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Welcome. We're going to talk about being strong with the 7 Domains of Strength Training. Now, 1,000 years ago, even 500 years ago, the vast majority of women on the planet didn't need a strength training program. Life was a strength training program. Even when I was young, taking out a big basket of wet laundry and hanging it over my head on the line to dry in the sun was hard. But for many of us now as we age, our physical activity isn't anything like what it was 50 years ago, and our bodies aren't necessarily better for it.

So we're going to talk about getting strong and staying strong, physically strong, and how that practice will overlap in all of the 7 domains. To help us think about this, we have Gina DiSera in the virtual studio with us. She is a certified strength and conditioning specialist, one of the only certifications which is nationally accredited. She's also a certified biomechanics specialist certified to understand the safe and correct way to position and stabilize bodies to enhance exercise performance, meaning she helps you get the best out of what you're doing and she's a post-rehab conditioning specialist, meaning educated with the skills and tools to be able to bridge with your current physical therapist in order to continue the progress toward full recovery from surgery or injury. And she has more than 35 years of experience in strength training and conditioning.

Dr. Jones: Welcome to the 7 Domains, Gina.

Gina: Thank you, Kirtly.

Dr. Jones: Okay, Gina. Let's get physical, physical and talk about the 7 domains, the physical domain. Help us a little bit. Think about why and how in the last 35 years of you doing this, what does strength training improve? How does it improve your health and prevent disease? Tell us a little bit about what you do to keep women strong.

Gina: Well, I believe that strength training actually strengthens women from the inside out. I think it gives them a sense of personal empowerment and the ability to control and change their own body without any plastic surgery.

Dr. Jones: Oh, I'm a fan.

Gina: I mean, it's just amazing when you see your body change and you think, "My God, I did that."

Dr. Jones: Is this going to work for my eyes?

Gina: We have to talk about that.

Dr. Jones: Oh, okay. Well, anyway. So right, so being not only able to see your body change as it gets stronger, but it actually, when you say it's the inside out, strength training changes the way your body uses glucose, it makes you more insulin sensitive, it decreases the risk of diabetes even if you don't lose any weight. So it helps you burn more calories while you're sitting on your rear because muscles burn more calories than fat and it helps your metabolism work more efficiently. This happens not just to 20-year-olds. It actually is ideal for 50 and 60-year-olds.

Gina: Yes. So many things are changing inside of your system. Your bones are getting stronger, your heart is becoming more powerful and healthier, which improves your circulation and your stamina.

Dr. Jones: This is good, this is good, but remember, I started training if you want to call it that with videos by Jane Fonda a jillion years ago. And she wanted me to, like, feel the burn.

Gina: I love it.

Dr. Jones: It's all about the burn with Ellie Goulding on burn, burn, burn. So Gina, does it have to burn? Is this now . . . Is this going to be hard?

Gina: You know, the original fitness philosophy was you had to really hurt to get results, but that's not the case now. I don't want people to hurt when they're training, but I want them to be neuromuscularly connected where their brain is connected to their body and they know what's happening, and why it's happening.

Dr. Jones: Right. And you've helped me think about how you try to do the move in your head before you actually do it and doing it in your head is actually starts to do a little bit of good stuff for your muscles even though you haven't done it yet.

Gina: I think it invigorates your cellular system. So even if you were injured in bed after surgery, you could picture and see yourself doing movement patterns and you would get a 30% result.

Dr. Jones: Yeah. Well, actually we've made some changes in terms of it used to be like, you had to pick the weight that you could barely pick up. So if you were going to do maybe just lifting things with your arms and you pick the heaviest thing that you can barely pick up, and that's what you're supposed to move, and certainly that builds muscle, but actually they've done some more recent work.

An interesting professor of kinesiology at McMaster in Hamilton, Ontario, studies muscles and exercise. And he said that many people found lifting really heavy weights to be daunting or unpleasant, and he took much lighter weights, but did many more repetitions. And over time they randomized people and found that they had very similar results. So do you start with the heaviest things that people when you're picking someone, helping them just get started? Do you pick . . . start with the heaviest?

Gina: I would actually do the opposite. I like the injury potential to be very low.

Dr. Jones: Injury potential is low and the sense of success is high if you start with little bits.

