YOGA AND BONE DENSITY: Are you just a pose away from better bones?

Are you just a pose away from stronger bones?

Could it be that easy? And actually, it's not a single pose, but about 12 minutes of yoga poses. All you really need to do today is breathe in and breathe out. And hey, that wouldn't be so bad either, would it? Today is a much requested and long overdue gift to some of our community members. You may remember this if you attended the 2023 What, When, and Why to Exercise for Women 40+. So I hosted that 2 years in a row. We're about to, to bring it back. I'd love to hear from you if you'd like to hear from us again about an event. We're also planning something live for later this year, so let me know if you want an invite to come. But in this particular episode, so what I'm doing is an introduction, then you're going to get the full share. So this one will also appear on our YouTube channel because it is such a popular topic and a bit controversial. So I'll have to admit, I don't discriminate. I'm a strength and conditioning coach, medical exercise specialist. I am certified in yoga and certified in Pilates, but there are certain things that I know about from my experience over 42 years and the wide continuum of results and where it comes from. So I played devil's advocate with this. Could it really be that "Tell me and explain to me why the mechanisms, because I'm just like you. Approve it to me, girl." And that means there is no arguing with science. We know the results are there. It certainly is not something that I discount. And it is now for our bone density course right now, tucked well within our membership site, bone density has 4 pillars as far as I'm concerned, and one of them is yoga. So here with me in this episode, which is a very special representation and bringing back something from the archives of the interview from the summit with Dr. Loren Fishman, and I, I loved him, loved the interview, and I think you'll love it too. And he's not done yet, so stay to the end and you'll hear what he hints about for what's coming up and what's what they're really looking at with the studies. He's got a great sense of humor. I think you're going to love it, and I'll be back on the other end to close this one out.

Dr. Loren Fishman is the medical director of Manhattan Physical Medicine and Rehabilitation in New York City, the author of 8 books, and the author of or editor of more than 70 academic articles. He's a world-recognized pioneer in the treatment of piriformis syndrome, and rotator cuff tear, an expert in curing back pain. And I'm afraid to say that out loud because I'm thinking they're gonna want me to ask you those questions. So you're gonna be a very popular person, I anticipate, after this. Fishman is an associate editor of Topics in Geriatric Rehabilitation on the staff at Columbia College of Physicians and Surgeons and past president of the New York Society of Physical Medicine and Rehabilitation. He teaches at Columbia Medical School. Integrative medicine and yoga are particular interests of Fishman, who's written 4 books about yoga and medical conditions throughout his career. When appropriate, he's incorporated yoga into his medical practice, has watched its healing effects. He's also an enthusiastic practitioner himself. He's been doing yoga daily since 1973. That's a pretty good track record. Namaste to you, Dr. Fishman. Thank you for being here.

And I did it this morning.

I bet you did. All right. So I want to dive into this. I want to give everybody the background just to set things up. So we're really here not to talk about your other areas of expertise, which are equally as important. Piriformis syndrome gets a lot of our women, and rotator cuff issues are also very popular here. But we're really here to talk about bone health today and really a study that I would call landmark. I don't know if anybody else does. I don't really care. But in 2016, you were a primary researcher on 12-minute daily yoga regimen reverses osteoporotic bone loss. And that study published was based on a 10-year study. So I really would like to unpack that and talk about, obviously, your personal practice may have lent itself to you wanting to use that and introduce it. But it's not the traditional way that we've looked at as exercise physiologists and kinesiologists to improve bone density. So talk a little bit into why yoga.

How did this come about?

