72: Atomic Health #2: Pilates Is Not a Cure-All for Women

Hey, this is Sonya from Dear Menopause. You've likely already noticed something a little bit different about this episode. Welcome to some bonus content that we have called Atomic Health. You are going to meet my good friend Roma and we will be breaking down some content related to women's health and longevity. I hope that you enjoy this fresh new bonus content that we have created just for you.

Hi, I'm Roma. I have a company called Vitel, which is a metabolic health platform helping women over 40 take care of their health right now and of their health long term. And I'm here with Sonya.

Hi, I'm Sonya, the host of Dear Menopause, the podcast, and I'm here to have a conversation with Roma.

We thought, after two conversations together, that it was high time to talk a little bit more about what the current landscape is of women's health over a certain age and to unravel that a little bit from just talking about perimenopause and menopause but rather focus on midlife and then everything that happens beyond. So, as this first topic today, we said, we're going to talk about something that can divide women a little bit. So we have the beautiful sport of Pilates Pilates on the mat, pilates on the reformer. Both of us have done it and we wanted to dive a little bit deeper If, as a sport which has become so popular, it's actually enough to keep us healthy beyond 40, 50, 60, 70. So what's your experience with Pilates so far, sonya?

My personal experience with Pilates. So I came to Pilates quite late, actually in the, in the scheme of things, I guess I started doing Pilates probably about, I'm going to say, seven years ago now, and I started a jump straight into reformer Pilates and I was actually rehabbing an injury and I was looking for something a little bit different to do. I have been lifting weights for ever and a day and I was in between gyms and I kind of I met the woman that owns studio and it's like you know what I'm going to go give this a try and I actually loved reformer Pilates for lots of reasons. It was something new for me, so it was something I hadn't done before and I always liked learning new things. But I also found that I was able to really target small muscles that I wasn't doing when I was lifting, and even though I was doing some you know training or to compliment my lifting, that meant I was working my whole body. I wasn't really getting into those teeny, tiny, little nitty gritty muscles that really make the big muscles work. And so from that perspective, I really enjoyed doing Pilates and I wish reformer Pilates, I wish that I had actually discovered it prior to that, because I really think it would have been such a great compliment to my lifting.

Yeah, yeah, that sounds about right. That sounds similar to how I got to it, but I was first introduced to Matt Pilates and so on, never to do it again, of course, like a good athlete. I got my butt kicked and I, you know, I'd done core work before I'd done heavy lifting. I'd done, you know, really hard training on the cardio front, so like running and swimming, and here comes this workout that is so intricate and so tiny and just hurts. So, and then when I discovered reformer Pilates, it was a bit like you. There's that challenge, accepted element. Quite honestly, there was also something to not sweating in a workout, but there's a. You can walk out of a reformer Pilates class pretty decent, whereas if you walk out from a lifting session, there's no chance.

Yeah, no, no, so pretty yeah. Yeah, it's very true. I know I used to go and squeeze Pilates reformer Pilates classes in in my lunch hour and I would go back to work, whereas you know, if I had gone to the gym and done a lifting session or a, you know, a hit session or something like that, there is no way you're going back to work after that not without a shower.

Yeah, exactly so I think I recently posted on LinkedIn about it and I said Pilates is not enough. Your body deserves more and it very much splits split women in two. There were a lot of people who came forward and said this is actually a really good point, and some of them were doctors, and they said we need to ensure that women, especially women, do regular aerobic exercise for their heart, and that includes moderate and vigorous exercise. And then there were people who took it personally and only saw the negativity in the first sentence and gave me a little rundown of what Pilates was and what it was designed for. And as a proud, proud, also German, just as Joseph Pilates, I realized in hindsight that it was everywhere, like in, but it was more. It was dubbed a senior exercise when I was growing up. So you know posture it was for. It was like easier exercises that you could do. You may be even supported by a chair. I'm sure there were elements of what we now call bar. And then I think of my grandfather, who lived to the age of 92, and he would do these exercises that were military inspired, which is what Joseph Pilates did, very much the same thing. He needed them every day his entire life, in his pajamas. Also didn't break his sweat. Now when I look back at it I go, okay, it makes a lot of sense. Right, it's for posture, it's how you carry yourself. I think the Reforma Pilates has made it a little more flexibility and mobility oriented, but the original form also included quite a bit of strength. But that made me look up a few numbers. And so, if you look at Australia and the United States, three in 10 female deaths in Australia happened from a cardiovascular disease, and that's more than breast cancer, if I'm not mistaken.

It is yeah.