Gina: Right, right. And truly myself having been a strength trainer for 30 plus years, I can get a good workout not even using a weight.

Dr. Jones: That's bodyweight work.

Gina: It's body weight. It's also mental.

Dr. Jones: Can you talk more about that?

Gina: You can create resistance with your brain. So you can be actually mimicking a bicep curl and have absolutely no weight in your hands, and you can feel it. You can create all the cells participating with your brain. It's a really inexpensive way to exercise.

Dr. Jones: And you can do it anywhere.

Gina: Anywhere.

Dr. Jones: Anywhere. Yes, and so I've always said that the best strength trainers are the smart ones who were able to really think about what they're doing and why they're doing it, and use their brain.

Dr. Jones: Right, right. So if people have never done any strength training and they don't even know how to identify their bicep or tricep, or any muscle group, sometimes having someone show you, this is the muscle group and this is what it feels like when you move it, and particularly for people who've never trained at all. Now is it ever too late to start training?

Gina: Never too late and it's fascinating to watch people in their 80s and 90s start to strength train because the results, they come actually quick.

Dr. Jones: Well, a famous menopause specialist had a menopause clinic in Miami and he showed with strength training, the biggest issue for women as they get older is they lose much more muscle mass than men do. Women don't have the testosterone that men do. Men continue to make testosterone even though it might be smaller amounts into their 70s and 80s, whereas women once their ovaries stop working don't necessarily have the same amounts of androgens. And women lose muscles in really important proximal muscle groups, meaning what it takes to get out of a chair. And he showed you could take 70 and 80-year-olds, and strength train them to the level of fitness and strength of a 50-year-old just by helping them come in and practice some things.

Gina: Absolutely.

Dr. Jones: Well, let's go to the emotional domain a little bit. How do you think that strength training helps people with their emotional sense of well-being?

Gina: You know, I have never seen a woman who embarked upon an exercise program not get happier.

Dr. Jones: Oh. I want to get happier. I want to get physical and I want to get happier. So tell me about that.

Gina: Well, I think there's a tremendous dose of possibility that opens up as a woman puts movement in her life. She says to herself, "If I can do this, what can't I do?" I mean, even me as a person who loves to exercise, there are days where I'm like, "I just don't feel like doing it." I put up barriers. I don't have the time, but once I actually do it, it's a crazy phenomenon. I feel like I can conquer the world. I got past that barrier, I can get past any barrier.

Dr. Jones: Gina, you just broke my haiku. Well, you have to hold on. You have to listen to the very end of this broadcast to hear my haiku, but I'm going to give you a disclosure here. Those of you who are listening can't see me, but I actually put my exercise tights on to do this podcast. So I would be in the mode of thinking about doing it because sometimes emotionally, when you just don't have the energy to do something, just put your tights on.

Gina: Absolutely.

Dr. Jones: Just put your tights on.

Gina: And a new pair of tights can do wonders.

Dr. Jones: Well, Gina would be . . . She would tell you that I wear the same pairs of tights until they totally fall apart and I never buy anything new. So I have my old tights on, but they're still pretty tight. I agree that just moving, we were engineered to move and the last 50 years, the combination of computers and television, and, of course, there's always been books around, and very few women on the planet had a very leisurely life. But most people had no choice, but to move, needs to. It's definitely linked with our endorphins. We've always thought about the runner's high, but you don't have to run. Just moving stuff makes you feel better.

Gina: Absolutely.

Dr. Jones: Because we're also a social, we're really a social species. And the whole business about going to the gym although under the COVID times we didn't necessarily go to our gyms, but there are . . . the social domain, there are something social about going to gyms. And Gina, I know once upon a time, you did classes with a bunch of people in your class, men and women, right?

Gina: Yes.

Dr. Jones: And did you make them smile? Did they laugh while they were . . .

Gina: We had so much fun, and truly classes give women a sense of support. The women in the class become their friends. Oftentimes we go to coffee after or we have a bowling night. I mean, the friendships are long lasting from attending classes.

