Fitness after 40 | Menopause, Perimenopause & Hormones with Dr. Shwetha Rao Warke | The YwR Podcast

Fitness after 40 | Menopause, Perimenopause & Hormones with Dr. Shwetha Rao Warke | The YwR Podcast

Author Name:Yogalates With Rashmi

Youtube Channel Url:https://www.youtube.com/@YogalateswithRashmi

Youtube Video URL:https://www.youtube.com/watch?v=UugRPIcb_88



Transcript:
(00:00) I actually wanted to bring you on to this podcast specifically to talk about women and women over 40. There has to be physical activity and especially resistance training. Muscle loss happens is when you start noticing that easy movements in your day start becoming little difficult. >> What are the first signs of osteopenia or osteoporosis? >> It's actually a finding that happens when an X-ray is done.
(00:25) A strong bone as I said will be highly packed with each other and osteoporotic bone will look like a honeycomb. >> Let's talk about permenopause and menopause. So sometimes you know in per menopause women start feeling that there is a brain fog you know cuz if your estrogen and progesterone are going down your cortisol level that is your stress hormone that's going high and cortisol hormone when it's high it's like you know it's like a flight and fight mode that suddenly she's like you know become this mata with anger issues and
(00:53) everything and it's like you realize okay fine this is not me it's actually the hormones everything is related to the hormones it's it's not something that a woman is making up very very important to be [music] that understanding person that say okay fine give her her time after some time she'll be fine kind of a thing rather than blaming that okay she's become into this another person altogether [music] hey [music] hello and welcome to the YWR podcast today we're going to talk about women's health espec Especially women over 40.
(01:34) Most of our viewers are between this 35 to 50 age. Everyone is exercising and working out. So let's get to know more about your health and what you can do to remain fit when you hit the stage when you're either permenopausal or menopausal. Today I have with me a very very special guest, someone who I have seen while I was growing up and she was this beautiful dancer.
(01:57) I remember the first time that I saw her. That's that's my visual of her. Today's guest is Dr. Schwa Rawark. She is a sports physiootherapist with over 21 years of clinical experience and the founder of physioinesis which is one of Tane's leading physiootherapy and sports rehabilitation ecosystem. Guided by her belief that you don't have to be better than anybody else, but you have to be at your best, she began her career in neurological rehabilitation before expanding into sports physiootherapy and through her own fitness and endurance
(02:35) journey. In 2022, she co-founded the physiochinesis performance lab with sports scientist Dr. Ha Takar. They offer scientific fitness testing, sports performance training, and recovery solutions for athletes, for fitness enthusiasts, for senior citizens, and anyone returning from injury to build a one-stop shop evidence-based performance and rehabilitation hub for the sporting community.
(03:03) Thank you for joining us today. Thank you so much, Rashmi, and thank you for that introduction. uh the memory of as a dancer I think it's another version and another lifetime for me at this point. Yeah. But yeah, I I did classical dancing for more than uh more than a decade but yeah then kind of gave it up but somewhere the dancer is always there within me >> always. Yes.
(03:26) >> I actually wanted to bring you onto this podcast specifically to talk about women and women over 40. >> Yes. >> And there are a lot of changes that we experience in our bodies. a lot of changes that we experience mentally, hormonally, so many things happening. Uh I'm going to hit 40 soon. >> Okay. >> And uh you are already somewhere there [laughter] in sailing in the boat.
(03:47) >> So um I wanted a physiotherapist perspective about a lot of questions that women have. >> The first thing is about muscle loss. Okay. Because I have read a lot of things about how women start experiencing mus muscle loss in their 30s and it accelerates in their 40s. So can you talk to us a little bit about it? Right.
(04:07) So, uh I think you're talking to the right person because I am right now sailing that entire boat of permenopause and I can actually give you uh real life experience of you know how these changes actually affect the body entirely. It's not just uh people think that it's hormones. So it only will be related to your cycles but it has an impact right from your gut to your brain to your muscles to your skeletal system uh digestive system and everything and uh unfortunately not much is spoken about it uh and obviously I what I also feel is that uh it's sometimes people
(04:46) feel or women feel that uh you know let's get to it when we reach that rather than being equipped with the knowledge of how to deal with it even before with it. Now when it comes to muscle loss, uh it it just happens because if you're not it's it's a saying if you don't lose it use it, you lose it.
(05:08) So it's uh in the early ages of when you're in your 30s it starts it's about 3 to 5% and with every decade it just increases and after 50s or 60s it's like an exponential you know decrease in muscle fibers that you get and that's [clears throat] how you are basically using your body and uh how you are uh educated in terms of uh workouts of in or investing in your body in fitness all that matters.
(05:35) And if you are not somebody who's not working out and if you're in your 30s, I think it's a right time to at least start getting initiated into some form of exercise. And um again, we'll come to that about what actually is exercise. That's another big question or you know to answer. But there has to be physical activity and especially resistance training that you have to get into in your 30s so that you have you know peaceful 50s and 60s.
(06:03) So it's a right time if you're in your 30s. If you're in your 40s or 50s, again, resistance training is going to help you tide over permenopause because in permenopause there are these two uh warrior hormones for us which are estrogen and progesterone and these start kind of declining and estrogen and progesterone receptors are there in all organs of our body >> and once the support of theirs is gone uh that muscle is very easily gets turned into fat.
