Kevin Ellis (Bone Coach):   0:05
Welcome to the bone code show dedicated to helping you understand all things related to diet, lifestyle, bone health and how you can live and thrive with low bone density and osteoporosis. I'm your host. Kevin Ellis, certified health coach, health and wellness speaker and, above all else, your bone coach. After being diagnosed with osteoporosis in my early thirties, I transformed my health through diet and lifestyle and now help my clients and community members do the same through my online coaching practice. Bone coach dot com Look, there are no quick and easy cures for low bone density, but the choices we make every single day can have a powerful impact on our bones, our health and our general well being. I'll share the research, interview the experts and help you figure out how to get the conditions right in your body so you can better your bones through diet and lifestyle. Short disclaimer. I'm not a medical doctor, and this show should not be considered medical advice. Always consult with your health care team before making medical decisions and changes to your diet and lifestyle. But that being said, let's get on to the show. Welcome, welcome to this episode of Bone Coach podcast. Today I'll be interviewing Dr Sherry that she's a doctor of physical therapy and a Pilates instructor with extensive work in the field of geriatric orthopedics, safe yoga and Pilates based exercise for people with osteoporosis. She served on the foundation of for Osteoporosis Research and Education and the National Osteoporosis Exercise and Rehabilitation Advisory Council. She's the director of a group of physical therapy clinics called Their Applaud is that specialized in geriatric exercise. An orthopedic rehabilitation involves Santa Cruz, California and Monroe, Louisiana, and her focus and passion are in helping people osteoporosis develop safe and effective exercise plans using Pilates, yoga, physical therapy and more. That's why I'm so excited for you to hear what share he has to say and how you can start incorporating some of these things into your bone-building plan today. Now, before we get out of the show, I want to encourage you if you haven't done so already. To head over to bone coach dot com, sign up for the free seven-day osteoporosis Kick start guide. That's gonna give you everything you need to start figuring out how to build stronger bones right now, and over the course of those seven days, I'm gonna highlight some of the discoveries I've made relating to osteoporosis that most people, by no fault of their own, just don't know. So if you're recently diagnosed or your recent Dexter results still show bone loss, you're gonna wanna pause this episode right now. Head over the bone coach dot com and sign up for that free seven-day osteoporosis Kick start guide. You'll be glad you did. With that being said, let's get on with the interview. So, Dr. Betz, welcome to the show.

Dr. Sherri Betz:   2:59
Thank you. I'm looking forward to talking to you about my favorite topic.

Kevin Ellis (Bone Coach):   3:02
Good, Good. Well, so so before you actually became a doctor. Physical therapy. Sherry actually started out as her career as a national gymnastics competitors. Fitness instructor, a personal trainer. And, you know, I really wanted to understand. How did your work evolve into working with people to improve their bone health, especially through safe exercise, physical therapy, Pilates and yoga and things like that? And I'd love if you could just share that with our audience.

Dr. Sherri Betz:   3:29
Yeah, the way I got inspired to become a physical therapist or even an exercise person was dealing with injuries and gymnastics and then wanted to stay in shape after retiring from gymnastics from a foot injury. And then when I went to Colorado to teach at Novelist Fitness Centers, I was wanted to go to college there and kind of when it there is a young girl right out of high school and started to work for anomalous fitness centers and was trained by an exercise physiologist there that said, You need to do this work, you love us. You're good at this, you know, He inspired me toe to pursue it. And then there was a physical therapist in an office next door to the health care facility that was so intriguing to me. I just wanted to soak up all his knowledge and learned everything that he was doing with patients. And when patients would get discharged, he would send him over to us and tell us their parameters and give us recommendations for exercise for them, and we will take them through an exercise routine. So this is back in the nineties, one personal trainers made about 5 25 hour and then so I was teaching glutes classes and aerobics, High impact aerobics classes and step classes were starting to get popular back then. So I'm like a diamond store in the industry. But But I, um I really got inspired to become a fiscal fair. So I started pursued to pursue my degree, and Petey ended up coming back to my home state of Louisiana because I could get in sooner. I could get the prerequisite sooner and being in state resident there. So I went ahead and applied at L s U and went Thio LSD Medical Center in the street for campus and graduated from PT School in 1991 on. So I'm practiced as an outpatient. Therapists work treating backs and next and shoulders and these and mostly orthopedic conditions. Some neuro cases, but mostly orthopaedics was my love. And then I, um, went to do traveling health care for a little while. And I always dreamed of doing that. And, um, I went all over the country doing travelling healthcare, and I ended up in a lot of nursing homes where people were in there because they had had a hip fracture and they never regained their prior status. So once they had the hip rupture. They couldn't live on their own. They couldn't be independence. They lost their independence and had to go into a nursing home environment or in assisted living environment. So I was working in those environments, mostly getting people out of bed, trying to get him to walk, trying to get him to stay on their feet, get on their feet and I'm stronger. Keep a mobile as much as possible. And I realized how many people have hip fractures. Then I had a colleague that I've met. I took a director position at Robert Wood Johnson Hospital in Count New Jersey, and I met a woman there that was an A B G Y, hand nursed, who had had a neck injury in a back injury from a car accident. Jenna, Pelvic girdle, rush Haitian things like that. And she just had all kinds of multiple communities. So she was very excited about the progress that she made with physical therapy were working with me. And then she invited me to come and speak to her group that she was working with once a week. She had a women's wellness program that was under the umbrella of on O B G Y m, and she was focusing on osteoporosis back in 1995. So she was quite the forefront of that whole wave and educating people on what they could do safely to prevent bone loss and to build bone density. So that included nutrition and, uh, supplements. Homey apathy. Pharmacology should have pharmacists come in formulary. Pharmacists doing more natural remedies for horse estrogen hormone replacement things like that. So she invited me to come in and do the exercise portion of her program, and I joined her full time. I quit my job, enjoying her full time doing the women's wellness programs. That was just amazing. And that's where I would really got my start and working with osteoporosis was nobody out there doing any education on osteoporosis at the time, and I took a couple of courses from colleagues. Kathy Ship, from Duke University did did, of course, back then on osteoporosis and exercise, and Sarah Meeks did, of course, on last year, person some exercise, so those are the only people doing anything with it, and I wanted to focus on the the yoga aspect of it, and I had become interested in Pallotti's and wanted t focus on the Pallotti's aspect of it, too. So that's kind of how I got into all this.