It came about— I spent more than 3 years in India, and one of them is with B.K.S. Iyengar. I just rented a room and went to what he did every day. And he was very generous and highly intelligent. And we had a goodbye party for, for me. When I was going back to the United States. It's not exactly, they weren't exactly expatriates. They were people who were gathered around him, maybe 30 or 40 people. And my friend and I, we had an agreement. We just invited them all over to our place and they came over. And afterwards I had something. I'll tell you the honest to goodness truth. It was like a vision. It may sound, I don't say this in the scientific articles, but it's true. It was a vision. And I saw him, and it seemed to me that yoga would, would work for osteoporosis. I was not a doctor yet. Went to medical school, spent about 20 years as a doctor when suddenly dawned on me, well, if I'm going to do something about yoga and osteoporosis, now is the time. And I told my friends and they said, you're, you're nuts. You're going to, you're going to break their bones. These people have osteoporosis. So I first did a pilot study in my office when I finished seeing patients about 5:30. I invited people that had osteoporosis to come, and in my practice, at the time I had about 200 people with osteoporosis. So I divided them into two groups. And one group I didn't do anything with, the controls. The other group, they did the yoga because I was worried that they were going to fracture something. I watched very carefully for two years. We did this every Tuesday after work and no fractures. And then I said, well, we had a DEXA scan to start with, one of these bone mineral density tests. And so let's get another one two years later. So we got them. Lo and behold, The people that were in the control group, they lost a little bone in their femur and in their spine, as you'd expect. Mm-hmm. But ones in the yoga study gained a lot of bone. And I was going over the data one night and one of my kids walked by and said, Dad, what are you doing? And I said, I'm looking at the data for a study I did. He said, are you gonna publish it? And I said, no, no, it's just a pilot study. I just wanna be sure it's safe. He said, give me the data. So I gave him the data, went upstairs, doot, doot, doot with his computer. He came down 5 minutes your dad, it's significant. So I got fire in my belly. I got really excited. I made 1,000 copies of a disc of the poses that I thought would work. And Mr. Iyengar, my, you know, adored teacher, was coming to town. And so I rented the back page of sort of the libretto for his visit to the city center. It's about 3,000 people that fit in there. And he's handing these out, and I got lots of patients for my study. And about a week later, I was looking in the mirror, and I said, you know, Dr. Fishman, you're not very smart. You are advertising yoga for osteoporosis for people that are doing yoga and have osteoporosis. How is that going to work? But I kept them in the study because they were enthusiastic. And of course, the poses I had them do were not all the traditional yoga poses. They were a clever, I thought, a clever selection of ones that I thought would be useful for the spine. For the hip and for the femur. And sure enough, took 8 years before the last people in the study finished their 2 years in the study and sent it off to my statistician up at Harvard. Good guy. I looked at the data. I said, Fishman, you just wasted 8 years of your life. And came back, it was highly positive. Even the ones who had done yoga before, some had done yoga for 24 years, 16 years, even they who were losing bone before they came in the of the study gained bone afterwards. About— not all of them, about 83%. So we failed with 17% and succeeded with 83%. So you want to know how much did it— how much good did it do them? Well, it does. For the first year, it does almost as much good as the medicines. In the second year, it does better than the medicines because the medicines— there's a very steep curve of how well your, your bone strengthens itself in the first year, but then that curve starts to flatten out. So by the third year, you know, I'm talking about the bisphosphonates. So either Fosamax or Boniva.

Yeah.

After 3 years, they're almost not working at all. I think the reason many doctors keep them on is because if they stop taking the medicine, there'll be a precipitous drop in their bone mineral density.

So I'm sorry to interrupt, but were the subjects in the study all confirmed that they were already on medication, or was it a mixture? None were. Okay.

None were on medication. No, there were a couple. Here's what I said. Then give me a DEXA scan from 2 years ago because some doctor put them on the medicine, so they definitely have an earlier DEXA. Let's see how you were doing in the 2 years before you came into the study but were taking the medicine. Let's compare that to what you're doing now, continuing to take the medicine and doing the yoga. And they all turned— almost all of them turned around and did, you know, became positive.

So interesting.

This episode is sponsored by the Flipping 50 Menopause Fitness Specialist. It is the framework that we designed our entire membership and program based on. Since 2013, I've been developing that after 30 years of working with women in midlife. That was born, and in 2018, we rolled out the Menopause Fitness Specialist specialist to train other fitness and health pros on how to actually prescribe exercise. Here's where we're going next, in case you want to get started now, that we're actually training physicians on exercise prescription, knowing they get very little of it in medical school, and hoping that it also bridges the gap for you who may be a fitness or health professional or want to be, who works with women in menopause, because there is so much demand and so much room for you right now. If you are working with women in menopause but not getting all the results, don't have a reliable, predictable framework that gets you results over and over that people know, like, and trust, come and talk to us. We'll put the link in the show notes for today. That's the Flipping 50 Menopause Fitness Specialist. And if you want to head on over to fitnessmarketingacademy.com, it's where we have all of the content dedicated to you, health and fitness pros.

So in those, those 17% that you say, well, you failed, but we don't actually know that, right? So they may have lost bone, but maybe they didn't lose as much as they would have had they not been doing yoga.

