Start Where You Are: #1 Orthopedic Surgeon’s Proven Protocol to Feel Stronger & Look Younger in Weeks

Summary

Podcast Summary: The Mel Robbins Podcast

Episode: Start Where You Are: #1 Orthopedic Surgeon’s Proven Protocol to Feel Stronger & Look Younger in Weeks

Date: May 18, 2026
Host: Mel Robbins
Guest: Dr. Vonda Wright (World-renowned orthopedic surgeon, longevity researcher)

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Episode Overview

Mel Robbins welcomes Dr. Vonda Wright, an orthopedic surgeon and clinical researcher specializing in the science of longevity and women’s health. This episode is a comprehensive, empowering guide for women (and their loved ones) on why and how to prioritize their strength, mobility, and health at any age—especially to avoid the decline, frailty, and pain so many saw in the previous generations. With research-backed insights, deeply personal stories, and practical, step-by-step actions, Dr. Wright breaks down the biggest myths about aging, offers a simple four-step protocol for getting stronger, and issues a rousing call for women to start showing themselves the same care they’ve always shown others.

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Key Discussion Points & Insights

1. The Common Fear: “I Don’t Want to End Up Like My Mother”

• Widespread Sentiment: Dr. Wright says the most frequent statement she hears from female patients is, “I don’t want to end up like my mother.” (00:55)
• What Does That Mean? It’s not just about appearance—it’s about seeing mothers in pain, losing independence, and missing out on life due to poor health (08:00).
• Action, Not Regret: If you don’t want your mother’s fate, you must consciously choose what to change—frailty, brain health, lack of enjoyment, etc.—and take action early, not wait for decline (09:00).

“If you’re saying that phrase out loud, ‘I don’t want to age like my mother.’ Go a little deeper. What part of her aging do you want to be different?"
— Dr. Vonda Wright (08:15)

2. The Biggest Lie About Aging

• Debunked: The notion that decline and frailty are inevitable is a myth.
• Aging is NOT the Enemy: It’s a natural, ongoing part of life—we celebrate it in the young, so why not in ourselves?
• Science & Experience Back This Up: Even 90-year-olds in nursing homes improved function by 150% with small strength exercises. Age is never a reason you can’t get stronger (12:31, 13:05).

“There is never an age or skill level when your body will not respond to the positive stress you put on it. We are made to adapt.”
— Dr. Vonda Wright (14:00)

3. Why Women Put Themselves Last (and How Biology Plays a Role)

• Cultural & Biological Factors: The hormone oxytocin (enhanced by estrogen) makes women hardwired to care for others (“tend and befriend”), but that doesn’t make it a life sentence (18:44).
• The Real Barrier: Letting go of the roles we perform (even down to how the dishes are done) can create the time and space to prioritize ourselves.
• Own Your Excuses: Instead of hiding behind time or pain, be honest about priorities—and give yourself permission to shift them (21:00).

4. Frailty, Falls, and the High Stakes

• Bone Health is Critical for Women: 70% of hip fractures occur in women. One in two women over 50 will have an osteoporotic fracture.
• The Compounded Risk: A hip fracture is often a catastrophic event: 30% mortality in the first year; 50% permanent loss of independence (21:49).
• It’s Not Just Accidents: Most “low energy” fractures (broken hips/wrists) come from simple falls—tripping over rugs, dogs, etc.—due to low bone density (23:04).

“Falling and breaking a hip is not inevitable. Having poor bone health is not inevitable. But poor bone health, which shows up later in life, begins when we’re young.”
— Dr. Vonda Wright (24:14)

5. When Bone Health Peaks—and Why Decades Matter

• Peak Bone & Muscle: Achieved by age 30. After that, women lose bone density slowly, then rapidly during perimenopause (up to 20% lost in 5-7 years post-menopause) (25:15, 26:08).
• Estrogen’s Role: Drop in estrogen (menopause) accelerates bone loss; connection often unknown to many women (27:09).
• Other Risk Factors: Chronic dieting, smoking, steroid use, energy deficiency in youth all harm long-term bone health (27:20).

6. You Can Build Bone and Muscle at Any Age

• Never Too Late: Even maintaining current bone density—instead of losing it—is a victory (29:45).
• Mindset Shift: Invest in yourself regardless of age; the body remains responsive to positive stressors.

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Dr. Vonda Wright’s Four-Step Protocol to Feel Younger & Stronger (31:12)

1. Start with a Walk (31:29)

• Put on the podcast and walk every day for a week (“build a streak”), preferably after your biggest meal (to help blood sugar).
• This builds momentum and self-efficacy.

2. Begin Resistance Training (32:00)

• After a week of walking, start strength work:
  • Start with bodyweight (like chair squats, lifting books).
  • Progress to light weights.
  • Two full-body routines per week is enough to maintain; advanced can do more.

3. Retrain Balance (33:06)

• Practice standing on one leg (e.g., while brushing your teeth).
• Improves fall prevention, which is critical for healthy aging.

4. Add Cardio Sprints (34:11)

• After your walk, do four 30-second bursts (pick up speed) with full recovery in between.
• This improves cardiovascular health and VO2 max.
• “The number one killer of women is heart disease.” (35:24)

“Just start with a seven-day walk streak. If you do that, you’ll want to keep going.”
— Dr. Vonda Wright (33:07)

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The Power and Purpose of Muscle (42:28, 44:06)

• More Than Looks: Muscles are a metabolic engine—essential for metabolism, glucose utilization (reducing diabetes risk), bone health, and overall independence.
• Resistance Training is Vital: Not for bulk, but for functional strength, energy, protecting against frailty, and maintaining physiologic reserve.
• Protein is Crucial: To build muscle, consume 0.8–1g of protein per pound of ideal (not current) body weight per day (49:22, 49:35).

“What you see in the mirror is not the story of muscle. The story of muscle is the other jobs it does in your body.”
— Dr. Vonda Wright (44:06)

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Facing Pain, Stiffness, and Chronic Excuses

• Stiffness is the Enemy: The less you move, the more pain and stiffness you’ll have. Joints and muscles need motion to stay healthy (39:10).
• Options for All: Can’t walk on land? Walk in a warm pool. Joints hurt? Strengthen muscles above and below for shock absorption (40:41).
• Cutting Sugar Helps: Removing added sugar can noticeably reduce joint pain within seven days (41:24).

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The “Critical Decades” & Longevity Leverage (54:22)

• Two Biological Inflection Points:
  1. ~44 years old
  2. ~60 years old (54:39)
• Three Key Life Stages:
  • 35–45: Peak hormones, time to set health standards that compound for decades.
  • 45–early 50s: Perimenopause; drastic hormonal shifts, accelerated aging—most urgent time to act.
  • 60+: Never too late; body still responds, though more slowly.
• Compound Interest Analogy: The earlier you start, the bigger your returns in mobility, strength, and independence (58:43).

“There is never a time when the body won’t respond. Is it going to be harder at 60? Sure. But that doesn’t mean don’t try.”
— Dr. Vonda Wright (59:58)

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Understanding & Navigating Menopause (60:24)

• Not to be Feared: Menopause is as natural as puberty; suffering through it isn’t necessary or virtuous (64:22).
• Physiologic, Psychologic, Social Shift: Everything changes—but with knowledge and action, it can be a positive turning point.
• Don’t “Suffer Through It”: Many women accept pain as normal; Dr. Wright urges openness to seeking solutions and using available tools (65:23).
• Hormone Replacement Therapy (HRT):
  • Should be a personalized, fact-driven choice—not based on fear or misinformation (71:45).
  • Benefits extend to bone, muscle, mood, prevention of frailty and falls (73:31).
  • Even topical (vaginal) estrogen has life-saving benefits for older women, reducing UTIs and fall risk (74:00).

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Dr. Vonda Wright’s Parting Words

If You Do One Thing After This Episode:

• Take action—today—not tomorrow.
• Start a 7-Day Streak: Walk every day, no matter your starting point. Tiny steps compound and transform how you feel (75:22, 76:29).