(06:37) If you're not think and that's why people start getting abdominal fat or you know they start feeling loose in their muscles around their thighs or in their buttocks and you see this pear-shaped you know changes that happens even though if you have been someone who is reasonably following a decent diet uh you know and um maybe involving in some movement but because of the lack of these hormones these changes just happen but having resistance training as a part of your fitness regimen is something that's going going to tide you over. M
(07:08) >> so what if I experience muscle loss like okay I'm I'm someone who's in my 40s just assuming somebody >> and they don't do any kind of resistance training they just go for walks and a lot of people think that oh if I go for a walk I'm exercising so this is great exercise or workout so what if I'm someone who does and I've seen a lot of Indian women specifically who just think that okay I can go for a walk or yoga >> so is that enough for me as someone who is in my 40s and 50s and even if I do just that so what if I experience muscle
(07:42) loss like what will happen if I lose the this muscle. So the most earliest signs uh of uh having muscle loss is that simple activities which you could do easier like maybe just you know run up a flight of stairs or you know come running down a flight of stairs or uh just picking up like uh a small kid from the from the floor.
(08:06) Maybe the kid is 10 kgs, 12 kgs. Those things start becoming difficult. Like suppose by mistake if someone you had to go to somebody's house or you go on a track where you have to sit in an Indian squatting position. Uh you know that becomes difficult you know. So muscle loss happens is when you start noticing that easy movements in your day start becoming little difficult.
(08:29) >> Second point that you start noticing is that you start getting injured also very often. maybe uh having some kind of issues like very commonly what we call it as tendinitis. Tendon is the area where the muscle gets joined to the bone and it's a highly fibrous and a structure and a very strong tissue which holds the muscle to the bone and again these m these needs to be exercised and that exercise doesn't come with walking or even yoga for that matter >> that has to come with strength training.
(09:00) Now what happens with walking is walking is a good exercise. I will not say it's uh it's a bad exercise but in the kind of life lifestyle that we are right now walking is like something that you do to expend energy. So usually total daily energy expenditure you should have like you know some movement should happen in your life.
(09:25) >> Yeah. >> Uh so that you are expending that energy whatever you are consuming. Now walking as such again it depends on at what pace you are doing, what heart rate you are reaching. Are you walking on an incline because all this matters on the effect that you want out of that walking. Are you walking fast and slow to make it like an HIT workout? >> So these are ways that you can put variations but having a chitchat work for 45 minutes you know where you know where hardly you're not you know expending any energy it's just movement
(09:57) for your body. It it has its benefits. From somebody who doesn't do any walking at all, you're at least doing something. But considering that walking is a complete exercise for me to give me strength benefits, to give me mobility benefits, then no, you know, it is not. So, you have to have a mix.
(10:17) You need to have some strength training to build that muscle that you are losing. Walking is basically to improve your aerobic and your cardiovascular health. that that has the major benefits of that >> and yoga obviously for improving your mobility doing some breath work meditation it's a mind body combination thing so a combination of these three is definitely something that they should think of and yes this is very common with the clients and the patients that I see is that you know very commonly they say walking or we put on you know yoga
(10:50) in the morning uh there are a lot of online uh you know portals right now which are making waves and you know people just put that on and they follow along. >> Yeah. >> But every human and every individual is different. Now saying that you know I can do these exercises so now let me go on a pilgrimage which requires climbing a lot of steps.
(11:12) Obviously you're not going to be able to do it in the best way because you've not trained for it. >> Yeah. >> So your body needs to be trained for that activity and the perception of exercise and movement and that education for women. uh or men in general has to change that you know that only doing one type of exercise is not going to give you the complete gains out of it.
(11:34) >> Okay, let's talk about permenopause and menopause. Mhm. >> So, um, medically, just because you're a doctor, let's talk about what are the kind of symptoms that women experience when they're p per menopausal and then during menopause, how it probably intensifies and what they can do um from a physiotherapist perspective to counter these um symptoms or to just make them feel more comfortable.
(11:59) >> The the moment a girl or a woman starts getting their period, okay, it's a cyclical thing. So, it happens every month. Okay. Now these hormones estrogen and progesterone they have their play every month and that's how you get your period and so now this cyclical thing changes and you know one day you reach a point where the cycle is not happening as per it is supposed to come.
(12:24) So >> uh for example I I can tell you by my personal experience is that fine you getting a period till a certain month and then it's off you're not getting it for 2 3 months. So and you're questioning okay what's happening with my body now a lot of our body functions are related to these hormones including digestion including uh you know the thinking processing uh the way the woman's brain function there are estrogen receptors even at the brain in the brain so sometimes you know in permenopause women start feeling that
(12:57) there is a brain fog you know not able to remember I kept my keys somewhere and then you go out of the house and you you know you have to think oh where did I put my keys you know >> simple things like that you don't remember it is valid >> it is valid this is not something that you know kind of a thing you know uh and it's it's not like everything is related to the hormones it's it's not something that a woman is making up it's very easy for caregivers or you know partners to think that okay you know what's wrong
(13:25) with her suddenly she's like you know become this mata with anger issues and everything and you know and till yesterday she was this calm because it regulates because if your estrogen and progesterone are going down your cortisol level that is your stress hormone that's going high and cortisol hormone when it's high it's like you know it's like a flight and fight mode.