That's possible, certainly. I mean, the way I look at it is that people tell you sometimes what they think you want to hear. So I think some of them, I suspect that some of them said they were doing the yoga. But they weren't doing the yoga. And some of them were doing it, you know, I'll do it on Sunday, then a week from Thursday, I got some time, you know. I want— I took the patients that were doing it at least 4 times a week, which means 3 other, a little better than every other day.

Okay. So let me ask you that. So you said originally that you were doing it once a week with them on Tuesday, then were you instructing them to do it on their own outside? Got it.

They actually had to confront me every week. I think made it likely.

And you're mean.

You're mean.

Oh, I am the worst.

Okay.

So I think that they, that helped them do better. Yes.

Okay.

So, and now, I mean, I've just closed my next study because we knew that the yoga worked, but we don't know which pose is doing, helping which bone.

Yeah.

I mean, for all we know, one pose is doing all the good and the other 11 are just draws. So we could make it an awful lot easier. Somebody could do that one pose 4 or 5 times a day and really go to town and rock it up. And others, which, you know, they lament they can't do this one, they're crummy at that one. They could, we could, this is the way you progress is to learn more about what you're doing.

I'm excellent at corpse pose. You have that included. I'm excellent at that.

Mr. Iyengar says it looks easy, but it's actually the hardest pose because you must quiet the mind, which is a restless creature.

But that out of all poses, of course, of course, as an exercise enthusiast, as an exercise and strength and conditioning coach, that would be the least likely in my mind to contribute to bone density.

I think that's right. I just do that because afterwards I don't want anybody falling and some people tuckered out. You know, also, I think, I mean, I happen to believe that Taking it easy, meditating, doing, doing nothing for a while is very difficult and also very worthy of your time.

And how much do we think, or do you know, stress itself contributes to bone loss?

Oh, quite a bit.

Yeah.

It changes the chemicals in the stomach so you don't absorb calcium the same way. Yeah. Your adrenaline. Which is definitely a factor that contributes to bone loss. Yeah, it activates certain cells that are really good at gobbling up the bone and returning its protein and its minerals to the systemic circulation. You know, everything that's in your bone gets returned into the bloodstream. And so stress is definitely not good. That's true. So lowering the stress helps, but we feel we want to help more than just that. That is definitely a factor. Yeah, you want to— I'm sure you want to know, well, how does it work?

Well, of course I do. And I'll play devil's advocate. Wow. And I have a hard time spitting that out. But for many, many of our audience members are familiar, may probably an equal number not. But if you were to read anything or go to a podcast or a video where I'm talking about bone density, you will hear me talk about the two most commonly addressed exercises, weight bearing, and mostly that, that has some kind of a heel strike. So there's a ground force coming back to it and weight resistance training, meaning lifting weights. And we don't care what shape it is. I don't care if it's a dumbbell or a weight or a, a big bag of dog food. I mean, this is lifting weights.

What about a grandchild?

Right, exactly.

Wiggly.

Even, even better.

Yes.

That's progressive because they tend to gain weight over time.

It's true.

Yoga is much better than that. I'll tell you why. Yoga and what you're talking about, the heel strike and weight bearing of whatever kind, are all based on what's called Wolff's Law. W-O-L-F-F. He was a German physician and surgeon in the 19th century. He read an article written by an engineer who was building a crane in the city of Cologne, who happened to wander into a natural history museum and look at the bones of a vulture's wing.. And he looked at them and he said, mein Gott, this is great. The bones of the vulture's wing are of the same function as the head of the crane I'm building. It looks just like the supports I'm building on the crane. He's like, God is great. I'll write an article about it. And he did. Julius Wolff read it and said, I see this all the time. And he formulated Wolff's Law, which is the architectonic of bone. That's the support system of a bone follows the lines of force to which the bone is subjected. And weightlifting and things like that do it to some extent. But we are much stronger than gravity. I mean, I ask you the question, what's stronger, our muscles or gravity? And you might say, oh, gravity. The planet, the Earth is huge. But let me prove to you that muscles are stronger than gravity. Are you ready?

I'm ready.

Are you paying attention?

Paying attention.

