I'll just pull my 20-year-old son over and say, can you please move that for me?

SPEAKER_02 7:57

Because it's got such a muscle.

SPEAKER_00 7:59

Um because you don't want to hurt yourself, and especially if you have very low bone mass, there is a potential for you to fracture, but there's ways of doing it. Lifting around the home is some of the most dangerous lifting you can do. Um, lifting in a gym with very good technique and somebody watching you is normally perfectly safe. The it's when people come from home back to to class and say, I just really hurt my back. And well, what were you doing? Well, I was lifting the edge of the couch so I could vacuum under it, and it was, what were you thinking?

SPEAKER_01 8:34

Yeah, that's just so we we have horses, so I'm lifting hay bales constantly, and it's not like lifting properly, you're twisting as you're throwing it into a car or into a truck.

SPEAKER_02 8:45

Yeah.

SPEAKER_01 8:45

I was talking to my trainer about it, and he said you need to lift it differently. So I remember unloading it once and filming myself doing it, rolling it forward. It was just this enormous workout, but once I did it correctly, it felt much better. Um, can you explain in simple terms what is happening in the body when we strength train that supports and improves bone density?

SPEAKER_00 9:08

A couple of things. The loads that our skeleton perceives come from two different um avenues. One is gravity. So we're all exposed to gravity. The the folks on Artemis right now who are in microgravity will be losing bone mass to tiny amounts. They're not there for very long. But as when you take gravity away, the bone perceives that. It doesn't need to be as big, and so it will reduce. So gravity is is the the first force. And the other one is muscle loading in resistance to gravity. So when we're lifting, we're lifting something against gravity. So the muscles have to work to resist that. Now, because of the structure of the attachments of muscle on bone, the forces that muscle apply are very high. I won't get into a fully anatomical description of why that is, but you do have to apply pretty high muscle forces in order to lift a load. Um, but that doesn't necessarily mean that the muscle forces on bone are larger than the gravitational forces because oftentimes when muscle contracts, there'll be a muscle on the other side of the bone or the joint that's contracting to help control that load and reduce injury to joints and slow down movement and so on. The most important thing to know is gravity is the thing that controls all of us, and muscles are contracting in response to that in order to move ourselves and the things that we need to move in our environment. Now, once those loads are applied, bone has the capacity to bend just a small amount. Not perceptibly, we couldn't see this with our own eyes, but it's just a tiny amount, and that's called strain. Bone bending is called strain. The higher the strain, the more the bone will respond because the cells are attuned to strain, and if the bone bends too much, it knows that it needs to be stronger. So that is a really strong stimulus to lay down new bone. There are cells all the way through bone tissue, bone cells, and they are all connected to each other. Hard to believe, right? If you look at a chicken bone, it's hard to imagine that that is full of cells, or when the chicken was alive, full of cells, and they're all connected with just these long processes. And they're bathed in fluid. And when you do bend a bone slightly, that fluid is squeezed from one side of the bone to another, and it pushes past the cells and its little arms, and that fluid movement is what stimulates the cells to know that it's being bent. Both muscle and gravity do that. The more you bend the bone, the more it's likely to respond. And transfer.

SPEAKER_01 12:03

And so be bending too far is at fracture, then.

SPEAKER_00 12:08

That's right. And it's it's very, very unlikely that you would ever be able to lift something that was heavy enough to break your bones. But it does happen. Occasionally you will see, say, an Olympic lifter who's going for, you know, a an Olympic record. Fracture. Um just pushing too far.

SPEAKER_02 12:29

Mm-hmm.

SPEAKER_00 12:29

Yeah. But very unusual. Normally our muscles really will will tap out at an amount where you you really can't overload your own bones.

SPEAKER_01 12:39

Hmm. Interesting. So your Lyftmore research really challenged what we thought was safe. Can you walk us through what you found in your research and why it was so significant?