Dr. Jones: There's a gym that I go to that has a very difficult class. It's a 90-minute class and it's including a lot of weight. So it's both doing some cardio exercises, but it has a lot of strength training, and it's very early in the morning on weekends. And so the young people are not going to get out of bed at 6:30 on a Sunday to do this class. So the average age of this class is probably around 65 to 70.

Gina: I love that.

Dr. Jones: These people are very fit and they're very smart, and they all know each other. They all have their own place, you know. Some, you know, they always have their own special place in the class and it is full, and they love to see each other, and they see each other at the end, and they chit-chat about their lives and their kids. And it's not a class for sissies.

Gina: I think these women become their support group.

Dr. Jones: Right. Especially in the domain of exercise. You go necessarily if there's a day you don't feel very much like you want to go, you know that your buddies are going to be there. So you put your tights on and you go do it. More women . . . Women are more likely to do classes than men. Do you think that's true?

Gina: I do and I think it's because women need that social support system even more than men do.

Dr. Jones: Right. Especially around exercise. Yeah, yeah.

Gina: The other women become their partners in crime to seek a better life, a healthier life.

Dr. Jones: Well, I'll say the gym often makes me smile and giggle, especially the Zumba classes because the Zumba classes, you get somebody else in front, who's really a great dancer and you've got 30 people in the class, who have I'll say a variety of dancing skills. But everybody is smiling while they're wiggling around. It's just adorable.

Gina: Dancing is fun.

Dr. Jones: I want to shift a little bit to the cognitive domain, the intellectual domain because that's where we found some data that is really interesting and I'm going to start with some rats just to . . . I'm going to talk about rats first. So this researcher wanted to know how weight training might affect the brain in terms of cognitive work and of course, they couldn't necessarily take humans because they didn't want to take the brains out and look at various parts. So again, our great debt that we owe, the rodent species. So they found some rats and of course, rats like to run, but they do not like to do weight training.

So what they would do is they take some little pellets and they had a ladder. So the rats had to climb up the ladder and they put some pellets tied to the rat's rear end. So the rats had to climb up the ladder and what do they get at the top? They got a Froot Loop. Now, I don't encourage anybody to eat Froot Loops, but apparently rats think that Fruit Loops are a really worthy the reward. So originally, the rats and like to do it and then they started climbing willingly for the Froot Loop. And then they actually stopped giving them Fruit Loops because that may have been affecting cognitive function. And they found that the rats wanted to do more and more. And then they give some of the rats this inflammation that was going to make the brain inflamed in mimicking Alzheimer's.

So they had rats that did nothing and did the regular running thing, and then they had rats that did the climbing, and they had rats that the climbing with the infection in their brain. And what they found was that the rats that did the climbing even with the inflammation in their brain had cognitive function that was equal to those that didn't get the infection stuff. In other words, the weight training helped the rats actually overcome inflammation and things in the brain that would normally cause cognitive dysfunction. There you go. And so it turns out that these rats when they had done the hard work of increasing their weight and then they had to run mazes, and do difficult things, and remember rat kinds of stuff, they did better than the rats that just ran in the mazes.

Gina: Actually, I recall training a gentleman who had recently suffered multiple strokes and for the first 10 sessions, he hardly spoke to me. I kept thinking, "I guess he just doesn't like me." And I kept pushing him and I pushed him hard because I had been taught that if you push someone hard that has cognitive issues, it'll start invigorating the central nervous system and it will help clear things up. And lo and behold, all of a sudden this man woke up. The intellectual being of him came forth. It was really beautiful. I saw what an intelligent man he was. I didn't know anything about him prior. He just came alive and it was great. And I know that studies have shown positive results for MS patients, Parkinson's patients. Really everyone can benefit with clear thinking from an awake body.

Dr. Jones: Right, exactly. And another group of researchers took some generally healthy women between the ages of 65 and 75, who are already enrolled in a brain study. So they were already getting brain scans and looking at parts of the brain that might be like, pre-Alzheimer's or mini strokes, but these are otherwise healthy women. And they randomize them to no weight training and they continued there once a week weight training or twice a week, or just regular, you know, walking around and trying to keep your balance kinds of training for a year.