Kevin Ellis (Bone Coach):   8:11
No, no, that's amazing backstory to So And what's interesting is you were really in the trenches of of working with people that had been in really unfortunate circumstances especially, you know, fracturing hips, having some other things that they had to work through. And you really helped get them to a point where they were in a better state, which I'm sure was difficult at the time. But I'm curious now. So now that you're working specifically with Pilates and yoga, a lot of people here that when they first started, especially their newly diagnose and they're kind of trying to piece together the pieces of Okay, this sounds like something I could incorporate. This sounds like something I should bring in, but they just don't know how to do it, or they might not even be familiar with it. So what? What are yoga and Pilates? For people who might not even know,

Dr. Sherri Betz:   8:57
right? Right. Yoga is a very old form of exercise that is actually a branch of the Hindu religion, so it's more of a spiritual practice, and it's a movement practice as well. So it does have that spiritual component to it. It is. Usually I talk about the differences in the physical aspects of New Gun Pallotti's, the Inn that yoga holds postures and range for long periods of time. Generally, there are certain styles, like the Viasa flow style that is more of a flowing stop. You don't called postures that m range for long periods of time. Um, you won't find that in Pilates. Pilates is a system of exercise developed by Joseph Pallotti's back in the early twenties, when he moved to United States from Germany, and he was very interested in health and fitness by mobility and posture. He wanted all of his exercises to improve everyday life, and posture, was very interested in functional and applications to daily life. So that being said, his program doesn't hold positions, there's no static stretching applies, and there's just a flowing movement that your goal is to flow from one exercise to the next and never stopped moving throughout the whole section. That's the goal now. That's not how you start it necessarily. You might rest between exercises that you're a beginner, but the goal is to flow from one to the next. And that, to me, makes it so great. Yes, as a dovetail with neurological information that we're learning now, the nervous system does much better with neurological conditions like Sai Attica. Carpal tunnel arsenic is radiating sin nerve kind syndromes. That body's does really well with that, because you don't take the body to M brane JJ. You start with small movements in mid range, or I'm closed range and then progressively make the movement's larger as you gain control. So I feel like the Pilates practice is so good to inform a younger practice and to incorporate a little bit more safety with the yoga practice instead of going straight out to end range. Before you have a really good control of your stay venture, you know

Kevin Ellis (Bone Coach):   11:16
that absolutely does so. So you would lean for somebody, especially just starting out. Would you lean more toward Pilatus just starting out?

Dr. Sherri Betz:   11:24
Well, I look at the clients in front of me, and if they are hyper mobile, definitely start with polite. He's so people that are very hyper mobile that tend to have too much range of motion in their joints. I would definitely start bloodies and then people that are very stiff or have a lot of difficulty with moving, um, stiff muscles. And, um, I might push them or toward yoga. Even though the core control aspects of bodies I'll always incorporate with people, I want them to have good pelvic stability and core control so that they can move their limbs without talking. They're back. Great. And you know, I really like the tail's wagging the dog instead of a dock white tail

Kevin Ellis (Bone Coach):   12:08
and and when someone is is starting out, you know, if they if they decide to take on yoga or Pilates, could you kind of kind of walk them through? Ah, what a basic session might look like, even when when they are

