Hey Team! 
This week, I want to feature one of the most important randomized controlled trials for menopausal women - the LIFTMOR Trial. "Lifting heavy" is not just the latest social media tagline - it is the foundation of our longevity - and the evidence supports it! 
I hope you enjoy this summary and this week's workout! 
Cheers!
-Dr. Carla

Women with osteopenia or osteoporosis have traditionally been advised to exercise cautiously and avoid heavy lifting. The landmark LIFTMOR trial challenged that approach by asking an important question: Can postmenopausal women with low bone density safely lift heavy enough to stimulate stronger bones?

What was the LIFTMOR trial?

LIFTMOR stands for Lifting Intervention for Training Muscle and Osteoporosis Rehabilitation. This randomized controlled trial included 101 postmenopausal women with an average age of 65. All had osteopenia or osteoporosis at the hip, spine, or both.

The women were assigned to one of two programs performed twice weekly for eight months:

• A supervised, 30-minute high-intensity resistance and impact training program

• A home-based, low-intensity exercise program emphasizing mobility, balance, and light resistance

The high-intensity program centered on four movements: the deadlift, back squat, overhead press, and a jumping chin-up with a drop landing.

After an initial period focused on learning proper technique, the three resistance exercises were performed for five sets of five repetitions at greater than 80–85% of one-repetition maximum. In practical terms, these were genuinely heavy loads—not light weights performed for many repetitions.

What did the researchers find?

After eight months, lumbar-spine bone mineral density increased by approximately 2.9% in the high-intensity group. In contrast, the low-intensity group lost about 1.2%.

At the femoral neck, bone density was essentially maintained in the high-intensity group, increasing by approximately 0.3%, while the control group lost approximately 1.9%. Preventing the expected decline at the hip may itself be an important benefit.

The high-intensity group also demonstrated favorable changes in femoral-neck cortical thickness. Cortical bone forms the strong outer shell of bone and contributes substantially to the hip’s ability to tolerate loading.

More than stronger bones

LIFTMOR also produced substantial improvements in physical function. Leg and back-extensor strength increased by approximately 35–36%, and participants improved their sit-to-stand ability, functional reach, mobility, and vertical-jump performance.

This matters because fracture risk is influenced by more than bone density. Strength, balance, mobility, and the ability to recover from a misstep can all affect the likelihood of falling—and whether a fall results in injury.

Was heavy lifting safe?

Across more than 2,600 supervised training sessions, only one training-related adverse event occurred: a mild lower-back muscle strain. The participant returned to training and completed the program. No training-related fractures or serious injuries were reported.

These findings are reassuring, but they require context. Participants were carefully screened, the exercises were introduced gradually, and every high-intensity session was closely supervised by qualified professionals. The study was also too small to prove that the program prevents fractures or is safe for every woman with osteoporosis.

The Bottom Line

The LIFTMOR trial helped overturn the assumption that women with low bone density should train only with light weights. Its message is not simply “lift heavy.” It is:

With appropriate screening, progressive loading, excellent technique, and qualified supervision, postmenopausal women can train at high intensity—and may meaningfully improve bone density, strength, and physical function.

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Everyone loves a good heavy day! There’s something very satisfying about moving heavier loads for lower repetitions. But this isn’t your typical “heavy day” where we do 5 sets of 5 and we’re done. Today, we integrate two movements - the dumbbell push press and the front squat. But we don’t stop there - we have a new movement called the “dumbbell bear crawl” performed between rounds of lifting. This movement requires coordination, balance, shoulder stabilization, and core strength, complementing the muscles targeted by the lifts and adding some unexpected intensity!

Movement practice

Take 5-7 minutes to watch the videos, practice the movements, and select your workout weight. Select one set of dumbbells to use for the push press, front squat, and the dumbbell bear crawl. The push press will be what limits the weight selection. This is a heavier weight that you can perform 5 push press repetitions where the movement becomes challenging at rep 3.

Next, watch the video and practice the bear crawl, starting without weight and then adding the dumbbells. For bear crawl modifications, check out this post from the Athletic Aging Archives: Strong on All Fours. If the dumbbell bear crawl is not accessible to you, forego the dumbbells (or use a second, lighter set) and do a simple bear crawl.

Workout

Perform 2 dumbbell push presses, 2 front squats, and a 25-foot dumbbell bear crawl. Then perform 4 push presses, 4 front squats, and a 25-foot dumbbell bear crawl, and so on until you finish the repetition scheme. Your last movement should be the 25-foot dumbbell bear crawl. As the sets get larger and fatigue sets in, break up the sets into smaller sets with a few breaths of rest in between.

A trick to help keep moving efficiently is to make a point to pick up the dumbbells before you really want to at the end of each short rest interval.

For Time:

2 - 4 - 6 -8 -10

• Dumbbell Push press

• Dumbbell Front squat

Perform a 25-foot dumbbell bear crawl (or simple bear crawl or other modification) after each round of push presses and squats using the same set of dumbbells used for the lifts. Alternatively, you can perform the bear crawl without weight. Click HERE for more bear crawl modifications

Cool Down

Your core is going to need some love after this workout. Jump-start your recovery with this 15-minute full-body stretch sequence.

Yoga Full-Body Stretches for Tension and Sore Muscles

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This just dropped…..

You did the workout, you ate “clean,” and your body still isn’t responding the way it used to. So what changed? In this episode, I sit down with Dr. Carla DiGirolamo, a double Board-Certified Obstetrician/Gynecologist and Reproductive Endocrinologist specializing in caring for active and high-performing women, to unpack what’s really happening to active women’s bodies in mid-life and beyond.

We get into why hypothyroidism can be misdiagnosed because of chronic underfueling, what LEA and RED-S are (and why most doctors have never heard of them), hot takes on microdosing GLP-1s and muscle/bone loss for midlife women, and how HRT, testosterone therapy, and IUDs actually fit together. This isn’t a decline — it’s a detour, and it comes with a new playbook.

NOW TAKING MEDICAL CLIENTS FROM COLORADO, CONNECTICUT, AND NEW HAMPSHIRE!