(13:45) So every time your body is like you know why did this not happen why did you not do this and it's like you realize okay fine this is not me it's actually the hormones but having this awareness not just for females but also for somebody who's at home with you is very very important to be that understanding person that say okay fine you know give her her time after some time she'll be fine kind of a thing rather than blaming that okay she's become into this another person altogether so it's very important for everyone to
(14:15) understand. So u estrogen receptors are there as I said in every organ of our body. Now when permenopause hits there are changes in how your body regulates temperature. Uh the AC might be on at maybe 20 25° but still you may be sweating. Uh the temperature may be around uh 20 25° but you may be freezing.
(14:40) So because these hormones also help how you regulate temperature in your body. >> Uh and this again happens at the brain level. It doesn't happen at the bodily level because the brain has the thermostat which tells the body and this hormone play again plays with this. So again trying to understand how your body is functioning what kind of clothing that you want to wear having a layer always along with you you know this all helps to carry along like if you're going for a seminar where there's going to be AC >> you might be wearing like uh a jacket or
(15:12) something that fine but suddenly you might feel so maybe layering yourself down so dress up smartly if you have to go somewhere because you might just feel hot or cold anytime >> and uh uh again lot of estrogen receptors also in the pelvic floor. So again lack of that the muscles also start becoming weak.
(15:32) Again signs of having incontinence or all these things also happen and plus lot of injuries happen because again estrogen receptors are there in every tendon in every joint at every muscles and if these are not there again the structurally uh the structural integrity of these tissues is compromised and hence the chances of having injuries is high.
(15:55) The best way to cope with this forward is that even though we are women, we do have some amount of testosterone in ours as well. >> Uh and uh uh that doesn't get enhanced but that is one hormone which will help to push you through because that is again an activating hormone and then you have your good hormones, your happy hormones that are your endorphins and opioids that uh that are secreted when you're exercising.
(16:22) So the best way to cope with permenopause is to engage in some form of workout which is involving in resistance training because that will push up all your hormones which are going down >> and help to kind of you know balance out some of the symptoms. So at least managing these symptoms or how you handle them becomes a little easier on you.
(16:46) So strength training is on the top of the list. Second is uh doing some form of meditation because that helps to kind calm the mind and obviously to complement with it is yoga. So yoga, meditation, strength training is something that you need to do. And also uh kind of maybe taking up something that relaxes you like even having a pet for that matter or having you know uh doing something pursuing something that you like like trekking or whatever you know gives you that happiness of doing it for yourself uh you know take up something. So it's not a so I feel that
(17:24) menopause or per menopause shouldn't be a phase where you are saying that you know abse in fact I think you should use it as a stepping stone to incre to make yourself powerful for the next phase of your life because if you see after per menopause or when you hit menopause you're no different than a man because that's the same thing right you don't have those those hormones So you can actually be very strong >> and work on becoming very strong so that when you are in your 60s7s 80s you can be that person who's independent mobile
(18:03) especially you know because we want to be independent you know to at least be able to walk do wherever you know go wherever we want to go. So >> that's very important. Okay. So, we spoke about muscle loss. >> I wanted to ask you about bone density and muscle mass because these are spoken of a lot >> and uh also there are changes in your bone density as you age. Right. Right.
(18:27) >> So, can you tell us first what is bone density and how you measure it also as a like if I'm your client and I come to you and I say I just want to know how healthy my bones are u as a woman who is reaching her 40s. So what would you do to tell me about my bone health? >> Now as such uh uh if you come to me as a client uh I will not be able to assess your bone health as such in terms of in my physical assessment or the tests that we do.
(18:59) uh but it's a lot of history taking that we ask like the main questions that I would ask you is uh about what is your fitness profile like what do you do to keep yourself fit you know so then if you say that okay I'm somebody who does resistance training or I've been doing strength training and yoga and whatever so I have a reasonable assumption to say that okay she is someone who is invested in her fitness so presumably her bone health would be good okay >> okay let me interrupt you there if I exercise and work out is is the assumption that I have good bone health?
(19:32) >> Yes. >> Okay. >> Yes. >> And those who don't exercise then what happens to their bones? >> So if I say to give you an example, let us take an example of uh if you're building a a building or a tower like a construction site. So there are the columns they are like thickly packed with cement or whatever their material that they're using.
(19:54) M >> so let us consider our bone is at like that structure it's like the foundation for our body the skeletal system is like gives the shape and the foundation >> now when we are uh happy healthy young active uh the bone cells are packed with each other like there's hardly any space between them okay >> now what happens when you don't use your muscle your bone as much like for example somebody sedentary just doing sitting hours of job 8 to 10 hours time workout traveling by car getting out of car that's the lifestyle. Now this
(20:29) person is doing this over a couple of years. At some point if he's also not nutritionally optimizing the body will also think that calcium let us take it from the bone. >> So the body itself starts leeching the calcium >> from the bone because it requires it. You know calcium is required for every process in our body.
