Bone Health Beyond Calcium: How to Build Stronger Bones for Life
In this episode, Haylie Pomroy is joined by Margie Bissinger, physical therapist, integrative health coach, and author, to explore what it really takes to build and protect strong bones at every stage of life.
Margie explains why peak bone density is built before age 30, how nutrition, gut health, and hormones all play a role in bone loss, and why stress and cortisol are often an overlooked but foundational piece of any bone health plan.
Together, they discuss which types of exercise actually move the needle for bone density, why posture and balance training are just as important as strength work, and specific movements to avoid if you already have osteoporosis or osteopenia.
Discover why bone health starts decades before osteoporosis is ever diagnosed, and how nutrition, movement, and mindset work together to build bones that support you for life, here on Fast Metabolism Matters.
If your body feels like it's running on empty, overburdened, or just not responding the way it used to, Haylie's latest book, Toxic Overload, tells you exactly what to do. Download your free digital copy today and start understanding what your body is trying to tell you.
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Margie Bissinger is a physical therapist, integrative health coach, and author who specializes in bone health and happiness. She hosts the Happy Bones, Happy Life™ podcast, is BoneFit certified, and has spent decades helping people build stronger bones through nutrition, targeted exercise, and stress reduction. She offers a free posture and bone health exercise guide, Two Weeks to Better Posture, through her website.
Website: https://margiebissinger.com/
LinkedIn: https://www.linkedin.com/in/margiebissinger/
YouTube: https://www.youtube.com/@margiebissinger6980
Learn more about Happy Bones, Happy Life: https://www.happyboneshappylife.com/
Haylie Pomroy, Founder and CEO of The Haylie Pomroy Group, is a leading health strategist specializing in metabolism, weight loss, and integrative wellness. With over 25 years of experience, she has worked with top medical institutions and high-profile clients, developing targeted programs and supplements rooted in the "Food is Medicine" philosophy. Inspired by her own autoimmune journey, she combines expertise in nutrition, biochemistry, and patient advocacy to help others reclaim their health. She is a New York Times bestselling author of The Fast Metabolism Diet.
Learn more about Haylie Pomroy's approach to wellness through her website: https://hayliepomroy.com
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Edited Transcript:
Haylie Pomroy: Today I am very fortunate. We are very fortunate that we're joined by Margie Bissinger. You guys, Margie is a physical therapist. She's an integrative health coach. She's also an author. She has got a great podcast called Happy Bones, Happy Life, and she is a happiness trainer.
Margie, thank you so much for being here with us today.
Margie Bissinger: Oh, thank you so much for inviting me. I'm so glad to be here.
Haylie Pomroy: I think this is a topic that a lot of us think about, maybe that we get to not worry about until later in our lives. I mean, in our community, we talk a lot about osteopenia, osteoporosis, and bone health, but it really hit me to study kind of more of the metabolism of the bone when I fractured my foot two years ago. And I thought, okay, how can I hyperfeed and hypernourish the bone for healing? And I started looking, and I started researching, and a good friend of mine kind of connected me to some of your work. And so I'm so happy that you get to be on here.
Everybody says, “What did you do?” What did I do? I had my foot taped and did a 14-miler in Yosemite. That's what I did. But I worked really hard on healing that. Margie, I want to ask you a couple of things. First and foremost, how important is nutrition in bone health? We know that it's kind of the building block and the structure, and there are hormones associated, but how important is nutrition today if we're thinking about bone health in our future?
Margie Bissinger: No, it's really important at every age. And you made such a good point, because a lot of people think, oh, this is an older person's thing. I don't have to worry about this until I'm older. And it's just the opposite. We develop 85% to 90% of our bone by the age of 18 in women and 20 in men. And our peak bone is before 30.
At every stage, it matters. And nutrition is the building block of our bones. If people don't, and that's one of the root causes, people aren't getting—people who've been on diets or had anorexia or eating disorders, it's such a high risk because all along they haven't been getting the nutrients that they need for feeding their bones. It's absolutely essential at every age, not just, okay, now you have osteoporosis, now you have to worry about getting the building blocks of bone. It really starts when you're born, at every stage.
Haylie Pomroy: I love that you said that, because we talk about pediatric nutrition, and in our nutrition programs, I always say it's something that you're going to be proud to feed your kindergartner before you send them off to school. But I didn't even think about that. I know that from back in anatomy and physiology class now, but I'm glad that you brought that to the forefront.
Men and women build peak bone around their 30s, right? But really, we create kind of the scaffolding, is that right? Or the structure of our bones.
Margie Bissinger: Women at 20, and men. It's so much what we're doing in those years.
Haylie Pomroy: If individuals weren't maybe on a healthy diet when they were kids, like for me, it's too late to go back and redo that. Does it mean that we need to double down now at this point in our life preventatively, before we get osteopenic or osteoporotic?
Margie Bissinger: It's never too early, and it's never too late. Whenever we can, to nourish our bones, and overdoing it and getting more of something, like a lot of people think calcium, and yes, calcium is important, but more is not better. It's not as though we're going to say, okay, let's go crazy now because we didn't get that when we were younger.
No, a healthy diet, one, for example, like your diet, is very bone-healthy with all the good vegetables and all the nutrients involved. I think when you're eating that way, that's going to be very healthy for our bones, but nutrition is so important. And the other thing is, a lot of people say, oh, I'm eating well, I'm taking supplements, I'm doing all those things, but they have major digestive issues. It's not just eating; it's also being able to absorb and digest.
Haylie Pomroy: It's not just what you eat; it's what you absorb and what you can metabolize. Yeah, for sure. Do you guys focus a lot on gut health to make a positive impact on bone health?
Margie Bissinger: Absolutely. And that's, I think a lot of times when people are diagnosed, even with osteopenia or osteoporosis, a lot of times the doctors will just say, okay, go on calcium, vitamin D, and exercise, and sometimes medications, and they don't really go into more depth. And the key is if you have a diet, and to me, the gut is really one of the first places to start, because if there's an issue there and you're not absorbing your nutrients, or you're having some type of inflammation, that's going to show in bone breakdown. It's absolutely essential.
And they've done studies on that too. The composition of the biome is going to affect your bones. Yes, that's a huge part of just a healthy bones program. And I think that's one of the places to start when people ask, where should I start? Start at your gut, because it affects so many other pieces of the puzzle.
Haylie Pomroy: And I love that. That's where we focus on biodiversity of foods to excite the gut biome. We focus on the fiber, we focus on pre- and probiotics, making sure that we're causing that scratch factor and that vitality there.
Well, you said something about how, when a person gets diagnosed with osteopenia or osteoporosis, they maybe say, okay, let's supplement with calcium and vitamin D and do some exercise, but they're not getting to the root cause of why we're losing bone density. And so I want to ask you about, and my team always laughs at me for this, I would say, my grandma always said, “If you don't feed yourself, you'll take it from your bones.” Our bones are a reservoir for mineral reserves. There aren't many in our body. But why do some people become osteoporotic or osteopenic and other people don't?
Margie Bissinger: There are many, many, many different reasons. And basically, throughout life we gain our peak bone at 30. And then with women, menopause is a huge time when we lose bone. We can lose a significant amount of bone in perimenopause, right before, during menopause, and after. And a lot of that has to do with hormones, and estrogen has a protective effect on our bones. I am a big believer in working with some—at that age they used to, there was a period of time where people were really against bioidentical hormones, but now it's really changed, and it really is safe, and you can totally protect your bone. It's something that you may want to work with your doctor on. Hormones are one big reason that many women will all of a sudden start losing bone.
And again, it depends where you start. It's sort of like a bank account where you build bone when you're younger, build bone, and then you do lose some.
It depends where you're at also in terms of how much you lose. But hormones are one reason.
Haylie Pomroy: In that hormones piece, I know we talked about estrogen, but what about stress hormones?
Margie Bissinger: Yes, cortisol. And that's such a big point, that a lot of people come to me and they're like, oh my gosh, tell me exactly what exercise I should do, exactly what I should eat, but they are stressed out, and they don't realize the stress itself has a negative effect on our bones.