“You are not the victim of time. You are an active participant. Your aging and your health can be by design.”
— Dr. Vonda Wright (77:11)

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Notable Quotes & Memorable Moments

• “I would rather people just say, ‘I don’t want to.’ Because that’s more honest.” — Dr. Vonda Wright (20:57)
• “Even if you are in pain, that doesn’t give you license to do nothing.” — Dr. Vonda Wright (41:24)
• “‘Do not wait till tomorrow. You are worth the daily investment to get in front of your aging process.’” — Dr. Vonda Wright (77:03)
• “Your body is designed to respond positively at any age. Small changes compound quickly.” — Mel Robbins (03:11 paraphrased)
• “The difference that these little changes have made… I feel like a different human being.” — Mel Robbins (46:17)

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Important Timestamps

• 00:55 — Fear of “ending up like my mother”; generational cycles
• 06:53 — Why improvement is possible at any age
• 13:05 — 86-year-old mother’s transformation; never too old
• 21:49 — Why falls can be fatal; hip fracture statistics
• 29:44 — How to build or maintain bone at any age
• 31:12 — Four-step protocol introduction
• 34:11 — Intervals & cardio for women’s heart health
• 39:06 — How pain and stiffness reinforce each other
• 49:22 — Dr. Wright’s protein recommendations
• 54:22 — The “critical decades” explained
• 60:24 — Menopause demystified; why it matters for aging
• 65:23 — Why women “suffer through it” and how to reframe
• 71:45 — HRT, facts vs. fear, and personalized choice
• 75:22 — The number one thing to do: start today
• 77:11 — Dr. Wright’s closing affirmation: you’re not a victim of time

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Final Takeaways

• Start where you are, at any age.
• Aging does not equal decline—unless you let it.
• Small daily investments in strength, balance, and nutrition transform aging from something to dread into something to design.
• Model vitality and agency for generations of women to come.
• Today’s seven-day streak: Put on your shoes, turn on the podcast, and walk.

Transcript

[A]

Hey, it's your friend Mel. And welcome to the Mel Robbins Podcast. Today, I am so thrilled that Dr. Vonda Wright is here for you and me. Dr. Wright is a world renowned orthopedic surgeon, a clinical researcher in the science of longevity, and a specialist in women's health. And today, she's not playing around. You better get ready. In fact, Dr. Wright is going to tell you something that might just break your heart. After seeing more than 100,000 patients in her clinical practice, she'll tell you that the number one thing that her female patients say to her as they're getting older, I don't want to end up like my mother. Just let that sit for a minute. And I want you to think about your own mom. Did she take care of herself? I mean, if you could go back in time, wouldn't you want to grab your mom by her shoulders when she was in her 30s or 40s or 50s or 60s, and say, Mom, I know you're taking care of all of us, but that's not an excuse to ignore your health. You got to start taking better care of yourself. This matters. And if you're lucky and your mom is still alive, I hope you send this episode to her. Because if you haven't been able to get through to her to get her to understand how important her health is, Dr. Wright will. Because Dr. Wright knows the simple things that you can do. She knows what your mom can do. She knows what every woman in your life needs to do in order to live a stronger, healthier life. And she's also gonna tell you you can start exactly where you are, and she knows how critical it is. She's gonna take this message very seriously. And she's the perfect messenger because nobody can out excuse Dr. Wright because she has heard every excuse in the book. I'm too tired. I have no energy. I'm gonna get hurt. I'm too old. I'm too fat. My kids need me. My parents need me. I don't even know where to start. I. Well, after listening to this episode, there will be no excuse that you or any woman in your life will be able to come up with to ignore your health. Because Dr. Wright has great news. Your body is designed to respond positively at any age. And the small changes that she'll tell you that you need to make, they are gonna compound so quickly. There is so much that she's about to teach you. You're gonna feel like you're sitting at a private appointment with her. You're gonna learn, for example, that there are two decades based on the research that matter most when it comes to healthy aging and longevity. And don't worry, one of those decades you haven't missed yet. She'll also boil all the science down to four simple habits that she will teach you to start practicing right now in your kitchen, for crying out loud. This is her protocol to help you start making small, simple changes to feel younger and stronger from now on. Hey, it's your friend Mel. Welcome to the Mel Robbins Podcast. I'm thrilled that you're here. I'm thrilled about our expert today. It's such an honor to spend time with you and to be together. And if you're a new listener or someone shared this episode with you, particularly if somebody in your family shared this with you, this is a gift. This is a way somebody has said I love you to you because you're gonna really be changed after you listen to this. I am so glad that you're here to experience the brilliance of Dr. Vonderight. Dr. Vonderight is a renowned double board certified orthopedic surgeon who earned her medical degree from the University of Chicago and her fellowship at the Hospital for Special Surgery in New York. She served as the very first Chief of sports medicine and Orthopedics for Northside Health System in Atlanta, and she is also the founding medical Director of the UPCMC Lemieux Sports Complex at University of Pittsburgh, where she also served as the director of many of their largest clinical research teams. Her pioneering work in mobility and musculoskeletal aging has changed the way medical professionals around the world treat the aging process. She's also the author of five New York Times bestsellers, including her latest, Unbreakable and What I love most about Dr. Wright is that she's not just a practicing medical doctor who has seen more than 100,000 patients in clinical practice, but that she began her medical career as an oncology nurse. That's what she did before she went to medical school, which means she's not just brilliant, she's a special kind of person. And today she stepped out of the hospital and her clinical practice to be here for you and the women that you love too. So please help me welcome Dr. Vonda Wright to the Mel Robbins Podcast. Dr. Vonda Wright, I am so excited to see you.

[B]

I'm excited to be here with you.

[A]

I am so excited to talk to you because every time I read your work or I listen to you or I get a chance to sit down with you, it really opens my eyes to both the stupid things that I'm doing that I didn't realize were counteractive. And also the simple changes you can make, I feel stronger. And I love how you break things down into what I can do. And how I wanna start is, I'd love to have you tell the person who's listening right now what they might experience about their life and how they feel that could be different if they really take to heart everything that you're about to teach us today. I mean, you've seen over a hundred thousand patients. You've authored 44 research studies. You are a renowned orthopedic surgeon. You are a team doc for professional sports. You are an expert in longevity. You have the number one book in the world ranked in longevity right now. The New York Times bestseller, Unbreakable. What is it that's gonna change about their life or my life if we take to heart everything you're about to share with us?

[B]

You know, Mel, the reality is that I find is sometimes we feel so bad. Sometimes the road has been so long since the last time we felt really good that we think that there's nothing we can do and that we've waited too long and. And that we should have. We have the regret of. Should have started before. But here's what we know from the science, here's what I know from taking care of people, that there is never an age or skill level when your body will not respond to the investment you make in it. So whether you take all the advice we give today and start down the road, or whether you just do one thing, not only will your body respond by getting stronger, by becoming less painful, but it will prove to yourself that you are worth this investment that you are making.

[A]

Amazing. You know, one of the things that you say that you hear most from patients is, I don't want to end up like my mother.

[B]

Yeah.

[A]

What does that mean?

[B]

Every day I have people come in and whether they're in pain or they have an orthopedic injury, or maybe they're just coming to me to talk about their menopause. And they look to the person that is closest to them to see how it's going to be. And sometimes they see their mother suffering, not able to do what they've always done, which is take care of the whole family, not able to enjoy the years that they should be enjoying. Right. We work our whole lives to get to a point where we have time to take care of ourselves or do what we want to do. And sometimes we're in so much pain or so frail, we can't and people come in and say, I'm afraid that's going to be me. I don't want that to be me. What do I do now? I'm already starting to be in pain or I don't know the roadmap to not end up in the same place as this person that I love. What am I going to do? But the reality is, if you're saying that phrase out loud, I don't want to age like your mother. Go a little deeper. What part of her aging do you want to be different? Is it the frailty? Is it the. We need to be concerned about our brain health because 70% of all Alzheimer's occurs in women. What do we do about our brain health and when do we start that? I just need people to not wait so long to care about their futures, to not assume we're always going to be the way we were when we were in our 20s and 30s. Because the reality is we will age like our mothers if we don't step in front of it.

[A]

I think so many people are going to resonate with that. And what I love about what you just said is that even if you're in your 20s, like so many of our moms didn't take care of themselves.

[B]

Yeah.

[A]

Or weren't taking care of themselves.

[B]

Midlife women with 20 year old daughters. Yes, absolutely.

[A]

Like I can. I almost sense those of you in your 20s and 30s sharing this with your mom right now, saying, mom, please take care of yourself. It's time for you to put yourself first.

[B]

I love you. It's time.

[A]

I love you. It's time for the person that received this from somebody that they love, what do you wanna say to them? Because they've hit play? Because their daughter or their son or their husband or their sister sent this to them.

[B]

Know that you are receiving this podcast out of love. This person cares for you and they want you to feel better. And they know that you deserve the same care that you have always given them. You deserve to take care of yourself. Take it in that spirit and take action.

[A]

And I also wanna say I am so glad that you hit play and you saw the invitation to listen to something that will help you improve how you feel in your body. You deserve that. Dr. Wright, what's the biggest lie that you and I have been sold about aging?