..in addition to MA, NY, NJ, PA, CA, FL, OH

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists.

To speak to this need, I launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

The strict shoulder press and the push press are movements that start with weight at the shoulders and finish overhead.

But what happens between those two positions makes them very different exercises — and both deserve a place in an Athletic Aging toolbox.

THE STRICT PRESS: Build the engine

In a strict shoulder press, the lower body stays quiet. No dip. No drive. No help from the legs.

The shoulders and arms have to do the work.

The strict press primarily trains the deltoids and triceps, while the upper back and trunk stabilize the body, and the shoulder blade must move appropriately as the arm travels overhead.

Because you can’t borrow momentum from your legs, the strict press is an excellent way to develop upper-body pressing strength and control.

Think: STRENGTH + CONTROL

THE PUSH PRESS: Connect the engine to the whole system

Now add the legs.

The push press begins with a short, controlled dip of the knees and hips followed by an explosive leg drive. That force travels from the floor, through the legs and trunk, into the arms and ultimately into the weight overhead.

Your shoulders are still working — but they are now part of a coordinated, whole-body movement.

That changes the training stimulus.

The push press develops power, coordination, and force transfer between the lower and upper body. It also allows you to move more weight than you typically could with a strict press.

Think: POWER + INTEGRATION

SAME FINISH. DIFFERENT JOB.

Strict Press
No assistance from the legs
Greater emphasis on upper-body strength
Slower, controlled force production
Requires trunk stability and overhead control

Push Press
Legs initiate the movement
Integrates lower and upper body
Develops speed and power
Trains coordinated force transfer through the body

Neither is the “better” exercise.

They simply ask your body to solve the same problem — getting something overhead — in different ways.

HOW TO DO THEM

For both movements, begin standing tall with the weight at shoulder level. Brace your trunk and keep the weight balanced over your base of support.

Strict Press:
Without bending your knees, press the weight overhead until your arms are extended. Finish with the weight stacked over your shoulders and body — not drifting forward.

Push Press:
Make a shallow, controlled dip by bending the knees and hips slightly while keeping your torso upright. Drive forcefully through the floor, extend the legs and use that momentum to help send the weight overhead. Finish in the same strong overhead position.

MAKE IT YOUR MOVEMENT

You don’t need a barbell — or a heavy weight — to benefit from either exercise

• Dumbbells — allow each arm to find a comfortable pressing path
• Lighter weights — practice mechanics before adding load
• Seated strict press — reduces lower-body contribution and balance demands
• Reduce the range of motion — work within the range you can control comfortably

And if an overhead position causes pain, don’t force it. Shoulder mobility, previous injuries, and individual anatomy can all influence which pressing variation feels best.

WHY TRAIN BOTH?

As we get older, maintaining strength matters. Maintaining power matters, too.

• The strict press develops the strength to produce force with the upper body.

• The push press teaches the body to generate force quickly and transfer it efficiently through multiple joints and muscle groups.

One builds the pieces. The other teaches the pieces to work together.

Strength gives us capacity.
Power and coordination teach us how to use it.

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Today’s workout provides the opportunity to practice the strict shoulder press and the push-press with accessory work before the main training set, followed by the push-press alternating with a cardiovascular stimulus.

Warm-Up

AMRAP 5 (As many rounds as possible in 5 minutes)

• 10 Up-downs

• 10 Mountain climbers (Right + left - 1 repetition)

Movement Practice

Today’s movement practice is an Accessory segment where you will practice the strict and push press movements.

To appreciate the greatest benefit from this accessory, watch the demo videos above for these two movements and pay close attention to the mechanics of these movements.

Select a light weight to start, building incrementally over the 3 sets.

Accessory Work

3 sets

5 strict press + 5 push press: Perform 5 strict presses, then without putting the weight down, go straight into the 5 push presses.

Rest 2 minutes between sets.

Workout

TIP! Break up the sets of dumbbell push presses into 2-3 sets. If you can do them unbroken, you have gone too light! (Recommended weights: 15lb dumbbells (beginner) to 35# dumbbells (advanced).

For Time:

• 21 Dumbbell Push Press

• 30 Calorie Row

• 15 Dumbbell Push Press

• 21 Calorie Row

• 9 Dumbbell Push Press

• 15 Calorie Row

Movement Options:

Substitute a kettlebell swing (eye level or if advanced, swing to overhead) if no access to a rower or jumping air squats if no access to a rower.

Cool-Down

Jump-start your recovery with this 15 minute Quick Escape Yoga sequence from Five Parks Yoga

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Housekeeping…

This is something you don’t want to miss. Check out this workshop featuring the awesome and amazing sports psychologist, Erin Ayala! Register HERE

NOW TAKING MEDICAL CLIENTS FROM COLORADO, CONNECTICUT, AND NEW HAMPSHIRE!

..in addition to MA, NY, NJ, PA, CA, FL, OH

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists.

To speak to this need, I launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

If you want one movement that trains almost everything at once, the dumbbell thruster is hard to beat.

At its simplest, a thruster combines two familiar movements: a squat and an overhead press. Put them together, and the legs, hips, core, shoulders, and arms have to work as one coordinated system.

And your heart and lungs quickly get involved too.

Why Thrusters?

The dumbbell thruster develops several qualities that matter as we age:

• Lower-body strength from the squat

• Upper-body strength from the overhead press

• Power as the legs and hips drive the dumbbells upward

• Core stability while transferring force from the lower to upper body

• Coordination as multiple joints work together

• Cardiovascular fitness when repetitions are performed continuously

That combination makes the thruster remarkably efficient: strength, power, and conditioning in the same movement.

How To:

• Hold a dumbbell in each hand at shoulder height, with your feet approximately squat-width apart.

• Descend into a squat while keeping your torso controlled and your feet firmly planted.

• Then stand aggressively.

• As you extend your knees and hips, use that momentum to help drive the dumbbells overhead. Finish standing tall with the weights controlled overhead, then return them to your shoulders and begin the next repetition.

• Think: Squat → Drive → Press.

