Tag Archive for: Teresa Maldonado Marchok

Magic of the Core

What Is the Core, Really?

When most people hear “core,” they think abs. But the core is much more than a flat stomach or six-pack muscles.

Think of your core as a 3-dimensional cylinder of support that surrounds and protects your spine.

This cylinder includes:

  • The abdominals in the front
    • Rectus abdominis (the outer abdominal muscles)
    • Transversus abdominis (the deepest abdominal layer—your natural corset)
    • Internal and external obliques (the muscles that create your waistline and control rotation)
  • The muscles in the back
    • Multifidus (small but powerful stabilizers between each vertebra)
    • Erector spinae (muscles that help support upright posture)
  • The diaphragm on top
    • Your primary breathing muscle, which plays a key role in core pressure and stability
  • The pelvic floor on the bottom
    • A supportive hammock of muscles that helps manage pressure, balance, and control

These muscles don’t work in isolation. They work in concert, creating internal support so your arms and legs can move freely and efficiently.

In simple terms:

Your limbs create movement. Your core controls it.

Why This Matters as We Age

As we age, the body naturally loses strength, coordination, and reaction time—especially in the deep stabilizing muscles of the core. When this support system weakens, the body compensates by gripping, overworking joints, or avoiding movement altogether.

That’s when we start to see:

  • Back and hip pain
  • Poor balance
  • Fear of falling
  • Reduced confidence in sports and daily activities

A study in the Journal of Aging and Physical Activity demonstrated that older adults who engaged in consistent training (specifically Pilates-style movements) saw positive long-term effects on balance and strength, effectively “buffering” them against age-related decline.

Pilates directly supports the “reactive balance” needed for hiking and skiing.  Pilates trains your brain and body to respond quickly to uneven terrain or icy slopes, making the difference between a “close call” and “a fall.” A strong core protects your spine from the sudden lateral lunges of pickleball and the high-torque rotation of a golf swing, thus preventing injuries.

Rather than bracing or gripping, we build responsive support – the kind that adjusts instantly when you step on uneven ground, change direction on the pickleball court, or rotate through a golf swing.

 

Core Strength = Freedom

A strong, integrated core:

  • Unloads stress from the spine and joints
  • Improves balance and reaction time
  • Protects against sudden, unpredictable movements
  • Extends your Active Life Expectancy

This is why research consistently shows that Pilates improves balance, reduces falls, and helps adults over 60 continue doing what they love for longer.

Increased core strength also extends our Active Life Expectancy. Injury is the #1 reason older adults stop playing sports like hiking, pickleball, golf, and skiing. A study in the Archives of Physical Medicine and Rehabilitation concluded that Pilates is a promising way to improve balance and lower the risk of falls in adults over age 60, and a study in the Journal of Gerontology found that core stability is the strongest predictor of a long-term “playing life”.

I believe I have a strong, functional core, and you can too.  And it has nothing to do with a flat belly (thankfully). My core shows up when I’m on autopilot: lifting Amazon boxes, moving furniture, sliding my carry-on into the overhead bin without a second thought. It’s muscle memory I can trust because that’s what I’ve practiced relentlessly.

On a recent trip to Costa Rica, my body was simply adventure-ready. I didn’t hesitate to zipline, white-water raft, or hike uneven volcanic terrain. When fun opportunities appeared, my answer was an unequivocal yes. To me, that’s the real measure of core strength.

Core-Centric Classes Offered

In addition to private and semi-private studio sessions, a clear core-centric focus runs through the following virtual group classes:

  • Superpowers
  • Core & Restore
  • Active Aging Bootie Barre
  • Signature BoneSmart: Standing Strong

These classes are available Live Online  or on demand through my BoneSmart Virtual Movement Library.

Remember, the goal isn’t rigidity.
The goal is support that moves with you.

 

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Capital Gains for Your Bones: My D.C. Symposium Recap

I just returned from the International Osteoporosis Symposium in D.C., where healthcare providers from around the globe gathered to share the latest research and insights. One fun takeaway? Those of us who specialize in osteoporosis—whether in movement or medicine—are affectionately known as “Bone Heads”! I’m proud to add that to my growing list of quirky titles, right alongside being a “Graham Cracker”.  Yes, that’s what they call dancers who’ve performed with the Martha Graham Dance Company.

The conference kicked off with an energizing keynote by comedian Kay Frances. She had us laughing while delivering a powerful message: take care of yourself, stress less, and embrace life with humor. With wit and wisdom, she reminded us to stay positive, let go of what we can’t control, and not take ourselves too seriously. Her blend of comedy and insight was the perfect reminder that laughter truly is the best stress reliever.

I realize you “BoneSmarties” (yes, that’s what I call you) include people navigating accelerated bone loss as well as physical therapists, health professionals, and movement specialists working with this population. I do my best to address everyone here.

I cover a lot, so to make it easier for you, here are the presentations I highlight:

  • BoneFit™ Training
  • Long-Term Osteoporosis Management
  • Protein for Muscle and Bone Health
  • Trabecular Bone Score- why it’s important
  • The Skeleton as an Endocrine Organ (The Bone is Not Stone)
  • Year in Review
  • Integrating Exercise and Rehabilitation: Enhancing Patient Care

Scroll down to find the topics that interest you and skip those that don’t.

1) BoneFit™ All-Day Training


I recently completed BoneFit™ certification, an evidence-based approach developed in Canada that tailors movement for individuals with low bone density and osteoporosis. What does that mean for you? It means the guidance I provide is grounded in science and designed with safety in mind. You’re in good hands with someone BoneFit™ certified.    (Full disclosure: This is actually my third specialized osteoporosis training for physical therapists—I just wanted to stay current and continue refining my knowledge.)

