Episode 13: Movement Is Medicine: What Women Need to Know About Exercise

In this episode of A Journey to Whole Woman Health, Dr. Jamie Erwin and Dr. Mary Kathryn Nader talk about exercise for women and why movement matters so much for physical, mental, and emotional health.

Jamie shares her own background as a lifelong athlete, from gymnastics and track to collegiate competition and marathon running, and explains how her relationship with exercise has changed over time. Instead of punishment and pressure, movement has become a way to honor the body, build longevity, and care for overall health.

Together, Jamie and Mary Kathryn break down a simple framework for women’s fitness using the acronym FACE:

F – Flexibility
Why mobility and stretching matter every day

A – Aerobic
How zone 2 cardio supports heart health, endurance, and longevity

C – Carry the Load
Why strength training is essential for women, especially in midlife

E – Equilibrium
How balance training helps prevent falls, improve stability, and support healthy aging

They also discuss:

•  common myths about women and weight training 
•  why women should not be afraid of lifting heavy 
•  the role of VO2 max in longevity 
•  why too much high-intensity exercise can backfire in midlife 
•  how exercise supports insulin sensitivity, bone health, and muscle mass 
•  the importance of movement during pregnancy 
•  why finding joyful movement matters for long-term consistency 

This conversation is both practical and encouraging, whether you are a marathoner, a walker, a class lover, or someone just trying to move more in this season of life.

Because movement is not about punishment. It is about strength, stewardship, and caring for the one body you have.

Transcript

SPEAKER_00 0:00

Welcome to A Journey to Whole Woman Health, the podcast where science, mental health, and faith come together to educate, empower, and encourage women in every season of life. We are your hosts, Dr. Jamie Irwin, Ford-certified OBGYN, and Dr.

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Mary Catherine Nader, licensed professional counselor with a PhD in counselor education and supervision. Jamie and I have been friends for over 30 years.

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Each week we explore the intersection of body, mind, and soul, bringing you evidence-based medicine, meaningful conversations about mental health, and stories that remind us we're not alone on the journey. So take a deep breath, settle in, and let's begin the journey.

SPEAKER_01 0:43

Welcome back. It's another Wednesday. We are in pink and we are ready to talk about something so important, which is moving our bodies, getting the exercise that we need. I am so excited about this topic because I know it's something that we all have lots of questions about.

SPEAKER_00 1:00

Yes, there's a lot of misconceptions, and we hope to uncover them today and address them and shed some light on exercise and what's best, and how do we do it and how much and and really why should we? All the benefits. Yes, I love that. That's great. Okay, well, let's get started. Let's get started. I love this topic. So um, you may not know my background. I know Mary Catherine does, but for our listeners, I've always been an athlete. You have an amazing athlete. Well, so proud. Thank you. I grew up as um was a gymnast early in life and really enjoyed that um until I didn't, and decided to move on and um ran track. I mean, so backstory on that, um, in elementary school and just running around on the playground and racing the boys and beating them. And um, my PE teacher, actually, he wasn't even my PE teacher, he was the other PE teacher, called my mom.

SPEAKER_01 2:04

Wow.

SPEAKER_00 2:05

And was like, this little girl is fast. Wow, you she saw that in you. How cool. You should look into a track team for him. Yes. So ended up doing that. Actually, my mom was my first coach. We signed up for a few little summer meets and you know, just didn't really know what I was doing, but went out there and won and had a lot of fun. And then we found a real track club and joined that and um had great coaches along the way that taught me a lot. And anyway, life went on and ended up running uh at the University of Arkansas. I was a hept athlete and a pole vaulter. Um, sprinter is my background. In high school, I went to state and the hundred-meter hurdles, the three hundred meter hurdles, and the long jump. Go Pascal. Woohoo! Go Panthers. So that's my background. Of course, you know, after you finish college and life moves on, you're not gonna go hurdle and pole vault. So I mean, you can. It might not be a great idea. Yeah. And for me, I definitely had my fair share of injuries and ended up having two back surgeries in college from injuries. So it was time to move on. Yeah. Um have in recent years become an endurance athlete. Something I never thought I would do. So just ran my fifth marathon and going for number six. Amazing. And loving it. And loving it. So Mary Catherine also runs, but she's really surrounded herself with all these runners in her life, which is so funny.