And what happened is the control group who were women who concentrated on balance and flexibility showed a worrying progression in the number and size of the lesions in their brain and slowing on their gait. They got slower and slower in their walking. And the people who just train once a week also had declined. But the people who lifted weights twice a week had significantly less shrinkage in their brain and their white matter, their cognitive sections did better, and they walked more smoothly and quickly. And how fast you walk, there's this get up and go test, which is how long does it take you to get up and walk a 10-feet, and that's a sign of future fragility and debility. So your ability to get up out of a chair and walk 10-feet is a measurable sign of your physical and cognitive decline. So twice a week sounds kind of the right one, huh?

Gina: That is fabulous.

Dr. Jones: Yeah. I'm reminded of Kelly Clarkson in "What Doesn't Kill You Makes You Stronger."

"What Doesn't Kill You Makes You Stronger" with Kelly Clarkson. Well, I think in terms of you don't have to go to the gym, these are things that you can do at home if you just pull on your pants or maybe you live a life where you're already very physical, you are a gardener or you are a rancher, and you're pushing and shoving animals around, or you are doing something. But most of us who have occupations which affect certain muscle groups don't work all of them. So we tend to have repetitive muscle groups of just one of the other. So do you think even people with pretty physical lives should be thinking about moving all of their muscle groups, Gina?

Gina: You know what I think is important is the symmetry of movement.

Dr. Jones: Oh, talk about that.

Gina: Even somebody who's an elite cyclist, they're using certain muscles all the time, but a trainer's responsibility in my opinion is to make sure the workout is balanced. Most of our lives are lived in front of us and so I feel the most important muscles to work are the back muscles, the posterior chain. Balance out what happens in life in front of us.

Dr. Jones: Right. Even if you're a gardener, a farmer, you tend to do everything in front of you with digging and moving things around or hoeing, or certainly lifting if you do it right does use your back, but . . .

Gina: But you want a strong back.

Dr. Jones: You want a strong back. Absolutely.

Gina: Because then you can't do it. Otherwise that's going to be the fragile link.

Dr. Jones: Right. I think about the environment in which people might do this kind of exercise, they might do it at home and, you know, you always want home to be a safe place, and you want not be bumping or tripping over things. But I'm actually kind of worried about the environment of the gym when we think about the fact that we are touching things that everybody else is touching.

But sometimes the disinfectants that people use in gyms are not always good for your lungs. People spray stuff all over and sometimes some of the spray disinfectant is not good to breathe in, and you might even ask your gym what they're using for spray disinfectants to clean the equipment that someone else has used or that you've just used because in fact, you know, plain old vinegar is probably as good as anything and it isn't bad for your lungs.

So I think the disinfectants that a gym might use could probably be looked at a little more carefully. The air filtration, of course, you got a lot of people breathing and you can measure carbon dioxide as a function of how much air turnover there is and a good gym will be very actively looking at their carbon dioxide level, meaning all those people are breathing in or breathing out carbon dioxide. And if you don't have a gym that turns over air frequently, you have rising levels of carbon dioxide. But that can be measured and dealt with with good fans. And talk to me about noise.

Gina: I have worked in the gym for over 30 years and the noise pollution is always been a little bit of a problem for me. I don't aspire to the typical gym music of rap or heavy metal, or something that produces so much anxiety that you want to lift 100 pounds. I more prefer the likes of Enya and other more relaxing music. I consider it more conducive to brain health, focus, concentration.

Dr. Jones: Right. Well, I didn't particularly figure that I can usually plug my own little sound in my own ears, but in some gyms or if you take some classes, we know that some music what does actually make you work harder. There have been studies on that. So the rate of the beat in the music will increase your willingness to put out more energy, but the sound level which is associated with putting out energy can be pretty damaging.

I'm particularly sensitive as I only have a few acoustic neurons left in my brain and I want to keep every single one of them. So the sound level is going to be important when you're doing a class and the music is really, really loud, or maybe the gym wants to be loud, and that's great for people who can still hear. But some of us don't hear that well anymore. So we want to be quiet, but I think just how you find a gym that's energizing and that has clean fresh air, and it's using disinfectants appropriately, these are all things that you can do a little research on in terms of what's the noise level or what kinds of products does your gym use.

And the environmental working group's website, ewg.org, you can actually look up different disinfectants or cleaning devices, and find out cleaning products, and find out whether they're really good for you or not, and then have a conversation about that I think.