(20:54) For passing some electron or some mineral from one cell to the another calcium is needed. For any muscle contraction calcium is needed. So it will take that calcium from that. So that's why sedentary people are more chances of having poor bone health is if because the body itself is taking the calcium from it. M >> when you're giving that impact to your body of little bit of jumps or little bit of weightbearing when it comes that stimulates it's a stimulate stimulation for the calcium to be secreted to be absorbed to be absorbed into the bone to
(21:27) make it more stronger. >> Okay. >> So the lesser you use it so as I said again you don't use it you lose it. So that's how the calcium starts getting out of the bone. M >> so the first phase before osteoporosis is called as osteopenia and >> you can see this on an X-ray >> or uh a better version of it would be a dexa scan.
(21:52) >> That was my next question actually about the dexa scan. You can just >> tell us more about it. >> Yeah. So the uh so ideally uh maybe around a perimeopause or if there is a history in the family. So usually again in the history we ask like did your mother have any kind of bone health issues or early arthritis or you know or was she on any supplements for bone health? Did she have many falls and fractures? So if you are osteoporotic uh if you have a fall and you end up having a fracture the chances of having you uh
(22:26) of you having another fracture in the year is like double. >> Oh >> yeah. So once so better not reach the stage where you get the fracture. >> But this is for older people I'm guessing [snorts] >> for older people but sometimes even uh women who are in their 50s or 60s also land up having this because of poor bone health.
(22:45) >> Okay. So investing in your bone health starts right from the age of 25 and 30 is you need to start doing some form of high impact activity whether it's playing a sport whether it's playing games whether it's dancing whatever you want to do that impact has to continue and then complement that with resistance training and that gives you a good bone health >> and that's what you can diagnose so as a physio if I had to diagnose you I would rather send you to an orthopedic surgeon uh who can help uh with the diagnosis of
(23:20) whether you have osteoporosis or osteopenia and there are different scores uh so when you do a dexa scan they basically see uh how the calcium deposition is there in each of your joints and and they give you a score. So according to that scoring they label you as in these joints you know you are osteopenic in these joints you are osteoporotic but the main treatment again is obviously taking your calcium vitamin D is something that we are not exposed most of us are working indoors and uh it's not that early morning
(23:55) sunrise is important it's is different for different parts of wherever you live >> so now and obviously as a culture in India we not sit bare you know somewhere we don't sunbathe or anything we're always clothed we have a layer and the main absorption of vitamin D happens from the skin so again you know having that supplementation history how much are they supplementing have they ever checked themselves so this is very important >> and then an orthopedic surgeon usually guides them that you know get into resistance training or some form of you
(24:27) know low impact training >> uh to build your muscle strength >> okay what are the first signs of osteo penia or osteoporosis. >> Unfortunately, uh there's no sign as such that you know a patient will come and say key. It's actually a finding that happens when an X-ray is done like they might come to me with a knee pain or with a back pain or something like that and they have been asked to do an X-ray and in that in an X-ray if it's a well done X-ray the doctor can say that okay you know so so for example if if I
(25:00) say a osteo a strong bone as I said will be highly packed with each other and osteoporotic bone will look like a honeycomb >> like it's kind of it has some holes in between when there's severe osteoporosis. >> So it's kind of crumbly structure >> and osteopenia would be just one stage between that where it is there and it's not that it can't be built.
(25:23) So there's lot of you know misconception like we have some senior citizens who say strength you know or bone strong. So there's nothing like that you can always be stronger at whatever age you start but consistent effort is needed. M >> so once your bones have kind of degenerated can you reverse that a little bit or >> uh stop it from accelerating? >> So let's talk about two things.
(25:48) So the bones degeneration ra so the joint kind of degenerates usually that's the language that you use that the joints degenerate >> the bones usually we talk about in terms of osteopenia or osteoporosis. >> The degeneration that happens rarely reverses because that's like an age related change.
(26:07) But the osteoporosis and osteopenia can be helped with medications and with the right form of exercise that can change. Now age related degeneration happens. So once you stop growing the degeneration starts. >> It all depends on how you are using it. Now sometimes the degeneration may be visible on investigations but you may be physically fit.
(26:30) So are we treating the X-ray or the MRI or are we treating the person? M >> so sometimes we also have patients who say that oh but you know the doctor told me that to stop running stop doing yoga not to sit in vajarasan not to do all these asans uh it all depends on how the functionality and mobility of that person is and whether he or she has pain in those movements or no >> if they don't have the pain then why to stop them from doing it so I'm from the school of thought where I do not like those medical practitioners who say that
(26:59) you know once you go to them with a knee pain that they say Now stop climbing stairs, stop sitting, stop sitting cross-legged, don't sit in vajrasan, do it only as much as it is needed. I feel that kind of restricts the mindset of the person >> and uh there are only studies which are talking positively about even for running for that matter.
(27:20) It just says that if you say if you take two runners one is uh somebody who as uh sorry if you take two people one both have degenerative uh knee conditions one is a runner and one is a non-runner chances are that the runner will have a healthier and a more mobile lifestyle and his like if they ever had to get a knee replacement done maybe the runner won't need it or and the non-runner might need it because he's not using it.
(27:45) So there are more evidence-based studies that are promoting physical activity to kind of uh maybe reduce the speed of degeneration. We can't avoid it but yeah reduce the speed of degeneration that is there. >> Okay. So the next thing I wanted to talk to you is about knees because uh a lot of my students a lot of people write to me saying that they can hear a cracking sound in their knees or suddenly when they start start climbing up the stairs they can hear some chick sound.