What they found is that cortisol, the stress hormone, actually reduces the osteoclasts, which are the, but actually increases, I'm sorry, the osteoclasts, which are the cells that break down bone, and reduces the activity of the osteoblasts, the cells that build bone. And there are studies on that, and they've shown that there's reduced bone density. There's a correlation between cortisol and bone density. People who have more social stress have lower bone density, and people who aren't happy with their life, happiness as well, have increased reduction in bone density. It all goes together. And this cortisol piece, to me, is foundational.
Like, there's just not one program that I teach that I don't incorporate stress reduction and happiness into, because I've seen over my career, even as a physical therapist, that once people start adopting this and adding that to their program, everything changes. But as you said, the cortisol is very important, and we can't ignore that. We really need to deal with that in terms of bone health. And the other thing is, when you do, your life just becomes so much more magical. And well, it's just a much better way to live when you can go with the flow instead of having a wave come and toss you over.
Haylie Pomroy: Exactly. Is that correlation, that kind of science correlation, what inspired you to also be a happiness coach? Because I think sometimes we think we can just muscle through our emotions and that it doesn't have a physical impact on our body. And I said, well, it's your physical body that's unhappy, though, or it's your physical body that's stressed. It's not some ethereal thing that's happening outside of our bodies. It's happening.
And we see it, the manifestation, in our hair and our skin, dark circles under our eyes or whatever. But was that how you made that correlation? Because I, personally, absolutely love that you incorporate that into the therapy aspect of it, but what made you correlate that?
Margie Bissinger: It's really interesting. I actually was teaching happiness before I even got into osteoporosis. Real early, in my early twenties, I was working as a physical therapist, and I had just gone through a bad situation in my life, not a good situation. And I was working in Chicago as a physical therapist with chronic pain patients. I was seeing people with TMJ, back pain, and neck pain, and they were all absolutely miserable and angry and not happy.
They would say to me, “Marjorie, you're so happy. What's your secret?” And I thought, if they only knew what I'd gone through, they would never say that. And then it hit me that, you know what, despite my circumstances, I actually was happy. And that happiness was something deep inside, an inside job. And it wasn't dependent on my circumstances. And I thought, well, what did I do? What did I do to help me get through this so that I actually could still be happy? I started teaching that to my patients who were miserable. I figured, what the heck? And miracles started happening. Neck pain and back pain got better so much faster than with traditional physical therapy. And I started seeing people just getting that joy back in their lives. And it was so miraculous that I, and now this is over 40 years ago. This is awesome. And so ever since then, I've just made that happiness piece part of the work I do. Then I had training. Then I actually studied positive psychology. I worked with Marci Shimoff, an amazing happiness coach, to actually learn how to teach happiness. And so I've been doing that for a very long, I mean, I have a whole program on it. And to me, it's so life-changing, not just that you feel happier, but health improves. It's really amazing.
Haylie Pomroy: We always try to come up with these little tidbits. I call it, like, “thin it in a minute.” Like, chew your food while you sing “Happy Birthday” to me.
You masticate; you get all your micronutrients out of your food.
Are there some little mindful, minute-long things that we can, that our community can kind of learn about today?
Hi, it's Haylie Pomroy, your host. I've written six New York Times bestselling books on metabolic pathways. And my latest book, Toxic Overload, tells you exactly what to do when your body's overburdened. If you go to hayliepomroy.com/book, for a limited time, you can download a digital copy of this book completely free. That's hayliepomroy.com/book. Grab your free copy while supplies last. Now, back to our show.
Margie Bissinger: I think one of the key things is that what we focus on grows, and so we wake up in the morning and we start focusing on what's not working and my to-do list. And so I think what happens is when you wake up in the morning, you want to really focus, I mean, they've done several studies, but I think mindset's so important. You want to sort of ask yourself some questions, like what's the best thing that could happen today? Or what good is here that I could not possibly see? And just try to be a detective for the good. Because oftentimes there's so much good in our lives, and we don't focus on that. We're all wired for negativity. We're wired to—because to live, we had to be more concerned if there was a tiger lurking in the past than if someone gave us a compliment.
Start looking for the good, but we can rewire that. And then when something good happens, and they've done research on this, you want to savor it for at least 20 seconds. If something good happens, if someone says, “This is such a great show,” and you say, ah, I really worked hard on it, you want to savor it. Or you see a sunset, like, take it in, absorb it, just feel it. Be a detective for the good. When something good happens, take it in. And not that we're going to push out the bad. There are many techniques. You can't just throw it in the closet when you get the negative thoughts, but you can also counteract them. I got this negative thought, instead of absorbing it and letting it totally take you over. I mean, I like to question it. There's a whole type of routine we can do, but the other thing you can do is counteract it with three true but positive things, like, okay, yes, that, but you know what? I'm eating well. I'm doing whatever it is. That's awesome.
Haylie Pomroy: Those are great tips. And in our community, I always say, I'm on a joy hunt. I'm on a joy hunt. I love being a detective for that, but I'm going to stick with savoring it, because so many times I'm a problem solver in my mind, and I do that every day in my career. And I do that. I'm the head of problem-solving for my household. For some reason, I'm hardwired to seek out the problem. I've been a health detective or whatever you want to call me, and I'm so fortunate to have beautiful things in my life, but the word savor just really resonated. I'm going to really try to practice today. I'm going to get really good at it, but I'm going to try to savor that because I love it, and I feel it deeply, but I move on probably too fast to the next problem, the next dragon to slay, for lack of a better way to put it. That's good. All you guys, listen, let's go on a, let's savor. I love that.
Margie Bissinger: Savor it. Celebrate. Like, you do something good, you could just.
Haylie Pomroy: People have told me, I don't know if it's imposter syndrome. I don't know what it is. I have a hard time celebrating personal success. Like when FMD launched, and it couldn't have gone better than number one on the New York Times bestseller list. When I was in my hotel room under the covers, they were partying. I didn't show up to it. It sounds terrible. My community, we get lots of great free therapy in our community.
So, celebrating, I'm a big celebrator of success for the kids' achievements, my girlfriend's achievements, and my community's achievements. I probably need to get better at that. And so I'm going to call our community out on that, and let's all try to be accountability partners to each other about celebrating our successes. I've had a massive health victory. That's how I got into this industry, but it's the everyday things that sometimes I needed that. Thank you for coming on to my podcast.
No, I know that I'm not the only one; I know that it's always in my community as well. Very meaningful for me. I thank you. I want to give our community another gem. And I know that you have a handout that you can give them, which is so generous, but walk me through what exercise looks like for bone health. Is it just heavy weights? Is it tons of cardio? Is it cycling, spinning? Like, what does that look like for bone health?
Margie Bissinger: I'm so glad you asked that question, because people really don't know. Oftentimes the doctor will say, do weight-bearing and resistance exercise. A lot of people are doing 20-mile walks. Not that that's a bad thing for your cardio, but what really has been shown to move the needle on bone health? And there are two things.
Number one is impact. Jumping, so adding jumping, even as kids when you're doing hopscotch, when you're, there are all sorts of jumping things.
Haylie Pomroy: Would the trampoline, would that work, like—
Margie Bissinger: The trampoline isn't as much force as jumping. There was one study done by Posh where they had women doing 45 minutes of a whole program on the trampoline, and it did show some improvement in bone density. It's certainly not a bad thing to do, but it's really that ground force, because the bones respond to the force placed upon them.
Depending on where you're at, if you have severe osteoporosis, I would definitely talk to your physical therapist or your doctor. You don't just start doing massive jumping. You can progress, do things like going up on your toes and your heels; you gradually do things. But for younger people listening, they've done studies on this. I mean, they had a study where they had people hop on one foot, and then the control group was the other foot. And the hip that they hopped on increased in bone density over the other hip. It really matters.
Haylie Pomroy: We're going to do a skipping challenge. We'll be happy, and we'll have impact.