And 44% of American women have currently lived with a cardiovascular disease, and to me that's just as someone who loves cardio and we talked about this before it's just there's definitely the biggest element that's missing for me that we don't look at that and then maybe you want to touch on the piece of strength, because you would have done both. Where do you see Pilates come in when it comes to muscle mass or mineral density over 40? What do you think from a coach's perspective?

Yeah. So it's such a great question and, as I said, I think Pilates and I put yoga into this same kind of basket as well. Great compliments to strength training and cardio training, and why. You know the argument that and I've been on the receiving end of this myself as well from predominantly women is no, it is strength-based. It's like, and actually it is strength-based. You are using your body weight in reforming. You've got the springs. You can add on some tension there, but what you can't do is progressive overload and it's the progressive overload that is needed to spark the adaptation of building the muscle and leveraging the bones, which is what is, you know, keeping that bone density nice and strong. So that is where I feel that Pilates definitely it lets strength training down. You're going to get to a point where, from a strength perspective, you're not going to be able to increase your strength. You're not going to get that progressive overload. You can probably get more flexible and you will get more mobility and you know there's a perception that you might get leaner, but you are definitely not going to be able to incrementally increase over long periods of time your strength and resistance.

Yeah Well, it's nice. Now we're getting into the meat of some, I think also some terminology that we might want to explain a little bit more. Would you explain adaptation in layman's terms?

Adaptation is the stimulus of the muscle to promote the growth of the fibres that are required to build that muscle, to make it bigger, to make it more responsive. So it's that triggering of the muscle fibres and that then promotes growth and strength to build in the muscle.

One of the things that we want to do with this podcast is there's so much talk right now on longevity and performance and gains and improvement and self-betterment. A lot of these conversations are being held between men and I think there's some terminology that gets thrown around right now that is not explained in the simplest terms anymore, Like we're sort of expected as the general public to understand what adaptation is. Or maybe some men who've put more thought into strength training know what adaptation is, what super compensation is. We're talking about muscle fibres and even the progressive loading, which I think is a very visual suggestion of what we mean. But I think it's nice to just take it a step back and just say, okay, adaptation is this. And now that we've talked about the muscle fibre and increasing the volume, we get to the point that women don't like and again it's with grossly exaggerating, but most women hear volume.

Yeah, and when we say volume, that translates to getting bulky.

What is your experience with that when you actually work with women? Like, how much of that volume do you actually see, especially in women over the age of 35, 40? And do you actually see it.

No, no, unless a woman is following a very, very controlled and specifically programmed strength program and alongside that following a very controlled and specific nutrition plan and often also supplementation plays a big part on that as well you are not going to get jacked and I just used air quotes and that's a little throwback to a comment that you know in conversation that you and I were having during the week that women tend to use the term jacked, but you know your muscles are not going to grow 10 times in a six week period to make you look like this perception of a bodybuilder. You know I have entered bodybuilding competitions, or I did the pre training for one, because I thought 10 years ago that that was a really good idea and I learned very quickly that for me it was not. But I cannot stress how regimented my nutrition, the supplements that I was taking, the training that I was doing I mean we were talking massive, big, heavy, overloaded strength sessions in the morning and cardio in the evenings every single day, with, you know, couple of rest days built in there, but nowhere near enough to create a tenth of what was required to have got me on stage.

Yeah, yeah, it's again. It's so important to highlight that. And I can add to that from a training standpoint of training for a multi-sport event and which included a lot of strength training. And at the time I was in my 20s which is when we're at our peak and we can we would actually build muscle more easily and we would have weeks, especially in the winter, where we were bulking up more, like everything was bigger volume, heavier weights, and then the closer you got to the actual event, you obviously didn't want to carry that around the. It was still not a lot of volume. And yet if I look, especially if I look at my body weight then versus now, it was just that the percentage of muscle to my body weight was higher. And this leads me to my next point, which is that's ultimately what we want. So a body at rest, our base metabolic rate, so what we earn throughout the day, depending on our body composition and our lifestyle, 22% of that is our muscle and another 22% is our brain and everything else is in the single digits. That is mind blowing to me. And again and this to bring it back to the Pilates If we look at there are a lot of people who do Pilates, a lot of women who do it as their soul sport. A lot of men will come in and they play sports. They play team sports, they run, they do triathlons, they lift, and then they come into Pilates and we make fun of them because they're so not flexible and they're struggling and some of it is really hard for them. But they see it as the component that you and I have just explained, which is it is an add-on to actually improve their movement, their core strength, their posture, when they're not training for all these other things they want to do in life. And then we quite often see people do it as a soul form of sport and it's just not enough. So to go back to the alternatives of how we would then structure somebody's week, let's say I think so. There's the cardiovascular aspect of actually doing aerobic or work. That is what we commonly refer to as cardio, but it's doing mild to vigorous exercise that is walking, swimming, running, biking, anything that works our heart, and we want to get about 150 minutes of that per week. There's also a huge correlation between that and our immune system, and during perimenopause or midlife our immune system can be affected disproportionately negatively by the loss of progesterone, which is tied to cortisol. So again there's another adaptation that we would get from cardiovascular exercise, which actually builds our immune system. And I think quite often we don't see that when somebody just goes in on one sport altogether, and I also wouldn't recommend that somebody only do cardio. I learned that the hard way as well. I decided at a certain point, especially around having children, that I was just going to run. And then you find out, well, just running will cause you overuse for injuries, just running without warming up doesn't work anymore. And then when you're out of the running then you need to re-hapen. Then you find Pilates.