Here goes. Okay. Of course our muscles are stronger. That's the whole point in having a muscle. Is that we, you know, on Venus or on Jupiter, we might need bigger muscles, but here it's sufficient. So we are much stronger than gravity. And in yoga, what you often do is you oppose one muscle group with another. Yeah. And that way all the muscles— Show off. —are working hard. All the muscles here are working to oppose them. And between the two groups, you probably generate 10 or 20 times what gravity can supply. Yeah. Further, some obsessive-compulsive neurophysiologists wanted to know how long do you have to put pressure on a bone in order for it to actually start making bone? Because it requires a stimulus. Answer? 12 seconds. Yeah. Now, how many— how many— how can you— can you strike your heel for 12 seconds? You cannot. And yoga, you hold the position. And I believe that's an important thing there. Now, there's a lot more to be said. And they've studied Wolff's law with, of course, with MRI and microscopes, but also with the atomic microscope and with the wonders of modern genetic chemistry. And they found at every level, This thing that dates back to, I don't know, 1893 or so is really true. There's nothing that contradicts its operation, which is pretty impressive. And that's the way yoga works. So we make them hold those from 30, really, to 50 seconds. Oh, another obsessive compulsive wanted to know, well, when do they turn off? Because there's a a refractory period for everything. That's about 72 seconds. Okay. If you do the pose for 3 days, well, the first 72 seconds count.

Oh my gosh. Okay. So we've got our window. There is a quiz later, everybody. 12 seconds to 72. You've got it. You've answered so many questions without me having to ask.

Well, we teach a course. We teach every Tuesday night. Still doing it on Tuesday from 5:30 to 6:30. I teach an online class where we go over all the poses. We've advanced. I mean, we've advanced somewhat. I wrote a book called Yoga for Osteoporosis with Ellen Saltenstall about 10 years ago. And now we're— a lot has happened in the last 10 years. We've changed our poses to make them really, I think, much more effective and sophisticated and accessible to people. We have a beginner version and an intermediate version, which is a bridge from the beginner to the classical pose. So And I teach this 5:30 to 6:30. Everyone is invited. If you're in our study, it's free. If you're not in the study, it costs a little. It's not going to break the bank. So I encourage you to go to my website, sciatica.org, and look at— I call it events upcoming and ongoing. I think those are such terrible words. I could not but put them together. Ongoing. Doesn't that mean going on?

You're the boss. You are the boss of your website.

My words. I'm the boss of my words. It's true.

This episode is sponsored by the Flipping 50 Menopause Fitness Specialist. It is the framework that we designed our entire membership and program based on. Since 2013, I've been developing that after 30 years of working with women in midlife that was born, and in 2008 Time we rolled out the Menopause Fitness Specialist to train other fitness and health pros on how to actually prescribe exercise. Here's where we're going next in case you want to get started now, that we're actually training physicians on exercise prescription, knowing they get very little of it in medical school, and hoping that it also bridges the gap for you who may be a fitness or health professional or want to be, who works with women in menopause, because there is so much demand and so much room for you right now. If you are working with women in menopause but not getting all the results, don't have a reliable, predictable framework that gets you results over and over that people know, like, and trust, come and talk to us. We'll put the link in the show notes for today. That's the Flipping 50 Menopause Fitness Specialist. And if you want to head on over to fitnessmarketingacademy.com, it's where we have all of the content dedicated to you, health and fitness pros.

So we're still interested, I promise you, in attending because you've got this perfect kind of continuum. So if I understand you correctly, I'm summarizing, you have the same 12 poses, but you're showing how to do them, how to regress them if you want them for some reason, a modification, or how to progress them potentially.

Yeah. Yeah.

And I say we do not know. For all we know, the beginner version is doing more than the advanced version. I caution people not to use that as a motivation to stay doing the beginner poses because The genius of Mr. Iyengar, my teacher, is that he aligned— the alignment makes it so that you can really try hard and not hurt yourself. You know, that's it. It's quite actually, that's a mic drop.

That was, that was really good.

I can brag a little more about yoga and say a good Italian study by Bisconti that shows that if you stretch one leg you increase the vascular flexibility in that leg. That's not so surprising. But if you do it, they also studied the vascular flexibility in the other leg, and you also increase it in the other leg further. You increase it in both arms. So they sort of inductively reason from that, saying, well, it probably does it in the heart, the lungs, and the brain. So it reduces the incidence of strokes, heart attacks, and pulmonary emboli. Now, what else can I say positive about yoga?

Oh, is there anything negative about yoga?

Yeah. Let me think about it. Some people get bored when they do it. I know they do. I see it on their faces.

Maybe those people are boring.

Well, what I say to them is, well, I don't always use these words. I say, you know, Awaken to your body. What's going on? Do you feel the breeze caressing your cheek? Do you feel a little irritation where your elbows are reaching your ribs? How are the soles of your feet? Do everybody reads the palms of your hand? Read the soles of your feet. You have to sort of initiate something new for them to get them excited about it. But pretty soon most of them live into it. What else is negative about yoga? Oh, there's a large group of people who think that yoga is Hindu, belongs to the Hindu religion, and you, it's desecrating it for you to practice, like walking on some native tribe's holy land. This is an ethereal holy land. It's in practice rather than real estate, but that's what they say. What else is negative about yoga?