Margie Bissinger: Jumping, doing some jumps that are comfortable and in good form. I mean, so the two things, though, that have really been shown are the impact and the resistance and strength training. It's not easy. It's not like, oh, I'll just do two pounds, because as I said, the bones respond to the force placed upon them. There was a study done. It was called the LIFTMOR study, and they did it in Australia, and they took people who had osteoporosis, and they had them do serious weight training, but supervised, which is important, under a physical therapist or exercise physiologist who was trained. And they were doing overhead presses and deadlifts with serious weight. They gained significant improvement in bone density, and the geometry of the hip actually changed, and there was a significant reduction in falls. Now there's a program in Australia, and they're starting to pop up in this country. It's called Onero. I actually have been doing it myself, and it's amazing. Women in their 60s and 70s are lifting. 60, 70, I mean, are doing, like, deadlifts, 60, 70 pounds. It's amazing. I mean, I can't know what's happened to me from this, but regardless, the point is you want to start somewhere. It's resistance exercise twice a week. And if not three times a week, I mean, three times a week is great, but at the minimum, they've shown that if you do it twice a week, and it doesn't have to be long, it just has to be that you're gradually improving.
In terms of repetitions, now in this study, you start out with more, and you go to fewer, but in this study, they did five sets of five repetitions with these intense weights, and you gradually had to learn how to stabilize. You have to learn the right form. I recommend people work with either a physical therapist or someone who really understands strength and conditioning.
Haylie Pomroy: Yeah. I want to bring up that point, because one of the things, like you said, you walk out of your doctor's office, you maybe even get given a prescription for bone density, and they tell you to go exercise, but they're not scripting for physical therapy. And many people's insurance covers physical therapy. And so I always encourage our community, like, anytime you have a medical diagnosis of anything, especially anything structural, ask for a physical therapy prescription. Because if you are having lower back pain, if you are having GI distress, if you're having bloating after eating, if you're having neck pain, if you're having, for sure, any osteoporosis or osteopenia, a physical therapist can guide you through staying—so I was in a massive car accident, and I was in physical therapy for three and a half years, with several surgeries and things. My physical therapist is why I don't have pain. I mean, I could have healed; I would have healed, but I would have healed structurally incorrectly, and it would have caused lifelong pain and inflammation or disharmony in my gait or whatever, or I could have ruined my shoes. I mean, there are so many things that can trickle down from that, but I love that you brought that up. If you get a diagnosis, if they are thinking that you are starting to lose bone density, get into physical therapy. Don't just run out and exercise, and ask for it; you guys, fill out your requests for care, ask for it. I think that's a really important thing to drive home.
Margie Bissinger: There are a couple of things. I couldn't agree with you more, because a lot of people are like, oh, that worked for my friend, or they'll just enroll in some, and that's how I actually started in osteoporosis. I was seeing people, and they were all doing exercises that increased their risk of fractures. We can go over that, but the point is, yes, see a physical therapist. In the United States, it's covered. Most, almost all insurance covers it. They can make sure your form is right. And sometimes people just think they have to live with—I've had this shoulder for 20 years. You don't. There's help for these things. And people just don't realize that it's important. A lot of times the doctor won't say that. They'll just say, “Go out and exercise.”
Haylie Pomroy: But you're the captain of your team, you guys. You have to decide, and always, that's why we do these health wish lists, dream big for your health, and it's never too late. I love what you just said. It's never too late to start physical therapy, even if it's a 10- or 20-year-old injury, because you can recondition. Remember, you guys, you're regenerating all your tissue all the time anyway. You might as well start regenerating in a healthy way, for sure.
Margie Bissinger: I want to give one more tip on the exercise. You want—but here's the thing: not every physical therapist is trained in osteoporosis. You can go to the Bone Health and Osteoporosis Foundation or Google; it's called BoneFit. There's a whole program out of Canada, and anyone who's gone through the BoneFit training—which I'm BoneFit certified—they have a really good understanding. You can find a practitioner in BoneFit. You can just Google BoneFit practitioners or go to the American Bone Health and Osteoporosis Foundation, and you can find a BoneFit trainer.
Or the other thing you can do is you can go to choosept.com, and the two specialties where you're most likely to find one are geriatrics or women's health. You just write that in, but otherwise, see who your insurance covers, get the list, and then call and say, do you have someone at your facility who has expertise or who works with osteoporosis? Because you don't want to go to a physical therapist who does sports medicine. It's a little different when you're dealing with bones, and there are certain things you want to avoid. I think it's really important to get a therapist who has expertise, and there are plenty of people that do.
Haylie Pomroy: Where would people go to get your handout on exercise?
Margie Bissinger: Oh, okay. Can I give that to you for the show notes? I mean, otherwise they could go, but this exact one that I want to give them is, I'll give you—I'm trying to think if I have it easy, tinyurl.com.
Haylie Pomroy: That's okay. I'll put it in the show notes. I'll get it to you guys.
I just want to make sure—
Margie Bissinger: If it's not this, I'm pretty sure it's tinyurl.com slash osteoporosis exercises. Pretty sure. I'm almost positive. That's it.
Haylie Pomroy: Okay, we'll make sure, and we'll get it out to everybody.
Margie Bissinger: I'll give you the link as soon as we finish.
Haylie Pomroy: I need tips on how people can get started, and then I need tips for our community on how people can stay motivated to continue.
Margie Bissinger: Well, in terms of getting started, there are a couple of things, though, that go into, I didn't really finish. I just want to finish. So twice a week resistance, and whatever it is, if you've never exercised, just using your body weight is going to be enough. It's for each person. It's not as though, oh, you must lift 10 pounds. It's not that; each person starts where they're at.
If you've never done exercise, lifting your leg is going to be more than your body's accustomed to. For example, when I bend my elbow, and I'm doing that against resistance, and it can be a weight, it could be resistance bands. It could be machines at the health club, whatever it is. But when the muscle's contracting, it's pulling on the bone and saying, hey, we need more bone here. That's going to depend on wherever you're at. I've seen people who are, like, using two pounds for years, but initially it might be enough to cause, but after a while your body gets used to it.
Haylie Pomroy: You need to make progress.
Margie Bissinger: Yeah. The thing is, they found anywhere between, I mean, as I said, this Onero program, this program that's really been so effective, is five sets of five repetitions. It's a heavy weight that you're tired. You can't really do more than seven, but most people start anywhere between, like, 8 and 10, even 8 and 12 repetitions. It's not doing 50 repetitions. Doing sets where you're somewhat tired after doing—
Haylie Pomroy: I want to person my name towards the end.
Margie Bissinger: But you gradually get to that. You could even start with 15 repetitions. You gradually get to that. The resistance you want to do, you want to do the weight-bearing. And for some people, it may just be, for those who can, adding the jumping and adding the higher impact is great. But if not, even, like, going up on your toes and down on your heels, there are things you can do, but walking still is a weight-bearing exercise, dancing, you have to have fun. So you want weight-bearing; you want resistance. I'm very big into posture exercises because you cannot exercise appropriately if you don't—first of all, you have to force strength, but if you're in a slouched, rounded posture and you try to lift your arm, you're going to cause impingement.
Haylie Pomroy: Give me some examples of posture exercises.
Margie Bissinger: And that's in the sheet. I go through it.
Haylie Pomroy: Are there things like, would Pilates be considered a posture exercise, or yoga?
Margie Bissinger: Yes. In the sheet, I did a program, Two Weeks to Better Posture, where I showed an exercise where you're bringing your shoulders back and down, your chin in, backbend things, and how to sit, how to visualize lengthening. It's all on that sheet that you can get. I have all the videos of me doing all those exercises, even for text neck. Children now, when they're on their phones and texting, the curve in their neck has changed.
Haylie Pomroy: You're making me, I'm sorry. I don't know if you guys are noticing. I'm like, yes, I know exactly what you're talking about.
Margie Bissinger: Posture has to be natural. It shouldn't be tight. It should just be comfortable and natural. I think posture is one of the first places to start. And so there are really easy exercises on that sheet.
The other thing—a lot of people are like, well, I have all these problems. I can't do strength training, but everybody, everybody can do balance, and balance—people fall. The reason people, the key thing, it's not that we want our bones so strong. We want our bones strong so we don't fracture. Fractures are the problem. That's what we really want to prevent in life.