[B]

Oh, the biggest lie is that there's nothing you can do about it. Just come on. Nature's that way. Aging is the enemy. Aging is the most natural part of living. Mel from you know what? I have Three grandchildren. They've been aging since the minute that they were conceived. Right. And we want them to. We celebrate their aging, you know, icing everywhere, candles. Why aren't we celebrating aging? Well, we can celebrate aging if we pivot our mindset and invest the energy and the equipment that we've been given. Right. It's just a very different mindset. Change of the inevitability of aging is decline in frailty. It is the reality for many people. I do, you know, I'm a practicing surgeon. You make a point of that all the time. Thankfully, I do see a lot of frail people who, for one reason or the other, who have taken care of everybody but themselves and they have slid down the slope to frailty. But that is not inevitable. And there are plenty of examples all over the Internet right now of people in their 70s, 80s and beyond who are just continuing to be mobile and living at a capacity that maybe they never thought possible, but they just kept at it.

[A]

So for somebody that's like frail right now. Yeah. So they had no access to you. They were told the lie that there's nothing they can do and they're feeling frail or they love somebody that's frail. What would you say to that person is available in what you're about to share?

[B]

You know, some of the various, earliest research that I ever read in preparing to be a longevity researcher was done on 90 year old men in a nursing home who really were living in chairs. And those people in the very first studies were put through chair exercises with little bitty hand weights and they increased their function 150%. The research shows that there is never an age or skill level when you cannot get stronger, no matter where you're starting. But I'm going to tell you a very personal story. Do you mind?

[A]

Please.

[B]

So my parents live with us. It's a tradition in our family. They're 86. My dad has been a lifelong endurance athlete, so he continues to do what he's always done. My mother, who's 86, was born in a generation where women didn't sweat. Right.

[A]

No. I'm laughing because it's true.

[B]

Yeah. And so, you know, she, she was doing fine, but she had very little physiologic reserve, meaning what's in the health bank account for her. So during COVID she got really, really sick and lost a lot of weight and became extremely frail. Well, the poor woman lives with me and she can't not hear me say all these things. So one day I look outside and she's shuffling along we are live in Florida around the pool and, and she's got these something in her hands and she's doing biceps things with it. And I look and my mother is curling Campbell's soup cans. And do you know that between that time when she was so frail that all she could do was shuffle around with Campbell's soup. She now is, is biceps curling 10 pounds. And squatting in her chair with 10 pounds. This 86 year old woman goes from almost dying in an ICU to curling 10 pounds. It just shows even within my own family, there is never an age or skill level when your body will not respond to the positive stress you put on it. We are made to adapt. It's the way we're made. And so that was a very long answer. To answer the question with the simple truth. There is never an age or skill level when your body will not respond to the positive stress you put on it. So don't give up people.

[A]

Well, what I Love about you, Dr. Wright, is you are the positive stress because you don't take excuses. You're the expert in longevity in my opinion because you've treated over 100,000 patients. You're still in clinical practice, you're an orthopedic surgeon, you have authored 44 research publications on the topic. But you're also like, you can't out. Excuse me.

[B]

Yeah.

[A]

So what has the research studies taught you about aging and people's like biggest excuses that they can't do anything?

[B]

I think there's so much that the research taught me. We did a series of studies at University of Pittsburgh while I was there earlier in my career that basically showed that when you take the variable of sedentary living away, like I only studied active people, not pro athletes. Active people over 50.

[A]

And what do you define as active?

[B]

They, they worked out most days of the week, they entered some races, they weren't winning the races, but they were purposely active every day. And we quantified that in the studies. But what we showed is that when you take sedentary living out of the picture, you're not just sitting on your couch waiting on the inevitable or not the not inevitable to happen. You can retain your muscle, you can retain your bone. We did a study, it took us five years. You retain executive function of your brain, you can stimulate your muscle stem cells. It just shows the regenerative capacity of our bodies when we're not sitting around. Right. That's what the research shows. But the reason I know that people can't out. Excuse me. Is because when you Sit across the exam table from this many people over this many years. You've heard it all. You know, I would love to do that, but. I hear you, but. And so I have an answer for time.

[A]

Let's hear your answer. Joy. What do you say to the woman who swears she doesn't have time to exercise?

[B]

The reality is we need to own our excuses. Why can't you find time? Well, maybe it's because you really are that busy. But how can we carve out an hour? You can't find the time because you can't trust anybody else to do it the way you do it. And maybe you need to step back if you value yourself more than how clean the dishes are. I mean, it sounds insane, but these are real things. You may have to let go of the control you exert over who does the dishes. Is it so important that you do every single thing? And what do you get from that? Right. Is there some gain you get from controlling every aspect when the reality is maybe someone that you live with could help you and give you an hour? I don't have time because I'm taking care of somebody else. Well, that may be true, but how can you. If you're taking care of children, how can you swap time with another mother so she has her hour and you have your hour? How can you stop saying, my husband is going to babysit our children? They're the children of the family. It's not babysitting. It's sharing. Parent. I mean, all these things. I could go on and on.

[A]

Well, I love the nuance of what you're saying, because it always struck me that if I think back to even a decade ago, somehow Chris always had time to play golf.

[B]

Oh, don't get me started.

[A]

Somehow, like, he was finding the time and not to throw him under the bus. I'm owning this.

[B]

Yes.

[A]

And so in our relationship, it was like he had free time to take care of himself. But somehow I never had enough time. Cause the laundry had to get done. Not because he was telling me to do it.

[B]

Because that's just what your role was.

[A]

Correct.

[B]

Right.

[A]

And so what are the other nuances that you see in terms of the excuses that women use in particular to not prioritize themselves?

[B]

Well, I'm going to give women some grace and just say, part of you taking care of everybody else has to do with our biology. And this hormone called oxytocin, which we make. Men make it, too, but we make it. And estrogen increases the receptors for it. Oxytocin is the befriend hormone and the tend hormone. Meaning? It's why. One of the biologic reasons why women take care of everybody else. We are biologically programmed through the hormone oxytocin to take care of people. I know. Isn't that interesting?

[A]

It is really interesting. And I kind of felt like, okay, I'm not an idiot. I just am wired this way.

[B]

Give you some grace. Okay, you are wired this way. But now that you know that. But now that you know, the more you know, the more you can act. You know, biologically, there is a hormone that makes you this way. It doesn't mean that you still don't have agency to evaluate your schedule and find the time. Do not sit around waiting for the phone call from your friend or your kid to see if they need your help. Do your thing and be available when you're available. Right. That was one example I had from a client of mine. Maybe you don't feel like you can invest in your health because your right knee hurts. If your right knee hurts, which happens in midlife a lot, or your left knee, I chose a knee. If your knee hurts, you have two strong arms, you have a core, and you have another leg that you can continue to get stronger. Your right knee hurting has nothing to do with what you put in your mouth, because a big part of pain and inflammation is the food we feed ourselves, including all the processed food, all the sugar. So you see how I break this down for people?

[A]

I do. I feel like I'm sitting in one of those medical gowns on a piece of paper in an exam room, and I've been trying to get around the advice that you're telling me. And Dr. Wright's saying, no, you can't out. Excuse me, Mel, you've got a mouth, you got other arms. Stop.

[B]

I would rather people just say, you know what, Dr. V. I don't want to. Because that's more honest and authentic.

[A]

That's true.

[B]

And then I maybe could show you data where you don't want to, but if you don't, this is what could happen.

[A]

What is the data you would show?

[B]

I would show things like when we are sedentary, after we eat a meal, how blood Sugars can spike versus if we go walk for 20 minutes after a meal, we're gonna keep our blood sugar more level, which is gonna keep us less inflamed. You're gonna be in less pain. And then people are like, oh, my God, is that all it takes not to be in pain? Well, what's one of the things. So let's do that. Right. But until we have that authenticity and that honesty about why we know it, to do what we're not doing, you

[A]

know, as an orthopedic surgeon, why can one fall be the moment that changes everything, especially for a woman?

[B]

Yeah. So one in two women will have an osteoporotic fracture. So a fracture related to poor bone health in their.

[A]

In one and two.

[B]

Yeah. So statistically, Mel, it's. It's either you or me. And when you say it like that, it becomes really real. But if you fall and you break your hip, these are the statistics you're talking about. 70% of hip fractures are in women. Because of the complications of being frail and fragile and being sedentary and having a big stress like a big fracture, 30% of the time, you may die in the first year. 30% of the time, it's not a small number. If you survive 50% of the time, you will not return to pre fall function, which means maybe you have to go live in a nursing home, which is nobody's destination of choice. Maybe you have to move in with your kids or you have to hire somebody full time. So this becomes not only a personal burden, it becomes a family responsibility.