(28:14) [snorts] A lot of dancers I've seen a lot of bharatamyam dancers experience this um and there's a lot of pressure on your knees also when you're doing classical dance because you sit in that murumandi arand you're going all the way up squatting and all of that so I wanted to ask you about um knee health and if you do experience these things is is it something that you need to really look into or is it normal? So >> first thing there are joints they're going to make noise so don't bother about it. Uh so if the cracking or the
(28:45) noise is happening with pain uh then it is something that we need to look into. If it's just happening you can just ignore it. Uh a lot of this also goes about hydration of your tissues. I feel that uh if you're not well hydrated then the noises are a little bit more. So uh and that is also I see uh a lot of uh women especially that they do not they like when I ask them okay how much water do you drink we don't measure or you know >> or not so thought about it so much so but at least >> uh targeting at least 2 and a half three
(29:21) liters uh of the day especially and also depends if you're someone who sweats a lot then again you know matching it up you know having making sure that they understand that they're well hydrated that also helps. So basically if your if your tissues are dehydrated when they kind of rub over each other they're going to make some noise.
(29:39) >> If they're well hydrated they are plump plush you're also doing some strength work keeping it agile mobile also doing good mobility >> the sounds sounds might reduce. So that's something yeah but if it has a pain associated then it needs to be checked. Sometimes the cartilage of the knee which is called as the meniscus maybe that's getting stuck in between.
(30:02) Sometimes people have the click, the pain and a sense of giving way as well. So that means that there is some damage to the cartilage and that then needs to be shown to an orthopedic surgeon or to a physiotherapist who can then guide you accordingly. So >> otherwise just ignore the pain the noise if there's no pain but if there's pain then get it checked.
(30:23) >> Let's talk about supplements now. Um a lot of companies and a lot of brands keep promoting different supplements that women should take. one for bone health, one for skin health, one for gut health, one for aging well, one for fine lines, one for wrinkles, all of these different things. So [gasps] from the perspective of okay, I want to keep my bones healthy, I want to keep my muscles strong.
(30:44) A lot of people say that you need to take extra protein or consume high protein. What is your take on supplements? Do we actually need them? What are the bare minimum supplements that you would recommend that a woman in her 40s or 50s should take? >> Okay. Uh so let's talk about this now. First let's take protein.
(31:04) Let's start with protein and then we'll talk about the rest of the supplements. >> Now protein is as we know we've all studied from I think seventh standard or eth standard science that they are the building blocks of the body right. So now these are building blocks of the body and we need it through our entire lifespan.
(31:21) As women we go through different phases of child birth you know postnatal antiatal depending upon how many children you have those many cycles you've gone through. So and all these changes uh makes a change in your body's metabolism as well and the structure as well and again depending upon the activities that you are doing you're a working professional or an athlete or whatever the protein has to be matched to that activity.
(31:50) M now uh usually they say about8 to 1 g of protein per body weight is needed. Now depending upon what's your uh activity style you need to supplement yourself. Now whether it is whether you need external protein blends which are available in the market or whether dietary protein is all depending or it's a personal choice whether you're whatever you're eating if you are a vegetarian or a non-vegetarian for that matter you take if you're 70 kilos then 70 g of protein is something that you need to have whether from your regular diet of whatever you're having
(32:27) is 70 grams met it's fine if they're not met then what happens that the body takes the protein from the body itself. So then you you are somebody who wants to build muscle but muscle build your body is not getting enough protein it's just using it from whatever is available. >> Okay. >> So that's why you need to supplement.
(32:48) So I am of the school of thought is that somewhere to meet that uh 70 gram because the quality of food that we are eating now if you're somebody who's a vegetarian and you're relying solely on pulses and uh you know for that for the for the protein and if again for on the top of that if some people are vegan as well then the paneer is also out of it then it's soya tofu that you can so again all of these are not class one proteins Class one proteins are pure proteins. So that's basically non-veg.
(33:21) Eggs, chicken, fish, all these are class one proteins and whey. All these class two proteins are all the proteins which are which have a mix of carbs in it. >> Then you have to put your mind into it of how you can make it more innovative and you know try to recycle all your sprouts and you know have a mix of them.
(33:39) So but 70 g if you're 70 kgs meat and then it all depends on now if you're an athlete you're in competition that has to be a little bit more then the nutritionist can advise you that you know how much protein you need but I feel that protein is needed because it's not just about building it's also about recovery >> and uh then what happens that if your protein uh goals are met then your tendency to look at carbs or those cravings, you know, that reduces because the satiety that you get by eating protein, the body feels full, okay, and
(34:17) everything is kind of satisfied. And that tendency to reach out to that chocolate chip cookie will probably, you know, >> be lesser to as a source of nutrition, you know, when you're really hungry because protein fills your tummy a little bit and that's how and then having that combination of protein, little bit of fiber and then having that carbs is something that gives you that balance.
(34:40) M >> now why it becomes more important in perry and postmenopause again we start again losing a lot of muscle in that phase uh uh instead of losing muscle a lot of fat deposition starts happening again >> again then there's a tendency there are mood swings again tendency to reach out to carbs as an easy easy source of food or fuel is very easy and that's why optimizing protein even and that in that phase is very very important.