But a big thing is falls. And a big reason people fall is because they don't have good balance as they age. If we don't use it, we lose it. One of the best, best, best things you can do is Tai Chi or Qigong. I show, I think seven, I show all these different balance exercises. I show two Tai Chi ones in the sheet as well, but even standing on one leg, there are things we can do so that your balance can stay good throughout life. You can get better, but a lot of people just don't even think about it. Balance is important. The strength training twice a week, posture exercises, I say daily. I love cardiovascular just because we want to enjoy our life. We want to keep our heart and lungs well. And it just lets us continue to be active. I believe in cardiovascular, and let's see, did I miss anything? I think those are the main things, twice a week. The trick is that you just start somewhere. It's sort of like a car sitting in the driveway. It's not going anywhere. If you just do something, even if you just put your sneakers on, step one, every day.
Haylie Pomroy: Is it more important that you do frequency or long durations during a day? Like, is it more important that I can dedicate an hour, hour and a half, or is it more important that I do 20 minutes, five times a week?
Margie Bissinger: No, no. And as I said, for the strength training, the things that really moved the needle were the strength training and impact. In this Onero program that people did so well on from Australia, that program was 30 minutes twice a week. That was it.
Haylie Pomroy: Wow. That's great.
Margie Bissinger: It's not the extent. I mean, they have found, though, that there's a correlation. People who are more active have increased bone density.
Haylie Pomroy: Well, they also have fewer stress hormones. I mean, it reduces stress too.
Margie Bissinger: People, start with something, and I'm a big believer in you just go step by step, and you have to schedule it in and make it non-negotiable, because it's that important and your life will change dramatically. That's the thing. I see all these people who are the biggest couch potatoes, and the doctor said you have to exercise. And especially when I was working one-on-one for years as a physical therapist. And I mean, right now I work with larger communities and group programs, but when I was seeing people who really never exercised, once they incorporated it, oh my gosh, they became lifelong exercisers because they're carrying their groceries, they can put their luggage up, they can do so much. It's empowering. There's nothing more empowering than being strong and capable. And that's possible at any age. I see this.
I have 85-year-olds helping me move chairs. I mean, it's amazing. Make it a non-negotiable. Even twice a week, do what works in your life. Now, if you're so busy, then do some exercises in between things. You can learn, you can do certain exercises in between.
Haylie Pomroy: Yeah. Get up and jump rope between your Zoom meetings. Make them 50 minutes instead of an hour long back to back, and do something. Move your body.
Margie Bissinger: If you're at work, bring a resistance band and do certain things. There are all sorts of ways that you can do it. As I said, posture is so important. And the one thing, for anybody that does have osteoporosis, you want to avoid the rounding, forward bending, like touching your toes. I love Pilates and yoga; they're fantastic, but you do need to make some modifications if you have osteoporosis. You don't want to do any of those rounding poses because, they have shown, it puts more force on the front of the vertebrae and the spine, where fractures occur.
Haylie Pomroy: Interesting. You mentioned, that leads me right to what you mentioned. I've made myself a note. There are certain exercises that you feel are conducive to injury.
Margie Bissinger: Yes. The ones that you—let's see if I have my spine here.
Haylie Pomroy: See if I have my spine, I'm sitting up taller.
Margie Bissinger: Yeah. No, I have this right on my desk. Okay. For the people who are watching, I know some people just listen, but anyway, so if we look at this spine here, this is the front, and this is the back, where you feel the bumps on your back. Ideally, like the top right here, this is nice and square, and inside it's thick; it doesn't have holes. But if we look at this, like with osteoporosis, and this is one that has osteoporosis, you see there are bigger holes in the bone, so it's not as compact.
Haylie Pomroy: Like porous.
Margie Bissinger: It's porous. Exactly. Osteoporosis. Porous bones. But now we see that it's wedge-shaped, and that's where the fractures occur, the front of the spine, not back here. If you took the spine and bent it forward, you can imagine that we're going to put more force on an area already weakened. So what you want to do, instead of bending from the waist, you do squats; you bend from the hips and knees, and you maintain—we all have a nice inward curve in our low back. You maintain that. It's just some modifications necessary for Pilates and for yoga and all those rounding positions.
And that was the sad thing. I used to see people who the doctor said to exercise, and they're touching their toes, and you'll go to senior classes and you'll see that. And I oversee all the osteoporosis initiatives. I'm part of a group in New Jersey, and years ago we sent out a flyer to all the exercise instructors that we had information for, explaining, because we were seeing too many injuries: do not do this with your patients with osteoporosis. Those are the main things.
And then also you don't want, if you have osteoporosis, and I also say osteopenia as well, you don't want to do extremes of motion. You don't want to do, like, the absolute extreme of rotation and side bending, or side bending and rotation, especially with weights. Especially if you're at, like, a yoga class and the teacher's going to do overpressure, you don't want that.
Haylie Pomroy: That makes sense. That makes sense.
Margie Bissinger: Those are the most, those are the most important things.
Now look, if you bend down one time, it's not that anything bad's going to happen, but you just want to get in the habit. It's also healthier for your discs as well to learn to do your activities bending from the hips and knees and not the waist.
Haylie Pomroy: Hi, it's Haylie Pomroy, your host. When I was going through my health crisis, the worst part of it was feeling lost and alone, and I decided that I didn't want anybody else to feel as desperate as I did. That's why we set up a private membership group where you can come in, ask questions, get support, and be connected with people that can actually help you on your health journey. If you go to hayliepomroy.com/member, you can join me for 30 days for free. I'll see you there. We can jump in, and we can start to organize the path for your wellness. That's hayliepomroy.com/member. I will see you there. Now, back to our show.
That's great. Well, we run community challenges. And one of the things that we'd really like to develop this next year is, we encourage exercise. In fact, we think it's really critical in healing the metabolism. And we talk about cardio and strength and weight training. But sometime we'd love it if you'd come maybe teach us a little class so that we could get some great, great knowledge. Okay, good. I would love that.
I think when you're incorporating, we talk about food as medicine, movement as medicine too. And it's an incredibly valuable piece of medicine. And you want to make sure that it's applied in a way that's going to promote health and healing and not that it's going to have crazy side effects.
Margie Bissinger: And that's why you don't want to run out. You can read these articles and see, oh, this, like this Onero program that I love so much. It's not safe to do it yourself. You really need to learn how to stabilize. The core is so important. There's preparation. Don't just go out and say, oh, I'm going to do this, because then you get hurt. Do things safely and step by step with the physical therapist. And you can, that's amazing. It makes such a big difference.
Haylie Pomroy: That's great. Well, thank you for putting together a handout for us. I'll make sure in the show notes that everybody gets that. It's going to be a great adjunct and asset to our community and to healing the metabolism.
Margie, I cannot tell you, thank you so much for being here. It's really cool to think about the fact that we build our health young. You guys, feed your kids, feed your grandkids, get them on those healthy foods so they can create bone density. And I think there should be, don't think about education in schools. I think we should be educating our children about, I always tell them, eat this so you can run faster, jump higher, but have strong bones. And I don't know that oftentimes we think that we're having dinner for our future self. Or we're exercising for our future self.
Margie Bissinger: That's such a good point. When you do this handout, like the posture things, teach your kids, because it's so sad. I see these children, and I'm just thinking, oh my gosh, what will they grow up to be with this posture?
Just share the exercises with the kids.
Haylie Pomroy: I appreciate it. Well, thank you so much for coming on. I really appreciate it. This is an issue that I always say: think of my grandma when you're stressed, when your body's nutrient-depleted, when you're not taking care of yourself, when you're not being physical enough, you're going to take it from your bones. And that grandma that taught me that was very physically active well into her 90s and didn't slow down until she had a fracture. She had great bones. She fell in her 90s. She was standing on the back of a bathtub, hanging up garments to dry, and flipped and had a fracture. It's one of these crazy things because she had fabulous bone density, but she healed from it because she had good bone density. And she went on to be very physical well into her 90s. She always taught me, feed your future self, and you want to stay healthy and be healthy and have good structure.
Margie, thank you so much for being here. Everybody's going to love this. And you gave us great tips, and we really look forward to that handout. I really appreciate it.
Margie Bissinger: Oh, my pleasure. Thank you so much for having me. It's been so much fun.
Haylie Pomroy: Great.
In this episode, Haylie Pomroy is joined by Margie Bissinger, physical therapist, integrative health coach, and author, to explore what it really takes to build and protect strong bones at every stage of life.