Exactly, and the same thing goes with strength training. I would never, ever have a client or suggest to a woman or a man that they only do strength training. You have to build into that your conditioning and your cardio work and your core work and your stability work and your mobility work, like I think that's what's so important is that we need to be looking at all these individual components of movement and exercise and bringing them together to create. It's like a recipe. I guess we're creating a dish that is going to provide you everything that you need and you can spread that out across a week or a 10-day period.

Yeah, and I love. One thing we haven't touched on yet is flexibility, and that is equally the draw of, I think, pilates and yoga, maybe because we are more predisposed to being more flexible. I've seen the extreme effects of that Either people have done a lot of yoga who are hyper flexible and then realizing that that's actually not a good thing. I've also seen people injure themselves when they were doing yoga, predominantly because there's that factor of you mentioned that earlier about ego. It's like if one person can do almost a split, I'll try to do a split and suddenly and that's also I've seen that in Pilates as well and then suddenly we get to this point where we're going beyond the flexibility and now we've omitted mobility.

And when.

I work with people. I talk to them about the incredible importance of mobility, even more so than flexibility. I don't care if you can touch it. It was like I was never particularly flexible, but my range of motion for the things that I have to do every day is probably above average. I will still now like we have baby gates in the house because I have a two-year-old and she will find an untimely ending if we don't.

But you know At her own hands or yours?

Oh God, she will be a woman that nobody will mess with and honestly, it's probably my proudest achievement. But she, it's the only thing she can't figure out right. If that gate is open, she eats dog food. She's in the dog bowl drinking out of it. So sometimes now I can't and you know, I don't know if you remember, but they're just so hard to open, even for adults. So often, just to prove to myself that I'm still mobile, I will crest it at, stepping over. And you know what the hardest part is. It's actually opening up your hip joint far enough to step over without hitting your toes or hitting your knee, and it's quite high Chipping falling on your face. Yep, it's like a meter, I think. And then I think back to when we were doing, you know, any mobility work for running and you know people think running is just put your shoes on, run in one in the straight line. We would actually do mobility work over hurdles forward and backwards and if you look at professional runners, they still do that. I could sit in a hurdle seat, press up, you know, without using my hands, and switch to the other side, and I think this ability to move in space and move in all the different pains of what we need, that's to me is mobility. And that is way more valuable because it means that, yes, if I need to lunge after my kid, I can do a really deep lunge, grab her and actually find a way to like get up again, whereas if I'm hyper mobile or hyper flexible, I'll get into the lunge and never get up again. Yeah, because I'll grab her. I thought it was four points.

It's great visual. Yeah. So I think it'd be a really good point to really actually explain the difference between flexibility and mobility Because, like you, when I first started lifting, you know, years ago we just focused on flexibility. There was no focus on mobility and it was and I still get clients into the gym that they think their warmups and call downs are all about stretching, and you know huge on mobility, so we always start with mobility flows. So let's really break down. Can you tell us what is flexibility and what is mobility?

Yeah, so the flexibility is the furthest, furthest length. I would say that you can. You can stretch a muscle in that particular space that you're trying to move in. So that would be a split. It could be, you know, legs forward and back or legs out to the side. In Germany we call the one leg forward, one leg back is the female split and then out to the side is the male split, but I think that's not the case in English and apparently one is easier to access for women, one is easier to access for men.

OK, I have. Never I used to be able to do what you're calling, I think, the female split. Yeah, when I did gymnastics when I was, like you know, preteen. I have not been able to do them for years, but I don't think I've ever tried to do the male split.

Yeah, so that's more your adductors. So, and correct me if I'm wrong, but I think that's tied mostly to the to your muscle, like how far you can stretch that muscle in order to land in that space.

Yeah, would have to be yeah.