The movement should feel connected—not like a squat followed by a completely separate shoulder press.

You don’t need heavy dumbbells—or even a full-depth squat—to get the benefits of a thruster.

• Two dumbbells: Adjust the load.
  The traditional thruster uses a dumbbell in each hand, but you choose the weight. Lighter dumbbells reduce the strength requirement while preserving the full movement pattern.

• Box or bench thruster: Adjust the depth.
  Find your pain-free squat range of motion. Use a box or bench as a TARGET (not to sit down, but to define your pain-free squat depth), then drive up and press. This provides a consistent target for squat depth and can make the movement more accessible when mobility, balance, or joint tolerance is a consideration.

• Ball thruster: Lighten the overhead load.
  Swap the dumbbells for a basketball, soccer ball, or weighted medicine ball held at the chest. Squat, drive through the legs, and press the ball overhead. This maintains the symmetrical, full-body movement pattern while allowing you to substantially reduce the overhead load.

• Ball + toss: Add some power—and fun.
  Use a lightweight ball and, instead of stopping at the press, use your leg drive to propel the ball upward with a small toss. Catch, reset, and repeat. Less overhead load allows you to move faster, adding an element of speed, power, coordination, and play.

Different tools. Same purpose.

The goal isn’t to perform someone else’s version of a thruster. It’s to find the version that allows your body to squat, drive, push, stabilize, and work hard..

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Today’s workout integrates the dumbbell thruster (or your selected modification) with a run. This workout will raise your heart rate while targeting full-body strength and power.

This is a highly efficient workout as it take you only ~20 minutes. Consider this workout while traveling or on a day when you are pressed for time. It will not disappoint!

Warm Up

AMRAP 5 min (As many rounds as possible in 5 minutes at low intensity)

• 1:00 Run, Row or Up Downs

• 10 Air Squats

• 5 Dumbbell strict press (light)

Movement Practice

Watch the dumbbell/barbell thruster movement video in the Feature Movement section and be mindful of keeping good form and mechanics with the thruster. Select a challenging weight that is moderately heavy that you can complete the 12 repetitions in 1-2 sets. Fatigue will set in particularly in the last 2 rounds, so it is ok to break up the thrusters into 2-3 sets as needed.

Tip! A great way to manage fatigue but keep moving is to slow the pace of your repetitions.

Workout – Part 1

5 Rounds for Time (1 round = run then thrusters)

• 400m Run, Row, or 800m bike (If no ability to run, row, or bike - try 20 burpees!)

• 12 Dumbbell or barbell thrusters (moderate weight where you can perform the thrusters in 1-2 sets).

  ** Goal Time: <20 min

**If you are new to fitness, substitute a brisk walk for the run and air squats for the thrusters.

Workout Part 2 - Core Accessory

Accumulate 5 min of a hollow hold.

Hollow Hold

• Every time you break, pause the clock and do 20 Mountain Climbers (R+L = 1 repetition) ….then continue on that 5 min clock and go back to the hollow hold until you have completed a total of 5 min in the hollow hold position!

Cool Down:

5 min Yoga: Leg and Hip Stretch

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Housekeeping…

This is something you don’t want to miss. Check out this workshop featuring the awesome and amazing sports psychologist, Erin Ayala! Register HERE

NOW TAKING MEDICAL CLIENTS FROM COLORADO, CONNECTICUT, AND NEW HAMPSHIRE!

..in addition to MA, NY, NJ, PA, CA, FL, OH

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists.

To speak to this need, I launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

The overhead squat is exactly what it sounds like: a squat performed while holding a load overhead. But don’t let the barbell version fool you. You don’t need to lift heavy—or even use a weight—to benefit from this movement.

The overhead squat asks a lot of the body at once: lower-body strength, shoulder and thoracic mobility, core stability, balance, coordination, and control.

Why It Matters in Midlife

Maintaining muscle and bone strength matters as we get older—but so does maintaining our ability to move well.

The overhead squat challenges several qualities that become increasingly important in midlife:

• Lower-body strength

• Overhead mobility

• Trunk stability

• Balance

• Proprioception.

And because the upper and lower body must work together, it trains the body as an integrated system rather than a collection of individual muscles.

How to Do It

Stand with your feet approximately shoulder-width apart and extend your arms—or a light object—overhead. Brace your core, keep your arms reaching upward and the load positioned over the middle of your foot, then sit your hips down between your legs.

Descend only as far as you can while maintaining the overhead position and good control, then drive through your feet to stand.

***Depth and load come after good movement.

Make It Your Movement

The overhead squat isn’t all-or-nothing. Keep the overhead component, then scale the load, range of motion, or complexity to meet your body where it is today.

• Arms-only overhead squat: Reach both arms overhead—or just one—and squat only as deeply as you can maintain the position.

• PVC/broomstick overhead squat: Practice the full movement with essentially no external load.

• Box overhead squat: Use a box or bench to limit depth while maintaining the overhead position.

• Single-dumbbell overhead squat: Hold a light dumbbell in one hand overhead, adding load and an asymmetric stability challenge.

• Barbell overhead squat: Progress to the traditional movement when mobility, stability, and control allow.

Safety

Shoulder, wrist, hip, knee, ankle, or back limitations may require modification. Never force range of motion simply to make the movement “look right.”

Identify your pain-free range of motion and choose the variation that allows you to move comfortably and with control.

Bottom Line

You don’t have to be young, exceptionally flexible, or an experienced lifter to train the overhead squat.

Start with the version you can do well. Then build from there.

The goal isn’t a perfect barbell overhead squat.

The goal is to keep building a body capable of doing more.

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This week’s workout is a 2-part effort integrating the overhead squat (or your chosen variation). The second part is a core finisher that will help you appreciate how much your core muscles were working during the overhead squat segment.

Warm-Up

TABATA (20 seconds of work/10 seconds of rest) - 6 minutes.

Perform each movement sequentially until you have completed each round of 3 movements 4 times.

• Up-downs (20s work/20s rest), then..

• Push-ups (easy option) (20s work/20s rest), then..

