Luyện nói tiếng Anh bằng Shadowing qua video: 5 Exercises to Improve Bone Density Even If You Have Arthritis

So you have arthritis and you're trying to increase your bone density, but you're like everything hurts.

I can't do anything.

Doc, what can I do?

Oh I see what you're saying because it's a weight -bearing activity that you usually have to do.

They impact stuff.

You're like telling me to run or jump or whatever and I got sore hips, knees, back.

I can't do that stuff.

And I'm picking up what you're putting down.

So today we're gonna give you five types of exercises

that you can do if these problems exist for you to still work on maintaining your bone density, which we know is critical as we age.

So there's hope.

Hope.

Welcome to Talk It With Docs.

I'm Dr. Brad Rian.

I'm Dr. Paul Salazar.

We talk a lot about bone density.

It's going down literally as we sit here.

Yeah, mine's gone.

The reason is because we're orthopedic surgeons and we work on bones a lot and we rely on good bones.

And we see people whose bones have gotten weak

and then suffer things like falls and subsequent hip fractures and this can really drastically alter the course of your life.

Yeah.

And then we tell people you need to do some weight -bearing exercises and then they say rightfully so, well it hurts when I do that, so what am I supposed to do?

Right, and we would always say it's easier to get in front

of this problem than try to react to it after you get in front of it.

Like all problems.

Yes.

So yeah, so running, jumping, high impact stuff, really, really great for it, but this is not practical.

So we're going to go through five things.

So the first one is the mainstay, honestly, I think of all health, and this is progressive resistance training.

Now help me understand, Paul, how lifting a weight is going to make my bones stronger.

Okay, that's a good question.

So what happens when you lift a weight?

You contract your muscle.

Right.

Your muscle's attached to tendon, and your tendon's attached to the bone.

So the load gets transmitted to the bone, and that's all we need to do, is load the bone.

So when that muscle pulls on the bone, that bone responds.

Yeah, bone responds to load.

But isn't bone just like an old dry piece of wood?

No, bone's a living, breathing, happy tissue.

That is mostly protein, really.

And some minerals.

I'm constantly remodeling.

Some of it's getting resorbed, and some of it's getting laid down.

That's the way it stays alive

so by loading the bone through contraction of muscle through resistance training you are actually increasing your bone density

and we would say that this is exercises for both your lower body

and your upper body so for your lower body larger compound movements like like deadlifts

or squats or leg presses and for the upper body again presses

or bent over rows stuff like that and the key for all this is

that it has to be progressive if you lift the same five pound dumbbell for the next 20 years, your body is very smart and very adaptable.

It'll get used to it.

It'll get very good at lifting that five pounds.

What you need to do is either increase the amount of weight, the number of sets, that the way that you do the activity, maybe alter it to make it a little more difficult.

You need to make things harder over time.

So if you start when you're young, by the time you're 80, you'll be lifting 1 ,000 pounds.

Well maybe, but probably not actually, but maybe.

And we've seen that there's videos around

that show like yeah i saw a 91 year old lady

that was like dead lifting like 110 pounds i'm like that's amazing it's impressive yeah it is okay

so number one progressive resistance training okay number two is something

i did this morning oh i used the stairs instead of the elevator okay

because i was in a rush and i knew the elevator would take a

while right and i knew that going up

and down stairs can help build bone it's a load -bearing exercise yes

when you take an elevator you're You're just standing there.

When you're going upstairs, you're contracting muscles, extending your legs, extending your joint.

However, that can be tough for some people.

It can be tough.

So the way to modify this is just use a smaller step.

Smaller steps.

Use the rail.

Yeah.

You can use a rail and you can do it slower.

So there are ways to modify this for hip and knee arthritis, but you can use small steps, which make a significant difference in the way that you're walking.

It's not just walking, right?

So when you bend that knee up, the way that the muscles pull in the bones is very, very different and increases bone density.

And the other thing to keep in mind, too, is a lot of people have startup pain, right?

So as soon as they get up, as soon as they instigate an activity, that's when they perceive the pain.

And then it goes away after a few minutes.

So if you have startup pain and you go up like one step and say, oh, forget it, maybe after a couple of steps, it might feel better.

Try it.

It might be.

Okay.

Number three is incline walking or walking up and down a hill.

So walking alone is a nice activity.

But when I'm out, say with my wife walking our dog, when I see people walking, There's like four ladies walking and they all have a coffee and they're chit -chan.

This is a nice social activity and you're getting really super low -grade cardio because they're not short of breath.

They're not having difficulty.

So this is nice to do because it gets you outside, but it's probably not enough.

Well, no, it's probably not.

It is not enough to stimulate your bones to maintain your bone density.

But if you see around it, say you like to do treadmill walking, you know, if you increase the treadmill incline, this changes the way that your bones are loaded it engages your posterior chain

and the muscles have to pull harder

and obviously it's harder you're like wow this is a lot harder i'm shorter

but my heart rate's going up or if you're doing it on hill

so walking alone is okay but

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if you're doing it for your bones it needs to be made more difficult

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and progressively more difficult just like the resistance training because same thing

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You see people that run really slowly for a long period of time.

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Your body just gets used to it.

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Very, very efficient and very adaptable.

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Adapt, yeah.