Dr. Sherri Betz:   12:22
suppressed? Well, yes. With with me as a physical therapist, I'm going to do a physical therapy evaluation. If I get somebody in front of one on one, I'm gonna assess them from head to toe. So start with the feet looking at. Do they pro Nate or stupid donated their feet? That's gonna create issues up the kinetic chain if they don't have good control of their feet. That's also gonna affect balance. So I look at feet posture. I look at the ability to stand with your feet close together, one foot, make in front of the other tandem stance and then single ex dance. That's gonna be a a must with every client that I see and then looking at leg strength, hip mobility, Can they do a full squat? Can they pick something off the floor? Functional tasks like that are gonna be a prerequisite and something I always look at. And then can they hinge at the hips without bending at their spine? That's gonna be very important for protecting their bones from fracture. And looking at Jurassic. Mobility often is a key into in my programs. So

Kevin Ellis (Bone Coach):   13:28
I think you're highlighting some really important things that people might not understand because, you know, when you get a lot of information, sometimes you just want to act on it because you think it might lead to the outcome that you want. But sometimes that could be the wrong decision. And that's one of the things I try to encourage my audience. To do is find the people that no, you know that like you're talking about. This is highly individual. You don't just want to start doing things because you may have something going on physically that needs to be corrected foreign adjusted for

Dr. Sherri Betz:   13:59
right. Because if somebody has back pain, they gotta deal with that before they can start loading their bones

Kevin Ellis (Bone Coach):   14:03
correctly. So, Sherri, could you share with me? What it would look like if somebody were to try to build a safe exercise routine for their specific body? Like, what are the steps that they need to be taking to make sure that what they're doing is not going to lead to an injury or a fracture that could have been prevented,

Dr. Sherri Betz:   14:21
Right. I think the most vulnerable areas of the bones in people's bodies are the spinal vertebrae and the hip so spinal vertebrae can fracture with sneezing, coughing, bending over with a rounded back, lifting something up off the floor with around its spine. Spontaneous fractures can occur, of course, but what we want to do is try to teach people immediately. The first concert act is to protect your spine from fracture. The next concept is fall prevention, and that that's how hips. Fractured hips don't fracture unless they fall and falling from a standing height or lower out of the chair or from a standing hiker look or not off of a roof for having a ski accident, a car accident. But if you fall from a standing height and have a fracture, you have osteoporosis. That is, people say, Oh, well, it was a hard surface. Now a kid can fall down onto their hip directly, and they will not have a fracture or 30-year old without osteoporosis, obviously can fall down onto their hip directly and not have a fracture. So if you fall and have any fracture it all from a standing height, that is what we call the clinical diagnosis of osteoporosis. So I want people to understand that they need to start taking care of their bones, that they have any kind of a spontaneous fracture or a fracture from a standing height. That said one of the most important concepts is spine protection and fall prevention, and then the next concept is leg strengthening. People lose about 1% of their legs strength every year after age 50 so we start to decline. Now, if we exercise and progress our exercise, you can't just do the same thing over and over again. So if you did the bin Jassem flow sequence the same way for 20 years, you will gradually decline in your strength, saying with Pallotti's network. If you just did a Pilates mat class start to finish the same way every time. With the 34 exercises from return to life as the protocol, you will slowly decline because you have to challenge yourself. I always tell people, if you're not progressing, you're regressing, so you always have to continue to challenge. You may not always be able to lift £100 but you're trying to do so, and the way you figure that out is you determine how many reps that you can do with a certain amount of weight, and that's creating that one. Repetition Max for each person's. So you put a box down in front of people haven't lifted, see if they can lift it at least 10 times. If I cannot lift it 10 times with good form, an alignment of their spine, especially then they shouldn't be looking that much weight so they need to drop it down and do, ah amount of weight that they can do at least 15 times 10 to 15 times. Once you get up to the point where you could do 15 or 20 it's too easy and you need to add more weight. So you keep challenging that resistance so that you build missile and bone. Because what builds muscle strength also built so and so is the same concept for building strengths. If you're doing 20 to 30 reps of something, you're building endurance. So that concept needs to be explained to everyone. And hopefully they can understand that. And you can assign the number of raps and figure out the amount of weight that people should be used. So that's one of the first things I teach is how to live something off the floor without bending your spine. Now, if you're too weak to even come down and touch the floor, um, I think I have enough bringing back here. I can show you. So if you can sit down, come down like this, touch the floor with your spine straight. Then you could likely start to add weight and lift a box off the floor. I want people to be able to lift at least £50 so that they can pick up their suitcase and traveled to Europe when the quarantine is lifted. So I want people to be able to pick up their own suitcase and put it onto the scales at the airport and take care of their own suitcase. And don't get someone else to always lifting things for you unless you're not lifting it correctly. Um, so that's something I teach. The very first lesson is lifting and the concept of how to strength train on. And then we goto the fall prevention fracture. You know, fracture prevention through fall prevention, starting with feet together, nearing the base of support. Standing on one leg, everyone gets he'll raise is standing on one leg. That's one of my favorite exercises. The calf is like the second heart, and it returns the blood to your heads. If you have swelling in your feet, have been sitting too much. Do you get those calves pumping that will help pump the blood out of your feet to your heart? So with neuropathy, things like that, we use dowels. We use things toe to press down on, and we determine how much assistance you need. So if you could only do three, you might need to stand against the door frame and then hold to dowels and push down on something or push down on your kitchen cabinet or lean forward a little bit to do your calf raises. So that is there some of the first things I would do and then, lastly, the next most important concept is strengthening. The Jurassic spine is what builds strength and your throw. ASIC musculature. That weapon down that that mid back area is what will help to build bone in the spine and prevent fractures. Can't guarantee that you're gonna build bone, but I can help you build fractures. Increase your costume. I do drastic extension exercises.