• Jumping air squats (20s work/20s rest), then back to the Up-downs

After you finish the TABATA, perform 12 PVC Pass-throughs with your broomstick or PVC pipe.

Movement Practice

WATCH THIS VIDEO TUTORIAL ON THE OVERHEAD SQUAT!

If you have never done this movement before PLEASE use just a broomstick or PVC pipe. This is a COMPLEX MOVEMENT, so until you feel ultra-confident and consistent with superb form, stick with a broomstick or PVC pipe.

Take 5-10 minutes to practice the overhead squats - Try 3-5 sets of 5 repetitions until you feel confident in performing this movement in the workout.

If you are familiar with the overhead squat, please watch the video tutorial and fine-tune your technique using an empty bar. Add weight as appropriate maintaining solid technique.

Movement alternatives:

• Use a box to squat to as shown in the video tutorial above if you cannot achieve sound mechanics and bar/pipe/stick position in a full squat.

• Single arm overhead dumbbell squat. If the restriction of a broomstick/PVC pipe makes this movement difficult to achieve with good form, try a single-arm overhead squat instead. Start with a lightweight object and work up to a dumbbell during practice.

Take another 5-10 minutes to practice the movements in Workout Part 1 and select your kettlebell weight. Select a weight that allows you to perform 12 repetitions unbroken for all rounds. This is a moderate weight where the last 3-4 reps become challenging.

Workout

Part 1

AMRAP 12 minutes (As many rounds as possible in 12 minutes)

• 12 Kettlebell swings (overhead or eye-level) (Alternatives: double dumbbell swing or a single dumbbell swing keeping reps even between sides)

• 12 Overhead squats (or your selected option)

• 24 Mountain Climbers (right + left = 1 repetition)

Part 2

Core TABATA - (20 seconds of work/10 seconds of rest) - 6 minutes.

Perform each movement sequentially until you have completed each round of 3 movements 4 times.

• V-Ups

• Oblique Twists - weighted

• Sit-ups (Ab mat style: Use an ab mat or rolled towel supporting your lower back. Alternatively, perform sit-ups with knees bent/feet anchored).

Cool-Down

15-minute Back Bending Yoga. Take 15 minutes to cool down and rebalance your back and front body.

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NOW TAKING MEDICAL CLIENTS FROM COLORADO, CONNECTICUT, AND NEW HAMPSHIRE!

..in addition to MA, NY, NJ, PA, CA, FL, OH

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists.

To speak to this need, I launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

One of my goals for Athletic Aging is to make functional movement training accessible for all fitness levels.

How many times do we see fitness influencers and online training programs performing various movements where we say “There’s no way I can do that”.

My goal with these posts is to take these seemingly inaccessible movements and creatively scale them so that they become accessible for all fitness levels, but retain the same benefits as the original movement.

This week we will focus on the bear crawl.

It may look like a children’s movement, but don’t let it fool you. It challenges strength, stability, coordination, and cardiovascular fitness all at once—making it one of the most efficient full-body movements you can add to your training.

Unlike many traditional exercises that isolate one muscle group, the bear crawl requires your shoulders, core, hips, and legs to work together while coordinating opposite arm and leg movements. That combination makes it a valuable exercise whether you’re training for CrossFit, recreational sports, or simply staying capable and resilient as you age.

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Why It Matters

Although research specifically in midlife women is limited, studies of quadrupedal movement training have demonstrated improvements in movement quality, shoulder and core activation, mobility, energy expenditure, and even aspects of proprioception and cognitive flexibility. The bear crawl doesn’t just build strength—it teaches your body to move well.

Benefits include:

• Improved core and shoulder stability

• Better coordination through contralateral movement

• Increased mobility and movement quality

• Moderate-to-vigorous cardiovascular stimulus

• A fun way to challenge your body in a completely different way

How to Perform the Bear Crawl

Start with your hands directly under your shoulders and your knees under your hips. Lift your knees one to two inches off the floor while maintaining a neutral spine and engaged core. Move forward by stepping your right hand and left foot together, followed by your left hand and right foot. Keep your movements slow, controlled, and deliberate rather than rushing through the exercise.

Movement Progressions

Whether you’re just getting started or looking for a greater challenge, there is a version of the bear crawl that can meet you where you are.

Use Caution If...

• You have significant wrist or shoulder pain or limited mobility.

• You’re recovering from an upper extremity injury.

• You’re in the second or third trimester of pregnancy, when changes in balance and joint stability may require modifications.

• Excess abdominal weight changes your center of gravity and places excessive stress on the wrists or shoulders.

Bottom Line

We spend our first year of life learning to crawl—but we don’t stop benefiting from that movement pattern simply because we learn to walk.

The bear crawl develops strength, stability, coordination, and conditioning in a way that few exercises can. Whether you’re beginning with a Bird Dog or progressing to a Dumbbell Bear Crawl, this movement offers a scalable way to build the kind of fitness that carries over into both sport and everyday life.

References

Buxton JD, et al. Front Sports Act Living. 2022.

Buxton JD, et al. J Strength Cond Res. 2020.

Pachava SR, Yadav D. Asian Pac J Health Sci. 2021.

Matthews MJ, et al. Hum Mov Sci. 2016.

Eckart AC. ACSM’s Health & Fitness Journal. 2023.

Today’s workout integrates the Bear Crawl with lower-body strength and cardiovascular stimulation. All it requires is a set of dumbbells and a little bit of space. Enjoy!

Warm-Up

Low-intensity walk, jog, or bike for 5-10 minutes

TABATA - 20 seconds of work and 10 seconds of rest. Do each movement in sequence for a total of 6 minutes (each round of the three movements, 4 times)

• Up-Downs (20 seconds work, 10-sec rest)

• Mountain Climbers (20 seconds work, 10-sec rest)

• Jumping air squats (20 seconds work, 10-sec rest)

Movement Practice

Take 5-10 minutes to watch the videos, practice, and select your movements/weights for this workout.