Key points:

  • 50-70% of fragility fractures occur in people with osteopenia. That’s always a startling statistic for me. It’s a reminder that having osteopenia, (DXA T score between -1.0  to -2.5) doesn’t mean you won’t fracture.
  • A fragility fracture is a broken bone that happens from a low-impact event — something that wouldn’t normally cause a break in healthy bone. Examples are: Falling from a standing height, rolling over in bed, or sneezing or coughing hard (in severe cases)
  • We need to emphasize as movement professionals that our goal is to “prevent fractures” through strength training, balance training, and functional movement education, like hip hinging and the golfer’s lift.
  • As professionals, use verbiage like spine-friendly movement strategies rather than spine-safe, which sounds scary. Many people are already scared by this diagnosis, so we want to empower them to continue to move.
  • Our focus is on preventing the first fracture (or subsequent ones). For example, after a spine fracture, there’s a fivefold risk of having another fracture.
  • For balance training, standing on one leg like a stork is not enough (though it’s a good place to start). We need to mimic real-life situations where we navigate unexpected environmental obstacles and perturbations, such as tripping over a dog toy on the floor or accidentally getting bumped by someone in a crowded store, and be able to maintain our balance.

 

BoneFit™ Updated Movement Guidelines

(The key difference from prior guidelines is avoiding language that states you should “never” do something or that these movements are “contraindicated” because using that vocabulary can be scary and instill a fear of movement.)

Spine movements to Limit:

Repeated/sustained, weighted, end-range, rapid/forceful, or combined:

  • Flexion (crunches or sit-ups, Pilates rollover, yoga plow pose)
  • Rotation (forced twisting of the spine to end range)
  • Side Bending
  • Combinations of above

Hip:

  • Forced, end-range rotations like the yoga pigeon pose
  • Surgeon-dictated post-surgery limitations (need to clarify for how long)

 

Also covered in this BoneFit™ workshop were these two questions that I often hear regarding OsteoStrong and weighted vests.

  • Will OsteoStrong help my bones? The research was poorly done. Here’s a link from a Bones Lab scientist at the University of Waterloo that clarifies the lack of evidence for its efficacy.
  • Are Weighted Vests good for osteoporosis? According to the Bone Health and Osteoporosis Foundation, “The evidence for using a weighted vest to improve bone mineral density or prevent skeletal fractures in women and men is uncertain. Larger studies of older adults with low bone density or osteoporosis over a longer follow-up time are needed to determine whether weighted vest exercise will lead to beneficial outcomes.”

In addition, a weighted vest may not be safe for those who have had a spine fracture, spine surgery, have hyperkyphosis (excessive rounding of the upper back), or are at high risk of breaking a bone.

 

Onto the next presentation 

2) Long Term Osteoporosis Management

Dr. Michael McClung from the Oregon Osteoporosis Center gave an engaging and informative roadmap for long term treatment.  Key points he made include:

The objective of treatment is to reduce the risk of fracture. Drugs can be catabolic – reducing bone breakdown and resorption and Osteoanabolic drugs which increase bone formation and restore disordered bone microarchitecture. Like other chronic diseases, osteoporosis requires long-term management. There are no treatment “cures” for osteoporosis. Anabolic agents are used only for 1-2 years. The effects of all therapies, including bisphosphonates, dissipate when treatment is stopped.

The decision to start medications is when a patient is at high risk of fracture.

He lays out in very technical terms with lots of evidence, why osteoanabolic drugs should be the initial treatment for high fracture risk patients with osteoporosis.

Why?  Osteoanabolic drugs increase bone mineral density more and more quickly than the anti-reorptive drugs (like alendronate/fosomax)  Clinically they are seeing larger increases in bone mineral density if osteoanabolic drugs are give first vs second.  “If cost were not an issue, all patients with osteoporosis and high fracture risk would be candidates for an osteoanabolic agent as initial therapy to optimize bone mass and strength”.  That benefit can then be maintained with anti-resorptive drugs like bisphosphonates or Denosumab (aka Prolia)

As a reminder Anabolic drugs include Teriparatide (Forteo) and Abaloparatide (Tymlos)

Catabolic/Anti-Resportive drugs include Alendronate (Fosomax), Denosumab (Prolia) and Raloxifene (Evista). Zolendronate (Reclast) infusion is a bisphosphonate derivative used for osteoporosis and cancers that spread to bone.


Onto the next presentation

3) “Protein for Muscle and Bone Health”

(presented by Andrea Josse, Ph.D. from York University, Canada)

This presentation focused on how we prevent bone loss through nutrition, though they pointed out that nutrition and exercise go hand in hand.

In a nutshell, adults older than 65 need more protein than the current RDA. On average, adults 65+ are not obtaining adequate amounts of calcium and vitamin D.

Key Takeaways:

  • Bone and muscle are dynamic tissues that turn over at different rates throughout our lifespan. Nutrition and exercise play key roles in their growth.
  • Older adult females are at greater risk for protein and nutrient deficiency (Calcium and vitamin D). It’s recommended that you get your calcium primarily from your diet.

 

 

  • Protein is beneficial for muscle and bone health across our lifespan. Particularly for the prevention of osteoporosis and sarcopenia (age-related muscle loss). Evidence-based recommendations indicate:
  • Older people should consume an average daily intake of 1.2 g/kg/d
  • If they have a chronic disease (such as osteoporosis) – 1.5 g/kg/d

I look at this and my eyes cross since I work in pounds, not kg. How do we apply this to our pound system?