Kevin Ellis (Bone Coach):   19:58
You're in a lot. That's great. And a lot of people, um, you know, the only thing that they see they might not see. They might not even be familiar with that the rats expired. They may only know of the lumbar because that's what they've got against the results for. So could you talk about the lumbar spine a little bit?

Dr. Sherri Betz:   20:13
Yes, they do. the imaging of the lumbar spine. L one through four on Lee. Okay,

Kevin Ellis (Bone Coach):   20:22
and and for those who are lit on podcast right now, there's also a YouTube version of this where Sherry is actually demonstrating some of this live, too. And I'll link to that YouTube video in the show notes.

Dr. Sherri Betz:   20:35
Okay, so here's the lumbar spine. The lumbar spine is differentiated from the Jurassic spine by the attraction of ribs, so the lumbar spine does not have rib attachments. There's five memory and the lumbar spine. And then there's 12. Drastic for each break that's attach. T 12 has a tiny little rib coming out, and then, um, T 11 has a little bit longer, one that comes out to the side of your waist, and then the rest of the ribs go only around all the way up to your shoulders, where t one sends out a rim around you, right on her collar. Bouts so they can image is just an X ray. It's a two dimensional view of your spine so they can image through those bones, and the ribs get in the way of looking at the bone density. So the only unopposed bones are all 1234 and l five. Can't be image because it's tilted so far down that the safe room actually covers up some of the bone of the outside. So you'll only get a score for Little 123 and four, and the most at risk for fracture are T 67 and eight. These minute. The rest T 12 does fracture quite often, but 678 Or, when you see the rounded back, that dowagers kind of hunk and the most popular sites for fractions. Once you have one fracture, your risk for having another one of Jason to that for extra site is high. Um, it exponentially doubles with each fracture. It's two things I would love to share that are so simple. To see if you're at risk is if you can stand against the wall and have your head mid back and say, Come against the wall. If you can keep your eyes forward and have your head against the wall. That's what we call the occipital wall distance test. If you cannot get your heads on the wall because you have stiffness in your back and your ended up looking up at the ceiling to try to get you your head back there. Then you're at greater risk for a fraction. So having your head be able to come back is not necessarily just your Mac. It's the upper back mobility that allows you to be able to bring your head back of your body. If someone has more than seven centimeters away from the ball with their occipital distance test, and I can provide you with that race resource from internally and calls, e

Kevin Ellis (Bone Coach):   23:03
sure a link to this in the show notes as well.

Dr. Sherri Betz:   23:05
Yeah, absolutely. I can let me be that howto actually do that test and that if the head, like I said, is seven centimeters or more away from the wall, it is very likely that person has had a fresh. So I almost don't even care if I have the bone density scan because I already know that someone is at risk for future fractures. If they cannot get that head batch alone can extend it for us. The other tests I wanna share with you guys is the rib to palace distance. Uh, I'm gonna grab my skeleton. Sure. Theology. You can see it on the boss

Kevin Ellis (Bone Coach):   23:49
and again and again. For those of you on on the podcast, there's, ah, corresponding video with this. And you, can you be able to watch that in the show notes as well?