[A]

And that we will break a bone or fracture a bone, not because of some catastrophic thing, but because our bone density's bad.

[B]

Low energy falls. So there's a difference.

[A]

A low energy fall, what is that?

[B]

Well, there's a difference. I'm making the distinction between being in a terrible car accident, wrapping your. That's another story. But all it takes is tripping over the curb or the little bitty dog that runs around the house, or the rug that wasn't latched down and you land hard and that frail bone, which had not previously broken, breaks. And if it's your hip and you end up in the emergency room, it sets off a catastrophic series of events that can lead to death. So we want to be as strong as possible, which as much lean muscle mass as possible. Not just thin, but lean as possible. We want bones as strong as possible. But what we really need to do is not fall. And so that's why in Unbreakable, I don't leave it as we got to do cardio, which I do say that. We have to lift weights, which I do say that. But we talk about rebuilding our balance and working on foot speed so that we don't have a fatal fall that ends you up in the emergency room dealing with that.

[A]

So I'm thinking now, because I've got daughters in their mid-20s.

[B]

Yes. Mel, here's the deal. Falling and breaking a hip is not inevitable. Having poor bone health is not inevitable. Poor bone health manifests when we're older, but it begins when we're younger. And so we need to pivot from only arriving in midlife to say, what am I going to do here? To pivot and saying, oh, my God, I've got to tell my kids this. I've got to talk to them about their bone health when they're reach in their late 20s and their 30s. When you talk about bone and muscle, we reach those peaks around the age 30. What peak are we reaching from then? We're gonna draw for the next 40, 50, 60 years. Right. So this is a lifetime conversation. Not just, oh, I've hit midlife and I'm getting older conversation.

[A]

How do you know if you have bad bone health or what should you be doing for good bone health?

[B]

Yeah, really good question. Bone reaches a peak between about 15 post puberty, 25, 30.

[A]

And we mean by peak.

[B]

Yeah, we have the most bone density we're going to have at that point. Right. The strongest bones. If we've been jumping around in our childhood, if we've been feeding ourselves, if we've actually had periods and enough estrogen, and there are some young girls who don't have periods. I mean, I didn't. I was a dancer. I thought it was fine. Little did I know. So we have to build bone so that we reach a peak. The best bone we're gonna get around age 30, because when we hit perimenopause and lose our estrogen, we could lose 15 to 20% in the five to seven years.

[A]

Wait, I just wanna make sure I understand this, because what you just said is very important.

[B]

Yes.

[A]

15 to 30, 25. You're reaching your peak bone density.

[B]

Yes.

[A]

Okay. And then 30 to whatever, 40 perimenopause, you're kind of in that zone. But then when you start experiencing perimenopause in the menopause, when estrogen basically falls off a cliff and women are, in the female version, castrated almost, because that

[B]

is the language,

[A]

you lose 15 to 20% of your bone density.

[B]

Yes. The loss of bone is estimated in men and women to around 30 after peak bone density to decline at about 1% per year. Men continue that. But women, when estrogen walks out the door, increase their loss of bone to 3 to 4% a year over 5 to 7 years of perimenopause, when most women are trying to figure out what's going on that adds up, I am

[A]

gonna say I never knew that there was a connection between estrogen and the fact that women experience. Is it called osteoporosis? What's it called?

[B]

Osteoporosis?

[A]

Y. No idea. That was. I always wondered why more women broke their hips. I always wondered why women had more frail bones. I had no idea it had to do with estrogen.

[B]

I think there are many reasons. Estrogen is one of the big reasons. Because estrogen is a key controller of bone remodeling. It controls how much bone is resorbed or taken away for the body to use. But here are other reasons why women have low bone density besides estrogen. Number two. What if we're stuck in skinny culture? And what if, like so many of us were, we were raised when the supermodels were this big and now unfortunately, we're getting back to that and I think we're going to see worse before we see better. It frightens me as a bone doctor, but that's another conversation. But if we never ate enough, we're not going to prioritize building bone. If we were in constant energy deficiency growing up, we're not going to build enough bone. What if we grew up in a time when we were smoking so much nicotine? Nicotine is bone poison and so we have weak bones. Or what if we were sick? What if we had asthma and we needed a lot of steroids? Or what if we succumbed to autoimmune diseases? All of these factors can influence how much bone we build. But I don't wanna leave people on a negative note there.

[A]

Well, no, but I think it's really important to understand because I'm just gonna speak for me personally. When you're younger there's a naivete to think that you're just gonna live forever.

[B]

Of course.

[A]

And the decisions and understanding that these things have a really important implication long term as you age, I think is an important thing to understand. And it also explains the urgency for those of us in our 40s and 50s to take the recommendations you're gonna talk about seriously. Because if we're already compromised in terms of the decline in bone density, which sets us up to have these low impact fractures or whatever you just call them now, all of a sudden. Resistance training protein. The things that you're gonna talk about really become important. Not just cause you're recommending it, but because I now actually understand why.

[B]

Yes. You understand the biology, you understand that they can be life saving.

[A]

Yes.

[B]

They're not just things to do, right? Yes, so how do we build better bone? Well, number one, I always start with mindset. Do you believe that you can influence your future? Yes. Okay, then we're going to work hard,

[A]

and I can build better bones.

[B]

Oh, yes.

[A]

You can rebuild bone. Even if I've blown it, Even if I'm all dried up and I'm in menopause at 57, I can do this.

[B]

We're never dried up. No.

[A]

Okay.

[B]

We just have to be smarter and wiser. We need to harness the wisdom of our age. Right. It's never over for this. But to your point, yes, we can build bones.

[A]

Wow. I didn't know.

[B]

You can build bones and we can stop the decline. You know, maybe you're going to stay steady instead of losing 3%. Well, that's technically lose building bone. Yes, because we know we're going to lose 3%. Well, what if we stay steady? That is still a victory.

[A]

It's a huge victory.

[B]

It's a huge victory.

[A]

I have so many more questions. I need to hit the pause so that we can hear a word from our amazing sponsors. But when we come back, we're going to dig into your protocol. You claim we can start where we are. I believe you. We're going to make this easy, but. And we're going to cover that and so much more when we return. So stay with us. Welcome back. It's your friend, Mel Robbins. Today, you and I are getting inspired and learning from one of the world's renowned orthopedic surgeons and Researchers on longevity, Dr. Vonda Wright. She is sharing her protocol to feel younger and stronger and helping us start exactly where we are. Dr. V, you have four steps to getting fit, even if you're starting from zero.

[B]

Yeah.

[A]

Walk us through what we should be doing.

[B]

So I think that it can be very complicated, but it doesn't have to be okay at all. It doesn't. So let's say you're stepping away from the couch for the first time in years.

[A]

Okay.

[B]

Let's just say I call that adult onset exercisers, meaning you've gotten the message. We're gonna start. All you have to do to start is go for a walk today. Okay? In fact, put this on. Put Mel and I in your ear, and let's walk together for as long as you can. And you're gonna do that for seven days. I don't want you to go to the. I don't want you to lift tomorrow. I just want you to walk for seven days. Because you know what that is, Mel? That is a streak in exercise. World and running world. We call doing something daily a streak. Well, if you walk every day, preferably after your biggest meal, you're not gonna wanna not do it on the eighth day. Cause you've accomplished something and you're gonna feel good about that. So after you've started that, then let's figure out how to lift some weights. So maybe we start out with body weights. We're just gonna get up and off a chair 10 times in a row. We're gonna grab some books off the shelf and do doesn't have to be complicated or lifting heavy weights. Because you know what'll happen when we start with our body weight and then progress to lifting light weights. Give yourself six months. You're going to be in a gym with a bar on your shoulders, throwing weights around. I mean, you can progress over six to nine months to truly lifting weights in the way that you see people in the gym doing it. We're going to start by walking and creating a streak. We're going to start lifting. Then once you're lifting, you can maintain by lifting twice a week.

[A]

That's it.

[B]

I mean, you can maintain twice a week, two total body workouts twice a week. And then when you get advanced enough to lift heavy, you'll get more specialized. But we don't start that on day one. Number three, we need to retrain our balance. We need to stand on one leg doing anything. Working at our desk, brushing our teeth, doing kitchen work.

[A]

So even if I just were to stand on one leg as I'm brushing my teeth, that counts.

[B]

Yeah, because you brush your teeth for one to two minutes and that's a lot of training.

[A]

No, I'm just kidding.