(35:10) So that you your main meals are you know you're saturated with all that you need a nutrition and then fine then occasionally if you could have that sweet tooth or something like that then you can reach out to it without guilt. >> Now coming to the other supplements is what we generally see in uh in the clients that we see that vitamin D and B12 these are two vitamins that are needed for muscularkeeletal health for muscles as well as for the bone health.
(35:39) Now these are two vitamins that I usually ask my clients whether they have tested for it and if they tested for it whether they have supplemented for it. So then having calcium, vitamin D, B12, uh these three supplements is something. B12 again if you are a vegetarian not much source from the foods that you get.
(35:59) That's why supplementation is important. B12 is important because it's like we have the wires running through our house and they have an insulation material. The B12, vitamin B12 is the insulation for the nerves. So the myelin which is the covering of the nerves, the main component of it is B12 and that's when you start getting cramps or you start getting tingling, numbness and all these symptoms and not or even fatigue for that matter >> if you are chronically deficient of vitamin B12. So supplementing with these
(36:30) are the main things that I ask and that's important to supplement. And the third thing I usually recommend is magnesium is uh because most of these women they feel difficulty in falling off to sleep or even uh difficult to relax as well. So magnesium is one of those hormones uh those elements which helps you to do that.
(36:54) So having a magnesium supplement at night before you sleep or even applying magnesium oil to the soles of your feet or to the palms of your hand getting a easy massage done either from your child or your partner if you're if they're obliging you with that you can get that done as well. So that will uh that helps.
(37:13) So majorly I uh I prescribe or I ask them about protein, vitamin D, B12 and magnesium. Uh otherwise the rest of them um calcium supplements. >> Yeah, calcium definitely calcium as well. Calcium and vitamin D is >> so you would definitely recommend a women woman in her 40s to >> be check and then if you're deficient you take supplements right.
(37:37) >> Yeah if your diet is rich in you know in and if your vitamin D is if if your vitamin D levels are good it helps to use the calcium that you have in your body. If your vitamin D levels are low, the calcium, you may have good calcium, but your body doesn't know how to use it. Vitamin D is needed for that. >> Okay, since we're talking about supplements, let's talk about creatin.
(38:01) There's a big buzz about creatin. Everyone talks about uh supplementing with creatin. Uh can you tell us a little bit about it? And uh from whatever knowledge you have about it, is it a good supplement for women uh to take whether they are strength training, not strength training? if I'm not working out, is it something I should take? I've uh some people they confuse creatin with creatinin and they think they say that it affects your kidneys.
(38:26) >> Yes. >> Um so should people should women be consuming it or not? >> So if uh for all the viewers if yall are more interested about knowing more uh I I follow this uh exercise physiologist her name is Dr. Stacy Sims and her uh work is all about uh about everything from the periods like from athletes to permenopause and menopause her she's done extensive work and she has a very nice book which is called as women are not small men like you know and her basic uh motive is to basically tell people is that you know women are
(39:04) cyclical athletes and she works a lot with the athletic population and uh the workouts the diet, the nutrition, the the the psychology, everything has to be cyclical rather than linear because men are a very linear kind of metabolism and athlete if they're training for that matter. M >> now creatine is um uh is a supplement which definitely enhances uh muscle function, brain function for women when they are in their per and postmenopausal because it uh when everything is kind of going down down for them especially the the hormones
(39:43) support that they have the creatin basically helps to optimize uh a little bit of the functions of the brain. For example, now the brain is the organ which requires the highest energy because it's doing a lot of thinking, processing, cognitive functions, etc. Now, when you have a little bit of creatine boost, uh it basically that uh it improves that cycle of using the ATP.
(40:08) ATP is like the currency of energy which is used and that's that's how it kind of optimizes the use of that. Same thing with muscle also. when the muscle is using energy for uh for any kind of an activity again creatine kinds of boost with it. The caveat with having creatin is to basically have good water intake because then it kind of also pulls water from your body when it has to you know get out of your system >> and uh that's that's the catch with it.
(40:38) So usually the only thing that you have to take care while you're taking creatine is to have a good water intake. It's not harmful at all but best done under the guidance of a good nutritionist who can who can help you, guide you and monitor you rather than coming from me as a physiotherapist. >> Do I take it creatin? Yes, I do take because it helps me in the condition that I am of perimemenopause right now.
(41:01) It's helping me a little bit to improve or push my metabolism a little bit. Now creatinine is a byproduct of when of your kidney functions. a waste product that comes out of your kidney when it metabolizes the nutrients of your body. Now that is a limit that is there and this creatine and that creatinine has no relation at all.
(41:24) But definitely hydration is very very important if you're taking creatine but obviously under the advice of a good nutritionist. I mean I I was also reading that your body also produces creative itself right >> it does it does produce it but sometimes when the hormone health is kind of men are blessed with that because they their their hormones don't fluctuate so much so the they have like a steady supply of this obviously they also go through age related changes yeah but having good protein supplementation and creatin will
(41:54) help again it all depends on what your goals are like uh if you I wouldn't say that a sedentary woman should uh you know consume creating but somebody who is planning to get active or in an active uh you know fitness like resistance training or training for high rocks or marathon or a trek or something definitely would help but again under a guidance of a nutritionist.