As an example of how to do this, I calculated the protein needs for “Sara,” a 69-year-old with osteoporosis who weighs 140 lbs. You can use this as a template and just plug in your weight to individualize it for you.

✅ Protein needs for Sara, a 140 lb female with osteoporosis at 1.5 g/kg/day

  1. Convert pounds to kilograms:
  • 140 lbs ÷ 2.2 = 63.6 kg
  1. Multiply by 1.5 g/kg:
  • 63.6 kg × 1.5 g = 95.4 g protein/day

🔹 So her target = about 95 grams of protein per day.

🍽️ Sample Menus to Reach ~95g Protein

You want to spread intake across 3 meals and 1–2 snacks, aiming for 20–30 grams per meal to optimize muscle protein synthesis.

🌞 Breakfast

  • 3 eggs (18g)
  • 1 slice whole grain toast with 2 tablespoons cottage cheese (5g)
  • ½ cup Greek yogurt (plain, 2%) (10g)
  • Breakfast total: 33g

🥗 Lunch

  • 4 oz grilled salmon (28g)
  • 1 cup cooked farro (6g)
  • Mixed greens salad with pumpkin seeds (2 tbsp = 5g) and olive oil
  • Lunch total: 39g

🍲 Dinner

  • ½ cup cooked lentils (9g)
  • ½ cup cooked quinoa (4g)
  • Steamed broccoli (1 cup = 4g)
  • Sprinkle 1 oz feta cheese (4g) over veggies
  • Dinner total: 21g

🥤 Optional Snacks (Choose one or two)

  • Protein shake (1 scoop whey protein powder = ~20g)
  • 1 oz almonds = 6g
  • 1 boiled egg = 6g
  • ½ cup edamame = 8g

And the next presentation

4) Trabecular Bone Score (TBS): How it can help you

Presented by Didier Hans, PhD, Switzerland

This relatively new technology complements bone density (DXA) exams (which measure the quantity of bone) and gives you information about the “quality” of your bone. It could help with clinical decision-making, like whether to start prescription meds.

Let’s look at three examples.

“Susan” has a DXA T score in the osteopenia range, and the doctor wants to put her on meds.  The trabecular bone score would give them further insight into the microarchitecture of the bone, helping to understand the quality and strength of the bone. If it’s good, and her other fracture risks are not of concern, Susan would be better informed to make a decision about starting meds or not.

“Rachel” is actually a friend of mine with osteoporosis. She was diagnosed in her 20s, was a dancer, thin, had a delayed menstrual cycle, and many other factors that put her at risk for OP.  With the proper education, strength training, balance, impact, functional training, dietary supplementation combined with an excellent trabecular bone score, she’s been able to approach this naturally and over 2 decades later, has never fractured.

“Monica” is 71 and has many risk factors for fracture, including being thin with poor balance and having a mother with a hip fracture.  Her DXA T score puts her in the osteopenia range, so she thinks she’s ok. Having a trabecular bone score that is poor could help her see that pharmacological intervention might be the right choice, along with proper nutrition and exercise to help prevent that first fracture.

You might ask, “How do you do a TBS test?”

Good question! A TBS test (Trabecular Bone Score) isn’t a separate scan — it’s an analysis done using images from a DXA scan (the standard bone density scan).

Here’s how someone would get a TBS test:

  1. Get a DXA scan: First, you need a regular DXA scan (usually of the lower spine and hip), which measures bone density (gives you the T-score).
  2. Request a TBS analysis: Not all DXA machines or clinics automatically do TBS. You or your doctor would need to ask if the machine has TBS software and specifically request that your DXA images be analyzed for TBS.
  3. Interpret the results: The TBS gives extra info about the quality of the bone’s internal structure (microarchitecture), not just the density. So even if your T-score is “okay,” a low TBS could still mean your bones are fragile.

Tip: If your doctor doesn’t mention TBS, it’s worth bringing it up, especially if you have risk factors like fractures with only mild trauma or borderline bone density.

I spoke with the reps at the conference. For those who live in northern CA, Stanford is in the process of securing this before the end of 2025. Sinomed in San Francisco currently has it. For those living elsewhere, click here to locate a TBS facility near you.

 

next presentation I’m sharing

5) The Skeleton as an Endocrine Organ

I found this fascinating, and it was very techie, but the main points are that:

  • Bone is not Stone. It’s metabolically alive, remodeling all the time.
  • Bone and muscles have cross-talk with each other through hormones secreted by bone.
  • The interrelationship between bone and muscle is under hormonal control in a two-way street. This brings a whole new face to the parallel development of osteoporosis and sarcopenia (age-related muscle loss) with age.

And the next presentation

6) Year in Review

Dr Lewiecki of New Mexico shared many interesting developments.  Here are just a few.

  • Trabecular Bone Score (TBS) is useful to understand fracture risk. The Frax (fracture risk calculator) now has a place to enter your TBS score to better understand your true fracture risk.
  • Medical Coverage of Telehealth is scheduled to expire 03/31/2025. Extended through 09/30/2025 with temporary government funding bill. After that…?
  • Mitigating bone loss for astronauts. Long duration space flights are associated with high bone turnover. An advanced resistive exercise device (ARED) does not totally prevent bone loss. However, ARED in combination with bisphosphonates is more effective.
  • Path of treatment (BMD = bone mineral density from a DEXA scan)

 

  • Here’s a slide of interesting recommended articles

 

 

And the final presentation

7) Integrating Exercise and Rehabilitation: Enhancing Patient Care

This well-crafted, evidence-based presentation by Rebecca Rotstein, NCPT, and Kavita Patel, DPT, approached this subject through the lens of the doctor or health care practitioner. They encouraged practitioners to promote frequent movement and joyful activities. We are reminded to use our words wisely, minimizing terms like “don’t” or “never.”