SPEAKER_00 12:54

Yeah, so prior to Lyftmore, most of the research studies had been doing exercise programs that doctors and and other, you know, Allied Health thought were were safe for for people with low bone mass. So that would be walking and swimming and cycling and Tai Chi. And but then as people were seeing, well, this isn't working, there were some people who were doing some gym programs and actually, you know, doing their regular three sets of 12 repetitions. And that's still, you know, it was able to maintain bone mass for some people, but but it wasn't able to grow bone. Now, if you've already got osteoporosis, you need to actually increase the bone. So what we did in Liftmore was we did a much higher intensity, a heavier lifting program than that. Bone doesn't need very much stimulus. It uh if you if the strain is high enough, you don't need to do it that much. So it was a short protocol, 30 minutes, twice a week, in postmenopausal women with low to very low bone mass. And we did it for eight months because that's pretty much the minimum time you need to be able to detect a change in bone from a DEXA scan. And we compared that heavy lifting with, and there was some impact in there as well, with a um an unsupervised home program of the sort that doctors would often tell people with osteoporosis to do. A little bit of walking, a little bit of stretching, a few heel raises and lunges, that sort of thing. Very low intensity home program. We tested biomeral density, we tested muscle function and strength, balance and so on, and posture and those sorts of things. And would you like me to tell you what we found? Yes, please. So at the end of eight months, about 50 women in each of those groups, we found on average that people did actually increase BMD at the spine, which was fantastic. Must have been so exciting. At the hip a little bit, but it was very curious that they didn't increase bone mineral density a lot at the hip because some of these women were lifting pretty heavy, and I couldn't understand why BMD wasn't increasing. But luckily we have a piece of software that we can use with our DEXA scans to look at three-dimensional structure of the hip. And that showed us that even though BMD wasn't increasing, the shape of the bone was improving and the cortex was getting thicker. And that conveys a huge amount of strength onto the femoral neck, which is where most hip fractures occur. So that was a real step change. We found yes, we could increase bone mass, yes, we could increase the shape and strength of the hip. Yes, we could improve function, and people were much less likely to fall, their balance and mobility. We improved posture, people were standing up straighter. And the elephant in the room, of course, was did we hurt anybody? And the answer was no. One person had um a mild back strain on one of the exercises, and they had some physio and came back two weeks later and just kept lifting. So it was a win-win. We had an effective program that was safe if supervised.

SPEAKER_01 16:03

And that was the And when what year was this?

SPEAKER_00 16:06

What year did all this come about? So we started in 2013. Um clinical trials take a long time. Takes a long time to recruit people, you have to do the intervention, do all the testing, and then the write-up. We published online in 2017, but the final um published print version was 2018. And uh meanwhile, we were doing the Lythmore for men study, which um which started concurrently and found the same thing. And round about that time I opened the Bone Clinic, and this was because I realized that this is a very effective program, but it does need supervision. Because as I've been saying to you, people are at more at risk of fracture with osteoporosis. That's the whole point, that's the whole nature of the condition. So you do need to be be careful when you're loading, you do need to have supervision, you need to have great technique, you need it to be introduced gradually at a rate that suits you, and you need somebody who knows everything about your medical history and your other comorbidities, other things that are wrong with you, so that they can take account of those. So this is not just something that you can read about and go and do in the gym because that's a bit of a recipe for disaster. So that's included that.

SPEAKER_01 17:29

And especially if you are on this more severe side of osteoporosis than the early stages, I would imagine.

SPEAKER_02 17:37

Yeah, for sure.

SPEAKER_01 17:38

Um yeah, but that just must have been such an exciting time for you and your team to see those changes. Yeah, yeah.

SPEAKER_00 17:45

I mean it it's so rare to discover something that I mean it was it was probably in plain sight, really, but but to that actually change practice because the clinic's been open for it'll be 11 years in um July. Have just uh hundreds or thousands of people really who have gone through the program and who are continuing to train with us and build bone in the real world. This isn't a clinical trial anymore. This is just people who are coming and doing O'Neero. We we call the program O'Nero. That's why I wear my little O'Nero t-shirt. Yes. Um and then building bone safely, but it's not just about the building bone anymore, it's about reclaiming their lives, getting strong enough, you know, doing the heavy lifting for their husbands now because they're stronger than them.