SPEAKER_01 3:45

Friends and family members who are runners, which is it's great. I love it. It's so fun. Um, and it's a good outlet for me. I've never I've run half marathons. I I've probably run about four, but never at the turnoff have I been like, and I want to do this whole thing again. Let's just keep going. Yeah. So it's more of a social thing for me. And good exercise, of course. Yes. Um, yeah. So I'm excited to hear all the tips that you have for us. And what we are not going to do is tell you that you need to run a marathon. No, no. That is not your story, one. It might be your story, but it doesn't have to be your story. It doesn't. And there's different seasons of life. I think that's the other thing. You know, there's been all kinds of seasons, you know, where we've done different um exercise activities. I've done, I've been on a tennis team, I've done chassis, I've done different now. I go to a gym where I love the classes that I attend. And um, you know, it's just kind of what works for this season of life that you're in. How do we stay active? How do we keep moving for sure? And stay healthy.

SPEAKER_00 4:48

And stay healthy and have a good relationship with your body. Enjoy the body that you're in, being curious about it, respecting it. I think for a lot of my running career in college, especially, I felt like I was punishing my body. It was pushing and doing one more interval and and push through the pain. And so as I've aged, it's more of I need to honor my body. Yes. I need to take care of my body, I need to rest. I need to, you know, really it's it's more about longevity. Yes. I want to, we only get one body, and I want to keep this body moving as long as possible.

SPEAKER_01 5:29

And avoid injuries too, as we get older. I mean, we've talked about you've talked about your back surgeries and what we've mentioned, my ACL surgery before, and I know you've had knee stuff. It's like we also want to be healthy so that we can prevent these injuries and um and then the setbacks that that can lead to. So yeah. For sure. So let's get it started. Tell us what we need to know about the exercising thing.