Dr. Sherri Betz:   24:00
Ok, so skeleton, every skeleton I've ever seen. Drawings, even better drawings and then regular skeletal models like this have way more space between the ribs and palestina actually gets so if I put mine four fingers here in between the ribs pelvis is about five fingers of space between the 10 through and the palace. Almost no one has that. I think I've seen that maybe twice in my career of 25 years of doing this. So if you put your fingers in between her ribs and pelvis, verdict and you see how many fingers you can get between that 10th ribs and the pelvis. If you go right in your axillary line, which is run into your arms, hit in life with your hip and go up and shoot. The muffin top test is with some of my patients. Call it you stick your finger in there and pull back a little bit. You'll touch that bill that coming that 11th rib and it's got a tickly and it sticks out there. Do you want to be just in front of that and you'll feel the 10th rib there. So for me, I have three fingers in between my ribs of hell. Because if I'm a sitting all day or from becoming airplane, I might handle juice. But I didn't let his class this morning. Sir, I feel like this. So I have three fingers. Normal is to before, and normal is one. And I have seeking many patients with zero so that this whole rig can just sitting right on the palace. If you stick your fingers right here, waistline there and you pitch your rib cage, you are very likely. It is very likely that you've had a lumbar fresh So lumbar means again. These words for here just behind your belly button, just behind l three. So, um, threat that l three is just behind your brother. Done. And that's how you can tell this small of your back and your middle of your one large star. So I'm holding those kind of little tests. Help. I teach my philosophy. Teacher. How do those I teach my yoga teachers had a D. Those and my colleagues who are physical therapist. We all love for them to do those as well so that they're just super simple. But very telling, because they do indicate that people have had fractures, even if they haven't had a bone density scan done. Sometimes people can't afford. So I have a bone density scanner. I'm done, and I don't really need that necessarily to build a program that's safe for somebody.

Kevin Ellis (Bone Coach):   26:39
So So let's say, because sometimes a lot of people are when they're diagnosed, they may be diagnosed because not just because, you know, there it's a test that they're there. Doctor wanted to run the decks of scan because they hit a certain age or certain time in their life. It may be because they fractured on their pain in their back, and they've already gone in once a fracture. How

Dr. Sherri Betz:   27:01
do you

Kevin Ellis (Bone Coach):   27:02
go about developing a safe plan for somebody that has already fractured?

Dr. Sherri Betz:   27:06
Yes, well, they have to get out of the pain first, so sometimes they're using a spinal matt brace. They might be using some bracing and have to wear a turtle shell. Sometimes brace T l S O is what we call that. And, um, make sure that they are healing properly without bending forward. Because as soon as I start to bend forward, the burger right hands to get can tend to get compressed. And so we want to hell with the vertebrae as high as possible and really doing the back extension work, which is counterintuitive for a lot of people. People love to bend forward. It feels really good. But we have to educate people that the front of the spines watched vulnerable a fracture. So we do backward bending exercises. We do prone extension exercises as much as possible as their healing to help them strengthen their back and prevent the collapse forward onto that vertebrate Senaki. Did it really interesting study looking at people that had had the type of class D and what they found was that exercise was actually better than having a conflict last E for prevention of future fractures.

Kevin Ellis (Bone Coach):   28:17
Could you explain what Kifle plastic and vertebral plast E r.

Dr. Sherri Betz:   28:20
Sure. So when you have a complete collapse of a vertebrate, what will happen is you'll either have one of two procedures. One is where they drill into the bone, and I insert cement into the bone so that it it fills up the bones shape. Problem with that. He has the vertebrae above and below it, our next to this hard surface. These air fragile bones next to a cement bomb, so they become more at risk for a fracture in a lot of cases. But it's so helpful for people that have pain because about 25% of people that have compression fractures have a lot of pain, so it relieves the pain. Great, but they've got to be really vigilant and village veer. You're careful not to do any forward bending exercises. Um, a chi flow Class T is when they do the same procedure that drew into the bone and then the insert a balloon inside the bone and blow it up so it blows it up to the normal height, and they still and start some cement in there. But I'm hoping they'll do with this procedure is put some things on cement. Maybe they can put some gelatinous substance or something that's not so hard, which will make it a little more successful because there are people that have had adjacent fractures. After those procedures on, we try as much as possible to not have people to those procedures unless they are in a lot of pain. Need relief from that pain.

Kevin Ellis (Bone Coach):   29:47
So in talking about safe movements to two, obviously we want to be avoiding movements that could potentially cause us to fracture. Or that could cause pain. And we want to be doing movements that don't lead to that and actually lead to benefits for our bones. So could you walk through for yoga and Pilates? What are the safe exercise we should absolutely be doing? Obviously, you want to check with someone first to make sure it's right for your body, but then also the ones we should absolutely avoid, too. Could you talk through those and share? He's actually referencing a download sheet that is on her website right now that I've actually seen the really great I'll link to those in the show notes. But sherry as your walking through these, Could you talk through that so the people on the audio can can ah understand which exercises will be good for them, too?