[B]

Well, some days I don't know dentistry, but any amount of time works, right? Just retrain your balance so that we don't have that fatal fall that we talked about. Retrain our balance and then we need to keep our joints flexible. And you know, yoga, Pilates are great for that. Just stretching in your living room is great for that. All in all in keeping our muscles out to length, our joints moving.

[A]

And what is the fourth?

[B]

After you have walked or done your cardio, I want you to get your heart rate up, okay. To build fitness, we have to challenge ourselves. So you can do that as simply as picking up your speed for 30 seconds and after 30 seconds, totally recover. It's called sprint intervals. It's really remarkable for building overall fitness.

[A]

So only 30 seconds and do it four times. Oh, wait, okay. I didn't know the four times was coming. So 30 seconds, four times, 30 seconds.

[B]

Completely recover and repeat it four times.

[A]

Okay.

[B]

But only do it at the end of your cardio so that you're warmed up.

[A]

Okay. So if I go on my walk, then I can either sprint on the

[B]

treadmill, Sprint on the treadmill. Any apparatus works.

[A]

Okay?

[B]

You could swing a kettlebell and get your heart rate up to the max. You could do a rowing machine, a treadmill. You could run between light posts on your street if you're so inclined. It's about your heart rate, not necessarily the apparatus.

[A]

Now, I'm gonna be honest. I don't like this. I was really excited when people started emphasizing. And by people, I mean you. Resistance training. Cause I'm like, great, I don't have to do cardio now. Cause I don't like.

[B]

No, no, no, no. You must. The number one killer of women is heart disease.

[A]

Wait, what?

[B]

Yes, yes. We think that cancer is the number one killer of women, but almost globally, the number one killer of women is heart disease.

[A]

And how does sprints, 30 seconds, four times at the end of my walk, help me?

[B]

By building cardiovascular fitness, which this does across a lifespan. It keeps our heart healthier. It increases something called the VO2 Max, which is a measure of our fitness. So walking with a low heart rate is amazing for metabolism, but to really build cardiovascular health, we need to challenge it a little bit. So unless your doctor has told you not to raise your heart rate, we need to get our heart rate up.

[A]

And so let me see if I can just understand this. So you've got the balancing, which helps with you preventing falls. Okay. You've got the stretching, which helps with flexibility and joints. You have the walking, which helps with mobility and metabolism.

[B]

Metabolism.

[A]

You have resistance training, which is for your muscles, which is very important to keep your muscles strong, because strong, healthy,

[B]

which in turn helps almost every organ system.

[A]

Got it. And then you've got these 30 second, four times just sprinting. Sprinting. And that keeps your heart healthy.

[B]

It does. But don't think of it as five things. Think of the sprinting as the end of your walking a couple times a day. So I'm not adding.

[A]

I just added something to that.

[B]

I'm not adding.

[A]

Okay.

[B]

We're just Dr. Vonda.

[A]

Right. Okay. But I can do that. I can do 30 seconds, get your heart rated, and total recovery for me is probably two to three minutes.

[B]

Two to three minutes.

[A]

Wow. Okay.

[B]

Those four things, as a way to start out, progressed from taking a walk, a month later, you're doing all four things is huge. It's Monumental. Then you can go and buy yourself some workout outfit. You don't even have to have the right clothes. Just put on your kid's big T shirt and whatever.

[A]

Right.

[B]

It doesn't have to be complicated.

[A]

Well, and I also think if you have kids and they're teenagers or older, if you were to go to them and say, hey, I've listened to this podcast of this orthopedic surgeon. I need to start taking care of myself, Would you help me?

[B]

Oh, nice.

[A]

Now you've got something where you can connect with them over it. They can show you a few simple things you can rope them in on. Maybe helping you be motivated to walk.

[B]

Look how multifactorial that is. You don't have to go to the weird gym alone. You're spending time with your kid. They probably know what to do and they're gonna be proud of you.

[A]

Yep.

[B]

I mean, it's so multifactorial to engage them.

[A]

I'm actually gonna take my own advice. Cause one of the things I've been practicing recently is hanging. Oh yes. You know, like hanging from a pull up bar. Cause I can't do a pull up, but my son can do. He's like unbelievable. He can do so many pull ups.

[B]

So strong.

[A]

I'm gonna ask him to help me learn how to do a pull up

[B]

and take the next step.

[A]

And little does he know I've set a trap so he has to hang out with me.

[B]

He does. Cause it's gonna take a minute.

[A]

Correct. It's gonna take a big minute for a number of months. A lot of people hear the word exercise and immediate. Yeah, it's too stiff, you know, And a lot of people do feel a lot of pain, whether it's arthritis or it's back pain, or they have a replaced joint or they're just tight. Exercise isn't for people like me. What do you want to say to a person that feels that way, Dr. V?

[B]

I understand where they're coming from. Pain is a huge deterrent. But what they don't understand is that stiff joints are painful joints. The stiffer you are, the more pain you're gonna be in.

[A]

Wait, so if you're stiff already and you don't move, you're gonna be in

[B]

more pain and stiffer. So the joints thrive on motion. We build more joint fluid by moving our joints so that even if we're stiff, moving our joints will help us feel not stiff, not sitting down. Think about if you're sitting in a car for long periods of time. Your six hour trek you know, you get out of the car and you're stiff and everybody's getting out of the car a little stiff. Well, moving makes that go away even if you have arthritis. So continue moving. The second reason we feel more pain with stiff joints or arthritis is because we don't have the muscle support above and below. For instance, when someone comes to me with knee pain, the first thing I do as I'm writing their notes is tell them we're going to get strong. We're going to get strong like a bull. We're going to build our butt, core and hip. Why my joints hurt. So that every time you take a step, it's not like putting a sledgehammer of two bones together. Muscle is shock absorbers, so we have less hard impact. So move, build muscle to get strong so you may not feel like it. Let's say walking on the road hurts. Well, let's find a YMCA that has a hot pool. They're like community resources with sliding scales for the fees. Right? They all have warm pools. You just get into chest high water. Don't even get your hair wet. Pile it up. I've got all. Listen, you cannot.

[A]

Excuse me, I was just gonna say there's nowhere to hide.

[B]

You don't have to get your hair wet. Get in the chest high water. You just walk back and forth because the buoyancy will help your pain. You really want to get out of pain. In seven days, you stop eating sugar of all kinds of. When people take my advice and stop adding sugar, read the label. So you know how much added sugar is in all this processed food we eat. Stop drinking juice and eating the fruit instead. I'm not kidding you. To a person, when they come back, they're like, you know, my joints felt better in about seven days. These are all really simple things. So even if you are in pain, it doesn't give you license to do nothing.

[A]

One thing I would love to have you talk about is you spent a lot of time in your New York Times bestseller, Unbreakable, teaching about the really magical impact that muscles have. Cause I think there's so much out there now about resistance training and getting more high quality protein in. But a lot of us don't understand why exactly. Medically speaking, resistance training is important. And I think as a woman for a long time, I resisted resistance training, no pun intended. And I resisted and didn't want to eat a lot of protein because I was so afraid to bulk up. But in reading Unbreakable, I learned so many new things about why muscles in Particular are so important to healthy aging. Could you just break that down in a simple way?

[B]

I think that it's an understandable position to not understand that what you see in the mirror is not the story.

[A]

What does that mean, what you see

[B]

in the mirror in terms of how much muscle, what do your muscles look like bulking up or. I look fine in my clothes, I don't need muscle. That's not the story. The story of muscle is that it was designed as a metabolic engine.

[A]

What does that mean, metabolic engine?

[B]

It is important for locomotion. Without muscle, you would just be a skeleton that didn't move. Just like without a skeleton, your muscle would just be a heap of tissue. So muscles are important for locomotion, but they're very important for glucose metabolism. When you eat carbs in particular, and your body breaks it down into glucose, it is your muscles that that work as a sink to that glucose so that it's not just all stored in fat. So it's really critical. Muscle itself contributes to your longevity. Muscle interacts, communicates with bone to help build better bone. So what you see in the mirror is not the story of muscle. The story of muscle is the other jobs that it does in your body. So if you want to walk around when you're 80, 90, 100, be less prone to falls. You need muscle to do that if you want to help control your metabolism, decrease your chance of getting diabetes or metabolic disease. We need more muscle. We need healthy muscle if we want to burn more calories. Because many people are worried about gaining weight, we need more muscle. Muscle burns more calories just to live than fat does.

[A]

You mean just sitting around muscles burn more calories?

[B]

Yeah. 120 pound person, that's 50% fat, will burn much less calories in a day just to live than 120 pound person that has a 25% body fat because of the different ratios of the tissue. So that's what I mean. When we tell the story of muscle, it's critical not for the way we look in the mirror. That's the bonus. It is critical for the metabolic way that it helps our body function today and for the longevity it infers through proteins in your body.