Mobility is your joints. Yeah, mobility is how do you move a joint in every direction and dimension that it's supposed to go, but also still being able to load it. So people with frozen shoulder, if they can't get over that 90 degree angle, that is a problem. Now, suddenly, you can't extend your arm up. You can't extend your arm up and forward. You know you can't reach for things overhead anymore. That's going to create a big problem in your life If your hips are so stiff because you're never doing that abduction. Yes, so you're lifting outward and and you know it's not the people do squats and squats and squats and they think, oh, it's so great when my thighs burn at working that area around the hip bone and those muscles that allow you that outward motion. That's an incredible strength that inserts with your pelvis and inserts with your, with the big muscles that run down your front, without now getting too technical, but ultimately that all supports your back, your lower back, you know. So mobility is also counteracting what we're doing right now sitting, like you know, we're all sit in a specific way and we can buy fancy chairs, we can have standing desk, we can kneel, we can walk. A woman just walked a marathon during a regular workday on a walking desk, really yes. So that's amazing right In an eight hour workday, but I think not then not being able to do a pistol squat and get out of that again and all the motions that come with that. That will seriously inhibit your quality of life. So that's why mobility is just so important. And, yes, we never stretch. We don't stretch passively anymore, unless we're gymnasts. We stretch actively. So in and out of a stretch. So so really, flexibility to me is not a litmus test of someone being particularly sporty or strong certainly not strong and it's another one of the big sort of selling points for Pilates where I think, done wrong, you then actually contribute to, to injuries again.

Yeah, and, and you know, some people are born hyper flexible or hyper mobile and we often see I think, if I'm right, swimmers in through their shoulder girdle, whether they were born with it or not, they become hyper mobile and high, you know, through their shoulders as a result of their swim training. And so if you are somebody that is prone to hyper mobility, it is really important to understand and the dangers, I guess, of actually pushing your body past certain points as well.

Yeah, yeah, it's almost a false friend because you're actually hyper flexible. Yeah, we've been feeling your own mobility. No, you don't want to extend that range of motion in a joint beyond a certain part, because there's especially for for midlife and beyond there's a certain. There's just so much wear and tear that you might, and professional swimmers walk away quite often. Professional athletes in general will walk away with injuries that are longer and I have them too Like. For me it's more an imbalance with. I did fencing, so one side of my body got overdeveloped, you know, my right shoulder, right arm got overdeveloped, a bit like tennis. My left side, you know, at the time was trained as much as that was possible but it would never catch up. My left leg, the calf, overdeveloped because it's pushing off. And then on the right side, my thigh was so overdeveloped that I needed one size up in jeans just to accommodate my right leg.

Just your right thigh, wow. Oh, and I remember, you know, I played squash. That was my representative sport when I was younger and I can remember more so in the, in the boys at the time, the, they would have those massively overdeveloped forearms and biceps on their rights, you know, or whatever hand they were that was stronger in. And in those times we didn't balance out the other side of our body. We weren't taught to, we weren't you know. There was no strength and conditioning programs. We weren't, you know, out coaching specifically focused on how to hit a ball More precisely, how hard, or it was the skill of the sport, not focused on your body. And it's funny, I have a client in the gym that works with me as on a one-on-one PT basis and she was a rower and she always ended up being, you know, they left using her left side of her body foot with the ball and she is so much stronger on her left side than she is on her right because there was never, ever a discussion around balancing out.

Well, and that brings me to like the last question that I had in this space, because we also kind of want to keep these episodes digestible Ego and beauty and how you know, strength is not sexy. Me, coming back from a long run, dripping in sweat is not sexy. Pilates is very much considered sexy. It's beautiful. You can wear really beautiful outfits, you know, not always practical, but you could walk, you know, from a Pilates class into a mall and go shopping.

Yeah, yeah, and I think it's also something that is glamourized by celebrities as well. I think, you know, I could think of I can think of at least two like really, really well-known global celebrities, women off the top of my head, that swear by Pilates to have created the bodies that they have. I think there's also a considerable amount of genetics that's involved in the bodies that they have, but they yeah, and so, yeah, I think that Pilates has definitely been glamourized.