SPEAKER_00 5:54

All about the exercise. I really love the advice from Dr. Vonda Wright. She is a renowned orthopedic surgeon. Um, and I just I love this acronym that she uses to explain kind of the the framework that we should focus on when it comes to exercise, for women in particular. So the acronym is FACE, F-A-C-E. Okay. So let's dig into it. Let's do it. What does F stand for? F is for flexibility. Okay. And this does not mean you have to learn to do the splits, Mary Catherine. Okay, thank you, because I've never been able to do the splits. Nor I. It's not ever gonna be a part of my future, and that's fine. That's okay. But flexibility means just mobility, moving our bodies, gentle stretching. It's something that we should be doing every single day. Yes. And I know I could do better on this. I I for sure could. Definitely as a runner, I need to do this after long runs, even before running. Some dynamic stretching can be a great way to warm up and get your body prepared for like the real exercise. Dynamic stretching meaning moving. Moving when you're stretching. So that can be air squats, um, kind of jumping up and down like pogo stick. You know, you're you're getting the joints lubricated, you're getting your tendons and your ligaments and and the blood flowing through your body to warm up the muscles. Okay. Um, so that's really dynamic stretching. And then we talk about static stretching, which is, you know, think of like sitting on the ground touching your toes. Okay. That's great after exercise and activity because your muscles are lengthened already, they're warm, and you're just, you know, kind of keeping that flexibility going and gently stretching them in a static way. Okay. So those are kind of two different types of stretching um ways to improve your flexibility and your mobility. Great. And that should happen daily. It should happen. Okay. And you can fit this in in little pockets of your day. Right. As you're waiting for that coffee to brew, as you're waiting in line at the grocery store or the pharmacy. Um, you know, just moving your body, touching your toes, getting up from your desk, shoulder rolls, um, you know, gentle movements to help with this mobility in all parts of our body. Gotcha. Really great. Really great for longevity. Okay. We need to move. Great. If you stretching, it's important. Flexibility. Exactly. And if you think about our bodies, think about how we're designed. Our biggest muscles are on the lower half. Right. We were built to move, to walk, and to run, and to jump, and to play. And, you know, if we weren't, if we were meant to be these sedentary creatures, we would be shaped like a mushroom. We'd have this one stalk that's stuck that doesn't move and just a big brain on top. Right. You know, those are that's a sessile organism. That is not us. We have these beautiful legs and we're meant to run and play and jump and be active. Got it. Yeah. Okay. So we're gonna be flexible. We're gonna stretch when we can as much as we can. Exactly. So A is aerobic. Okay. So let's talk about that. There's a lot of different ways we can get this aerobic activity. And define aerobic. What does that mean? Yeah, it means getting your heart rate up. A certain um like a at a certain level? Or so most of the aerobic is kind of zone two. Okay. All right. So zone two, again, it's gonna be different for everybody, but think of zone two heart rate. It's conversational. You're not so breathless that um you can't talk through the activity. Um, that's really kind of the cardio. It's it's it's gentle, it's not, you know, too stressful. Okay. Um we're not sprinting here. Not sprinting. We're gonna talk about sprinting as well because that does have a role and a place, even in midlife. Okay. But um, this is aerobic, this is gentle cardio, walking, elliptical, um, maybe even treadmill on an incline. This is walking around your neighborhood with the podcast going in your ears. We're with you in this, you got this. We're here for you. Um about running? This can be running. Okay. So, you know, for me, I when I'm in a marathon training cycle, obviously I'm running a lot. And I will do two days a week where I'm at this zone two easy pace. So typically my Monday run, I'm trying to keep my heart rate for me like 130s, maybe low 140s, but the lower the better. Okay. I'm conversational and I'm doing my mileage, whatever that week plan, you know, has for me on the mileage. So Mondays, I'm doing this easy run, zone two, and then Saturdays are my long run days. Again, but easy zone two, conversational pace. I love running with my running group because we can chat. It's kind of built in. If if you are too breathless, you can't chat it up. Um, then you slow down. Okay. Yeah. So that's really kind of what we're talking about, the cardio. Gotcha. Um, that zone two. Now, let's talk about the speed, the sprints. Dr. Wright talks about this as well. Dr. Stacey Sims talks about this. She's an exercise physiologist with you know, many books and podcasts, etc. So speed interval training is important. Okay. All right. Now, this can be running. This can be on a bike. Yeah. Because some people are just like, I am not gonna run fast. And maybe they shouldn't, right? Maybe they've had an injury or they're injury prone, and I think it's not a good idea to like go out and sprint as fast as you can, especially if you're not properly warmed up. If I've learned anything as I've aged, I now have to warm up. There were things I could get away with in my teens and twenties, like not warming up or cooling down. Uh-huh. That doesn't work with my 40s. Right. Oh, no, no, no. Yes. Yeah. So to avoid injury, always be properly warmed up before you exercise.

SPEAKER_01 12:10

I love psychoclasses. I did one this morning. It's fun. And you're especially when you're with your, you know, group and it's a fun sense of community and yeah. And so encouraging too, right?