Dr. Sherri Betz:   30:34
Yes, I thought the picture would be better. They are the words are backwards because of the way that I'm gonna start shut. So these are my favorite poses for yoga. And I'll tell you why. This is the tree pose a lo ve it for balance and see how lengthened the spine gets and really working on that balance aspect. And then I love half 1,000,000 pose because it's also balanced exercise. But it's strengthening the legs and really challenging the core to hold that position so it's quite a challenging exercise, are opposed. And then there is the triangle pose that is a nice pose as well, as long as you don't let your spine ground during it. My very, very favorite post is the Warrior three, which is right here. This is awesome because it's balanced, its leg strength and its back extension. All three of the things that you need to take care of your bones as you as you deal with the condition of osteoporosis. Some of these air really nice for extension of the hip. So this is your warrior to like chocolate, where 1.5 it's Ah, hi Lund Door Miner's Lunch. Some people call it a runner's high lunch, and then you're really giving that back extension both legs or parallel on this one. This is warrior too, which I like, but not as much as warrior 1.5. And then I love the share posed because it's very functional. And it teaches people how to keep their spy lined and targets those back its sensors and glutes. Then these exercises on the bottom of these poses on the bottom. This is upward facing dog, which is a really great preparation for Thor ASIC extension. But if you're using her hands to push up your not so much using her back its sensor. So it's very important that you do something like this one, which is like a cobra, Um, And then take your hands off the floor so that you're actually using your back to hold you up instead of pushing into your hands. And then here is what we call a story of a modified locust pose, which I love that man change. So these are my favorites. The ones that you should avoid are gonna be your forward fold with around it back. So if you could do the Ford fold without running back, you're certainly welcome to do it usually have to get people to bend their knees to do the Ford Fault d Twist with excessive assistance with your hands. You want to avoid that. And then, um, this is the one of the pigeon poses and you are trying to stretch your kip, and you don't want to force your body weight down on that hip. So if it's easy to do and your hip is on the floor when you do it, then it's It should be safe. But if you don't have really good a hip mobility, what happens if your capsule of your hip is really tight? You could have a fracture instead of stretching her capsule. The capsule is quite strong. So if your castle is stronger than your bone, then you could end up with a little fracture that twist through the hick. Um, and then this is Warrior one. I don't like this post because I don't like what it does to the foot and the knee. It with a lot of strain on the knee and a lot of strain on the foot and buying mechanically. It's almost impossible for people that you very well if they're not very mobile on their hips. And lastly, I suggest that people avoid overpressure from their teachers and don't allow, you know, adjustments are fine or corrections, or find that no overpressure, very strong overpressure.

Kevin Ellis (Bone Coach):   34:08
And what is overpressure for those who don't know,

Dr. Sherri Betz:   34:11
that just means when the teacher is pressing hard on your body or pushing you down, so encouraging. Touching is fine. But pushing on someone's body when they have low bone density is probably not a good idea. Uh, there is something else. I'm number two. Yes, so the other poses that I definitely want people avoid are the shoulder stand and the plough that is a huge amount of load on the thoracic spine. So you don't want to do anything where you're balancing on your Jurassic spine and your body's Overman spots. You can see how that could be very compressed, it said. That's something I want people to avoid.

Kevin Ellis (Bone Coach):   34:53
Those air. They're all great. And, like I said, for those who are listening to the podcast, obviously couldn't see the visuals that the cherry was pointing out. But we will link to the P D EFS for those in the show notes, so you could see which ones to avoid which ones are safe and recommended by my sherry. And that's gonna be really helpful for you as you're getting started with this. So we've talked about injury prevention. Could you talk about, um how does physical therapy specifically tie in tow? Osteoporosis?

Dr. Sherri Betz:   35:26
Well, we can see people as a wellness visit and help them with putting together a safe exercise program that they're trying to prevent osteoporosis. If they actually have osteoporosis and they have a fracture or any of pain or underlying condition, we can see them and help them treat the pain safely. And then along with that, teach them exercises that are gonna be safe for us. Your purposes helping them deal with the injury that they have. Because sometimes people are told Oh, you have been journeys toward your chest around your back because your back hurts. Well, that would be problematic for somebody that has osteoporosis. So, for example, someone comes in with cyanosis and have osteoporosis. Will still knows this. We tell people around forward and with osteoporosis would tell me back back. So we changed them ways that they can deal with both of those conditions and be safe, not causing a pensioner from the stenosis and not causing a fracture for osteoporosis. So there's almost as conundrums that we're trying to deal with with our patients.

Kevin Ellis (Bone Coach):   36:28
And what about for scoliosis? Because I do have, you know, I have some clients and community members that I know have. Scoliosis is, well, where some of the things that are done. They're also in conjunction with osteoporosis.

Dr. Sherri Betz:   36:38
Yes, when someone has scoliosis, there are greater risk for osteoporosis. And there's also that greater risk of collapse. With this, I've been cursed. So all of those love the Shroff technique, where your lengthening up and stretching and using a lot of axial elongation techniques for decompressing the spine is excellent for osteoporosis as well. So, usually someone that specializes in the Ashraf Scalia's. This technique would be a great resource for you and your community. If you can't find someone that specializes specifically osteoporosis, um, you can find someone that also works with that technique, the shots technique,

Kevin Ellis (Bone Coach):   37:23
and is there a database or something like that where they can look that up and find someone local to the area that does that?