You know it's been glamourized, but there also seems to be this notion that it's enough because that's how it's being marketed right now and that because when you walk out you obviously feel like usually a chorus, pre-sore, a core glutes. I find that because women fear that some of the other sports are, so either they're time-intensive, then you know, strength just doesn't have a good rap because it's you know it's considered more male that women forget the incredible benefits they would draw from that and, honestly, you could probably just strengthen, hit and get away with not doing more low cardio like walking. Most of us walk a little bit, because at least you get that heart rate up a little bit. And I've seen women, when I worked with people after having kids, and I saw them go from the postpartum stage like the immediate postpartum stage, having kids then the rush on the weight loss, right, and then that often happened with food first and foremost, rather than actually doing cardio and strength, which probably would have been quicker and more sustainable. And then they realized everything was getting a bit soft and I mean that'd be. And then it's like, oh yeah, I'll go to Pilates. And then the worst thing that I would see, if it's not and I always want to uplift good coaches and trainers but if it's somebody who's just not experienced and I've tested it I've gone into Pilates Studios and I've put trainers on the spot and I said I have this injury or that injury and they didn't know what to do with that. And I go, oh okay, just take it easy. And then if you add on that hard Pilates work, that works that midline. You know, in this constant extension that puts pressure on the we just call it the midline, which is officially called your diastasis recti. It's where your belly button meets and it separates during pregnancy and bodybuilders sometimes separated just from the pressure that they put on it. And if you layer that on top of a woman who has just had a baby and she doesn't do anything else to correct that, you end up with a very skinny woman who probably has a pretty high body fat percentage because she doesn't have the muscle mass somewhere. You know that that there needs to be that like. Your body is just going to redistribute If you, if you weigh the same, it's going to take away the muscle and it's going to be distributed as at a post fat. So you might end up with a woman who weighs very little but has 25% of body fat, which is terrible for the heart cholesterol, blood pressure and then she doesn't even have good abs because they've been split. For the last year to I've seen women up to five years postpartum. I took one look at the abdomen and I said you have a separation of your abs and they said no, that's not possible. It's just flab. You know, they get very, and I gave them three months of exercises that were just deep core and very simple to do at home and they came out with six packs.

And then I said it's really important to remember that you can't, as a rule you can't spot train. So I think the message for women that are in midlife, that are in their 40s and 50s, that have noticed perhaps a redistribution of their fat in their body and they're carrying a little bit more of a tummy than perhaps they did before, that it is not possible to spot train and you know, just not have a fat tummy anymore.

Yeah, Even if our husbands look like they can. No, you can't spot train, but men definitely have a better response to certain training. Yeah, absolutely.

The same way. You know, men will lose weight so quickly and so easily in comparison to women, and you know and that's one of the reasons why you and I have having these conversations is to move women away from their only option or source of information being men. Speaking to men about training from a men's perspective, with from research that is all been based on men previously as well that you know there is a significant physiological and biological difference between men and women, and our bodies will respond to training differently as a result.

So I think, to summarize that really we want women to, of course, maintain their pilates. I would also strongly recommend that somebody doesn't just do three or four sessions of pilates per week, but instead liberally replace one or two of them with. You know, let's start with low intensity cardio. Yeah, you can walk. If you don't have access to a strength gym, you can start with very simple exercise snacks. They don't even have to be a full session, it could be 20 minutes each day of doing a few push ups. You can do them on your knees. There's really no way to do it wrong. Don't be afraid to pick up a heavier kettlebell. Most women are already carrying things around the house that are ridiculous. So you know, carry more groceries.

Faskets of washing.

Do a few squats. Elevate your back leg. Do a few lunges. Move in every direction that your body should like, use all the different planes. Did I miss anything? So, with the strength that you can do at home, we have more cardio.

Work on mobility. It's not just about flexibility.

And play. I think I wrote this down. This is like one big thing that I had actually underscored, for if people don't know how to incorporate modders or vigorous movement, sometimes it's really just play Run with your kids, run with your dog, find a downhill and find that fun again, and just discovering how quickly your feet will carry you down. Play a sport that will get your brain fired up. Tennis, yeah, and pickleball.

Pickleball. That's a bit of a thing at the moment, isn't it? But also, you know, when you said play there, I was thinking about. You know, often I will incorporate if I'm feeling like I'm a little bit bored with you know, maybe something that's in my programming and I kind of want to change things up a little bit. You know I'll play around with handstands and you know, yes, I've got a gymnastics background and you know, but I don't do handstands that aren't wall assisted. I still need a wall, but I still play on play with those and I still play with moving myself out from the wall and with that, you know, one day I'll get to be a non wall assisted handstand. But you know, I'm in my 50s and I still love doing nothing more than playing around with things like handstands in the gym. I think that you know anything you can do that brings a little bit of fun and lightness and joy into your training is also so important.

Couldn't have recap this better All right Roma.

It was awesome chatting with you.

Yes, thank you very much, and I'm only talking about more topics. Soon we will.

You've been listening to Atomic Health, a sub series of dear menopause with Sonja Lovell and Roma Van der Volt. If you'd like to know more, check the show notes for links and further details. Thanks for listening.