Margie explains why peak bone density is built before age 30, how nutrition, gut health, and hormones all play a role in bone loss, and why stress and cortisol are often an overlooked but foundational piece of any bone health plan.
Together, they discuss which types of exercise actually move the needle for bone density, why posture and balance training are just as important as strength work, and specific movements to avoid if you already have osteoporosis or osteopenia.
Discover why bone health starts decades before osteoporosis is ever diagnosed, and how nutrition, movement, and mindset work together to build bones that support you for life, here on Fast Metabolism Matters.
If your body feels like it's running on empty, overburdened, or just not responding the way it used to, Haylie's latest book, Toxic Overload, tells you exactly what to do. Download your free digital copy today and start understanding what your body is trying to tell you.
Free Download: Get Your Copy of Toxic Overload 👉 https://hayliepomroy.com/pages/toxic-overload?utm_source=podcast&utm_medium=podcast&utm_campaign=margie_bissinger
You don't have to figure this out alone. Inside Haylie's private membership community, you get personalized guidance and support, member discounts on supplements and shakes, and the ability to ask questions directly to podcast guests like Dr. Systrom. Join free for 30 days and take the next step on your health journey.
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Margie Bissinger is a physical therapist, integrative health coach, and author who specializes in bone health and happiness. She hosts the Happy Bones, Happy Life™ podcast, is BoneFit certified, and has spent decades helping people build stronger bones through nutrition, targeted exercise, and stress reduction. She offers a free posture and bone health exercise guide, Two Weeks to Better Posture, through her website.
Website: https://margiebissinger.com/
LinkedIn: https://www.linkedin.com/in/margiebissinger/
YouTube: https://www.youtube.com/@margiebissinger6980
Learn more about Happy Bones, Happy Life: https://www.happyboneshappylife.com/
Haylie Pomroy, Founder and CEO of The Haylie Pomroy Group, is a leading health strategist specializing in metabolism, weight loss, and integrative wellness. With over 25 years of experience, she has worked with top medical institutions and high-profile clients, developing targeted programs and supplements rooted in the "Food is Medicine" philosophy. Inspired by her own autoimmune journey, she combines expertise in nutrition, biochemistry, and patient advocacy to help others reclaim their health. She is a New York Times bestselling author of The Fast Metabolism Diet.
Learn more about Haylie Pomroy's approach to wellness through her website: https://hayliepomroy.com
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Edited Transcript:
Haylie Pomroy: Today I am very fortunate. We are very fortunate that we're joined by Margie Bissinger. You guys, Margie is a physical therapist. She's an integrative health coach. She's also an author. She has got a great podcast called Happy Bones, Happy Life, and she is a happiness trainer.
Margie, thank you so much for being here with us today.
Margie Bissinger: Oh, thank you so much for inviting me. I'm so glad to be here.
Haylie Pomroy: I think this is a topic that a lot of us think about, maybe that we get to not worry about until later in our lives. I mean, in our community, we talk a lot about osteopenia, osteoporosis, and bone health, but it really hit me to study kind of more of the metabolism of the bone when I fractured my foot two years ago. And I thought, okay, how can I hyperfeed and hypernourish the bone for healing? And I started looking, and I started researching, and a good friend of mine kind of connected me to some of your work. And so I'm so happy that you get to be on here.
Everybody says, “What did you do?” What did I do? I had my foot taped and did a 14-miler in Yosemite. That's what I did. But I worked really hard on healing that. Margie, I want to ask you a couple of things. First and foremost, how important is nutrition in bone health? We know that it's kind of the building block and the structure, and there are hormones associated, but how important is nutrition today if we're thinking about bone health in our future?
Margie Bissinger: No, it's really important at every age. And you made such a good point, because a lot of people think, oh, this is an older person's thing. I don't have to worry about this until I'm older. And it's just the opposite. We develop 85% to 90% of our bone by the age of 18 in women and 20 in men. And our peak bone is before 30.
At every stage, it matters. And nutrition is the building block of our bones. If people don't, and that's one of the root causes, people aren't getting—people who've been on diets or had anorexia or eating disorders, it's such a high risk because all along they haven't been getting the nutrients that they need for feeding their bones. It's absolutely essential at every age, not just, okay, now you have osteoporosis, now you have to worry about getting the building blocks of bone. It really starts when you're born, at every stage.
Haylie Pomroy: I love that you said that, because we talk about pediatric nutrition, and in our nutrition programs, I always say it's something that you're going to be proud to feed your kindergartner before you send them off to school. But I didn't even think about that. I know that from back in anatomy and physiology class now, but I'm glad that you brought that to the forefront.
Men and women build peak bone around their 30s, right? But really, we create kind of the scaffolding, is that right? Or the structure of our bones.
Margie Bissinger: Women at 20, and men. It's so much what we're doing in those years.
Haylie Pomroy: If individuals weren't maybe on a healthy diet when they were kids, like for me, it's too late to go back and redo that. Does it mean that we need to double down now at this point in our life preventatively, before we get osteopenic or osteoporotic?
Margie Bissinger: It's never too early, and it's never too late. Whenever we can, to nourish our bones, and overdoing it and getting more of something, like a lot of people think calcium, and yes, calcium is important, but more is not better. It's not as though we're going to say, okay, let's go crazy now because we didn't get that when we were younger.
No, a healthy diet, one, for example, like your diet, is very bone-healthy with all the good vegetables and all the nutrients involved. I think when you're eating that way, that's going to be very healthy for our bones, but nutrition is so important. And the other thing is, a lot of people say, oh, I'm eating well, I'm taking supplements, I'm doing all those things, but they have major digestive issues. It's not just eating; it's also being able to absorb and digest.
Haylie Pomroy: It's not just what you eat; it's what you absorb and what you can metabolize. Yeah, for sure. Do you guys focus a lot on gut health to make a positive impact on bone health?
Margie Bissinger: Absolutely. And that's, I think a lot of times when people are diagnosed, even with osteopenia or osteoporosis, a lot of times the doctors will just say, okay, go on calcium, vitamin D, and exercise, and sometimes medications, and they don't really go into more depth. And the key is if you have a diet, and to me, the gut is really one of the first places to start, because if there's an issue there and you're not absorbing your nutrients, or you're having some type of inflammation, that's going to show in bone breakdown. It's absolutely essential.
And they've done studies on that too. The composition of the biome is going to affect your bones. Yes, that's a huge part of just a healthy bones program. And I think that's one of the places to start when people ask, where should I start? Start at your gut, because it affects so many other pieces of the puzzle.
Haylie Pomroy: And I love that. That's where we focus on biodiversity of foods to excite the gut biome. We focus on the fiber, we focus on pre- and probiotics, making sure that we're causing that scratch factor and that vitality there.
Well, you said something about how, when a person gets diagnosed with osteopenia or osteoporosis, they maybe say, okay, let's supplement with calcium and vitamin D and do some exercise, but they're not getting to the root cause of why we're losing bone density. And so I want to ask you about, and my team always laughs at me for this, I would say, my grandma always said, “If you don't feed yourself, you'll take it from your bones.” Our bones are a reservoir for mineral reserves. There aren't many in our body. But why do some people become osteoporotic or osteopenic and other people don't?
Margie Bissinger: There are many, many, many different reasons. And basically, throughout life we gain our peak bone at 30. And then with women, menopause is a huge time when we lose bone. We can lose a significant amount of bone in perimenopause, right before, during menopause, and after. And a lot of that has to do with hormones, and estrogen has a protective effect on our bones. I am a big believer in working with some—at that age they used to, there was a period of time where people were really against bioidentical hormones, but now it's really changed, and it really is safe, and you can totally protect your bone. It's something that you may want to work with your doctor on. Hormones are one big reason that many women will all of a sudden start losing bone.
And again, it depends where you start. It's sort of like a bank account where you build bone when you're younger, build bone, and then you do lose some.
It depends where you're at also in terms of how much you lose. But hormones are one reason.
Haylie Pomroy: In that hormones piece, I know we talked about estrogen, but what about stress hormones?
Margie Bissinger: Yes, cortisol. And that's such a big point, that a lot of people come to me and they're like, oh my gosh, tell me exactly what exercise I should do, exactly what I should eat, but they are stressed out, and they don't realize the stress itself has a negative effect on our bones.