For the front squats, select dumbbells at a moderate weight that will allow you to do the 10 repetitions in 1-3 quick sets. Use one of these dumbbells for the burpee lateral jump over a dumbbell.

Practice the Bear Crawl or its modifications and select your option for the workout.

Movements

• Burpee lateral jump (or step) over a single dumbbell

• Dumbbell front squat

• Bear Crawl (or the following modifications)

  • Bear Crawl hold for 30 seconds

  • Bear Crawl march (right hand/left foot alternating with left hand/right foot) for 30 seconds

  • High plank hold for 30 seconds

  • Advanced option: If you are proficient with the Bear Crawl, try the dumbbell Bear Crawl.

Workout

5 Rounds for Time

• 10 Burpee lateral jump (or step) over a dumbbell

• 10 Dumbbell Front squats

• 50-foot Bear Crawl (modify distance as needed).

SCORE: Amount of time it takes to complete 5 rounds of all 3 movements.

Cool-Down

Finish this training day and jump-start your recovery with this 25-minute Stretch and Release Restorative Yoga class from Five Parks Yoga

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This just dropped….

Check out my latest podcast guest appearance on Modern Menopause. Morven, Dr. Robyn, and I dive into the biggest myths keeping women from training hard in perimenopause and menopause. We discuss cortisol, carbohydrates, testosterone, joint pain and injuries, and the best place for women to start who might feel like they’re losing their mojo.

You can find the episode on your favorite podcast platforms:

• YouTube

• Spotify

• Apple

NOW TAKING MEDICAL CLIENTS FROM COLORADO, CONNECTICUT, AND NEW HAMPSHIRE!

..in addition to MA, NY, NJ, PA, CA, FL, OH

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists.

To speak to this need, I launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

My Friends!

This week I need to recharge my batteries and just chill. Like so many clients whom I see, I am running in so many directions being a doc, performance consultant, mom of a 19-year-old college student, wife, and recreational athlete - that I forget where I am. My advice to my clients is always to take time for “you” and recharge. Prioritize your mental well-being and dial down the madness because if you don’t, it will catch up to you.

Well, it’s time that I take my own advice! My family and I are enjoying this week in Wakefield, New Hampshire at this beautiful home we are renting on Pine River Pond. I have committed to minimizing my time on technology and just soaking up all that Mother Nature has to offer.

See you all next week! … and don’t forget to carve out time for YOUR bad-ass selves!

Cheers!
-Dr. Carla

PS. Scroll down to check out a new podcast guest appearance that just dropped, and don’t forget to check out the Weekly Workout archives for a treasure trove of past workouts.

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This just dropped….

Check out my latest podcast guest appearance on Modern Menopause. Morven, Dr. Robyn, and I dive into the biggest myths keeping women from training hard in perimenopause and menopause. We discuss cortisol, carbohydrates, testosterone, joint pain and injuries, and the best place for women to start who might feel like they’re losing their mojo.

You can find the episode on your favorite podcast platforms:

• YouTube

• Spotify

• Apple

NOW TAKING MEDICAL CLIENTS FROM COLORADO, CONNECTICUT, AND NEW HAMPSHIRE!

..in addition to MA, NY, NJ, PA, CA, FL, OH

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists.

To speak to this need, I launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

Hey Team! Running has been front and center in my own training lately as I completed my very first road race: The 54th Annual Blessing of the Fleet Road Race in Narragansett, Rhode Island. Although I certainly wasn't breaking any records, it revealed some incredible new opportunities for me to take my fitness to the next level. 

I hope you enjoy these next few posts on this movement that has gone from being my nemesis to my greatest fitness opportunity. 
Enjoy! -Dr. Carla 

You’ll find many posts about hip extension in Athletic Aging because it is one of the most fundamental movement patterns we perform—from everyday living to athletic performance.

When you think about improving your running, what comes to mind?

• Better shoes?

• More miles?

• Speed work?

Probably not hip extension. Yet every stride depends on it.

The squat is an excellent illustration of hip extension. As we descend into the bottom of a squat, the hips hinge and the angle between the torso and thighs becomes more closed, or flexed. As we stand, that angle opens, or extends.

Now imagine a squat jump. The gluteal muscles, hamstrings, and quadriceps contract rapidly and in sequence to extend the hips, generating enough force to lift the body off the ground.

Running relies on this same movement pattern.

One way to think about running is as a series of controlled single-leg jumps, with each stride requiring the body to generate force and briefly become airborne. Each stride requires the coordinated extension of the hip, knee, and ankle—a movement known as triple extension.

Hip extension is the first link in that chain.

During push-off, the gluteal muscles and hamstrings generate force through the hip while the knee and ankle extend in sequence, helping propel the body forward. Efficient runners don’t simply move their legs faster—they transfer force into the ground more effectively. Hip extension plays a central role in making that happen.

This doesn’t mean that more hip extension automatically creates better running. Running economy depends on many factors, including cadence, posture, coordination, lower extremity stiffness, and force production. But without adequate strength and power at the hips, the push-off phase becomes less efficient and less force is available to propel the body forward.

For active adults, maintaining hip strength and power isn’t just about running. It also helps preserve stride quality, uphill walking ability, hiking performance, and the ability to accelerate when life unexpectedly asks you to.

If you’d like to learn more about the role of hip extension in running mechanics, check out these two articles: Improving Running Efficiency: Hip Extension and How Does Hip Extension Affect Your Running Technique?

Bottom Line

Every running stride begins with a powerful push into the ground. While many factors contribute to efficient running, hip extension is one of the fundamental movement patterns that helps generate forward propulsion.

Running may look effortless, but every stride is powered by a coordinated sequence of movements that begins at the hips. Understanding that simple concept can change the way you look at running—and the way you train for it.

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This week’s workout develops hip extension through three movements: the kettlebell swing, box jump, and push press. As you watch the demo videos, pay attention to what they have in common. Although they look very different, each relies on the same powerful movement pattern—rapid hip extension—to generate force.