SPEAKER_01 18:37

It's like, no, no, I've got it, step aside.

SPEAKER_00 18:39

You know, being able to put your your carry on in the overhead locker by yourself.

SPEAKER_01 18:46

It's true. I mean, I know myself, I lift quite heavy. I feel amazing when I do. Like people think perhaps you might feel fatigued or you might need a little lay down afterwards, or you know, but you it's the opposite. It energizes you. You feel amazing when you lift heavy.

SPEAKER_00 19:04

Well, muscle is king. You know, muscle is honestly the king of health. And it's so great for your metabolism. So aside from the mental health benefits of just feeling empowered and strong enough to do stuff, um, it's just so good for your metabolism to have more muscle tissue that is less infiltrated with fat and is more functional and strength strong and healthy. Um, if you look at the people in aged care facilities, uh the people who are either bedridden or who are on walkers, and you look at the size of their legs, they've got these skinny little legs because they're sarcopenic, no muscle, they're falling all the time. Yeah, you want to avoid that at all costs. Even if you never grow bone, you want to grow some muscle.

SPEAKER_01 19:50

And so just to be clear, it is possible for people to rebuild and even reverse bone loss once it started?

SPEAKER_00 19:59

100%. Yeah. Yeah. Yeah. It is. There's and this is the great thing that people don't sit on their couch wrapped in cotton wool. It it it is actually empowering. Get out and do it.

SPEAKER_01 20:12

Yeah. And how often should women be checking or rechecking their bone density, especially later on in life? Are there any specific tests, or is it the the dexter scan the main form of testing?

SPEAKER_00 20:29

Yeah, uh it's it's quite a topical issue at the moment because there are n various new devices that come onto the market now and now and again. And I'm always open to to looking at them, and I'm very interested in doing research with different measures. But I for all its flaws, and then it does have flaws, DEXA has stood the test of time because the relationship of bone mineral density that you measure from DEXA, dual energy X-ray geometry, is highly predictive of fracture. The lower your BMD, the more at risk of fracture you are. And on a population level, that is extremely consistent. It's also a good, reliable measure that you normally will get the same measure twice in a row if you measure it twice. Um, there are problems with it in that it only detects mineral. It's an X-ray device, so it doesn't detect new bone that hasn't been fully mineralized yet. So there's no point in having a DEXA shorter than six months apart because that new bone that you will have developed won't have mineralized and so it won't be detectable. We I would say that it's there's really no point in having a DEXA less than a year apart. That's probably the you know the shortest epoch that you would want. I believe the government reimburses for people who have osteoporosis or are over 70, they will reimburse for a DEXA every two. Years and that's fairly consistent around the world. But if you have a diagnosis of osteoporosis or you have a fracture, they probably will reimburse more than that, and your doctor will probably want to track any change. If perhaps they put you on a medication, they'll probably want to track you annually. Not necessarily. The most important thing I think is for women to consider having a DEXA around the time of menopause so that you have a benchmark, so that you know where your bones are. If your bones are through the roof, you've got this beautiful fantastic genes and you've got lovely strong bones, then perhaps you you need to worry less. If it's if they're very low, then as you go through menopause, they are going to get lower. Just knowing that is a very powerful tool for managing your bones throughout the rest of your life.

SPEAKER_01 22:50

I want to touch on GLP1 medications. Seems to be everywhere at the moment. There's been a huge rise for weight loss. From your perspective, what impact do these have on muscle mass and bone health, particularly for women in that midlife stage?

SPEAKER_00 23:10

Well, I haven't done any research in particular on this myself, so I can only report on what others have reported. And as far as I'm aware, and what sadly seems to be the case, is that if you are on um a GLP, you will lose bone and muscle as well as fat as you're losing weight. That does tend to happen with regular weight loss as well. I'm not sure if it's worse when you're on a GLP one. It may be that it's more rapid, so it happens more rapidly. I think the take-home is if you are taking one of those drugs, then know that you are at risk of losing bone and muscle. So you need to be doing something like O'Nero to hold on to your bone and muscle. And so the loss is just fat because the fat will come back quickly. Bone and muscle doesn't come back that quickly. So it is definitely something to be aware of.