What they found is that cortisol, the stress hormone, actually reduces the osteoclasts, which are the, but actually increases, I'm sorry, the osteoclasts, which are the cells that break down bone, and reduces the activity of the osteoblasts, the cells that build bone. And there are studies on that, and they've shown that there's reduced bone density. There's a correlation between cortisol and bone density. People who have more social stress have lower bone density, and people who aren't happy with their life, happiness as well, have increased reduction in bone density. It all goes together. And this cortisol piece, to me, is foundational.
Like, there's just not one program that I teach that I don't incorporate stress reduction and happiness into, because I've seen over my career, even as a physical therapist, that once people start adopting this and adding that to their program, everything changes. But as you said, the cortisol is very important, and we can't ignore that. We really need to deal with that in terms of bone health. And the other thing is, when you do, your life just becomes so much more magical. And well, it's just a much better way to live when you can go with the flow instead of having a wave come and toss you over.
Haylie Pomroy: Exactly. Is that correlation, that kind of science correlation, what inspired you to also be a happiness coach? Because I think sometimes we think we can just muscle through our emotions and that it doesn't have a physical impact on our body. And I said, well, it's your physical body that's unhappy, though, or it's your physical body that's stressed. It's not some ethereal thing that's happening outside of our bodies. It's happening.
And we see it, the manifestation, in our hair and our skin, dark circles under our eyes or whatever. But was that how you made that correlation? Because I, personally, absolutely love that you incorporate that into the therapy aspect of it, but what made you correlate that?
Margie Bissinger: It's really interesting. I actually was teaching happiness before I even got into osteoporosis. Real early, in my early twenties, I was working as a physical therapist, and I had just gone through a bad situation in my life, not a good situation. And I was working in Chicago as a physical therapist with chronic pain patients. I was seeing people with TMJ, back pain, and neck pain, and they were all absolutely miserable and angry and not happy.
They would say to me, “Marjorie, you're so happy. What's your secret?” And I thought, if they only knew what I'd gone through, they would never say that. And then it hit me that, you know what, despite my circumstances, I actually was happy. And that happiness was something deep inside, an inside job. And it wasn't dependent on my circumstances. And I thought, well, what did I do? What did I do to help me get through this so that I actually could still be happy? I started teaching that to my patients who were miserable. I figured, what the heck? And miracles started happening. Neck pain and back pain got better so much faster than with traditional physical therapy. And I started seeing people just getting that joy back in their lives. And it was so miraculous that I, and now this is over 40 years ago. This is awesome. And so ever since then, I've just made that happiness piece part of the work I do. Then I had training. Then I actually studied positive psychology. I worked with Marci Shimoff, an amazing happiness coach, to actually learn how to teach happiness. And so I've been doing that for a very long, I mean, I have a whole program on it. And to me, it's so life-changing, not just that you feel happier, but health improves. It's really amazing.
Haylie Pomroy: We always try to come up with these little tidbits. I call it, like, “thin it in a minute.” Like, chew your food while you sing “Happy Birthday” to me.
You masticate; you get all your micronutrients out of your food.
Are there some little mindful, minute-long things that we can, that our community can kind of learn about today?
Hi, it's Haylie Pomroy, your host. I've written six New York Times bestselling books on metabolic pathways. And my latest book, Toxic Overload, tells you exactly what to do when your body's overburdened. If you go to hayliepomroy.com/book, for a limited time, you can download a digital copy of this book completely free. That's hayliepomroy.com/book. Grab your free copy while supplies last. Now, back to our show.
Margie Bissinger: I think one of the key things is that what we focus on grows, and so we wake up in the morning and we start focusing on what's not working and my to-do list. And so I think what happens is when you wake up in the morning, you want to really focus, I mean, they've done several studies, but I think mindset's so important. You want to sort of ask yourself some questions, like what's the best thing that could happen today? Or what good is here that I could not possibly see? And just try to be a detective for the good. Because oftentimes there's so much good in our lives, and we don't focus on that. We're all wired for negativity. We're wired to—because to live, we had to be more concerned if there was a tiger lurking in the past than if someone gave us a compliment.
Start looking for the good, but we can rewire that. And then when something good happens, and they've done research on this, you want to savor it for at least 20 seconds. If something good happens, if someone says, “This is such a great show,” and you say, ah, I really worked hard on it, you want to savor it. Or you see a sunset, like, take it in, absorb it, just feel it. Be a detective for the good. When something good happens, take it in. And not that we're going to push out the bad. There are many techniques. You can't just throw it in the closet when you get the negative thoughts, but you can also counteract them. I got this negative thought, instead of absorbing it and letting it totally take you over. I mean, I like to question it. There's a whole type of routine we can do, but the other thing you can do is counteract it with three true but positive things, like, okay, yes, that, but you know what? I'm eating well. I'm doing whatever it is. That's awesome.
Haylie Pomroy: Those are great tips. And in our community, I always say, I'm on a joy hunt. I'm on a joy hunt. I love being a detective for that, but I'm going to stick with savoring it, because so many times I'm a problem solver in my mind, and I do that every day in my career. And I do that. I'm the head of problem-solving for my household. For some reason, I'm hardwired to seek out the problem. I've been a health detective or whatever you want to call me, and I'm so fortunate to have beautiful things in my life, but the word savor just really resonated. I'm going to really try to practice today. I'm going to get really good at it, but I'm going to try to savor that because I love it, and I feel it deeply, but I move on probably too fast to the next problem, the next dragon to slay, for lack of a better way to put it. That's good. All you guys, listen, let's go on a, let's savor. I love that.
Margie Bissinger: Savor it. Celebrate. Like, you do something good, you could just.
Haylie Pomroy: People have told me, I don't know if it's imposter syndrome. I don't know what it is. I have a hard time celebrating personal success. Like when FMD launched, and it couldn't have gone better than number one on the New York Times bestseller list. When I was in my hotel room under the covers, they were partying. I didn't show up to it. It sounds terrible. My community, we get lots of great free therapy in our community.
So, celebrating, I'm a big celebrator of success for the kids' achievements, my girlfriend's achievements, and my community's achievements. I probably need to get better at that. And so I'm going to call our community out on that, and let's all try to be accountability partners to each other about celebrating our successes. I've had a massive health victory. That's how I got into this industry, but it's the everyday things that sometimes I needed that. Thank you for coming on to my podcast.
No, I know that I'm not the only one; I know that it's always in my community as well. Very meaningful for me. I thank you. I want to give our community another gem. And I know that you have a handout that you can give them, which is so generous, but walk me through what exercise looks like for bone health. Is it just heavy weights? Is it tons of cardio? Is it cycling, spinning? Like, what does that look like for bone health?
Margie Bissinger: I'm so glad you asked that question, because people really don't know. Oftentimes the doctor will say, do weight-bearing and resistance exercise. A lot of people are doing 20-mile walks. Not that that's a bad thing for your cardio, but what really has been shown to move the needle on bone health? And there are two things.
Number one is impact. Jumping, so adding jumping, even as kids when you're doing hopscotch, when you're, there are all sorts of jumping things.
Haylie Pomroy: Would the trampoline, would that work, like—
Margie Bissinger: The trampoline isn't as much force as jumping. There was one study done by Posh where they had women doing 45 minutes of a whole program on the trampoline, and it did show some improvement in bone density. It's certainly not a bad thing to do, but it's really that ground force, because the bones respond to the force placed upon them.
Depending on where you're at, if you have severe osteoporosis, I would definitely talk to your physical therapist or your doctor. You don't just start doing massive jumping. You can progress, do things like going up on your toes and your heels; you gradually do things. But for younger people listening, they've done studies on this. I mean, they had a study where they had people hop on one foot, and then the control group was the other foot. And the hip that they hopped on increased in bone density over the other hip. It really matters.
Haylie Pomroy: We're going to do a skipping challenge. We'll be happy, and we'll have impact.