Warm Up

AMRAP 7 (As many rounds as possible in 7 minutes)

• 10 up-downs

• 10 air squats

• 10 easy push-ups (knees, toes or elevated on a stable box, bench or chair)

Movement Practice

Take 5-10 minutes to review the workout movement videos and options below and select your weights and movements for the workout.

The prescribed workout weight “RX” is noted below the workout for reference. These weights are for more advanced athletes. If you are a beginner or intermediate athlete, select movement options and weights that you can perform confidently where each set of 10 repetitions can be performed in no more than 2 sets with a brief rest in between. Once you have selected your weights/options, practice 3-5 repetitions of each movement in the order written in the workout to be sure you are comfortable with the flow between movements.

Movement options

• Push Press (Alternative: dumbbell push press)

• Kettlebell Swing (American) (Alternative: Swing to eye level; If no kettlebell, - Double dumbbell swing

• Box Jump - (Alternative: Weighted box step-ups or dumbbell thrusters).

Workout

AMRAP 20 (As many rounds as possible in 20 minutes)

• 10 Push presses

• 10 Kettlebell Swings

• 10 Box jumps

Score: Number of completed rounds and repetitions.

(RX for women 75# barbell, 35# kettlebell, 20-inch box jump)

TIP! Manage fatigue by slowing down your repetitions. This allows you to achieve some “rest” while continuing to accumulate repetitions.

*Be sure to document your movement options and weight choices so that you can replicate the workout for your “re-test”.

Cool Down

As an expert in the hormonal physiology of the stress response system, I cannot overstate the importance of a thorough cool-down after an intense fitness benchmark workout. Yoga is my go-to because it promotes whole-body flexibility and mobility care as well as calming the mind and increasing the vagal tone needed for our stress response system to return to baseline.

Indulge yourself in this 15-minute full-body stretch yoga sequence to jumpstart your recovery! #dontskiptheyoga

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This just dropped…..

Could you have PCOS and not know it? You sure can, says reproductive endocrinologist and menopause specialist Dr. Carla DiGirolamo, who is hopeful that the recent renaming of the condition from “polycystic ovary syndrome” (PCOS) to “polyendocrine metabolic ovarian syndrome” (PMOS) will help raise awareness—and improve care. This episode breaks down what PMOS actually is, why the new name matters, and how this androgen‑driven metabolic condition shows up across the lifespan, from irregular cycles and fertility struggles to increased cardiometabolic risk, especially once you hit the menopause transition. We also cover treatment options including metformin, inositol, and compelling new research on GLP‑1 receptor agonists, plus what all of this means for active midlife women when it comes to fueling, Reds/LEA risk, resistance training, and long‑term glucose control.

NOW TAKING MEDICAL CLIENTS FROM COLORADO, CONNECTICUT, AND NEW HAMPSHIRE!

..in addition to MA, NY, NJ, PA, CA, FL, OH

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists.

To speak to this need, I launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

Most exercises challenge us evenly.

A barbell squat loads both legs equally. A bench press uses both arms together.

But life rarely does.

You carry a suitcase in one hand. Reach overhead to place luggage in an overhead bin. Walk across uneven ground while carrying groceries. Catch yourself after a stumble on one leg before the other.

These everyday moments require your body to stabilize against forces that want to pull you out of position—not simply produce force.

That ability to resist movement is one of the hallmarks of functional strength, and it becomes increasingly important as we age.

One of the simplest—and most effective—ways to train it is the single-arm farmer carry, also known as the suitcase carry.

What is the suitcase carry?

The suitcase carry is exactly what it sounds like: hold a dumbbell or kettlebell in one hand at your side and walk.

Because the weight is carried on only one side, your body naturally wants to lean toward it. Your core, hips, shoulders, and legs must work together to keep you upright.

This is known as asymmetrical loading. Rather than simply producing force, your muscles learn to resist unwanted movement—an essential skill for both athletic performance and everyday life.

Why it matters

Research shows that asymmetrical exercises can improve much more than strength alone. They challenge the muscles responsible for posture and stability while enhancing balance, coordination, and single-leg control.

The suitcase carry also develops grip strength, which has emerged as one of the strongest indicators of healthy aging and long-term physical function.

Perhaps most importantly, asymmetrical training exposes side-to-side differences that often go unnoticed during traditional bilateral exercises. Identifying and improving these imbalances can enhance movement efficiency and reduce unnecessary compensation patterns.

Whether you’re hiking, lifting a grandchild, carrying groceries, or simply navigating uneven ground, these are the qualities that help you move with confidence.

How to perform it

• Stand tall holding a dumbbell or kettlebell in one hand.

• Keep your shoulders level and your eyes forward. Brace your abdominal muscles gently and imagine balancing a book on your head.

• Walk with slow, controlled steps without leaning toward or away from the weight.

• Continue until you notice your posture beginning to change, then switch hands and repeat.

**Quality matters far more than distance or weight.

Safety considerations and scaling

Start with a weight that allows you to maintain perfect posture throughout the carry.

If balance is a concern, begin by simply holding the weight while standing before progressing to walking.

As your strength improves, increase the load before increasing the distance.

Other excellent examples of asymmetrical training include:

• Single-kettlebell step-ups

• Single-arm overhead press

• Offset front squats

• Single-arm rows

• Single-arm overhead lunges

• Front-rack and overhead carries

The principle remains the same: don’t let the weight pull you out of position.

Bottom line

Life isn’t symmetrical. Neither should your training be.

Adding asymmetrical movements to your workouts teaches your body to stay balanced, stable, and resilient while performing the tasks you encounter every day.

The suitcase carry may be one of the simplest exercises in the gym, but don’t let its simplicity fool you.

Sometimes the movements that look the easiest are the ones preparing us best for real life.

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This week we are “doubling down” on building functional capacity by developing the strength, skill, and stability that allow us to carry loads in multiple ways. Today’s workout targets core and shoulder strength and stability, inserts a component of coordination and balance and challenges these movements under the fatigue of short, high-intensity sprint segments.

Warm Up

AMRAP 7 (As many rounds as possible in 7 minutes). Perform all three movements in sequence for as many rounds of the three movements as you can on a 7 minute clock.