SPEAKER_00 12:22

You get a good workout. Yeah. Yeah. So the speed interval training is gonna be little burst of all-out intensity. Okay. So think on a bike. This is gonna be like your 10 to 20 second all out, all out, all out. Okay. And then you're gonna fully recover in between. Right. Okay. And if you do those inner, so this is interval training, right? Um do that three times maybe at first. Maybe you build up to five times. So you're going all out, you know, 20 seconds, 30 seconds, maybe you could build up to that eventually. Okay. And then like a two to three minute recovery in between. Okay. So that speed interval training is also very helpful. I mean, it's great for overall health, for cardiovascular health. Um strengthening your heart muscles. It is. It is. Um, and it's a good type of stressor. Right. Now, in midlife, doing things like that all the time. So these high intensity interval trainings, um, this kind of orange theory, like when it's all out, that sort of thing, you know, I think you could do too much of that. Okay. What ends up happening is like you you leave exhausted and you're like, oh my gosh, I sweated so much. And I just there's too much of a good thing when it comes to that. And again, I'm talking more like midlife. I think for our teens and 20s, go for it. Go knock yourself out. Like, that's awesome.

SPEAKER_01 13:48

Is there a concern for injury when we do that too much? Or what's the stress?

SPEAKER_00 13:52

Okay, the stress is on our body. So it raises cortisol up. It raises cortisol, um, which can affect our insulin resistance and and just increase our stress hormone. Like that's not a place where we want to be living for long periods of time multiple times a week.

SPEAKER_01 14:10

I've definitely noticed um after certain classes, I can feel a lot hung more hungry later in the day for sure.

SPEAKER_00 14:17

Yep. Cortisol spikes and that causes hunger cravings. So what ends up happening, I've talked about zone two, and that's that's really a great place. Kind of low impact, you're getting good benefit without like the 45 minutes. Yeah. But what ends up happening with some of these high-intensity training is that you end up kind of being in the middle. Like you're not all out like speed for short bursts with full recovery, but you're more in kind of this like zone three, zone four. Okay. And it's too intense for like the low impact cardio benefit, but it's not quite intense enough of the speed training with full recovery. Gotcha. And that's and it's just it's just stress. Like you're just in the stress zone without the benefit. Without the benefit. And you end up not getting great benefit from it.

SPEAKER_01 15:09

Okay. Because our benefit of the cardio is what?

SPEAKER_00 15:13

Again, the cardiovascular, the VO2 max. Okay. So VO2 max is how we how efficiently we we use oxygen. Oxygen. Okay. And that one parameter is the biggest predictor for longevity. Really? Yep. So it's not body mass index. It's not your hemoglobin A1C, which is your average glucose over 90 days. It's not your cholesterol. It is your VO2 max. How do you how well do you utilize oxygen is the best predictor of longevity?

SPEAKER_01 15:45

So I think one of our um workout instructors, uh, Danessa, the that the gym I go to, has talked about um zone two being when you can uh breathe through your nose. Is that right? You don't have to use your mouth. Like yeah, you can keep it like conversational and okay, and that's probably related to the VO2, I would guess, because you're able to use it effectively efficiently. Okay. Yes.

SPEAKER_00 16:07

So as you improve your VO2 Max, and and how do you know? Like, how would you even know what your VO2 max? Well, some of the wearables, I have a Garmin, um, will give you a number of a VO2 Max. It's a best guess. Sure. To truly know your VO2 Max, you need to do a test with a physiolog, exercise physiologist, scientists, who this is what they do. I've done one on a treadmill. You wear this mask, you're hooked up to all these machines, you have a heart rate monitor on, and they're you feel like you have this Darth Vader mask on, and it's literally measuring your oxygen, how much you're taking in, and then the carbon dioxide that you're putting out, and it's calculating all this. It's really fascinating. Fascinating. Yeah. So, I mean, if you want to just really do a deep dive on this, um, I would encourage you to to seek that out and do that testing and know where you are, and and actually have like a a data point to you know, to see where you're at and then have a goal. Yeah. And improve that. Okay. So maybe that's something you do once a year or or what have you. But I love the numbers. Obviously, I'm a scientist. Yeah. And um I kind of geek out about that. So Okay. All right. So that's kind of aerobic. Yes. Okay. So C super important here. Carry the load. Okay. So this is our strength training, our weight training. This is probably one of the most important things as women we can do. All right. This is what is going to set us up for success when we're in our 70s and our 80s and our 90s. Getting strong, building the muscle. As we age, a normal part of aging is losing muscle, unfortunately. And we've talked about hormones. Estrogen is anabolic, meaning it helps build muscle. Testosterone is as well. And as we age, we're losing those hormone levels. They are decreasing. It's a roller coaster ride to the end, but they are decreasing in their quantities. Therefore, we naturally lose muscle mass. Wow. So in order to combat that, we've got to lift weights to build that muscle mass, to stay strong and even get stronger as we age.

