Maggie McKay (Host): Welcome to the Better Health Podcast from Tidelands Health. I'm your host, Maggie McKay. How much do you know about strength training? It turns out it could be the key to longevity. So, I think we better find out more about this with physical therapist, Elizabeth Bennett. Elizabeth, thank you for joining us.

Elizabeth Bennett: Hi. Thanks for having me.

Host: So, let's dive right in. What are the primary benefits of strength training in helping to slow the aging process, especially for women?

Elizabeth Bennett: Well, for women, it's the most important. You're going to increase your muscle mass and your strength. You're going to enhance your bone density. For women, this is really particular because we face menopause at a later age, which decreases our bone density. You're going to improve metabolism. So at a baseline, a pound of muscle versus a pound of fat, a muscle will burn more calories at rest.

And then, overall, you're going to have better joint health, less risk of arthritis. And then, you're going to reduce your risk for chronic disease like type 2 diabetes, stroke, cardiovascular disease. So overall, it's a great preventative tool.

Host: It sounds like it. How does muscle loss contribute to aging and how can strength training mitigate this effect, especially in people over 50?

Elizabeth Bennett: Yeah. So at 30 years of age, you're at your peak bone mass. And then when we age to about 60, it accelerates very quickly. So when we strength train, we can actually remodel our bone by activating our muscles. Our muscles activate our cells called osteoblast, and those rebuild our bones. So as we age, strength training is crucial to aging well.

Host: Elizabeth, what are the recommended strength training exercises aiming to combat aging effects? How often should they be performed? And when we talk about strength training, we're talking about lifting weights?

Elizabeth Bennett: Yeah. So even like small weights, like two to three pounds is a great start. The most under utilized form of a resistance and strength training is actually the pool. So, I recommend this a lot to patients. You can start out with water aerobics because the pool provides resistance too. Frequency wise, a lot of places will say two to three times a week for about 30 minutes. I recommend four to five days a week of 30 to 45 minutes. And I've seen my patients who age well, they're working out about four to five days a week.

Host: What about those bands, you know, those big rubber bands.

Elizabeth Bennett: Yeah, those are great to use. You can use ankle weights, bands. Any form of really resistance is strength training.

Host: Let's talk about enhancing bone density, because that's a big one later in life why it's especially important. Does strength training help with that?

Elizabeth Bennett: Yeah. So, you have this thing called Wolff's law. Bone lays down more bone with stress on it. So, our body will adapt to whatever we want it to do over time. So to increase bone density, we have to load our bones. I do it every single day in the clinic to strengthen my patients, specifically women in general, as we talked about earlier with menopause. So yes, strength training does increase your bone density. And therefore, you're more functionally independent as you age.

Host: When you say you do it every day, what does that entail?

Elizabeth Bennett: So, take a total knee replacement, for example. They come in here, they're super weak in their thighs, which are their quads and their glutes. What I'm doing is starting them out by walking, but then we're using weights such as ankle weights on their ankles. We're doing what's called long arc quads or kicks, because we're trying to strengthen the muscles. So therefore, their body can regenerate bone around that implant; and therefore, make them stronger, have less pain, and be more functionally independent after a knee replacement.

Host: So, is that why sometimes I've heard people say exercise, you know, you have the bone density of a 30-year-old, but you're 60, but it was in someone who exercised all the time?

Elizabeth Bennett: Yeah. What I'm seeing in my practice, so I treat anywhere from 15 years old to 95, a hundred. I've worked in the hospital. I've seen pretty much it all. The people who age well, who are still playing pickleball in their 80s or walking or hanging out with their grandkids, able to pick up their grandkids, things like that, those are the patients that have strength trained for the course of their life, and it's never really too late to start either.

Host: How early should you start to see significant benefits? What age is considered optimal to begin?

Elizabeth Bennett: Optimal is honestly in your teens, so at that high school sports age. But it's really never too late to start. I have patients who come in here with, you know, shoulder pain, knee pain. They're trying to prevent surgery. They're 50 years old. They haven't really ever strength trained before. I kind of give them the tools fundamentally to start. And then, we kind of have a fitness after rehab program where they go to the YMCA after that, and they continue their strength training. So, they end up doing it kind of for the rest of their life, and they're going to be set up to age way better than they were before. Strength training.

Host: I think that you just said the key in addition to strength training is you have to keep moving for the rest of your life. You can't do it for just a certain surgery or a birthday coming up or a trip. You have to walk a lot. My mom was 88 when she passed away. But until then, she did yoga and walked every day and did any class she could find, stretching. And she said, "You can never stop exercising." She said, "If I haven't taught you anything, that's the one thing I want you to know." And I think she's right.

Elizabeth Bennett: Strength training is the most underutilized form of medicine

Host: What are the common misconceptions that exist regarding strength training for women and aging, and how can these be addressed in patient education?

Elizabeth Bennett: So, the biggest one is that women are going to get bulky. They don't want to be bulky. Take me for example, I heavy weightlift and I've done it for about two years now. I used to do a lot of cardio before, but I've implemented strength training into my day to day. And I'm not bulky. It takes a lot of intentionality to become bulky. So, it's not like it's easy.

There's also the misconception that older women shouldn't be strength training because they're at risk for fractures. That couldn't be farther from the truth, because that's actually going to put them at a decreased risk of having fractures because they're going to increase their bone density, become stronger, less risk of falling, things like that. So, those are probably the biggest two misconceptions about it all.

Host: How does the research on strength training and aging change the paradigm of geriatric care?

Elizabeth Bennett: So, I think it's now becoming a preventative medicine for geriatrics. It's helping them age well, like we were discussing earlier. It's no longer something after the fact. It's before. How can we get these patients to live long good lives to spend time with their family, to stay out of the hospital, things like that. So, I think that's the biggest shift in geriatric care, is trying to prevent illnesses.

Host: So, let's talk about arthritis and osteoporosis. Can strength training help delay or prevent those?

Elizabeth Bennett: Yeah. I mean, obesity is one of the biggest ones that it can affect because you're increasing your metabolic rate. When you have more muscle on your body, you're decreasing your risk for having diabetes and obesity, which is one of the biggest comorbidities of this country for sure.

Host: What else would you like to add in closing that maybe we didn't cover, that you would like people to know when it comes to strength training and how crucial it is to our overall health?

Elizabeth Bennett: Yeah, I think you can start really anywhere. If you're not familiar with it, go to like your local gym or your YMCA, and ask them a physical trainer who can kind of show you the main machines to start with. There's also a lot of online programs that you can do today. You can simply go on YouTube and find strength training for beginners. And that's an easy way to begin. It's also never too late to begin. And it is a form of medicine. So, I recommend that everyone should be participating in it. And I think that's pretty much it. I appreciate you having me today.

Host: Well, thank you. This has been so fun and so educational. Again, that is Elizabeth Bennett. And to find out more, please visit tidelandshealth.org. And if you found this podcast helpful, please share it on your social channels and check out the entire podcast library for topics of interest to you. I'm Maggie McKay. Thanks for listening to the Better Health Podcast from Tidelands Health.