(42:21) >> Okay. Okay. My next question to you is about rest and recovery. I think uh a lot of times I am one of these people who tend to really push yourself, push yourself, push yourself, keep doing more and more and more thinking that is the best way to go about it and then somewhere your body tells you to slow down.
(42:42) Um tell me how how important is rest and recovery especially for women uh over 40s who are uh doing strength training yoga and if they're not then they're resting enough but if you're working out and exercising how important is it for you to rest and recover? So according to my clinical experience and also according to recent research uh rest and recovery is most neglected form of actually uh a part of the entire puzzle that makes a woman or a man for that matter because I think traditionally we've always been pushed to do more and more and you know and
(43:18) because of being the multitasker I think we also put a lot of pressure on ourselves that you know okay we can take care of children we take care of home and our work and also work out and then one day comes where your body says you know sorry I can't give up >> so to avoid this I just say that especially after 40 see up to your 20s 30s your body is still building okay and then building and breaking down is happening simultaneously and the breakdown kind of accelerates once in your 30s and 40s so the building back
(43:51) takes a little bit of time so I just feel that giving Rest and recovery its due importance is very very important whether you're a man or a woman in 40s because the body does take time to recover especially if you're somebody who's very physically active and you know does puts in at least four to five um moderately you know heavy workouts in a day uh in the week for that matter.
(44:16) >> So best way to understand whether you're recovering is your heart rate. So your resting heart rate in the morning should be whatever it is like if it is around 65 then it should be if it is plus or plus 10 that means that you have not recovered completely. So it would be a good time to not do something heavy on that day and do something light.
(44:38) That is one way of understanding whether you're recovered or not. Obviously, if you're somebody who has like a smartwatch and a gadget and you're tracking your sleep, it also gives you a lot of data. >> Whether you work on that data is a big question mark all that matters. You would tend to ignore the reminders.
(44:54) It tells you that you know you need so many hours of recovery. But we tend to ignore that. Uh also I there are also different ways of recovery. Taking some massages is also a very great way of recovery or you can also understand which muscles are getting sore and tight. having cold showers or you know uh something like that that also helps you.
(45:16) Uh need not be like an ice bath. Ice bath doesn't work especially for women. Uh you can take even normal cold water showers that also helps and obviously working on your sleep is something that will help you recover and active forms of recovery like sometimes going for a swim or doing easy workouts, easy cycling.
(45:37) This also helps as an active form of recovery. But give that time. You don't need to go hard all the time. >> Uh if there is uh if something that we use especially as physios or as sports scientists is something is called as an RP scale that is rate of perceived exertion. >> So it's like a scale of a gradient from yellow to bright red to understand how exerted are you.
(46:00) So all your workouts shouldn't be like 8 9 on 10 like you know there should be some workouts which are easy on you. So having a balance of those workouts the scale is easily available if you Google it you'll understand that okay you know all workouts need not be hard there have to be some moderate intensity some low intensity so that will keep you motivated to do exercise and these breakdowns that happen because your because your immunity goes then if [clears throat] you're if you're really pushing yourself too hard >> the immunity gets conf compromised and
(46:29) then you are likely to get the local infections that are running around and then that that puts you off for for a week again getting back to your workout if you know if you're resting from a viral or recovering it takes time for your body to get back again plays in your mind and again you go in that guilt then the mind and the body you know they kind of fight with each other there you know so just to avoid all that confusion uh I feel ideally three to four times a week of workout one day of complete rest is something that I recommend
(46:59) >> okay cool so I have a bunch of questions that I want to ask you part of a rapid Okay, >> your answers just have to be quick and to the point. Can be one word or one sentence. Okay, >> so um let's start with what is one early sign of muscle loss that women often miss? >> Having bat wings, [laughter] sagging muscles where maybe you know you start sagging in places where you feel that you were toned.
(47:29) >> Yeah. >> Yeah. I've seen a lot of like whenever you do these arm extensions, I've seen a lot of women have these >> sagging uh Okay. >> Uh one everyday activity that secretly strengthens your body. >> Squats. >> One joint that women neglect the most? >> Upper body, shoulder. >> Uh what would you choose for women over 40? Strength training or cardio? >> Strength training.
(47:53) >> Uh one unexpected cause of knee pain in women over 40. Uh urine infection >> cause of knee pain. >> Yeah. >> Yeah. Okay. What is your go-to choice for knee discomfort? Heat or ice? >> If it's acute and it's an injury related, it's ice. If it's more stiffness or, you know, related, then it's heat. >> Okay.
(48:17) What is the most underrated mobility drill for women around 40? >> Underrated mobility drill sit cross-legg sit vajrasan. Do butterflies. Hip mobility. a lot of hip mobility you should do. >> Okay. Uh what is the biggest misconception about osteoporosis? >> That it can't be reversed. >> Okay. One physiootherapy technique more women should try >> at least coming and getting an AMC done from a physiotherapist.
(48:46) You did not have an injury or pain. You you need not come to a physiotherapist for pain. You can just come to check your muscular skeletal health to understand where you're weak, where you're strong, where your joints are stiff. They can that can help give you a lot of insight of which exercise program would suit you best and you know what how you should approach your fitness rather than jumping into something and getting injured.
(49:08) >> Okay. What is one red flag that your bone health is declining? One red flag is uh I think I did mention this while you were speaking but uh difficulty in uh um difficulty in doing the normal activities and also uh some people also experience like a a dull pain especially at night when they are sleeping like they feel this bone kind of a pain that they have.