[A]

Thank you for explaining that. Because I feel like you hear the words resistance training, you hear the words protein without understanding the actual why of what muscles do for your overall health.

[B]

I personally love feeling strong, not weak. It kind of ticks me off when I can't do something I want to do. So building muscle is a way to get to do what you want to do when you want to do it.

[A]

You know, I recently, my husband Chris gave me a hug the other day and he said, gosh, you really feel a lot stronger.

[B]

That's nice.

[A]

It was the sexiest compliment I think he's ever given me. And I'll tell you, ever since I read Unbreakable and of course since our last interview on this podcast, I have prioritized because of you. Resistance training, lifting, heavier incline walking.

[B]

Do you feel good?

[A]

Not only do I feel good, I feel incredibly strong. I have also because of you, I have prioritized high quality protein. It is so hard to get a lot of it in, but my entire body composition has changed. I love that I have more energy. I cannot believe the difference that these little changes have made. And I've also recognized how stupid it was to think that I would ever bulk up. Because the amount of lifting you need to do to actually get big, it's like a full time job completely over decades. Yes.

[B]

Yeah.

[A]

Yes. Like, what a joke that I thought that if I went to the gym and lifted heavy weights that I would get big. Like I don't spend enough time there doing it and I don't lift enough weights to do it and I never will. But simply following this advice over. It's only been six months since I've seen you, a massive, massive change. And for my husband to hug me and say, God, you feel a lot stronger, that's so great. Wow. Yeah, I don't look ripped, but I am feel stronger. Oh, I feel like a different human being. I always thought about taking care of myself so that I look good. And yes, I wanna look good, but there's a very different level of satisfaction that comes when you feel good in your body and you feel. And it pays dividends for me anyway. I feel more energized. I have better focus. I'm not as bitchy to my family, particularly with the protein. Getting protein first thing in the morning, resistance training, it's changed my mood.

[B]

Yes.

[A]

Why are you saying yes? Is that like a known thing?

[B]

Well, no, because that happens to me when I am well fed and strong and can do what I want to do. It changes everything.

[A]

I feel like I have reserves that I can draw on. Yes, you talked about that.

[B]

Like physiologic reserves.

[A]

What does that mean?

[B]

That means just like putting money in the bank, we have a little stockpile. Physiologic reserves is having enough physical health, enough muscle, enough bone, enough cardiovascular fitness, that one cold isn't knocking us off the chair. Or one long travel stint is not just exhausting us for months. We continue to have enough reserve to draw on. And that only comes by building it.

[A]

Well, I will say I have always been an active person. I have never been a weightlifter. I'm only six months into this. And the transformation and how I feel from the inside out, thanks to you, has been life changing. Yeah.

[B]

Thank you.

[A]

In your New York Times bestseller, Unbreakable, I am looking at this entire chapter and you even have recipes in this book, but you have an entire chapter in your New York Times bestseller, Chapter 10, Unbreakable Nourishment. And you write extensively about protein as an orthopedic surgeon. Will you just bottom line for us how much protein you recommend that we get, especially as women, because it's very, very confusing.

[B]

To support our growth of muscle, to support our normal metabolism, I recommend 0.8 to 1 gram of protein per pound a day. The protein should be high quality protein, which means it contains the essential amino acids, including the most important one, leucine, which is the most powerful stimulant for muscle growth. So we need an absolute amount and we need high quality protein.

[A]

When you say either 0.8 grams or to 1 gram per weight, is it what you weigh now, what you want to weigh? Like, how do you do? Because that's a, like, when I think about that, I'm like, that's a lot of fat. That's a lot.

[B]

So I know, am I going to

[A]

get bulky from eating that much protein?

[B]

Yeah. No. I normally say the very minimums that muscle scientists talk about are about 100 grams a day.

[A]

A hundred grams a day, minimum.

[B]

But if we're really growing muscle, 0.8 to 1 gram per ideal pound. Most of us know ideally what we would want to weigh, or we do know because we've had a body composition and we know for the body percentage. So it's not what we currently weigh unless we're at our ideal weight. It's our ideal weight.

[A]

Thank you for clarifying that. I have so many more questions. I need to hit the pause so that we can hear a word from our amazing sponsors. Don't go anywhere. We have so much more to cover with the extraordinary Dr. Vonda Wright when we return. So stay with me. Welcome back. It's your friend Mel Robbins. I'm thrilled that you are here. Thank you for listening to this. Thank you for sharing this with the people that you care about. We're talking with the extraordinary Dr. Vonda Wright. Her New York Times bestseller is Unbreakable and she is a world renowned orthopedic surgeon giving us all the research and her protocol to feel younger and stronger. Starting exactly where you are. You know, Dr. V. One of the things that you hear from patients is, I don't want to be a burden as I get older. Can you speak directly to the person that's either watching or listening and feels that way and are starting to get nervous about it?

[B]

Yeah. So when someone is in my office and they say, I don't want to be a burden to my children, and yet they're sitting in front of me with terrible knee pain or they've come in for whatever reason, I know what they mean. They mean that they have always been the independent person, the person who took care of everything, held the glue of the family together. Usually it's women who say this to me. They have always had it all together, but they see themselves in pain, they see themselves slowing down, they see themselves not the way that they were, and they're getting afraid. And I don't want to be a burden to the people that I love. And I completely understand that because this person is used to being independent and they want to be viewed that way. If you do not want to be a burden to those you love, then that requires action. Now. It requires not wistfully hoping that you will never become a burden. What can I do today, even if it's as simple as, can I stop eating sugar today so that my joints don't hurt as much, so that I can get in the pool in chest high water and keep moving? Do I not want to be a burden in the future so that I do some chair squats? People misunderstand me sometimes when I say, I need you to lift heavy, I do need you to lift heavy. But if you are at a place where you just have trouble, get off the couch, well, then let's just do that 10 times in a row. Because remember what I started this with. There is never an age or skill level when your body will not respond to the positive stress. So. So if you don't want to be a burden to your children, but you see yourself in fear of getting there, well, let's start where we are and let's take some action to get in front of it instead of just looking down the road in fear. Does that make sense?

[A]

Oh, my gosh. So much sense. But I can see how if you think that it's inevitable, you're not gonna do anything and you're just gonna sit with your fear and you're here with the Research to say no. Your body is designed to respond, and it will respond. And regardless of how frail you may think you are right now or whatever ended up happening to your mom or your grandmother, you can change this.

[B]

Well, and I just want to make clear, we talk about longevity a lot in this very point in the conversation. I'm not talking about living another 120 years. I am talking about living the best every day that you have, right? Sitting in pain in a chair because you cannot or refuse to take the next step. We need to choose what we can do and do it and not just sit and wait so that we feel better today, so that that will spur us to feel better tomorrow. And by plugging in all the exercise and the things we talk about, you may live longer, but I want you to live better today.

[A]

Oh, I love that. Yeah, I love that. You talk about something called the critical decades in your work. Can you explain what they are and why critical decades matter so much? Dr. V. Yes.

[B]

So there was a paper that came out last year that looked at the inflection points of aging, meaning when biologically do we age rapidly? And I think we were all surprised to read it happens, according to this paper, at 44 and 60.

[A]

44. And so there's two. 44 and 60.

[B]

Well, two big inflection points, 44 and 60. So for me, it divided our lives into critical decades. Right. So if we start at the youngest critical decade, I call it 35 to 45. It is the decade in life when you're not a child anymore. You have more access to choices, but you have all your hormones. It is the decade to get your health standards together. Let's figure out how to live, figure out how to eat, figure out how we're going to commit our lifestyle to the standards that will help us live in the future the way we're living today. That is a critical decade. And notice what happens at the end of that critical decade, the first inflection point of aging for women. The next critical decade is this perimenopause decade, 45ish to 50, early 50s, when our estrogen is going out the door. Why does that happen? It's because our ovaries, which are not sex organs, they just happen to make estrogen, which is not a sex hormone. Ovary Aging is an emergent science that really informs us why women age differently. And it's because in men, we have a slow, steady decline, about 1% a year. Right? So that's why when the bros talk about longevity, it's a very different thing than for women. Longevity. Meaning because we have a catastrophic decline and change in our ovarian health, our release of estrogen. Estrogen is such a critical hormone in every organ. It profoundly affects our aging process across the body. We know we lose muscle mass. We know we're going to lose bone density. We know we accumulate fat. We know our cartilage is highly responsive to estrogen, as are our muscle stem cells. This is another critical decade that we cannot wait through to establish health standards. If we haven't started all the lifestyle behaviors before, let's start them now and let's make our hormone optimization decision so that if we choose to replenish our estrogen, progesterone and testosterone, that we make that decision now and not wait until the next decade when we've already hit the second inflection point of 60. Now, hear me, people.