Let me ask you a question about body parts before I forget. So notoriously, when when we're helping someone try and prevent falls and fractures and we're trying to strengthen, we talk about the osteozones being the hip, the spine, and the wrist. And you studied the hip, the femur, which is your large thigh bone. Everybody attending who wasn't sure on that one and the spine. Has there been any study or reference to the wrist?

We're doing it right now. Okay. We, I made a second series and a third series based on the same exact principles as the first. But as of yet, While the study's going on, only the first has been proven to work. But I believe the second and third will work too. I certainly have people who've been doing almost what I do, but a little bit different, and it works on them too. Yes, we're doing— I mean, here's the order, really. Most frequent fracture is the spine. Second is, is the femur. And that's by far the most dangerous one. That's the one where 25% of the people die. Another 25% enter a nursing home from which they will never emerge. And the other 50% do return to their normal life. Third, the hip. Fourth, the wrists. Fifth, the ribs. So we're doing this in the second and third series, address the wrists and the ribs. And we're testing them right now to see— testing the second one to see if it works. So, yeah, I mean, the thing is, there's more to your fragility than just the bone mineral density. On the one hand, the— Debbie, the bone, your likelihood of fracture is directly related to your bone mineral density. But wait, I've got something here. Here, you're— I suppose this were a bone. The bone mineral density only measures the very periphery, the circumference, just the outside. All the bone mineral density is concentrated in a 2 or 3 millimeter rim of your bone. But there are also trabeculae. There's inside, there are supports and bulwarks and edges that crisscross all through there. And people who've devoted their lives to this say 30 to 70% of the strength of your bone is in here. And the DEXA scan doesn't touch it. What does touch it is a new, new thing called bone quality, which will probably be the standard in 5 or 10 years. And we, we have an agreement with a doctor, a colleague of mine at NYU. Even though I'm at Columbia, I'm friends with people at NYU.

Can you believe it? Yeah.

Can you believe it? I don't let the air out of the tires. And he is studying the inside here. He's got the most powerful MRI on Earth. There's one more at the University of Northern Finland where the sun don't shine and they all have osteoporosis. But he will do a study for free of the bone mineral quality and the, what's called the trabecular strength in here. And if you want to let them write to you, Debra, Debbie, okay. And then you write to me and I'll tell you where you can send the letters or the, all the names. Or if you like, I'll tell you afterwards. Fantastic. It's easy. And then they'll be very happy to have these people in the study. Fantastic. It takes an hour. I did it myself first because I said to myself, I'm asking people to do a study that isn't really for their health, and I don't know if this is going to hurt anybody. So I said, you're putting them up to it. You do it first. So I went down there and I did it. No, it's just an MRI, but it lasts an hour. Talk about boredom. I mean, that's a good place to meditate. They play— you can get them to play music in your ears, which probably was good when you do it. But it's— that's the whole thing. And they will be. Yeah, it's a very nice thing to do for the world. Find out because the 38 yogis I've sent to them so far, you know what Dr. Chang says? What's that? MD PhD says they have better than average bone in there inside here. Some of the medicines like these bisphosphonates I mentioned before, Fosamax and Boniva, these drugs, they do increase the bone mineral density around the periphery. They actually decrease the bone quality. Mm-hmm. They don't all do that. There are other drugs that don't do that, but those, those bisphosphonates do it and they borrow from Peter to pay Paul. And the trouble is they borrow more from Peter than they pay Paul. Some of the bone is not in evidence anywhere.

Yeah. Yeah. And I think, I think a portion of our attendees have that and know, and it's why they're here. They want to know what can I do? What I in control of, and this is definitely one. Would you share the 12 poses? Do you have them recited?

I have them recited, but I also have it for free. I put them for free on YouTube. They go to YouTube and say Dr. Fishman's Yoga for Osteoporosis or Yoga Versus Osteoporosis. That's what I called it there. They come up now. I warn you, there are about 10 other people who have put up Dr. Fishman's yoga for osteoporosis. Honest to goodness. And I've looked at a couple of them and they're not bad either. But look at mine first. You get a better explanation of what's going on. You know, I prefer somebody else doing it, which is okay, but they're free every, every minute of the day, every day of the year.