Margie Bissinger: Jumping, doing some jumps that are comfortable and in good form. I mean, so the two things, though, that have really been shown are the impact and the resistance and strength training. It's not easy. It's not like, oh, I'll just do two pounds, because as I said, the bones respond to the force placed upon them. There was a study done. It was called the LIFTMOR study, and they did it in Australia, and they took people who had osteoporosis, and they had them do serious weight training, but supervised, which is important, under a physical therapist or exercise physiologist who was trained. And they were doing overhead presses and deadlifts with serious weight. They gained significant improvement in bone density, and the geometry of the hip actually changed, and there was a significant reduction in falls. Now there's a program in Australia, and they're starting to pop up in this country. It's called Onero. I actually have been doing it myself, and it's amazing. Women in their 60s and 70s are lifting. 60, 70, I mean, are doing, like, deadlifts, 60, 70 pounds. It's amazing. I mean, I can't know what's happened to me from this, but regardless, the point is you want to start somewhere. It's resistance exercise twice a week. And if not three times a week, I mean, three times a week is great, but at the minimum, they've shown that if you do it twice a week, and it doesn't have to be long, it just has to be that you're gradually improving.
In terms of repetitions, now in this study, you start out with more, and you go to fewer, but in this study, they did five sets of five repetitions with these intense weights, and you gradually had to learn how to stabilize. You have to learn the right form. I recommend people work with either a physical therapist or someone who really understands strength and conditioning.
Haylie Pomroy: Yeah. I want to bring up that point, because one of the things, like you said, you walk out of your doctor's office, you maybe even get given a prescription for bone density, and they tell you to go exercise, but they're not scripting for physical therapy. And many people's insurance covers physical therapy. And so I always encourage our community, like, anytime you have a medical diagnosis of anything, especially anything structural, ask for a physical therapy prescription. Because if you are having lower back pain, if you are having GI distress, if you're having bloating after eating, if you're having neck pain, if you're having, for sure, any osteoporosis or osteopenia, a physical therapist can guide you through staying—so I was in a massive car accident, and I was in physical therapy for three and a half years, with several surgeries and things. My physical therapist is why I don't have pain. I mean, I could have healed; I would have healed, but I would have healed structurally incorrectly, and it would have caused lifelong pain and inflammation or disharmony in my gait or whatever, or I could have ruined my shoes. I mean, there are so many things that can trickle down from that, but I love that you brought that up. If you get a diagnosis, if they are thinking that you are starting to lose bone density, get into physical therapy. Don't just run out and exercise, and ask for it; you guys, fill out your requests for care, ask for it. I think that's a really important thing to drive home.
Margie Bissinger: There are a couple of things. I couldn't agree with you more, because a lot of people are like, oh, that worked for my friend, or they'll just enroll in some, and that's how I actually started in osteoporosis. I was seeing people, and they were all doing exercises that increased their risk of fractures. We can go over that, but the point is, yes, see a physical therapist. In the United States, it's covered. Most, almost all insurance covers it. They can make sure your form is right. And sometimes people just think they have to live with—I've had this shoulder for 20 years. You don't. There's help for these things. And people just don't realize that it's important. A lot of times the doctor won't say that. They'll just say, “Go out and exercise.”
Haylie Pomroy: But you're the captain of your team, you guys. You have to decide, and always, that's why we do these health wish lists, dream big for your health, and it's never too late. I love what you just said. It's never too late to start physical therapy, even if it's a 10- or 20-year-old injury, because you can recondition. Remember, you guys, you're regenerating all your tissue all the time anyway. You might as well start regenerating in a healthy way, for sure.
Margie Bissinger: I want to give one more tip on the exercise. You want—but here's the thing: not every physical therapist is trained in osteoporosis. You can go to the Bone Health and Osteoporosis Foundation or Google; it's called BoneFit. There's a whole program out of Canada, and anyone who's gone through the BoneFit training—which I'm BoneFit certified—they have a really good understanding. You can find a practitioner in BoneFit. You can just Google BoneFit practitioners or go to the American Bone Health and Osteoporosis Foundation, and you can find a BoneFit trainer.
Or the other thing you can do is you can go to choosept.com, and the two specialties where you're most likely to find one are geriatrics or women's health. You just write that in, but otherwise, see who your insurance covers, get the list, and then call and say, do you have someone at your facility who has expertise or who works with osteoporosis? Because you don't want to go to a physical therapist who does sports medicine. It's a little different when you're dealing with bones, and there are certain things you want to avoid. I think it's really important to get a therapist who has expertise, and there are plenty of people that do.
Haylie Pomroy: Where would people go to get your handout on exercise?
Margie Bissinger: Oh, okay. Can I give that to you for the show notes? I mean, otherwise they could go, but this exact one that I want to give them is, I'll give you—I'm trying to think if I have it easy, tinyurl.com.
Haylie Pomroy: That's okay. I'll put it in the show notes. I'll get it to you guys.
I just want to make sure—
Margie Bissinger: If it's not this, I'm pretty sure it's tinyurl.com slash osteoporosis exercises. Pretty sure. I'm almost positive. That's it.
Haylie Pomroy: Okay, we'll make sure, and we'll get it out to everybody.
Margie Bissinger: I'll give you the link as soon as we finish.
Haylie Pomroy: I need tips on how people can get started, and then I need tips for our community on how people can stay motivated to continue.
Margie Bissinger: Well, in terms of getting started, there are a couple of things, though, that go into, I didn't really finish. I just want to finish. So twice a week resistance, and whatever it is, if you've never exercised, just using your body weight is going to be enough. It's for each person. It's not as though, oh, you must lift 10 pounds. It's not that; each person starts where they're at.
If you've never done exercise, lifting your leg is going to be more than your body's accustomed to. For example, when I bend my elbow, and I'm doing that against resistance, and it can be a weight, it could be resistance bands. It could be machines at the health club, whatever it is. But when the muscle's contracting, it's pulling on the bone and saying, hey, we need more bone here. That's going to depend on wherever you're at. I've seen people who are, like, using two pounds for years, but initially it might be enough to cause, but after a while your body gets used to it.
Haylie Pomroy: You need to make progress.
Margie Bissinger: Yeah. The thing is, they found anywhere between, I mean, as I said, this Onero program, this program that's really been so effective, is five sets of five repetitions. It's a heavy weight that you're tired. You can't really do more than seven, but most people start anywhere between, like, 8 and 10, even 8 and 12 repetitions. It's not doing 50 repetitions. Doing sets where you're somewhat tired after doing—
Haylie Pomroy: I want to person my name towards the end.
Margie Bissinger: But you gradually get to that. You could even start with 15 repetitions. You gradually get to that. The resistance you want to do, you want to do the weight-bearing. And for some people, it may just be, for those who can, adding the jumping and adding the higher impact is great. But if not, even, like, going up on your toes and down on your heels, there are things you can do, but walking still is a weight-bearing exercise, dancing, you have to have fun. So you want weight-bearing; you want resistance. I'm very big into posture exercises because you cannot exercise appropriately if you don't—first of all, you have to force strength, but if you're in a slouched, rounded posture and you try to lift your arm, you're going to cause impingement.
Haylie Pomroy: Give me some examples of posture exercises.
Margie Bissinger: And that's in the sheet. I go through it.
Haylie Pomroy: Are there things like, would Pilates be considered a posture exercise, or yoga?
Margie Bissinger: Yes. In the sheet, I did a program, Two Weeks to Better Posture, where I showed an exercise where you're bringing your shoulders back and down, your chin in, backbend things, and how to sit, how to visualize lengthening. It's all on that sheet that you can get. I have all the videos of me doing all those exercises, even for text neck. Children now, when they're on their phones and texting, the curve in their neck has changed.
Haylie Pomroy: You're making me, I'm sorry. I don't know if you guys are noticing. I'm like, yes, I know exactly what you're talking about.
Margie Bissinger: Posture has to be natural. It shouldn't be tight. It should just be comfortable and natural. I think posture is one of the first places to start. And so there are really easy exercises on that sheet.
The other thing—a lot of people are like, well, I have all these problems. I can't do strength training, but everybody, everybody can do balance, and balance—people fall. The reason people, the key thing, it's not that we want our bones so strong. We want our bones strong so we don't fracture. Fractures are the problem. That's what we really want to prevent in life.