[A]

Yeah. Everybody over 60 is having a heart attack right now. So if you're past the critical decade and say again what the critical decade means, these are moments when these are inflection points.

[B]

35 to 45, you still have all your hormones. Let's get our standards going. They're gonna make a huge difference. Right now, 45 to early 50s, we're in perimenopause. We're more rapidly aging because of our ovarian aging. That's happening and the role of estrogen. Once our ovaries have retired, gone. It is never too late. You can still respond to lifestyle interventions. Sometimes it's just harder. It doesn't mean don't try. It doesn't mean don't start. There are plenty of examples, commonly now all over the digital world, of people picking up the mantle of I'm gonna live better starting at 60. There's never a time. Is it gonna be harder than it was when you were 35? Sure.

[A]

Okay. So what you're basically saying is, if you're listening or you have people in your life that you love that are 35 to 44, send them this because they need to wake up. Because if they start making the changes now, it's gonna have a bigger impact on longevity because they still have all their hormones. It's a season of life.

[B]

Truly adulting. Yes. If we're truly adulting and preparing for our adult life out of grad school, we're out of college. We're hopefully have a job that's sustaining us. Well, let's do the next adult thing and figure out how to maintain our body for the rest of our lives, Right?

[A]

Yes. And it has a bigger Impact long term.

[B]

There's like a compound and you know, in banking you put a little money away in the beginning and it compounds. Think of it like that. We're building physiologic reserve that we get to draw from. But if we, if we in our 30s are frail already, what are we gonna be doing for 50 more years?

[A]

Right.

[B]

So that's the first critical decade. Got it. And then through the perimenopause time, it's another critical time to make these decisions, to get into these lifestyles, to start not treating our bodies like garbage disposals, to make our hormone optimization decision. And then if we've gotten all the way to our 60s and we haven't started yet, that it's okay. Our bodies will respond. Remember the research we talked about? 90 year old people in nursing homes were responding to physical activity because our bodies are equipped if we're gonna use the equipment. Right, Got it.

[A]

Got it. So the critical decades is really something to pay attention to because you maximize return faster during those windows. And especially the second critical decade from kind of like the perimenopause 44 is your women are losing hormones. Doubling down then is important, but if

[B]

you haven't started before, double down then.

[A]

Got it. And your body will respond even if you're in your 60s, 70s or 80s.

[B]

Completely.

[A]

Great.

[B]

Completely.

[A]

I am leaning in because I was so taken by the connection between women fracturing their hip and women having these low impact fractures and menopause and bone density.

[B]

Yeah.

[A]

And so Dr. V, what do you wish every woman knew about menopause?

[B]

Menopause is not to be feared. If we step in front of it. If we are lucky enough to live long enough, everybody born with XX chromosomes and therefore ovaries will go through it. I am going to be honest with you. It can be very hard if you are not prepared. But that's why I want us all to know what's going on. Menopause is a physiologic, a hormonal, a psychologic and a social transition. Nothing will be the same, but it can be great or better. That's the framework I want people to know. What is menopause biologically? Well, it is the exhaustion of our ovaries. We are born, little girls are born with two ovaries that contain all the eggs they're ever going to have. Those eggs are used all through our cycling years until we have so few during perimenopause that we can't produce the estrogen that we once did. And it starts getting a little chaotic Horm until, skip ahead to on average, depending on who you are. 51, 52, your ovaries are just done. They're no longer producing any eggs, therefore, no estrogen from the egg follicle. And you're postmenopausal. Right. That's what menopause is. Everything we feel, from our brains to our hearts to our bones to everything, our mood, I don't feel like myself is due to the alteration in estrogen load. It's such a critical hormone in our body. It doesn't mean life's over when it stops. It just means life's different. And what I encourage women to do is not just to take the attitude that I hear a lot, which is women tell me they have a really high pain tolerance and they're just gonna suffer through it. And I ask, why do you have to suffer through it? Why do we enculturate women to bear suffering? Why is that our lot in life when there are things we can do to feel better? Right. That is another common thing women say to me is that they're used to the suffering. So when it comes to menopause, some women say, I'm just gonna gut through this. Some women say, I didn't really feel that bad. But even if women say I don't feel that bad, they can't perceive the physiologic changes that are happening, like loss of bone density, loss of muscle mass. I need people to understand that whole picture. It's a physical, psychological, social, and hormonal transition that is natural. We are all meant to do it. It's not that we did anything wrong. It's not that we're not trying hard enough. It's the way we are designed.

[A]

I'm just struck by your observation, as a physician of how often you hear women say that they're going to suffer through it.

[B]

Every day. I have clinics every Tuesday and Thursday, every day, without fail. People say that to me. And I wonder why. Listen, I'm a sports doctor. I get being in pain. I get it right. I take care of athletes. We're in pain all the time. But it's different. What these women say to me is not pain of blowing out their ACL or being tackled on a football field. What these women are saying to me is that their body hurts and they're just going to live with it for years. So I just want to know why we accept that. I don't have an answer for that. Why do we enculturate our girls to accept that?

[A]

The only thing that Popped into my head is I wonder if it has anything to do with the pain associated with childbirth and the expectation that you're just gonna have to bear it and then.

[B]

And live through it.

[A]

Yes.

[B]

Well, I think you may be right. Right. For some women, their periods hurt. We know predictably, we're just gonna bear it. And then we go through checks.

[A]

And you're not gonna talk about it publicly every week.

[B]

I mean, every month for the 30 years you have your period. And then childbirth hurts. And then. So maybe it's just another phenomenon we're going to live through. But when it becomes limiting, when it becomes a reason not to live with hope for the future, when it becomes a reason not to seek out the kind of lifestyle and hormonal and all the other interventions that could possibly help you live to the capacity you were created to live, I think it's not useful.

[A]

What do you say to somebody that's sitting across from you as a patient that just says, I'm just going to suffer through it?

[B]

Well, I respect their autonomy in doing that if that's what they want to do. I'm not here to berate them for making that choice. But that's such a different way to think about it. Yes, exactly. I educate them that it doesn't have to be this way. Here's. Here's all the resources in my office. I hand write notes for everyone. I send them home. Like, if you were my patient, I would have been writing our conversation notes here because that slows down the conversation. It gives them something to walk away with that's not a photocopy. But I will give them multitudes of solutions to how to not be in pain. And they can choose to follow these or not. They have agency. They can be their own gate if they want.

[A]

But I think it's a life changing mindset switch to consider the possibility as a woman in particular. And you may be thinking about your mother, you may be thinking about your grandmother, you may be thinking about your sister, someone in your life, your wife, who has been suffering through it and thinks that's just the way that it is. I think it's a life changing perspectives shift to imagine a world where you don't have to suffer through it. There is hope, there are things you can do that you deserve to not suffer through it.

[B]

Well, listen, Mel, in my own story, I suffered through perimenopause. I didn't. You know, I'm a longevity researcher. You would have thought I would have known, but it was so long ago. We weren't Talking about it, Right.

[A]

How much time did they dedicate in either your training as a nurse, oncologist, or in medical school to menopause?

[B]

I didn't. I don't remember ever talking about it. I don't. And in fact, I know the data. That's not uncommon. You know, so we're at a real crisis point in this country with finding people who even know how to talk about women's health across the lifespan. Because I don't believe it's just the OB's responsibility. I believe it's every doctor's responsibility to know enough to at least direct in the right direction and not just say, oh, you're just getting old, which I think is a complete cop out. That is not caring for people. Look how mad I get. That is not caring for people.

[A]

I love it when you get mad.

[B]

That's a cop out. But in my own perimenopause, I suffered. But if I would have left it there, I wouldn't be sitting here today. I would not be feeling like I'm on top of the world because I took the time to say, I am suffering, and I don't want to feel this way. So what do I need to know? Who do I need to find? You know, I got to dig to the ends of the earth to find the resources. And I did that by taking action. I guess the central theme of our discussion today is you can sit there and let time happen to you, or you can take action and make the choices that are gonna make you live in the way you envision.

[A]

Well, I have somebody I love very deeply who has the mindset that I'm just gonna suffer through it. And I'm sending this to her as soon as we are done editing this episode. Cause I hope you can open her mind to a different future. And I'm sure as you're listening or watching right now, you have someone in mind who suffers through it. And this episode is a gift you can give to them to consider a different possibility. Dr. V. How does menopause change how you want us to think about exercise, strength training, recovery?