A movement-based approach for those with compromised bone density should include multiple factors: resistance, balance, functional training, impact, posture, and spine-safe movements in daily activities.

Interprofessional collaboration in bone health was highlighted to improve outcomes. This collaboration encompasses Medical, Physical Therapy, Exercise/Physical Activity, Nutrition, and Pharmacology. Talking with each other as a team is optimal for patient success.

The presenters encouraged doctors to refer their patients for spine-friendly exercise; however, not all physical therapists or movement professionals are knowledgeable about the latest osteoporosis guidelines. The presenters provided sample questions to assist medical professionals in finding a reputable physical therapist or exercise professional who is current with movement-based guidelines. A few sample questions included: “Have you completed advanced training in osteoporosis?”  “Do you know what motions and exercises to avoid and when?” “Are you aware of key elements and exercises to include?”  “Do you work with any bone health associations?”

 

FINAL REFLECTIONS

 

Attending the International Osteoporosis Symposium left me both inspired and energized. The breadth of information—from cutting-edge medical interventions and pharmacological advances to the vital role of targeted movement—reinforced how multifaceted and hopeful osteoporosis care has become. As a teacher and physical therapist, I’m grateful to be at the intersection of science and movement, translating research into practical strategies that help people thrive.

I return to my work with renewed clarity and commitment, knowing that when we blend evidence-based medicine with empowering movement, we not only build stronger bones—we support a life of confidence, vitality, and resilience at every age.

 

 

 

 

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Fall Prevention & Balance

Perhaps you’ve been diagnosed with low bone density, and avoiding falls is critical to preventing fractures. If you’ve fall-proofed your home, you must also be aware of hazards outside the home. I’ll offer a few tips to avoid falls in various settings outside the home, and I’ll conclude with the importance of balance training and a few tips to help you be steady.

 

Parks and Playgrounds

Are you headed out for a walk or hike in a park? Your health and safety are of utmost importance. Watch for uneven terrain. Areas to watch for include spots where two types of terrain meet, like a mulchy playground and a walking path. Ensure your footwear is appropriate, such as sneakers or hiking shoes.  If you need a little extra stability, I’m a big fan of hiking/trekking poles.  They not only help with balance but when you use them to propel yourself forward, they integrate upper body strength, a plus!

 

Public Staircases

Use extra caution on stairs as they might be a different depth and width from the stairs you are used to at home. My number one tip-hold the handrail!   I tore my rotator cuff falling on icy stairs in NY while NOT holding onto a handrail.  My daughter fractured her leg bone when she slipped on our stairs during our remodel when no handrail was present.  Lesson learned.  ALWAYS hold the handrail.

 

Public Bathrooms

These are notorious for having wet, slippery surfaces that could cause you to slip and fall. In addition, public restrooms often have poor lighting.  Enter with caution and have your phone handy in case you need to call for help.  When available, use the handicapped stall, which has grab bars and a higher toilet.

Stores

Stores often have slippery, smooth floors. When shopping, wear shoes with nonslip treads (especially on a rainy or snowy day).  If you have balance challenges, grab a cart. It will provide support and stability. My mom, at 94 y/o is quick to grab a cart when shopping.  It gives her a sense of security.  If you need to reach for items on a shelf, stand with one foot forward and one foot back at hip-width distance for better stability, or just ask for help!

 

Consider the weather and how it affects your fall risk

Preparing for the weather before leaving home is an important part of protecting yourself from falls.  As we enter the summer, it can be sunny and hot, making dehydration and overheating a risk. Feeling dizzy from those conditions can make you susceptible to falling.  Wear a hat and keep a water bottle handy to stay hydrated.

Conversely, if it’s rainy or icy, ensure you have the right treaded foot gear to decrease your risk of slipping and falling.

 

Stop moving before using your cell phone

If you’re looking at your cell phone, you will be distracted, and distractions often lead to falls.    Whether it’s stubbing your toe on an uneven piece of sidewalk, or missing the wet spot in a public restroom, stopping before you look at or talk on your phone is a good rule of thumb!

 

 

The Importance of Balance

No matter where your life takes you outside your home, balance training will better equip you to navigate unexpected fall hazards.  Strengthening your hips, legs, and core is one of the best things you can do for your balance.

Your vision, vestibular health (inner ear), and proprioception (sense of where your joints and feet are in space) are also essential for balance.

Ensure your regular exercise routine includes sit-to-stand exercises that strengthen your core and hips. Here, I demonstrate sit-to-stand using a dowel (or any stick you have at home) as an alignment tool. Ideally, you want the back of your head, shoulders and bottom to be in contact with the dowel. Additional exercises such as lunges, leg lifts in all directions, and single-leg balance are helpful. Standing on one leg for 38 seconds is considered “excellent.”  Not being able to stand on one leg for 10 seconds is indicative of a fall risk.

 

 

 

 

 

 

Want an easy way to incorporate some single-leg balance exercises into your day? Stand on one leg for a minute as you brush your top teeth, and stand on the other leg for the bottom teeth. Do that twice a day, and you’ll have four minutes of balance training seamlessly woven into a task you already do every day. You can also balance on a concrete ball in Barcelona, but I wouldn’t suggest starting there!