Dr. Sherri Betz:   37:29
Yes, you can just look up, Schroth. Scoliosis. And I'm so sorry. I don't remember the exact website, but But if you enter if you Google Stroth, scoliosis, um and then after the podcast, I'll look that up for you, give you that resource you can stick.

Kevin Ellis (Bone Coach):   37:44
Okay? Great

Dr. Sherri Betz:   37:45
affection. Yeah,

Kevin Ellis (Bone Coach):   37:49
well, so I I want to just I I know we're We're closing in on our time together here, but any other important things that you think would be important to discuss? I know we talked a lot about physical therapy exercises you should do and shouldn't do. Um, yoga. Pilates is Maybe we could talk a little bit. About what are the benefits of doing this for their bones Specifically, What have you seen clinically? What is some of the research? Stay out there. And, ah, anything else you think would be important to share?

Dr. Sherri Betz:   38:21
Yeah. Okay. So I realized that I didn't talk about Pilates exercises, so I'm looking at mostly Pilates mat work. I'm not talking so much about apparatus here, and this is one of my favorite exercises for building strength in the core hands, abdominals. And it's safe for people of osteoporosis is called single leg kick push ups I love. And then here this is a side lift exercise. Some people caught side plank, but it's actually technically called Side Bend and Pallotti's and I love that one for strengthening shoulder torso, hip knee, ankle it just a multipurpose exercise. Also the shoulder bridge with. Usually it's done with a straight leg, but this is a modified version here called Shoulder Bridge and where the leg is jumping up and down. And then here is like a which is a very hard exercise, but great for targeting the hips and the spine as well. And here is the swan looks a lot like Cobra and yoga, and then double leg kick is also looks a lot like locust in yoga and swimming is one of my favorite exercises from the mat work. It is incorporating hip extension and Jurassic Extension, and it's quite challenging for the upper back and the Draco lumbar musculature. So you're building bone and muscle strength. There on Senaki did some great research to are really some chart reviews on people that did extension exercises much like these, and saw that they had a lot less fractures in the people that practiced extension and greater numbers of fractures and people that practice flexion. Exercise is that's what Before that I know how was backtracking from the other conversation we're having? I didn't say anything about the bloodies message. Um, but yeah, the main points. What a couple of things I love to share is the, um, water exercise has been a little controversial. Hand does not generally build bone. What we see and water polo players and swimmers is that they actually lose bone density during the season in their spine and hip, and they might gain bone density in their arms. That's where they're out of the water. I'm so water Rick. But what are exercises not recommended for people last year? Paralysis. It's fine to start a water program if you have arthritis and you want to try to get to start to start, to get to feeling better. And I'm just feeling like less pain and easier to move and just Segway quickly out of that water program. Get onto land. We need land based exercises to promote bone walking does not build bone unless you have been very sick or sent here, so that's the only exercise you done in years, and it's taxing to you to go out for a walk, then that's perfect. That will be fine. You will probably see some bone building benefits from walking. But if you're already exercising and walking and you think that walking is gonna help putting weights on yourself or easy weighted vest, wind walk. Yeah, that's endurance exercise that's not so great for billing Bo in the spine with a hip. And it's good for maintaining your bone health and get for your longevity and well being. A card investor system. We definitely need exercises for your cardiovascular system, but they're not the same as exercises for bone house. Strengthening strength training builds bone and muscle strength, and then endurance exercises are for your heart. So you need to be doing your cardiovascular fitness three times a week, and then your bone strengthening muscle, strengthening legs, strengthening fitness three times a week. That would be your goal is to do, especially during this teen time would be great to focus on that and let's see if we can get stronger at the end of this instead of decline. There's no reason to decline right now, especially if you're not working. I know that some people have Children at home and, you know, getting your kids involved would be great. They need more activity and exercise. So I know it's tough for families that are stuck all together at home and then driving each other crazy a little bit. But yeah, those air. Some of my favorite recommendations to give people and inspire them thio afford with that, I've definitely seen bone health benefits. I've seen people going 15% in one year. I've seen 8% 6%. I've seen 2% at times, which is great if you're over 50 and you're gaining 2% in your bones, bones density from your spine or your hip. That's actually excellent, because you're supposed to decline at 1% heard here after age 50. So if you even stay the same or just build one, maybe 2% don't don't pooh pooh that that's great of that's excellent to build anything at this time of your life. So don't be discouraged about it. For taking some medications that may be detrimental, like cortisone, things like that, you just want to try to keep strong, keep doing your fracture prevention things and keep at it, because the things that you do to help your posture help your form and alignment as you're doing. Activities of daily living and exercise is going to help you prevent fractures, even if you don't build bone density. So don't make it all about just building bone density. Yes, stronger. You always do that and that really practiced awareness and alignment of your body and get better at that.