Well, fantastic. I don't think I'm one of them, but I have done the poses in a grid and shown everybody what they look like.

So. Oh, great. I do have them memorized. But if I just say them, I think it'll fall on ears that do not understand.

It is true. It is true. This has been delightful. And thank you so much for your work and for explaining to not to a skeptic, but to— I'm so curious about how this works. And now I completely understand it.

So I'm grateful.

Please, please don't stop quite yet, because I want to be paid for this. And here is my me. Okay. I am doing another study on adolescents using yoga and botulinum toxin for scoliosis. Here, here's the thing. My theory is it's been borne out. I published this 3 times already, by the way. Now I have 100 papers published. Yeah. Anyway, so now if this were a radio antenna you saw on a rural drive, If the cables were pulling down equally, it would be vertical. But in fact, if one side's cables were pulling more strongly, it would curve to that side. But we're not radio antennae. We're people. So we have ribs that splay out and separate the soft tissues and muscles and skin. And then the muscles migrate back into the space created by their separation. And so this side gets big. It's hard. Big and hard. Isn't that where the stronger side is? No. Nothing could be further from the truth. The strong side As we said, is where the cables are pulling down more strongly, right? We use yoga on this side to strengthen the weak side, which is being stretched all this way. And we use botulinum to temporarily weaken the muscles here. It only lasts 4 weeks, but in that time, the muscles on this side come together and gain strength. And we have fabulously good results. 14 to 18-year-old kids with lumbar curves. If you or your children or your grandchildren or your great-grandchildren have scoliosis let them consider this. It's free, of course. And it's been approved by the FDA and everybody else, IRBs. And just write me a note, Lauren@sciatica.org. S-C-I-A-T-I-C-A dot org. Okay, so now we've been paid in full. And I didn't even tell you I was going to do that, but I'm glad I did. Thank you.

And thank you to our sponsors. Yes, our sponsor right there.

Thank you so much for the time and for the work that you've done for all of us.

A pleasure.

A lovely interview. Thank you, Debra.

Thank you.

So there you have it.

Pretty impressive, right? Now, in terms of, I don't have time to do that, you know, I think I could say that too. If we were talking about a 45-minute or an hour class, I could say, you know, I have time to go for a walk 'Or do yoga, which one is more beneficial?' I'm probably going to go for the walk. Or, 'I've got time to do yoga or lift weights.' I'm going to probably lift the weights if I'm due. However, when it's 12 minutes, that's really hard to push back on. And if we dig deep into our conversation today, or the one you've heard today, No discounting, this is a prerecorded and we did it some time ago. You're going to realize really quickly that, you know, there are probably maybe 6, maybe 8 of these poses that are really the bone-stimulating biggest benefits. So what if you and I chose 4 of them on any one day? Are we going to still do some positive good? I think so. I think it's worth it. And I do know this, no matter what, let's say at the end of the year we go back, we do that DEXA scan, and all we've done is yoga and maybe it's not done anything. And by the way, shh, I would not want it to be all you've done. So do that resistance training, do the jump training if you're able, do movement, do go walking, be on your feet, resist gravity that way. And do yoga and you've got the best of both worlds or all worlds from activity standpoint, then get your sleep, work on that stress level, girlfriend, and make sure your gut is fixed so you're absorbing the goodness that you are taking in. If you've got that, maybe we could all kiss low bone density goodbye and be on our way. But no matter what, we need to move move, not in just ways that pay attention to our bone density, but that restore our mobility, as yoga does, work on our stability, as yoga does, and work on our strength along with your resistance training. So there's that. If you want to get your hands on the full set of recordings from 2023, it's not that long ago, even though, yeah, we're 2026 as I do this live, you can still get your hands on them and we've made them a great rate because they're no longer brand new. However, everyone we interviewed has something that is still true. Dr. Lauren Fishman— this research didn't go away. It's not discounted. In fact, you should be waiting with, with bated breath on what's coming out. What are we going to learn next? But Dr. Stacy Sims, we interviewed her, talked about low energy availability. Revisiting some of these are like mini masterclasses, nearly 40 of them that you will have to go back to again and again and again. So I highly encourage you, if you're thinking about it, you'll see the link in the show notes for this one and you can come and check it out. If it feels like a great fit, get your fingers on it. Just get a little bit more education And knowledge is power. Make your choices. There's always something you can do if there's something that you can't. What are you waiting for? Let's start Flipping 50 the stronger way.