SPEAKER_01 24:08

I mean, are we moving backwards with weight loss coming at the expense of strength and muscle?

SPEAKER_00 24:15

Well, it's hard to say we're moving backwards when these actually these drugs have changed the face of diabetes and and weight loss does change a lot of people's general health. Reducing inflammation, reducing pressure on osteoarthritic knees. Um, I think these are actually good drugs for a large part of the population that struggles with weight loss. I'm not writing them off. I'm just saying that if you are on them, you do need to make sure that you're taking care of bone and muscle. And for people who who are taking them as a shortcut to weight loss, I'd probably say maybe think again, maybe just go back to your basics. Uh less energy in than energy out.

SPEAKER_01 25:04

And uh and you might you said get getting a baseline perhaps before you start that journey of the GLP ones to see where your bone density's at, to then be able to make an an executive decision and then looking at things like the O'Nero program to keep building muscle and looking after your bones.

SPEAKER_00 25:24

Yeah, and people who are taking these drugs could be any age. Um, it's you know, we don't talk about O'Nero as being an old person's exercise program. It's a bone exercise program. So at any age, we have people of any age at the clinic doing ONERO. So it's definitely something that people who people could do when they go on a GLP one.

SPEAKER_01 25:46

So talk me through what it's like for a woman for the first time walking into an Enero style program. What does it look like?

SPEAKER_00 25:54

Probably different experience for different people. There might be people like yourself who are already doing some weight training, and so they're quite confident. They just just tell me what to do, I'll do it. And I know how to hold the bar, I know how to hold my body, and so you're quite confident and ready to, ready to go. And then there will be others who have never been in a gym in their life, don't know which end of a bar you're supposed to hold on to, and don't know anything about how their body feels in space in certain positions, and they are probably quite intimidated and quite anxious. And of course they're worried about a fracture. So we have the full spectrum from one extreme to the other, and and at the clinic at least, and I'm certain all the O'Neuro licensees do the same thing, you just treat each person individually. The one thing that the person who's feeling intimidated and scared should be assured of is that they are not the only one feeling that with that degree of experience, there are hundreds of people like them, and we can look after all of them. And all of a sudden, they're going to find in six months' time it's just what they do, and it's not scary anymore, and they just they just become one of the one of the class.

SPEAKER_01 27:13

Yeah. And are there specific key exercises that are more important than others?

SPEAKER_00 27:20

Well, yes, the ONURA program is a very specific set of exercises, and what we do is we try and focus on those and getting people lifting as heavy and doing the impact as as as firmly as we can. What differs between people is if they perhaps have something, say a frozen shoulder and it makes it really hard for them to lift, then we will do something different for them, some modification in order for them to be able to improve their shoulder. And once their shoulder gets to the capacity where it can they can actually lift, then we introduce them. Um we tend to focus on compound movements. I don't talk about the specific movements publicly because people try and do them by themselves and they hurt themselves. We we don't talk about the program um on podcasts typically, but they um they're technical. You do have to learn a very specific form. Um there are dangerous ways to do them and safe ways to do them, and and that's what your coach is for.

SPEAKER_01 28:24

Yeah, and I understand there's balance work and impact and jumping included. It's not just a heavy lifting. So why are they incorporated in?

SPEAKER_00 28:34

Yeah, well, falls are just the nemesis of osteoporosis, is my catchphrase. Because you could go throughout life with osteoporosis and never have a fracture if you don't fall. But you combine the two and that's when fractures happen. So 90% of hip fractures are a direct result of a fall. So even though the ANERA program itself, or the the main heavy lifting exercises, do actually reduce your risk of falling, we think that you need more dedicated balanced training to really train the neuromuscular system to be able to balance in a in a situation where you might be slightly off balance, but also catch yourself if you are going to fall. So, I mean, if you think about circumstances where maybe you're traveling and you're on that bus that picks you up from the terminal and takes you over to another terminal, and you're packed in with people and you can't reach a pole to hang on. You're standing on that bus and you've got to keep yourself still. This is a skill that I swear people who are doing ONER are going to be much better off than uh than people who don't. You you find yourself in these situations where you do need balance more often than you think. Now, I'm not suggesting that anybody should not hold on on one of those buses. They are lethal. Don't test it out straight away, people. But these balance exercises that we introduce are high challenge balance because just standing on one leg, you know, you back in the day we'd say just stand on one leg while you're doing the washing up. It's it's not going to cut it. It will improve your balance standing on one leg, but it won't improve your balance when you're moving, or if somebody perturbs your balance when you're standing, and maybe your feet are close together and so you're you're um not very stable. So we do, we've incorporated those extra exercises to try and work on that because you do need quite a lot every week to actually improve your balance and reduce false.