• 5 Burpees (Watch the linked video for options for all skill levels)

• 10 Mountain Climbers (Right + Left = 1 repetition)

• 10 Air squats

Once you have completed the 7-minute AMRAP, perform this follow-along core-activation sequence from Train FTW.

Movement Practice

Take 5-10 minutes to choose your weights/options for the workout.

All but the suitcase carry require 2 dumbbells. Choose the same weight for all carries where you can carry the dummbells for 100m with no more than 1-2 stops along the way to rest.

For the sprints, see the options below for the sprint intervals. As the name implies, this is a SPRINT, meaning that this is a short duration of high intensity (RPE of 8-9) for 30-45 seconds. Choose one modality for all the sprints or try more than one! Choose your own adventure! Whatever you choose, bring your A-Game to every sprint interval.

Movement options

• Sprint (30-45 seconds at RPE 8-9): 200m row or run, 400m bike, 75 single-under (35 double-under) jump rope, or 15 burpees

• Carries: For best results, perform all carries as prescribed. However, if overhead shoulder mobility limits you, substitute the bear crawl and/or the Farmer’s Carry for the overhead carries.

Workout

200m Sprint (row or run, 400m bike, jump rope, or 15 burpees)

50 m Suitcase Carry (SINGLE DUMBBELL)

200m Sprint

50 m Double Dumbbell Overhead Carry

200m Sprint

50 m Front Rack Carry

200m Sprint

50m Waiter Carry (Switch arms after the first 25 yards)

200m Sprint

50 m Bear Crawl (For an advanced level option, bear crawl with your 2 dumbbells)

Cool Down

Show your shoulders some love and jump-start your recovery with this 15 minute shoulder and upper body yoga sequence. #dontskiptheyoga

Share

This just dropped…..

Could you have PCOS and not know it? You sure can, says reproductive endocrinologist and menopause specialist Dr. Carla DiGirolamo, who is hopeful that the recent renaming of the condition from “polycystic ovary syndrome” (PCOS) to “polyendocrine metabolic ovarian syndrome” (PMOS) will help raise awareness—and improve care. This episode breaks down what PMOS actually is, why the new name matters, and how this androgen‑driven metabolic condition shows up across the lifespan, from irregular cycles and fertility struggles to increased cardiometabolic risk, especially once you hit the menopause transition. We also cover treatment options including metformin, inositol, and compelling new research on GLP‑1 receptor agonists, plus what all of this means for active midlife women when it comes to fueling, Reds/LEA risk, resistance training, and long‑term glucose control.

NOW TAKING MEDICAL CLIENTS FROM COLORADO, CONNECTICUT, AND NEW HAMPSHIRE!

..in addition to MA, NY, NJ, PA, CA, FL, OH

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists.

To speak to this need, I launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

Strength helps us move.

Power helps us move quickly.

And as we age, power declines faster than strength, making it one of the most important qualities to train if we want to remain athletic for decades to come.

The box jump is one of the simplest ways to develop lower-body power. Far more than “jumping onto a box,” it teaches the body to produce force rapidly through explosive hip extension while improving coordination, balance, and confidence.

Why It Matters

For active women, power training offers benefits that extend well beyond the gym.

Research shows explosive training can improve:

• Lower-body power and rate of force development

• Balance and neuromuscular coordination

• Functional performance in daily activities

• Athletic performance for hiking, pickleball, tennis, skiing, CrossFit®, and running

How to Perform the Box Jump

• Stand facing a stable box with your feet about hip-width apart.

• Begin with a small hip hinge while swinging your arms naturally behind you. Drive explosively through the hips, knees, and ankles, using your arms to help generate upward momentum.

• Land softly with your entire foot on the box, knees tracking over your toes and hips slightly bent to absorb the landing. Stand fully before stepping back to the floor under control.

The goal isn’t to jump onto the highest box possible—it’s to move with speed, control, and confidence.

Safety & Modifications

Power training should always match your current abilities.

If jumping isn’t appropriate yet, perform step-ups instead. Focus on a strong, controlled drive through the working leg, and progress by adding a dumbbell or kettlebell as your strength improves.

You can also adjust the challenge by changing the height of the target. Start with a single 45-pound bumper plate or a short stack of plates before progressing to a low box and eventually a standard-height box.

Choose a height that allows you to land softly without having to pull your knees excessively toward your chest. If your landing becomes noisy or your technique deteriorates, reduce the height or return to stepping until your power and confidence improve.

Remember: quality always comes before height.

The Bottom Line

The box jump isn’t about proving how fearless you are.

It’s about preserving one of the physical qualities we lose most rapidly with age: power.

Whether you’re stepping onto a plate or confidently jumping to a higher box, you’re training the same movement pattern. Progress gradually, prioritize good mechanics, and remember:

The goal isn’t the highest box. It’s building the power to keep doing the things you love for decades to come.

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I was inspired to write about the box jump this week because I have spent some time doing them at my own CrossFit gym, CrossFit Peacedale. It has reminded me of what a key longevity hack this simple movement is, because it targets power and plyometrics in one, simple movement and is infinitely scalable for every fitness level. Enjoy this week’s workout!

Warm Up

AMRAP 7 Perform each movement in sequence for as many rounds of the 3 movements as you can in 7 minutes.

• 10 air squats

• 10 light kettlebell swings

• 10 box step-ups

Movement Practice

Take 5-10 minutes to select weights/options and practice the movements you will do for the workout. Select options/weights that allow you to confidently do 5-10 repetitions unbroken.

For the box jump, select a STABLE box or stack of plates at a height where you can confidently jump and move at a steady pace with only a couple of breaths of rest after 5-10 repetitions. For experienced athletes, the suggested box height is 20 inches (50 cm).

If jumping onto an object at any height is a limitation, perform box step-ups instead. You can choose to hold a pair of light dumbbells or kettlebells for some extra intensity, or simply use your body weight.

For the kettlebell swing, select a moderately heavy weight and swing to eye level (“Russian”-style swing). For experienced athletes, the recommended kettlebell weight is 35 lbs (16kg).