[B]

I think it adds a sense of urgency to it. We know how much muscle, bone, tendon we're gonna lose. We know. We know that the future that I see in the emergency room of women laying frail in a bed with a broken hip, we know that happens a lot. So for women in menopause, the messaging of now is the time. Even if you've never paid attention to yourself before, if you were overrun with oxytocin and you took care of everybody but yourself. You don't have as much estrogen right now, so you're not going to have as much oxytocin. So now is the time. It's this sense of urgency. It's now or never, people. And that's not true. It's not never, but it's now. What is holding us back? Why can't we step across the threshold of caring about ourselves in the way that we've always cared about other people? Right. What is that? And maybe, Mel, that takes a little bit of work, some stepping back of reflection of what is keeping me from taking care of myself, from doing the thing. Because it's not motivation. Motivation lasts about 32 seconds, you know, or 21 days according to the resolution people. It's not that it has to be a deep abiding belief that you are worth it, that you are worth the investment, that the future can be hopeful. It's a mindset shift. Right. The actions will follow.

[A]

Well, what's interesting is you have a lot of daughters coming in saying I don't want to turn out like my mom and there's an opportunity for you as the mom to go, I don't want to model this for my daughters.

[B]

Oh, such a good point, Mel. Exactly. Across their lifespan. Right. How do our children learn how to be healthy? They watch us. Right. And so if you're a midlife woman and you're in a position that you have 25 and 30, like both of us, we have daughters in this. I have two daughters and three daughters in law, all in this age group. They are very self motivated. But let's say they were watching me to see how could it be, do I have to suffer. I can model for them vibrance and energy and doing really hard things and acting now as I have my whole life. Or I could model for them getting weaker and sadder and not being able to do what I've always done that the family has enjoyed. Right. And therefore giving them hope for the future. That's the real gift, Mel.

[A]

Truly. And your granddaughters and your grandson. I love that shift in perspective. As an orthopedic surgeon, what are your thoughts on hrt?

[B]

Oh, my thoughts on HRT as an orthopedic surgeon are that number one, everyone gets to make their own choice. We're not going to put this on you, but you must make this choice from facts, not fear. And that includes knowing the data. And if you have to dig deep and read the studies that are now everywhere, or if you just want to Be told what to do. The guidelines that the medical societies put out, like the Menopause society, are very clear. They're in layman's language. Find the information, number one. Number two, if you don't want to end up frail in a hospital bed with a broken bone, low muscle mass, fat everywhere, unable to live the life you envision, well, then let's consider adding estrogen, progesterone and testosterone to the toolbox of your lifestyle interventions. It is a critical part of lifestyle intervention. I just think you need to make the decision conscientiously, not out of fear.

[A]

Do you have a concern? Because there's a tremendous amount of misinformation out there about it.

[B]

I have a concern. I just think that certainly in the era where any computer can generate an AI image of me saying whatever they want it to say, that you have to be responsible for the information you take in.

[A]

Right? Yeah.

[B]

So exercise that responsibility. Read the original book. Just dig a little deeper. You're worth that curiosity, right?

[A]

Well, it changed my life.

[B]

Yeah.

[A]

And I had a lot of unfounded fear about it because of all the reports that had been reversed, and come to find out that if it's a safe option, which it is for the

[B]

vast majority, for the vast majority of

[A]

people, and now that I understand the connection to bone density and the implications, I'm like, like, why wouldn't you? If it's safe for you.

[B]

Like, if it's safe for you, why wouldn't you? Right. It's still your choice. But if it's safe for you, which it is for most people, why wouldn't you? But even if we're talking about, if we're clarifying who, what does safety really mean? Well, we're really talking about systemic estrogen. And, you know, take high enough doses that affect your whole body. But what if even from an orthopedic perspective, even if it's not safe for you, systemic, because of a history of certain kinds of cancer, personal history of certain kinds of cancer, vaginal estrogen is safe for everybody. The studies have been done. It does not absorb, but it can save you from the genitourinary syndrome of menopause, which from an orthopedic perspective, many old ladies fall down in their kitchens and break a hip and potentially die because they have chronic UTIs, bladder infections that have never been treated. They've never had vaginal estrogen. They have chronic infections, which makes their heads a little woozy. They lose their balance because they're feeling woozy and they break their hip. It is a known phenomenon that chronic bladder infections can affect your balance and your brain and you fall and break your hip and it just leads to this spiral. So if I'm trying to prevent falls, I want every tool, I want everybody to be on vaginal estrogen so that they don't have these chronic UTIs that can lead to falls.

[A]

Dr. V. If the person listening to this takes just one action today, from everything that you've shared and that you've taught us, what do you think the most important thing to do is?

[B]

The most important thing to do, the one thing to do if you have never invested in your health, health ever, is to start today. Don't wait till tomorrow, because you're motivated right now. You're listening to this right now. Somebody sent you this podcast or you took our advice, you put on the headphones, go do something right now. Do not put it off another day. Whether you're doing the walking thing, if you have been going along being active for a while, but have never pushed yourself to the next level like you just did this year, pushed yourself to the next level, start that today. You know, get down and do this push up thing that we did. Just do something harder because that's the way our body is made to adapt. I mean, I could tell you one thing, go lift weights, one thing, go walk. But the thing is that you do it today because then you will start your seven day streak and you're on your road to feeling better, longer.

[A]

Seven day streak. That's the challenge. Seven day, seven day streak, walk. That's all we're asking.

[B]

That's it. Just start there. Totally worth it.

[A]

And then report back. I want to hear how the seven day streak goes.

[B]

People should post it and show us their streak and that they are worth the daily investment.

[A]

Oh, I would love to see that.

[B]

I would love to see that.

[A]

All right, so you heard that it is a prescription from Dr. Vonda Wright. She is telling you your assignment starting

[B]

today is seven day streak to start your journey. Do not wait till tomorrow. You are worth the daily investment to get in front of your aging process.

[A]

And it's just going to start with a walk.

[B]

We can start with a walk. If we're starting from the couch, it can start with a walk.

[A]

Dr. Vonda Wright, what are your parting words?

[B]

Here's what I want all your fabulous people to remember. What we've talked about today is summarized by. You are not the victim of time. You are not the victim of time. And in fact, aging is a very natural part of living. But what matters is not the time but is how we build our life. What are we going to add in? What are we going to contribute to our own well being? So you are not a victim, you are an active participant. And your aging and your health can be by design.

[A]

Well, Dr. Vonder Wright, thank you for all of the work that you do.

[B]

Thank you.

[A]

Please keep shouting from the rooftops and doing the research and writing your books and sharing this wisdom. We need you. We really do. You've made a enormous difference in my life and I wanna thank you for that. And I wanna thank you on behalf of the person that is with us right now and the difference that you've made in their life and the gift that you've given them in this episode as a free resource to share with people that they care about. And I will start the seven day challenge. I walked this morning so I am gonna start the seven day challenge myself. And I will do it with all line and that's it. I love you.

[B]

Thank you. I love being here with you.

[A]

Well, I'm so glad you came. And I'm so glad you came too. I know that you have so much going on, but the fact that you made a decision to listen to or watch something that is going to help you take control of your health, that is extraordinary. And in case no one else tells you today, I wanted to be sure to tell you that I love you. And I believe in you. And I believe in your ability to create a better life.

[B]

Life.

[A]

And part of creating a better life is understanding that you are not a victim of time. That you have time to take control of your health. That you deserve to feel good in your body, to feel stronger. And Dr. Vonda Wright just gave you a very simple research backed way that is going to help you do it. And I sincerely hope as your friend that you will. Alrighty. I will see you in the very next episode. I'm going to welcome you in the moment you hit play. Doctor Vonda Wright, I am so excited to see you. I'm excited to be here with you, Dr. Wright. Thank you for saying that. That's just incredible. I have a so I have so much more I want to ask you and I need to take a quick break. Hold on a second. Okay, got it. Okay. I'm just going to give you one break. You ready? So it's in the room toe welcome. You're doing dynamite by the way.

[B]

Oh, thank you.

[A]

And that's it. I love you.

[B]

Thank you. I love being here with you.

[A]

Oh, and one more thing. And no this is not a blooper. This is the legal language. You know what the lawyers write and what I need to read to you. This podcast is presented solely for educational and entertainment purposes. I'm just your friend. I am not a licensed therapist. And this podcast is not intended as a substitute for the advice of a physician, professional coach, psychotherapist, or other qualified professional. Got it? Good. I'll see you in the next episode.

[B]

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