 

 

A final word about upper body strength and balance. 

Although it seems unrelated, having the arm, shoulder girdle, and core strength to “catch yourself” should you slip could mean the difference between a hip or knee injury and walking away intact and injury-free. A great way to train this is with the “Knees Off” exercise, which I teach in all my classes.  While on all fours, spine in neutral, just lift your knees off an inch or two and hold for 10-30 seconds.  I’m using the BoneSmart inflatable core ball here between my knees to activate my inner thigh muscles and deep core and to ensure good hip and knee alignment. This exercise builds core, hip, shoulder, and spine strength. A reminder that if you have low bone density, your spine, hips, and wrists are most vulnerable to fracture when falling.

An extra bonus with the “knees off” exercise is that the weight bearing on your wrists helps build bone there.

In conclusion, when you leave your home, heighten your awareness of your surroundings and how you’re adapting to keep safe.  Research indicates that a fear of falling is a big risk factor for falling.  Do all you can to strengthen your body and improve your balance. A stronger, steadier body will increase your confidence, especially when you’re out and about in the world.

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Support a Healthy Spine with these Work from Home Tips

One of the most significant changes to the landscape of our work environment has been the direct result of the COVID 19 pandemic. A study published in the International Journal of Exercise Science found that people are sitting an additional 7.8 hours per week – since the pandemic started. More people than ever in history are now working from home even after restrictions were lifted. Working at home involves many challenges, including protecting your spine while hunched over a laptop or scrunched on the couch. Fortunately, there are many ways to protect your back and your productivity. Support spine health while you work with these tips from BoneSmart Pilates.

Take Steps to Reduce Stress

Stress can wreak havoc on your life, but it can also make chronic pain more challenging to manage Stanford Medicine points out that easing stress will reduce pain, so taking steps to de-stress is worth the effort. Eliminating work-related stress starts with creating a comforting and inviting home office space. De-stress your workspace by cleaning up clutter, storing scattered paper records, and adding natural lighting. Having a space that is clean and organized supports clear thinking and productivity.

Take Walks to Reduce Stress Further

Step away from your computer or to-do list at lunch or quitting time. Taking a walk is a great way to relax and clear your head. If you have a pet, it’s an even better reason to keep you and your buddy healthy and your bonds strong. Consult a Walk Score map of your community or the area near your office to find the best walking spots.

Though your work setting is one factor that creates stress, getting enough sleep, exercising like the walks I mentioned, and mental stimulation are also critical.

 

 

Work on Proper Posture

Protecting your spinal health means more than avoiding injury; maintaining proper working posture protects your back.  For good posture, stand tall with your shoulders positioned back and down in a relaxed manner and your chin parallel to the floor. While seated, aim for a 90-degree bend at your knees and elbows with your spine long and straight.  A healthy spine position reduces strain on your muscles and joints and can even make you appear taller and more confident.

 

 

 

 

Make a Reminder Poster

Using a free online tool to design a poster or vision board, like the one I created above, is a fun and effective way to remind yourself of good postural habits and practices.

These tools offer a range of templates you can customize to suit your preferences, allowing you to add your own text and photos. You could include tips for maintaining proper posture while sitting or standing, exercises to strengthen posture-supporting muscles, or even inspirational quotes to encourage mindfulness about body alignment. Place the poster in a prominent spot where you spend much of your time, like your workspace or living area. This visual cue reminds you to adjust your posture, cultivate healthier habits, and reduce the risk of discomfort or strain.

Invest in Creative Furniture

If your current office setup is not conducive to good posture, consider changing things up. An ergonomic chair, or even a desk with adjustable height, can make a world of difference for your seated posture. Many work-at-home professionals swear by standing desks. My son even installed his own. This could help you avoid the effects of “soft tissue creep” that occurs with sitting for prolonged periods in a slumped posture.

Try sitting on a physioball as an alternative to a chair. It promotes movement and better posture, which is great for your spine. It’s also easy to shift forward and drape back over the ball to relieve back strain, as seen
in this stretch here.

Perform Spine-Safe Exercises

Strengthening your spine is one way to improve posture and prevent back pain. Dr. Stuart McGill is a renowned Canadian spine expert who has developed the Big 3 top exercises to prevent back pain, which I demonstrate in this video. I look forward to advancing my spine assessment skills by immersing myself in coursework with him this spring!

Other activities that strengthen your core muscles can also minimize pain. Swimming and cycling are excellent examples of low-impact exercise that is spine-safe and healthy; however, if your goal is improving bone density, don’t let swimming or cycling be your primary choice. They don’t build bone.  Walking and hiking are excellent options for building strength, maintaining or building bone density, and promoting healthy circulation. Practicing BoneSmart Pilates can improve your strength, mobility, posture, balance, and bone density while relieving chronic stress and tension.

Enjoy Regular Movement Snacks

Our bodies crave movement. One of the worst things we can do to our body is sit unmoving for prolonged periods. Something known as “Soft tissue creep” occurs. That’s when our connective tissue reshapes and adapts to that cashew posture position you’ve been adopting. The body erroneously thinks it needs to “stabilize” you in this new faulty posture by adapting and reorganizing connective tissue.  Studies show that “movement snacks” – bite-sized spurts of exercise throughout the day – can be just as effective as lengthy sweat banquets.