SPEAKER_01 18:22

So lifting weights basically stress, how does it help build the muscles? It's like it challenging them, it's like stressing them out, making them work harder. Exactly.

SPEAKER_00 18:32

They need that stress, that feeling of fatigue. That's how muscles grow. They hypertrophy. You act you literally make more muscle fibers and your muscles get bigger. Okay. And that's important for bone health. We have to have those muscles to support our skeleton. But our muscles are a huge part of our metabolism, our glucose metabolism, how we process carbohydrates, um, and then our insulin sensitivity. So if we lose muscle, we are more prone to insulin resistance, to prediabetes, and then diabetes. Yikes. That's part of why diabetes becomes more prevalent later in life because we're losing the muscle mass. Okay. So can you imagine some barriers that women have to building muscle mass? Some myths that are out there.

SPEAKER_01 19:23

I think we've talked about before, I mean, you and I, but just with the the gym being intimidated. A lot of women, I know they walk in and they feel intimidated to go over to the weights. Uh the perfectionism sets in. I don't know which ones to do, how heavy, how to like what how to make it work. Yeah. And then maybe there's just a lot of men usually in that section. And it could be just feel like you're not supposed to be there, like you don't belong.

SPEAKER_00 19:52

Yeah. I agree. I felt that way. I've walked to a gym and have had those feelings and and I do know what I'm doing. Right. We we would strength train and weight train in college and doing Olympic lifts. I mean, I was I was trained to do deadlift and clean and clean and jerk and snatch. Like I know how to do all those things, and yet I can still have this feeling going into a new place and feeling intimidated. So it's a very real barrier that I think all women can face when they show up. Um, all those machines. Yes. How do I work it? How do I set it? Should should it be at this level? I don't know. Um, I don't even know where to start. What muscles should I do? How heavy do I lift? There's a lot that keeps women from starting the strength training journey. I think another myth is women think they're gonna get really bulky.

SPEAKER_01 20:47

Right. Yes, definitely a concern for me. And as you can tell.

SPEAKER_00 20:52

And that's just not an aesthetic that most women are wanting. We're surrounded by this thin and ultra-thin culture these days, seeing all these celebrities who are perhaps on GLP ones, they're getting uber thin, looking so skinny and frail. I mean, that's that's like the image that's putting out there, but that's not healthy. Right. We're not going for frail. Right. We need to be going for strong. Strong. Yeah. So don't be afraid to lift the weight. So here is what I recommend. And not just me. I mean, this is not this is not just my advice. So evidence-based here. Focus on the large muscle groups. So I've mentioned that our some of our biggest muscles are below the waist. Think about the front of your legs, so your quads. Okay. Think about the back of your legs, your hamstrings, and your glutes. Okay. So things like lunges, um, things like squats, things like deadlift are amazing. And maybe at first you are just doing your body weight. Okay. Guess what? That's okay. That's okay. That's okay. And heavy, what I mean by Heavy and what is meant by heavy is you can only do that repetition four, six, maybe eight times before you need to stop and put that weight down. Okay. Right? So it's a journey. It's a journey. We start somewhere. We have to start somewhere. You have to crawl before you can walk. It's okay, right? There's no perfect way to do this.

SPEAKER_01 22:20

Just there isn't.