But a big thing is falls. And a big reason people fall is because they don't have good balance as they age. If we don't use it, we lose it. One of the best, best, best things you can do is Tai Chi or Qigong. I show, I think seven, I show all these different balance exercises. I show two Tai Chi ones in the sheet as well, but even standing on one leg, there are things we can do so that your balance can stay good throughout life. You can get better, but a lot of people just don't even think about it. Balance is important. The strength training twice a week, posture exercises, I say daily. I love cardiovascular just because we want to enjoy our life. We want to keep our heart and lungs well. And it just lets us continue to be active. I believe in cardiovascular, and let's see, did I miss anything? I think those are the main things, twice a week. The trick is that you just start somewhere. It's sort of like a car sitting in the driveway. It's not going anywhere. If you just do something, even if you just put your sneakers on, step one, every day.
Haylie Pomroy: Is it more important that you do frequency or long durations during a day? Like, is it more important that I can dedicate an hour, hour and a half, or is it more important that I do 20 minutes, five times a week?
Margie Bissinger: No, no. And as I said, for the strength training, the things that really moved the needle were the strength training and impact. In this Onero program that people did so well on from Australia, that program was 30 minutes twice a week. That was it.
Haylie Pomroy: Wow. That's great.
Margie Bissinger: It's not the extent. I mean, they have found, though, that there's a correlation. People who are more active have increased bone density.
Haylie Pomroy: Well, they also have fewer stress hormones. I mean, it reduces stress too.
Margie Bissinger: People, start with something, and I'm a big believer in you just go step by step, and you have to schedule it in and make it non-negotiable, because it's that important and your life will change dramatically. That's the thing. I see all these people who are the biggest couch potatoes, and the doctor said you have to exercise. And especially when I was working one-on-one for years as a physical therapist. And I mean, right now I work with larger communities and group programs, but when I was seeing people who really never exercised, once they incorporated it, oh my gosh, they became lifelong exercisers because they're carrying their groceries, they can put their luggage up, they can do so much. It's empowering. There's nothing more empowering than being strong and capable. And that's possible at any age. I see this.
I have 85-year-olds helping me move chairs. I mean, it's amazing. Make it a non-negotiable. Even twice a week, do what works in your life. Now, if you're so busy, then do some exercises in between things. You can learn, you can do certain exercises in between.
Haylie Pomroy: Yeah. Get up and jump rope between your Zoom meetings. Make them 50 minutes instead of an hour long back to back, and do something. Move your body.
Margie Bissinger: If you're at work, bring a resistance band and do certain things. There are all sorts of ways that you can do it. As I said, posture is so important. And the one thing, for anybody that does have osteoporosis, you want to avoid the rounding, forward bending, like touching your toes. I love Pilates and yoga; they're fantastic, but you do need to make some modifications if you have osteoporosis. You don't want to do any of those rounding poses because, they have shown, it puts more force on the front of the vertebrae and the spine, where fractures occur.
Haylie Pomroy: Interesting. You mentioned, that leads me right to what you mentioned. I've made myself a note. There are certain exercises that you feel are conducive to injury.
Margie Bissinger: Yes. The ones that you—let's see if I have my spine here.
Haylie Pomroy: See if I have my spine, I'm sitting up taller.
Margie Bissinger: Yeah. No, I have this right on my desk. Okay. For the people who are watching, I know some people just listen, but anyway, so if we look at this spine here, this is the front, and this is the back, where you feel the bumps on your back. Ideally, like the top right here, this is nice and square, and inside it's thick; it doesn't have holes. But if we look at this, like with osteoporosis, and this is one that has osteoporosis, you see there are bigger holes in the bone, so it's not as compact.
Haylie Pomroy: Like porous.
Margie Bissinger: It's porous. Exactly. Osteoporosis. Porous bones. But now we see that it's wedge-shaped, and that's where the fractures occur, the front of the spine, not back here. If you took the spine and bent it forward, you can imagine that we're going to put more force on an area already weakened. So what you want to do, instead of bending from the waist, you do squats; you bend from the hips and knees, and you maintain—we all have a nice inward curve in our low back. You maintain that. It's just some modifications necessary for Pilates and for yoga and all those rounding positions.
And that was the sad thing. I used to see people who the doctor said to exercise, and they're touching their toes, and you'll go to senior classes and you'll see that. And I oversee all the osteoporosis initiatives. I'm part of a group in New Jersey, and years ago we sent out a flyer to all the exercise instructors that we had information for, explaining, because we were seeing too many injuries: do not do this with your patients with osteoporosis. Those are the main things.
And then also you don't want, if you have osteoporosis, and I also say osteopenia as well, you don't want to do extremes of motion. You don't want to do, like, the absolute extreme of rotation and side bending, or side bending and rotation, especially with weights. Especially if you're at, like, a yoga class and the teacher's going to do overpressure, you don't want that.
Haylie Pomroy: That makes sense. That makes sense.
Margie Bissinger: Those are the most, those are the most important things.
Now look, if you bend down one time, it's not that anything bad's going to happen, but you just want to get in the habit. It's also healthier for your discs as well to learn to do your activities bending from the hips and knees and not the waist.
Haylie Pomroy: Hi, it's Haylie Pomroy, your host. When I was going through my health crisis, the worst part of it was feeling lost and alone, and I decided that I didn't want anybody else to feel as desperate as I did. That's why we set up a private membership group where you can come in, ask questions, get support, and be connected with people that can actually help you on your health journey. If you go to hayliepomroy.com/member, you can join me for 30 days for free. I'll see you there. We can jump in, and we can start to organize the path for your wellness. That's hayliepomroy.com/member. I will see you there. Now, back to our show.
That's great. Well, we run community challenges. And one of the things that we'd really like to develop this next year is, we encourage exercise. In fact, we think it's really critical in healing the metabolism. And we talk about cardio and strength and weight training. But sometime we'd love it if you'd come maybe teach us a little class so that we could get some great, great knowledge. Okay, good. I would love that.
I think when you're incorporating, we talk about food as medicine, movement as medicine too. And it's an incredibly valuable piece of medicine. And you want to make sure that it's applied in a way that's going to promote health and healing and not that it's going to have crazy side effects.
Margie Bissinger: And that's why you don't want to run out. You can read these articles and see, oh, this, like this Onero program that I love so much. It's not safe to do it yourself. You really need to learn how to stabilize. The core is so important. There's preparation. Don't just go out and say, oh, I'm going to do this, because then you get hurt. Do things safely and step by step with the physical therapist. And you can, that's amazing. It makes such a big difference.
Haylie Pomroy: That's great. Well, thank you for putting together a handout for us. I'll make sure in the show notes that everybody gets that. It's going to be a great adjunct and asset to our community and to healing the metabolism.
Margie, I cannot tell you, thank you so much for being here. It's really cool to think about the fact that we build our health young. You guys, feed your kids, feed your grandkids, get them on those healthy foods so they can create bone density. And I think there should be, don't think about education in schools. I think we should be educating our children about, I always tell them, eat this so you can run faster, jump higher, but have strong bones. And I don't know that oftentimes we think that we're having dinner for our future self. Or we're exercising for our future self.
Margie Bissinger: That's such a good point. When you do this handout, like the posture things, teach your kids, because it's so sad. I see these children, and I'm just thinking, oh my gosh, what will they grow up to be with this posture?
Just share the exercises with the kids.
Haylie Pomroy: I appreciate it. Well, thank you so much for coming on. I really appreciate it. This is an issue that I always say: think of my grandma when you're stressed, when your body's nutrient-depleted, when you're not taking care of yourself, when you're not being physical enough, you're going to take it from your bones. And that grandma that taught me that was very physically active well into her 90s and didn't slow down until she had a fracture. She had great bones. She fell in her 90s. She was standing on the back of a bathtub, hanging up garments to dry, and flipped and had a fracture. It's one of these crazy things because she had fabulous bone density, but she healed from it because she had good bone density. And she went on to be very physical well into her 90s. She always taught me, feed your future self, and you want to stay healthy and be healthy and have good structure.
Margie, thank you so much for being here. Everybody's going to love this. And you gave us great tips, and we really look forward to that handout. I really appreciate it.
Margie Bissinger: Oh, my pleasure. Thank you so much for having me. It's been so much fun.
Haylie Pomroy: Great.