SPEAKER_01 30:43

Absolutely. It's easy to lose your footing or fall down a pothole. Balance is especially important as as we get older because, like you said, if once you get that hip fracture or a break, it's it's a long recovery.

SPEAKER_00 30:55

And you think about how older people fall. It's a bit like a tree toppling. You know, they just sort of they lose their balance and down they go. Whereas you nothing bends. I I've noticed that. Well, w you and I would be able to get our foot out in front of us to stop that. So the tree would topple, but our leg would come out to stop us.

SPEAKER_02 31:19

Yes.

SPEAKER_00 31:20

Or if and oftentimes a hip fracture is a fall to the side. So you could get your leg out to the side, or you could get your arm out to catch something. Whereas older people often don't have they've lost their reactions and they can't get their body into a position to stop themselves falling. So that's also part of what we do. It's reactions and weight shifts and so on.

SPEAKER_01 31:42

Yeah, I saw that in a dog park once. I have a ridge back, and she was running with another ridge back. And I could see it about to happen before it happened. Dogs knocked into this elderly person, it was just terrible. But luckily somebody caught. But I remember the man, he he went down, like you said, just no arms, no legs out. It was she caught him before he hit the ground. But yes, quite quite scary for them as well.

SPEAKER_00 32:08

Especially when you're not expecting it. And it's one of the reasons why I I tend to discourage a broad brush approach of saying walking is good for everybody. Walking is a really good exercise for so many reasons. But if you tell a very frail old person to go walking by themselves and the neighbor's dog runs out, even if they don't run out to the street just to the fence, give them some a fright and they fall on a hard pavement. So walking can actually increase fractures if it's a frail person without anybody with them.

SPEAKER_01 32:49

Professor Bett, you spoke about your program that it's specifically for sports physiologists or physios, physiotherapists. But what about people from a financial perspective that can't afford the program? Is there anything they can do at home to help support themselves in the early stages?

SPEAKER_00 33:13

Yeah. So um definitely just do something. Um we do offer an online program as well that is at five dollars a week, it's for two years. It's just it's focused on false prevention. That's a great idea. It has a little bit of bone loading, uh a little bit of muscle training, but it's focused on on um balance and mobility. Uh we're actually re-jigging that, and I can tell you when that is launched, it should be in a month or so with some new better exercises, but that's a really um inexpensive way to do it. We can also do telehealth appointments with people who want to be given a program, and we can do that. We won't give them O'Neiro, but we'll give them the next best thing that they can do at home or in their gym. Um, and that's just through the bone clinic. If you can't do any of those things, I just encourage you to do something. Now, if you're very frail, don't do that thing by yourself. You need somebody with you. But if you are, say, in your 60s, 70s, and you're still quite uh fit and robust, just keep doing something. Some of those activities that are quite social, like playing netball or tennis, are good because these are unusual movements that will also be training your reactions. So running backwards and forwards on a tennis court is really good for helping to prevent falls. And it's a hard court, you're getting a little bit of loading from the running backwards and forwards. And it's something that is social, so it encourages you to do it. Doing things on your own can be a little demotivating for some people. So I don't know, my pickleball. Possible. Yeah. Just be careful. Yeah. Be careful.