(49:37) So >> is walking enough to maintain your muscle mass? >> No. [laughter] If someone has only 10 minutes to move, what would you recommend they do? >> Uh 10 minutes is a good time. If you have 7 minutes, you can make a circuit out of it of uh doing squats, push-ups, burpees, jumping jacks, and do it for 1 minute on, 1 minute off.
(50:00) Your workout is done. >> What is one posture correction almost everyone gets wrong? >> One posture correction. Okay, that's a lot of things. This is a tough one. >> It's a tough one. But uh uh a lot of people I think uh they don't understand how to engage your core and uh you know work on how to keep the lumbar region you know engaged not too arched or not too flat >> uh but just how to understand to engage their core.
(50:33) And this I am talking about even athletes or bodybuilders or you know powerlifters also even they don't understand actually how the core helps to stabilize the spine. So sometimes I just feel that having that knowledge >> about how to activate the core for daily people is very important. >> Okay. What is one food that women over 40 should eat more often for strength? >> Protein. Protein and more protein.
(51:00) one supplement that you think will benefit most women. >> Magnesium is helping me a lot especially when it comes to you know relaxing and you know if you don't want to have a supplement just and if you are not in the diabetic thing you can always have dark chocolate. >> Okay. What is one supplement that is overhyped for women? >> Okay.
(51:25) I'm not somebody who is in this uh um beauty thing but I think this uh glutathione and collagen I think >> for skin and anti-aging and all of that. >> Yeah. So I'm not sure about how much that helps uh >> or even collagen for bone health because it um not sure about how much is getting absorbed. The research is kind of kind of ambiguous >> whether taking oral collagen is you know going to help with joint health.
(51:54) Yeah, it does help with maybe fing nails and hair or whatever >> but not sure about. >> I've seen a lot of influ in influencers who talk about taking it for bone health. >> Yeah, but the results scientific results are ambiguous about how much is actually helping with the the bone health. >> Okay. What is your favorite quick fix for a stiff back? >> Bjangasana.
(52:20) >> One simple test that you love for assessing someone's fitness, >> whether they can get up from the floor. >> What is a message that you want every 40 plus woman to hear in one sentence? >> Uh 40s is like the new 30s. [laughter] >> It's so true. >> So, it's the best time of your life. I think uh you're um uh I think professionally you're doing reasonably well.
(52:49) Your children are probably in in school and they are away for quite some time but uh invest in some time for your fitness and at least an hour for your fitness and nutrition is something that >> I also think that the childbearing age has also gone up. >> It has gone yes it has gone up. we are having more later pregnancies and you know >> I'm one of those examples.
(53:12) >> Yes. Yeah. >> And I have a lot of friends who have had kids first kids in 39 38 39 40 41. >> Yes. Yeah. >> Um >> yeah. So that that gives you all the more reason to strength train [laughter] >> because you have to pick up that 15 20 kg of that child at least till they are 5 years old.
(53:32) You know they want you to be picked up. So all the more reason to take up that barbell and lift. >> Okay, I'm done with my quick fire, but I have one last question for you. Uh from a physiotherapist perspective, what does aging well truly mean for you? Uh so uh it's a good question also a lot of things to share but from a physio's perspective uh I feel that aging well means that you have your mobility uh your ability to move for whatever functional activities that require in your life whether it is uh sitting cross-legged whether it is squatting
(54:13) whether it is running trekking doing whatever it is you should be able to do it till you are ripe ages and uh uh don't stop uh you know strength training don't consider that you know strength training is only for the young strengthening can happen even in 70s or 80s there are lots of evidence-based studies which are showing which people who are able to reach their fitness goals and this is I feel um lot of Indian mentality also in this uh which affects uh the thinking about you know whether to go to a gym or not why
(54:53) at this age you know I don't think that should be a restriction you see people in the west like when I've gone for my international marathons you know there are people who are in their 70s and 80s who are running their marathons you know why do we restrict our senior citizens and that's also to do a lot with us who are their caregivers who restrict them from doing oh if you go you'll fall or you don't do this or you don't do that you know we do it out of care but somewhere I feel that we are restricting them so I feel that strength training
(55:25) should continue your mobility should continue and enjoy and live life to your fullest potential that's how you age yeah thank you thank you so much for joining us today and I hope our audience has found this conversation super insightful >> and uh if they want to connect with you how can they reach you what's your Instagram handle.
(55:47) >> Thank you so much again for having me. I hope that I have answered a lot of questions and if anyone wants to ask any questions, you can always ask in the comments that come and uh Rashmi can uh uh direct them to me and uh I'm uh based out in Tane. I uh the handle that we have for the clinic is just uh at the rate physioynesis and for the performance lab at PQ performance and uh you can just put them down in the comments and people can follow those for more information and also our website is has pretty lot of information that we
(56:25) have. We also do online consultations if required. If yall are remote, not here in Tani, but if you're in in Tani, then I think you should come first [laughter] to to my center. >> I will. >> Yeah. And then uh yeah, the rest will follow. Yes. Yeah. But really happy to be here. Uh happy to share this knowledge and looking forward.
(56:47) >> Thank you so much for joining us. It's been a pleasure having you on the podcast. [music] Hey, hey, hey.