Kevin Ellis (Bone Coach):   44:01
I love that sherry, and I think that's Ah, that's a really good note to end on. And when I do want to end with is actually where Where can my audience find find you your work? What are the resource is that you've got available that are out there, and we can absolutely linked to those in the show notes as well.

Dr. Sherri Betz:   44:20
Okay, so first Resource is their apologies dot com that has a lot of information on osteoporosis. It's a Web site of the working on for about 20 years. It's based around my clinic in California, and my mother was getting older, and it was kind of time for me to transition to working with her more closely and helping her as she ages she's doing great, but she's actually better since I've been here, because he's taking classes and exercise more and issues. He's now regretting me coming here. She was excited at first, and I think she's still excited. But, um, anyway, and then I have a clinic and count in Monroe, Louisiana, where my mom lives, and it's called Sherry Bettes, Dr. Sherri bats dot com, and you can get information there on my local practice. If you want to work with me, um, you know, virtually on a 1 to 1 session doing consultations. I do that That website and its hip, a compliance software that we used to work with people. So it's private. And that's called again Dr Sherry. That's dot com. The free resource is that I love to recommend for you are the American Bone Health Website, just American bone health dot org's. There's a lot of great consumer outreach, and resource is there. I have a lot of videos there due to some of the training programs for the volunteers that are speakers and then Um National Osteoporosis Foundation, on the liaison for the American Physical Therapy Association and a ref. There's wonderful resource is there for both clinicians and consumers. And, um, in the American Physical Therapy Association has a wonderful tool called shoes petey dot com. And that's where you can find a peachy locally that is a board certified geriatric specialist. Those of the people that have been trained and working with people have asked your paralysis. It's under that geriatrics umbrella. Even if you're not a geriatric. That's where you could go to get information about osteoporosis. And then, um, the last one is osteoporosis. Canada. I think they do a wonderful job. They have some great videos and great resource is that air free, wonderful booklets and video vignettes about different cases. And Laura John Gregorio has done excellent job of leading that research team. And like I said, it's a lot. Andi, I'm moving. It's good because these were re sources that are gonna be very helpful. And they are non profit organizations that have free information for you. They're not trying to sell you anything. I just want you to be able to use your household tools that you have at home to be able to help your house and not have to buy a product. I don't want to sell any products to you. I think you've got everything you need in your own home to be able to get healthy. So if you need anything else, absolutely feel free to ask. One more link is Pilate's anytime dot com offers a free 30 day trial. If you enter the letters s betz s b e T Z, you can enter that and get a free 30 day trial with A with their resource is on there. So I have a lot of classes on equipment and offer equipment that classes like that are on there as well.

Kevin Ellis (Bone Coach):   47:47
That's that's amazing. And, I really appreciate you taking the time to share this information, your knowledge or expertise. Everything you've learned in your career with our audience today. And I just want to say thank you very much, Dr Bettes, for coming on the show.

Dr. Sherri Betz:   48:03
Well, thank you, Kevin. And I'm so excited that a young male is interested in sharing information about osteoporosis. This is a pediatric condition with geriatric manifestations. This is for young people that take care of their bones now so that they don't have these problems in the future. We will all of our bone. About 95% of our bone that we're ever gonna have aged 20. So we need to be teeth thinking about that when we're young. So thank you, Kevin. I'm so excited for

Kevin Ellis (Bone Coach):   48:31
you. Absolutely. And it's my pleasure, and I hope to talk to you again soon.

Dr. Sherri Betz:   48:37
All right. Thank you.

Kevin Ellis (Bone Coach):   48:38
Thanks. I hope you enjoyed this episode with Dr Sherri Betz. We covered a lot of information on physical therapy, yoga, Pilates and safe exercise for osteoporosis. For this episode, you find all the resource is mentioned. Show notes and Maur information about Dr Sherri Bets over a bone coach dot com forward slash yoga dash Pallotti's dash osteoporosis. One last thing I wanna spotlight a review I received on iTunes. It really touched my heart from C C five Blue. That said I was diagnosed with osteoporosis about six weeks ago. Kevin's podcast has helped to educate me on the steps I need to take to figure out why this is happening. Me? There is so much information on the podcast and free resource is to help you get started and learning about how you got the disease and how to go about healing highly recommend. You know, these kind of reviews and comments really mean a lot to me personally, since this podcast is something I spent extra time on outside of working with clients is spending time with my family. So if you found this episode or any of the episodes helpful, I'd love to hear from you through a positive rating review on iTunes. Like, I always say, become educated, become empowered, commit to improvement because that's the only way for any of us to improve our bone health. I think that's it for this one. I'm your bone coach. Kevin Ellis. See you in the next episode.