SPEAKER_01 35:05

Injuries do happen. And it depends on how competitive you are. It does. Yes. So be aware, be self-aware. Don't hurt yourself. No, don't get too competitive straight away. So many women are still afraid of lifting weights. I know, just through conversations that I have, they're more worried about bulking up than doing harm. But I guess a little bit of doing harm as well, perhaps having children, some issues with their back or a lax pelvic floor, perhaps. So where do you think that fear comes from, that notion of like bulking up? Prefer to do Pilates than do weights?

SPEAKER_00 35:48

Um I suppose it's just intuitive that if you work out your muscles, they're going to get bigger. But whenever somebody says that to me, I just say, mate, you wish. It's not going to happen. It's just, you know, we have people who are lifting so heavy at the clinic and they're like, Where are my muscles? This is why am I not getting huge? And so you do get muscles, you get beautiful, toned, firm, strong muscles, but they do not get big. One, we don't have testosterone, which is the primary driver of muscle size. And two, most people are older, so even estrogen's disappeared. So yeah. We put nothing. We even get nothing. You just have low body fat, you're gonna look at your arms and go, oh, I've got lovely, shapely arms, because the muscles will be visible and they are lovely and shapely, but they're not gonna be big.

SPEAKER_01 36:46

No, you don't want us have those flabby arms later on in life. It's nice having a little bit of definition. But like you said, the yeah, you can't you can't I lift quite heavy. I'm not bulky at all.

SPEAKER_00 36:59

Yeah, and you know, you'll there's a a lot of on Instagram of um mainly younger women, occasionally an older woman, um, that is big and buff, but these are people who are doing specific power lifting workouts to booty stuff. Specifically to build themselves up. They're taking supplements, they could be taking other things which are actually helping to boost their muscle health. There are some people who are more genetically predisposed to be more muscly, and we all know them. We grew up with that really muscly girl. A lucky thing, they have the ability to do that, but that that disappears as you as you age, unfortunately.

SPEAKER_01 37:39

I still think there's just that stigma, isn't there? Just that conditioning around skinny versus strong.

SPEAKER_00 37:46

Yeah, but I mean, how great do lovely, shapely arms look? I mean, that's yeah, that's the goal.

SPEAKER_01 37:55

Yeah, we don't want to be covering them up as we get older. Yeah. So what are some of the biggest benefits you see for women, especially in your clinic, when they begin lifting heavy weights beyond bone health? Perhaps from a mental perspective.

SPEAKER_00 38:12

Yeah, it it is all about independence. It's the the idea that you don't need to rely on anybody to be able to do the things that you like to do. The the story I normally tell is the woman who says that she opens the Vegemite jar for her husband now. How great is that?

unknown 38:34

You know.

SPEAKER_00 38:35

Um so these that independence is gold. And it I don't think quality of life questionnaires capture that. It's that feeling like I don't need to call my son to come and help me shift a box of books. I can do that myself. You know? Yeah. Yeah, within reason.

SPEAKER_01 38:58

Yeah. Within reason. So that because that is just a red rag to a boy. And so carrying couches out on their shoulders. Yeah. That's that's right. It's like don't try that at home.

SPEAKER_00 39:12

No, the um the principles of lifting that we teach in the in the gym, we say they apply everywhere, not just here. That's at home as well. Remember these principles.

SPEAKER_01 39:24

Yeah. Yeah. So what role does cardio play alongside strength plane training? Is it something we should include? And what type and how often?

SPEAKER_00 39:38

Well, I'm first and foremost an exercise physiologist, so I I think about the whole body. And public health recommendations do say that twice a week in resistance training and the other days, if you can do aerobic exercise, you should. And that can be anything. It should be the thing that you love to do so that you you do it as frequently as you can. It's really important to keep your heart beating and your blood moving. That is helping with uh brain health as well as heart and lung health is a it's not going to necessarily improve your bones, but that's not the point. You've got your two days a week, that that handles your bone. The other days, do whatever your heart desires to get your blood moving. Um, get up all the sweat. Again, I'm I mean, it's it's not uh aerobics training is not my thing, so I I'm I wouldn't go out on a limb and give somebody a a program for that, but my mantra is do the thing that you love to do, because otherwise you're not going to do it. You know, most people are not going to start marathon running at age 60. Quite often they they will walk. If you're walking, remember that you do actually have to put a little bit of stress on the system. So try to include steps or hills in your walk. And if everything, if it's very flat, like if you walk along the beach every day, then try and uh maybe walk in the water a little bit, on the soft sand a little bit, be careful you don't cause an injury in soft sand. And perhaps try and walk quickly. Walking quickly is going to raise your your heart rate.