 

In addition to reducing your risk of health complications, consider these perks:

  • Better sleep
  • Bursts of mood-enhancing endorphins such as dopamine and serotonin
  • Increased longevity
  • Clearer thinking, learning, and judgment

To prevent prolonged sitting, set a reminder on your computer every half hour and enjoy a regular 5-minute movement break.  Even hourly will help!

What should you do?  Play a favorite song and dance like no one’s watching.  Do some squats, heel raises, or counter push-ups.

Enjoy a BoneSmart Burst™, a 5-10 minute curated movement snack, easy to incorporate into your day, that’s bone-safe, and will help prevent you from getting the dreaded Dowager’s hump, that exaggerated rounding in the upper back.

 

Seek Care for a Better Back

Severe back pain can impact your ability to work, no matter how many precautions you take or adjustments you make to your work-at-home routine. Be sure to seek medical guidance if your back pain doesn’t resolve. We want to rule out any underlying causes that might manifest as back pain.

Healthy Back for Life

Spine health is serious business. If you work from home, especially if you sit for long periods, you must take care of your back. Use the tips I’ve shared today to help your back remain mobile and healthy throughout your life.

 

In the comments section below, let me know which tips made a difference for you!

Do you have some tips that I haven’t mentioned?  Please share!

 

 

 

 

 

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Invite Joy into Exercise

Exercise can feel like drudgery when you frame it as something you “have to do” rather than something you “get to do.”

As a movement educator and motivator, I’m always searching for ways to infuse joy into the classes I teach. Why? Because it makes it fun. If movement isn’t fun, why do it?  It should feel good and help change your outlook in some way.

The way I teach is informed by science and research. I’m particularly influenced by the research findings of Kelly McGonigal, a health psychologist and author of “The Joy of Movement: How Exercise Helps Us Find Happiness, Hope, Connection, and Courage.”

Across cultures and ages, there are specific movements that both express and elicit joy. Think about hitting a goal, winning a race, or accomplishing something important to you. The universal physical sign for joy is arms thrown overhead in the air. This is seen with young and old, internationally, and even with blind people who’ve never visually seen that movement. It’s a universal physical manifestation of an emotion.

 

 

 

If we listen to music in a group, we might notice people swaying their arms overhead, often in unison, expressing joy and connection.

The feelings you derive from a class can have lasting positive effects. For instance, if you felt strong and capable during certain exercises when you encounter a challenge later in the day, you are already armed with the sense that you are strong enough to handle it. You’ve altered your outlook even outside of class. That’s a powerful way to use movement to foster a positive mental state.

 

Celebrate what you CAN Do!

Sometimes we become so focused on our limitations that we forget to celebrate what we CAN do! Maybe it’s just moving to your favorite music in a way that makes you smile. That’s an absolutely legitimate form of exercise, and you should incorporate whatever kind of movement brings you joy. Movement in any form should be viewed as a gift to celebrate.

Try these Incentives

Use one of these three ideas to feel good during movement: music, nature, and/or people.

Add some motivating music. According to McGonigal, music is a “powerful evoker of joy” and can help release endorphins and dopamine. Endorphins and dopamine are both chemicals in your body that make you happy, but they function in different ways. Endorphins relieve pain naturally. When they attach to your brain’s reward centers (opiate receptors), dopamine (a mood-boosting neurotransmitter) is then released. For example, endorphins will naturally help soothe a runner’s achy muscles.

 

 

“Green Exercise”, working out in nature has an immediate effect on mood and can help people feel calmer and happier, improving mental health.

 

 

 

 

Moving Together
As Barbara Streisand so eloquently sang, “People, people who need people, are the luckiest people in the world.”   As a former professional dancer, I felt firsthand the power I experienced dancing, moving, and even breathing as one in a group. The sensations and emotions you experience, whether they be strength, joy, or discovery, are amplified tenfold in a group setting.

 

 

I’ll never forget my first time back teaching in-person group classes toward the end of the pandemic. One of the participants came up to me with tears in her eyes after class. She shared how deeply moved she was by being able to exercise in connection with others again, breathing, laughing, and moving together. This revelation both surprised and touched her.

Track Progress In a Novel Way

Give your trackers a break for a bit. Maybe be a little less data-driven; find a word that best describes how you feel after a workout. Track that instead to support a mindset of joy.

During one of my recent Signature BoneSmart Pilates® Standing Strong classes that I teach, I asked the participants to note how they felt before class with just one word. Some of their words included: “discombobulated, vulnerable, stiff, tired, flustered, and exhausted.”

After an hour of moving together with beautiful music and supportive cues, they each shared a word describing how they felt. These descriptions included solid, confident, invigorated, hopeful, and free. The evolution that occurred with each individual is a testament to the transformative power of movement to elicit joy and optimism.

In Conclusion
The process of moving (even over Zoom) with a joyful mindset and perhaps some motivating music can be transformative and set you up to have a fantastic day!

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Which is better for building strength? Weights or Resistance Bands?

Some people are either or people. I believe both have benefits for improving bone health.

When you add resistance to your routine, your muscles release calcium, magnesium, and other minerals that strengthen your bones. Your muscles don’t know whether the resistance comes from bands or weights.  Whatever you are more prone actually to do, that is the mode of choice. If you dislike weights, go for bands.
I personally like mixing things up.

Here’s the thing, though, you need to really challenge yourself for change to occur.

With resistance training, it’s too light if you can breeze through 20 reps of an overhead press. You’re building endurance, not strength. You should feel “worked” after 10-12 reps at a given resistance (whether it be weights or bands) with excellent alignment and good breathing technique.