SPEAKER_00 22:21

Just do something. So, and then the big muscles in the upper body think your shoulders and your biceps. Okay. Okay. So shoulder press, maybe bench press, um, and then curls. There's a lot of different ways to do a curl. There's hammer curls, there's other curl or suck, I mean, all these different things, right? Um, I think investing in a personal trainer is so helpful. Sure. I know my trainer has changed my life. Um, shout out to JB at the function in Fort Worth. Okay. Life changing. Yeah. I mean, I am now so much stronger, which means I have less pain when I'm running. Awesome. So strength training is just it's a non-negotiable for runners. I truly believe. Yeah. If you want that longevity in your running career, you have to be strong to support your body through all this mileage. So carry the load. You gotta do it. Okay. So we've got F, we've got A, we've got C. E is equilibrium. Okay. So this is all about balance and balance training. So again, we can go back to our yoga. Yoga is great for that F, that flexibility, but it's also a really important part for equilibrium. Um, if yoga's not for you, that's okay. This could just be balance training on your own, standing on one leg while you're brushing your teeth. Challenge yourself in that way. The next day, do it the other leg. You get really good at that, try closing your eyes. So challenging yourself in balance um is is really important as we age to prevent falls, to create stub stability. Um it challenges our muscles in different ways. So the E in equilibrium is not to be overlooked. Um, very important part. So that's a pretty simple breakdown. F-A-C-E, flexibility, aerobic, carry the load, and train the equilibrium.

SPEAKER_01 24:15

Okay. I love that because it's easy to remember. It's simple. Yeah.

SPEAKER_00 24:20

I'd love to just mention that you can still exercise in pregnancy. Oh, yes. We want you to. It's recommended. And really, you can keep doing all of these things. Um, I would only cut out that speed interval training in pregnancy, but the aerobic, the um, the conversational pace is is a great place to live, whatever it is you're doing. The strength training, you need to still be, you know, not so breathless you can't talk. Sure. But training the balance, the flexibility, the mobility, it all can still be uh incorporated even in that season of pregnancy.

SPEAKER_01 24:56

Okay. Yeah. I mean, obviously talk to your provider if you have concerns, but yeah, so important. Yeah. And helps you to sleep better, feel better. Uh, mental health is so um impacted by just getting that exercise, getting outside, taking a break. I know whenever I'm able to just go for a walk in the middle of my day during lunch, that can just be a reset for me.

SPEAKER_00 25:19

Yeah. You know, it is mental health. I mean, I I say that running is my therapy. Yeah. It feels like one of the few things that I do just for me. We spend our life, we are caregivers at work, at home. You and I are caregivers. So many of our listeners are. So finding that that one thing or something that really is just a gift to yourself, for me, that's running. For me, that's my strength training. I'm doing it for me. I'm not doing it for anybody else. Yeah. Mm-hmm. Yeah.

SPEAKER_01 25:55

And everybody that's gonna look different, but like finding the thing that you really enjoy that um gives your body that movement, whatever that might look like.

SPEAKER_00 26:04

Movement is medicine. I love that. Yeah. Yeah. We hope you'll get out there and move your bodies. Find something that brings you joy. Um, do your 80-year-old self a favor. She's gonna thank you. Thanks for joining the journey. We hope you will come back next week. This episode, we'd love to highlight Moms in the Making. Moms in the Making is a faith-based fertility community that exists to support and encourage women on their journey to becoming a mom by sharing the hope and truth of God's word. Whether you're walking through infertility, grieving loss, navigating secondary infertility, pursuing foster care or adoption, going through IVF or IUI, or exploring natural options, moms in the making, with their help, you're never alone.

SPEAKER_01 27:01

Thank you for joining us on a journey to whole woman health. If this episode encouraged you, share it with a friend, leave a review, or subscribe so you don't miss future conversations. Remember, your questions matter, your health matters, and wholeness is a journey. Until next time.

SPEAKER_00 27:21

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