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Okay.

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People in San Francisco are laughing at us right now.

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That's why I moved here.

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I wonder if they have us.

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We should do a study.

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Maybe the trolleys, though, because they do take the trolley.

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True.

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Yeah, okay, number four.

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Okay, so along the same lines as loading your bones and standing there is a loaded carry.

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Okay.

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Which I think seems weird to people, though.

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It does.

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Like, yeah, why am I going to carry a load and walk when I just use a wheelbarrow, for example?

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Yeah, fair.

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But yeah, that kind of makes sense.

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If you load your body while you're walking, then you're going to increase the load on your bone.

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That brings into question those vests.

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Do those vests do anything?

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Do you have any evidence for those vests?

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Yeah, first of all, I totally agree about the vests.

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So you're carrying things so you have to engage your core, your forearms and your wrists are involved in carrying the weight this loads your spine, your hips, your knees, because you have to stand up straight.

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And this is something that actually allows you to easily progress too.

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So first you can start with even having a bag of groceries or a light dumbbell.

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And then this is nice and easy to increase.

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So back to that progressive resistance, you can increase the dumbbells progressively.

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So if you're like, well, what if I don't want to carry?

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What if I throw a vest on?

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So what I would say is that the data on weighted vests is really mixed.

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And generally speaking, I'd say it's probably the benefit is overestimated yeah for sure

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I mean I've seen people walk around with those vests

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and I mean I don't know there might be other benefits to it

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but the data is mixed on whether

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or not it's gonna build up your bone density

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and probably those studies weren't long enough to see

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if they agreed I'd say the other thing too they actually were there's one postmenopausal woman say

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that showed no benefit is that our bodies are good at adapting

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so unless you're gonna all of a sudden you start with

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a 20 -pound vest by the end you can't get the vest on it's

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so heavy yeah because your body adjusts and that for You don't get that progressive.

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Why are you lying on the ground and going for a walk?

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So there are not a lot of specific studies

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that have looked at loaded caries but intuitively it does make sense

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and this is good for your bones

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and actually we know it improves your grip strength and we know

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that grip strength is one of the things correlated with mortality and general health.

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Sir Isaac Newton would have said I told you so because he's one with a, didn't he come up with F equals MG, four equals mass times the gravitational constant.

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Yeah.

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So you can't change the gravitational constant on earth so you got to increase the mass.

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Okay, last one is weight -bearing multi -directional activity.

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So our bodies like surprise, and we talk about strain rate when it comes to bones.

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Some people hate surprises.

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Yeah.

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So can you talk about what is strain?

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What is the rate at which the force is applied, why does it make a difference?

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So we have learned that the rate at which strain is applied, so not just straining the bone like,

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you know, pushing on it at a constant load for a while, the rate at which, so rate means how fast it happens over time.

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So if you do it quickly, the bones respond more to that.

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They respond to strain rate by creating more bone.

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So how you increase the strain rate would be like jumping, for example.

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But obviously, jumping can be difficult if you have arthritis or if you have any aches and pains,

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but just somehow trying to increase that strain rate by low impact movements.

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And that's the thought behind the multi -directional stuff is that

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if you're doing a reverse lunge and then a forward lunge and then a side lunge, the way that your body's reacting is a little bit different and you're changing that.

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And this, I think, is probably the reason why racket sports have benefit to your bones.

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There's actually pretty good data to show that racket sports improves your bone density is because you're going side to side.

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You're going forward.

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You're stopping quickly.

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You're going back.

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And again, if you have sore hips, knees and back, this is something that you're not jumping up high in the air, but often, hey, go to any pickleball court and see who's there.

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Those people have arthritis.

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They got braces on.

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Yeah, they're jumping around.

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Right?

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This is good for your bones.

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Or crossing a busy street, not at the lights.

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That's right.

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New York City.

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We don't recommend doing it, but boy, you're changing direction fast.

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So what we'd say is maintaining your bone density is critical for your health, and it should start at like age 30, because that's when your bone density starts going down.

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So progressive resistance training, a combination of stair climbing, incline climbing, multi -directional weight -bearing activity, and even loaded carries are ways

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that you can do it instead of just having to go

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and doing the hard jumps that we've been telling you to do before.

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And everybody's different.

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Everyone has different severities of arthritis and different parts of their body.

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So it's up to you to find a way to do some of these activities that is comfortable enough for you.

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And the best activity is the one that you're going to do.

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That's it.

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I remember Steve Phillips when he was like, what's the best exercise?

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The one that you'll actually do.

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Unless it's sitting on a couch watching Netflix.

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Right.

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That's probably not the best activity.

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Now you know.

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If you like this video, please like it, subscribe to our channel, leave a comment.

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If you have arthritis and what you do to maintain your bone density to help other people.

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And remember, you are in charge of your own health.

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We'll see you next time.

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Những cấu trúc người nói dùng nhiều nhất, kèm đúng cụm từ trong video:

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Câu bị động be + quá khứ phân từ — nhấn vào việc xảy ra, không phải người làm	are loaded · be made · are involved
Thì hiện tại hoàn thành have/has + quá khứ phân từ — việc đã xảy ra nhưng còn liên quan đến hiện tại	have gotten · we've seen · I've seen

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