SPEAKER_01 41:15

Changing it up. Yeah. Yeah, so it's not the same every day. And you spoke about the Onero program. So lifting only twice a week? Could you do four times a week?

SPEAKER_00 41:28

Um, you're supposed to have a day of rest in between each session, and that allows your muscles to recover. And that's important because if they don't recover properly, you can't lift as heavy as you need. So that means three times a week is the max you can do because we run out of days of rest days.

SPEAKER_01 41:45

Yeah.

SPEAKER_00 41:46

So um we recommend twice a week because we know that it's enough. But if you come three times a week, it's possible it might be better. We don't know for sure. I've got a little bit of data that suggests it might be better, um, but we don't know for certain. Once a week, if you can only manage once a week, is definitely better than not at all. So it's it's a case of what you can manage feasibly. Many people are still working and they've got kids still at home and aging parents that they're looking after, classic sandwich generation, so they're busy. Once a week, if it's all you can manage, you should you should still do it.

SPEAKER_01 42:28

Okay. And out of curiosity, what does your typical week of movement or training look like? My personal week? Yeah.

SPEAKER_00 42:40

Uh I'm a bit of an oddball. Uh uh of course I lift, but um on the other days, I also love to read. And I can't believe I'm telling you this. So my my exercise routine is reading and walking. And I walk because I can't go faster and read. But if I read when I walk, I can kill two books, two birds with one stone. I get to read that I love, and I get to walk that I need. So I live in a very hilly area.

SPEAKER_01 43:17

So you're when you're actually walking, you have a book that you're reading. So you're not listening to an audiobook. You're you're looking at a book when you're reading.

SPEAKER_00 43:28

Yeah. Well, I mean, I actually I'm sorry, when you're right, when you're walking. I I don't like walking very much, and and I live in a very hilly area, so it's quite unpleasant. I'm walk walking, it's it's hard work. So I'm sort of distracting myself as well as reading. I normally have a Kobo, so it's quite small. So I've got plenty of peripheral vision and I know the area very well. So yeah, I'm the crazy person who walks around my area for for an hour free.

SPEAKER_01 43:56

Yeah. And you must have really good balance and spatial awareness. To be able to multitask like that? Well, I I never fall over. Yeah. Yeah. Well that's because you're doing the O'Nero program. Oh, I love that. So for women who are constantly doing things like Pilates or yoga only, what roles do these play and where might they fall short when it comes to bone health?

SPEAKER_00 44:25

Well, both of those things are wonderful. I'm a big fan of Pilates. Um, however, our MedXOP trial used Pilates as the control group and showed very clearly it did not increase BMD. In fact, the women in that group lost bone. So it's not a bone program, and we know that, but it is a wonderful program for all manner of other things. And it should help with muscle function and falls. We don't know that for certain, but I suspect it will. Yoga is wonderful for balance and mobility as well. With a caveat, there are some people who think if you do yoga, you have to be able to lie your chest down your thighs and grab your ankles and so have that ridiculous hamstring flexibility where you have to be able to touch your toes in any position. That is not a position that is friendly to an osteoportic spine. So deep forward flexion, I really discourage. If you have severe osteoporosis, it's not necessary. If you want hamstring flexibility, you can get that flexibility in other positions without rolling your spine down. There is some evidence from some published data showing that people doing that sort of yoga do increase fractures. So just be careful with yoga. It's um there's no need for that sort of really curved spine.

SPEAKER_01 45:54

And for women listening who feel they may have left it too late, is it ever too late to start lifting weights?

SPEAKER_00 46:02

Never too late. Never ever too late. We have 90-year-olds at the clinic. And uh and honestly, the older people are the ones who get the most benefit.