How about the financial domain? You can get tights for pretty cheap and you've talked about doing weight training just with your body weight.

Gina: I think someone can get a workout with very little, with their body. Using body weight, it doesn't take much to get a good workout. A couple of kettlebells and off you go. And if you don't have kettlebells, how about half gallon milk jugs? You know, something you can get a grip on and you can drink the milk after.

Dr. Jones: Or once the milk is empty, you can just fill them with water.

Gina: Right, right. Exactly, but, you know, where there's a will, there's a way. And during COVID, so many people did push-ups and squats without any weight bearing. You know, they just found something in their house that weighed something, you know, a few books.

Dr. Jones: Well, there are some . . . There are number of YouTube videos on, you know, nine-minute strength training and so there are some that for strength training for beginners at home. So there are a number of videos, but I do think you can do it for almost no money if you have the will. But if you have particular disabilities or you have an injured joint or joints, or you're worried about arthritis, it's worthwhile getting an expert to give you some pointers when you get started. That's what I recommend for my patients.

If they've got a problem or their knees aren't working, or they're really uncomfortable, the issue around osteoarthritis and we haven't talked about this very much is that as you get older, your joints get sore. But the best primary treatment for osteoarthritis in your joints and that includes shoulders, knees, hips is to move. So movement is critical for people with osteoarthritis. Even though it hurts a little bit, after a while it will feel better and you will keep your muscle strength around that joint and protect that joint more.

Gina: Absolutely. Movement is a solution for so many things.

Dr. Jones: And so if you do have a problem with a particular joint, it might be worthwhile having someone who's a professional, show you what kinds of things might be best for you, whether you have a long-term relationship with your trainer or if there's somebody for a couple sessions who can show you what you can do or certain kinds of movements that might be best for you. But don't let those things get in the way of you moving because there's so many choices of what's the right thing to do for you that doesn't have to be horribly expensive.

Well, as we think about the end, Gina, you've often talked about how strength training helps people connect with their inner ability to do something larger. That's what I consider is the spiritual domain.

Gina: I so believe in that. I just feel like life is in session and it's often not easy. But you put movement in your life, you conquer the little small things of getting in control of your body, and suddenly you have hope.

Dr. Jones: Once you can make a little step forward and you realize you're strong, you realize that you have the energy to do something for someone else or some other part of your life, then your connection with your community and with the parts of the world that are bigger than you seems very reassuring rather than daunting I think.

Gina: I think it really puts a lift in your step.

Dr. Jones: Right. You mentioned that you've trained some older people who never trained before and you've found how many possibilities that they discovered.

Gina: Oh, it's such a fun thing to train. I mean, not that I want to have many people exist who have never moved before, but if you start working with someone that starts out shuffling and struggling, and then you see them start to get control over their movement patterns, they start feeling like, "Wow, I have balance. I can balance," and all the activities of daily living become easier. They start feeling hopeful that, you know, everything's going to be okay. Getting old is not easy, but getting old with strength is so much easier.

Dr. Jones: I completely agree. I think specifically for older people being able to age with balance and strength so that you don't fall down, we haven't talked too much about falls and how for women in particular, a fall and a broken hip can be the end of their independence and women who have fallen, have a broken hip have a very high mortality in the next year or two.

Gina: That is why I believe we all should be working on balance from an early age. To have mobility and balance I think is the foundation to move forward with everything else.

Dr. Jones: Right. Well, Gina, we've been very grateful to have you join us because 35 years and thousands of people getting stronger has been your career and thank you for joining us to talk about that.

Gina: Thank you, Kirtly.

Well, we're going to take this out with a little 7 Domains of Strength Training haiku.

Standing straight and strong
Rising up with confidence
Life seems doable

Thank you all for listening and if this is meant something to you or if you're thinking about strength training, share this podcast with friends and have a conversation about how you might do things together because in fact, the "7 Domains of Women's Health" is all about sharing your conversations with others and the other women in your life, and doing things together. And when it comes to exercise, it's great to have a buddy. So share. You know how to get us. You can find us wherever you find your podcasts and you can find us at womensseven.com. And we're going to take it out with Sia in "Titanium."