I tell Pilates teachers to load up the springs on the Reformer for leg work for their clients with osteoporosis. If the springs aren’t heavy enough, they won’t gain strength or bone. (of course, ensuring proper form)

The other thing to remember is that your bone health is not only a reflection of your exercise. It’s also a function of your nutrition, supplementation, daily activities, or lack of…it’s difficult to tease out.

I believe your best shot at optimal bone health is doing weight-bearing resistance and impact exercises, dancing, walking/hiking, sports you enjoy AND also addressing other factors in your life that support bone health. When appropriate, medications may be the right choice.

Most people want a multifactorial approach to their bone health. I get that. In many ways, we are our own laboratory.

I want to share this interesting study from researchers at the U. of Oregon demonstrating how training with resistance bands increases bone mineral density.

“It is sometimes difficult for sedentary people to change their habits, and going to a gym would be more difficult. But elastic bands offer an interesting alternative since they allow enough intensity to stimulate bone mass, and a multitude of exercises are possible. Regular practice of 2 weekly sessions involving work on the main muscle groups of the body will increase bone mineral density.”  Here’s the research study

 

 

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We’d like you to meet Amy!

Amy SmileyAmy Smiley, Age 62

TELL US A LITTLE ABOUT YOU

I spent most of my life in California, with a short stint in Sweden in the 1970s. My degrees are in Chemical Engineering and I worked in the biotech industry once I got out of graduate school. I loved working in such a new field at the time. As the family grew, I decided to quit my paid job and stay home with the children. As time went on I realized I needed a creative outlet and took up Plein air painting (with the same fantastic friend who introduced me to Teresa’s classes!). After my family and friends, I love the outdoors, science, gardening, and art.

WHEN DID YOU BEGIN SESSIONS WITH TERESA?

I started classes with Teresa in 2012 and have continued with them ever since. Teresa’s Pilates classes are a priority for me because of the physical and mental benefits they provide. I have celiac disease, which causes any number of inflammatory problems and Teresa’s classes are essential to my ability to manage those issues. When something has to fall off my plate it won’t be Teresa’s class!

 

WHAT MOVEMENT OR PRINCIPLE HAS HELPED YOU THE MOST?

I’d like to choose just one movement or body dynamic principle that I learned from Teresa that has helped me but there are too many!  From ribs down to soup bowl to lifting your toes…I am always learning something new, even ten years later.  I think, for myself, as I continue to become more body aware, I continue to learn in each class.  And, as new issues develop as the years march on, I discover new fixes for them.  Everything that I have learned from Teresa applies not only in class but in other activities and my daily movement.  Not to mention that Teresa is so gracious with her time whenever anyone has a question about alignment or movement difficulties.  She always takes time to answer any questions and I learn from my questions and those of others.  What a fantastic tool!

 

Amy Smiley Testimonial for Aging Strong Pilates

WHAT WERE THE EFFECTS OF THE PANDEMIC ON YOUR MOVEMENT PRACTICE?

At the beginning of the pandemic, I dropped the gym and in-person classes.  Although we stayed active, I really missed the benefit and connection of group exercise classes.  I worried about how well I would maintain mobility and strength without the motivation and guidance that Teresa provides.  When Teresa opened her remote classes I jumped right in and was so grateful! Now that some degree of normalcy is returning, having the option of in-person and virtual classes is even better than before.

I absolutely love the energy and camaraderie in the in-person classes.  They are a tonic for the soul.  I can’t think of a single class where I haven’t had a good laugh for one reason or another.  I missed that tremendously until in-person became available again.  But it’s also great to have access to the class online if I can’t make it in person and to have the videos afterward.

 

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Not just for the hardcore exerciser, foam rolling is both self-care and self-repair.

Foam rolling is a form of self-massage that alleviates tightness and trigger points (aka muscle knots) by using your body’s weight against a foam roller. The benefits are many.

 

 

BENEFITS OF FOAM ROLLING:
  • Increases blood flow and elasticity of muscle tissue, joints, and fascia, the body’s connective tissue, which helps with mobility and overall well-being.
  • Reduces inflammation that occurs during the muscle repair process.
  • Helps injury prevention by maintaining muscle length and alleviating tension and tightness.
  • Releases tension promoting relaxation.
FOAM ROLLING PRO-TIP: 

Click to view the video. If you are new to the Aging Strong Pilates Facebook Community, you will have to join the group to see the video.

For all the moves, you’ll want to stop wherever it feels tight or tender. Breathe allowing the pressure and stillness to create a release. You’ll note the benefit immediately. When you experience that release, inhale, and then as you exhale, slowly roll your way to another tight spot and repeat.

DEMONSTRATIONS:

Want to see some demonstrations of key roller exercises? Watch the video on our Aging Strong Pilates private FB page where I demonstrate effective techniques to melt away your stress and your knots. You can also ask your questions there. I moderate daily.

 

HOW ELSE CAN YOU USE THE ROLLER?

The foam roller is not just for relieving knots and tension. It can also be used to increase the challenge to certain muscles and improve your postural stabilizers which are important for balance.

Imagine lying on your back with bent knees, the soles of your feet on a roller that’s perpendicular to your body.  Doing bridging this way increases the challenge to the muscles in the back of your legs because your feet are on an unstable surface that, without adequate hamstring firing, will roll away from you.

Here’s another scenario:

Lying vertically on the roller with your head to your buttocks supported by the roller- similar to the photo on top, knees bent, feet and fingertips on the floor.  Challenge your postural stabilizers by marching in place – lifting and lowering one bent knee. Notice how your balance systems kick into high gear to keep you from falling off the roller.