SPEAKER_01 46:17

I love that. Is there anything we're missing from today's conversation, Professor Beck, that you'd like to fill the gap with?

SPEAKER_00 46:28

I suppose my most important message is just do something. Um if you want to grow bone, do supervised evidence-based exercise. Find yourself somebody who, for example, offers ONERO and do that. Just get started. You actually will be maybe a bit anxious to begin with, but once you start and get into a routine, you'll meet friends in that class who will make it appealing for you to keep going and they will look out for you. When people don't come to class at the clinic, they've got people on the phone saying, Marjorie, where are you? And it becomes a social thing which actually almost becomes more important to some people than their bones. So just get started and let the exercise do the rest.

SPEAKER_01 47:33

I love that because you're not only rediscovering yourself and understanding your own strengths and capabilities, but but you're connecting with a community and you become part of something which is so powerful within itself.

SPEAKER_00 47:47

I really love that. They have the same goals as you, the same interests as you. They've probably had many of the same life experiences you. They possibly starting to have grandchildren, travel, you can swap stories, recipes. They're looking online for high calcium recipes for to improve their diet. So it's this wonderful exchange of like-minded people. It's not like going to a gym where you've got the muscle set who are kissing their biceps and those sorts of things.

SPEAKER_02 48:19

You're actually people like you.

SPEAKER_01 48:25

Yeah, I love that. So, Professor Beck, I always love to wrap up with a moment of reconnection. What is your body taught you about yourself?

SPEAKER_00 48:34

Oh, that is a that is a tough one. I don't even know where to start. It's taught me so many things. Uh, I I feel like one of the most important things, it's it might not exactly answer your question, but one of the most important things that I am realizing is that my extremely active childhood, where I spent many, many hours outside down the paddock, playing horses with my friends, and we didn't have a television. So just being an active tree climbing, running around kid with a mother who was quite particular with our diet really set me up for an extremely healthy life. So, of course, that information is is important for people our age to translate to kids and grandkids. So those those growing years, right through to age 20, when we're growing our peak bone mass, they are absolutely vital, not just for bone, but for all forms of health.

SPEAKER_01 49:41

I had such a similar childhood up in Queensland with horses and barefoot and out getting home when it turned dark and having all that vitamin D, and like you said, climbing trees, falling out of trees and breaking arms, which is a rite of passage, which would just never it's almost child abuse these days to let your child climb a tree. But I yeah, I believe that they're the foundations that set you up for everything else, particularly a good diet, like you said. So, where in your life do you feel most connected?

SPEAKER_00 50:15

Outside. Out out in the bush. I'm I'm very much an outback girl, not a beach girl, even though I live at the beach. Um, yeah. I a road trip is the most fun thing in the world for me to get in the car and just drive. And uh we drove out to Quilpi last year and just camped out near a beautiful lake with the birds and the frogs and the and all the flowers from the rain. That is my absolute happy place.

SPEAKER_01 50:44

Heaven. And what does strength mean to you beyond the physical? Strength means independence. Yeah. That's a powerful message and and such a great way to finish. Thank you for today's conversation. For me, what really stands out is this shift away from being careful and towards being capable, that our bodies aren't something to shrink or protect from life, but something to build, support, and strengthen. And perhaps more than anything, it's a reminder that it's never too late to begin. Professor Beck, thank you. Where can people find you and your work?

SPEAKER_00 51:22

Probably the easiest place would just be to Google O'Nero. You can you can find an O'Nero locations map. That's not me, there's licensees everywhere. But also Google the Bone Clinic. And that's so we can help in other ways, for example, with telehealth. The Bone Clinic has a Facebook page where I post scientific stuff that I put in lay terms for people to learn about how to manage their osteoporosis and various things. For for my friends, it's a really boring Facebook page for people with osteoporosis.

SPEAKER_01 51:53

It's a really helpful page. That's that's a really good tip. Thank you so much. Pleasure. Thank you for joining me on Inside Out Connections. I hope today's conversation reminds you to tune in and find small ways to self reconnect. If this episode resonated, please share it with a friend or leave a quick review. Come join me on Instagram at insideout skin gutcoach.