YOUTUBE FOR ROLLER AND MORE

My Youtube channel “BoneSmart Pilates” has many free videos that support your movement practice. Check out this one which includes 6 Great Foam Roller Exercises to Start Your Day!

 

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Booking Virtual Classes 101

Have you found navigating my online booking system challenging?
I created these short video tutorials to make everything easy peasy, crystal clear!
  1. First view the “Overview for All” before clicking the video for the category of class that interests you.
  2. Bookmark my scheduling home page BoneSmartPilates.as.me for easy access
  3. If you prefer using mobile devices, download the free app “Acuity Scheduling Client” from the App store. My sisters find it easy to navigate.
  4. Always Log In whenever you’re on the site. If  you haven’t created an account you can Create an Account Here

 

 

 

 

 

 

 

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Recode Finish Line

Here it is, almost 10 months after I started this ReCode (Reverse Cognitive Decline) Clinical Trial.

Allow me to back up for a moment and share with you what got me concerned about my brain health in the first place. Back in 2019 and before, I noticed I was forgetting people, appointments, names, why I was holding the object in my hands, and so on.  True it’s common for that to happen occasionally but it was happening more and more frequently. I have a strong family history of Alzheimer’s disease and I was worried.

Through clinical study genetic testing, I learned that I carry the ApoE4 gene, that sucky one that makes me susceptible to Alzheimer’s disease. The good news from the book “End of Alzheimer’s”  written by Dr. Dale Bredesen from which this clinical trial is based, is that your genes are not your destiny.  I believe that is true really of any genetic predisposition you might have for whatever disease. The genetic gun may be loaded but you have the power and choice to avoid the triggers that will tip the balance that puts you over the edge.  Those are the secrets I learned in this trial. How not to pull the trigger.

Time to celebrate!

What are my key learnings from this clinical trial that might help you?  I’ve experienced improvements in cognition, weight loss, sleep, gum health, and overall energy.  When reading the recommendations given to me, keep in mind that many of the nutritional supplements and hormone choices were selected for my unique biochemistry so the type and dosage may not translate to you. Best to consult with your own wellness practitioner for customization.

My Cognition Improved
The Recode protocol which includes a combination of a Ketogenic diet, Intermittent Fasting, exercise, nutritional and hormonal supplementation, brain training, and mindfulness training has helped me to crawl out of the abyss of cognitive decline.

  • Cognitive function tests have all markedly improved since baseline testing in December of 2019 to the point of testing “out of the range” of cognitive decline to normal levels.  I was in the range of “cognitive decline” for my initial testing.

I lost considerable weight

  • I lost 15 pounds on this diet, with a noticeable improvement around my waistline. I’ve lost fat but not muscle as evidenced by the physical testing that I underwent at the beginning and end of the study and by Body Mass Index (BMI) testing on special equipment.  For me, I believe the aspects that contributed to weight loss were intermittent fasting (no nighttime snacking), no sugar, high fat/low carb ketogenic diet which includes no bread. Exercise is also very important but I was doing that already. It was the food and fasting that were the new variables.

I’m Sleeping Better

  • Since I’ve been in this study my sleep has markedly improved.  I used to get up repeatedly to go to the bathroom and at times would have difficulty getting back to sleep. I now sleep through the night and when I do get up, I can fall right back asleep easily.
    From my understanding, the following that I’m taking positively affects my sleep. Remember it may look very different for you and your body.

Over the counter supplements:

    • NeuroMag by Designs for Health 3 capsules at bedtime  (=144 mg magnesium)
    • Melatonin SRT by Designs for Health 1 tablet bedtime (6mg)

Prescription meds

    • Progesterone 200mg cap (Costco has it the cheapest)
    • Naltrexone 3mg tablet

Improved Gum Health

  • Dentalcidin toothpaste with Biocidin by Bio-Botanical Research is the natural toothpaste that I’ve been provided to use for the entire clinical study. My dental hygienist asked me what I was doing differently as my gum health improved significantly. I told her about the study and apparently, the change in diet and toothpaste resulted in this improvement.  Marie, one of my Pilates students, started using this same toothpaste after I mentioned it in class and she shared this with me. “I went to my dentist yesterday and got a great review on how well my gums looked after using this natural toothpaste.”

Reflecting on this clinical trial I found further evidence of the efficacy of a multimodal approach to cognitive decline and the prevention of Alzheimer’s Disease.   Doctors often tell patients at high risk of Alzheimer’s due to having pre-dementia conditions—such as Mild Cognitive Impairment (MCI) or Subjective Cognitive Impairment (SCI)—that there is really nothing that they can do other than wait and monitor. A recent study from Australia suggests that advice may be out of date. Researchers found that modest lifestyle changes (e.g., a nutrition plan, a physical exercise plan, and BrainHQ brain training which was all included in my clinical trial plus more) significantly reduced Alzheimer’s risk after only eight weeks. You can read a news article about the study here.

As I contemplate life after ReCode, I know that I’ll continue brain training, sauna, intermittent fasting, and will continue with the Dentalcidin toothpaste. I’ll maintain aspects of the ketogenic diet, and will add some carb cycling in.  I miss things like my brown rice and beans, bananas, and sweet potatoes. I don’t really miss bread and will choose to keep that at bay. I believe dropping bread and sugar contributed to my weight loss.  As I prepare to have my final clinical study doctor appt on Oct. 8, I’ll be advised then on how to smoothly transition out of clinical study mode with guidelines on what supplements to continue and what I can drop.  I’ll fill you in on the details next month in my epilogue!

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