For the single arm overhead alternating lunge. Select a weight that allows you to do 10 total repetitions (5 each side) unbroken. If this movement is new to you or challenging, select a light object to hold overhead such as a shoe or a can of beans. Holding a single arm in this position is more important than the weight used. For experienced athletes, the recommended dumbbell weight is 20-25lbs (12-14kg)

Movement Alternatives

Box jump alternative: Squat jump for height is a great option if you can jump but are not comfortable jumping onto an object. Otherwise, a box step-up as described above is another appropriate scale.

Kettlebell swing alternative: Double dumbbell swing. If you have a barbell and are proficient with Olympic weightlifting, substitute a hang power clean.

Single arm overhead alternating lunge: If holding a single arm without weight overhead is not accessible to you, perform the alternating lunges holding a single dumbbell by your side, switching arms as needed.

Workout

AMRAP 16 (As many rounds as possible in 16 minutes)

Repetition scheme: 2-4-6-8…. and so on adding 2 repetitions per round.

HOW TO: Perform 2 box jumps, 2 overhead lunges, 2 kettlebell swings, then 4 box jumps, 4 overhead lunges, 4 kettlebell swings, then 6 box jumps, and so on. Continue with as many rounds as you can on a 16-minute clock. Your score is the total rounds and repetitions. (Ex: completed the round of 14 and 15 repetitions into the round of 16.)

• Box jumps

• Single overhead dumbbell alternating lunges (Switch arms as needed. Alternate legs with each repetition)

• Kettlebell swings

Cool Down

Show your hips and legs some love with this 20-minute Yoga Flow for Hips from Yoga with Adriene. The best results gained from training start with recovery. #dontskiptheyoga.

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NOW TAKING MEDICAL CLIENTS FROM COLORADO, CONNECTICUT, AND NEW HAMPSHIRE!

..in addition to MA, NY, NJ, PA, CA, FL, OH

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists.

To speak to this need, I launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

If there is one muscle group that tends to get overlooked in many training programs, it’s the triceps.

That is unfortunate because the triceps are responsible for one of the most fundamental human movements: pushing.

Whether you’re lowering yourself into a chair, pushing yourself up from the floor, placing luggage into an overhead bin, performing a push-up, or locking out a barbell overhead, strong triceps play a critical role.

The box dip is a simple exercise that develops this strength with minimal equipment, making it accessible to nearly every athlete.

How to Perform a Box Dip

Sit on the edge of a sturdy box or bench and place your hands beside your hips with your fingers pointing forward.

Slide your hips just in front of the box while supporting your body weight with your arms.

Slowly bend your elbows, lowering your body until your upper arms are approximately parallel to the floor or until your shoulders remain comfortable.

Press through your palms and fully extend your elbows to return to the starting position.

Throughout the movement:

• Keep your chest tall.

• Maintain shoulders gently pulled back rather than rounded forward.

• Keep the elbows pointing mostly behind you instead of flaring outward.

• Move under control—especially during the lowering phase.

Quality matters much more than depth.

Why Train the Triceps?

Research consistently demonstrates that resistance training preserves muscle mass, strength, and physical function with aging.

Although studies rarely isolate the triceps specifically, elbow extensor strength contributes to numerous daily activities requiring upper-body force production.

For active, midlife women, maintaining upper-body strength has been associated with:

• Improved functional independence

• Greater ability to perform daily tasks

• Better overall muscular endurance

• Preservation of lean muscle mass

• Improved bone health through resistance training

• Enhanced performance in pressing movements such as push-ups, overhead presses, and burpees

The triceps also assist in stabilizing the elbow during many athletic movements, making them an important component of injury-resistant training.

Safety Considerations

The box dip isn’t appropriate for everyone.

The greatest stress occurs at the bottom of the movement, where the shoulder moves into extension while supporting body weight.

Individuals with a history of anterior shoulder pain, rotator cuff pathology, shoulder instability, or acromioclavicular joint symptoms may find deep dips uncomfortable.

Fortunately, there is an easy solution:

Don’t chase depth.

Current evidence suggests that strength improvements occur throughout the range of motion that is trained. A controlled, pain-free partial range is often a better option than forcing excessive depth.

If discomfort occurs, choose another pressing exercise rather than pushing through pain.

Progressions

One of the best aspects of the dip is that it scales beautifully.

Beginner

• Bench-supported triceps extensions

• Wall push-ups

• Incline push-ups

Intermediate

• Box dips with feet on the floor

• Bent knees to decrease load

• Straight legs to increase load

Advanced

• Feet elevated box dips

• Parallel bar dips

• Weighted dips

Elite

• Ring dips: The instability of gymnastics rings dramatically increases demands on shoulder stability, core control, and neuromuscular coordination. Ring dips should only be attempted after demonstrating excellent control with traditional parallel-bar or box dips.

Bottom Line

The goal isn’t to become great at box dips. The goal is to preserve the ability to push powerfully throughout life.

Strong triceps help support everything from athletic performance to getting off the floor with confidence decades from now.

The box dip is simply one accessible tool to build that strength.

Train within a comfortable range, progress gradually, and remember that every great ring dip once started with a single supported repetition.

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This week’s workout incorporates the box dip and the thruster to target triceps strength with some plyometrics for bone health to create a spicy combo of strength and cardiovascular stimulation! Enjoy!

Warm Up

Tabata 20:10 (20 seconds of work, 10 seconds of rest) x 6 minutes. Perform each movement in sequence for 20 seconds of work then take 10 seconds of rest until you have completed 4 rounds of the three movements.

• Air squats

• Single-under jump rope (or simulated jump rope if no access to a rope)

• Easy bench dips

Movement Practice

Take 5-10 minutes to select your weight for the thrusters and set up for your bench dips. Choose a barbell or dumbbell thruster weight that is on the heavier side. Select a weight that allows you to do all 7 repetitions unbroken across the 7 rounds. Be mindful of the fatigue that will be generated by the jump rope and the dips as you select your weight for the dumbbell or barbell thruster!

For the dips, set up a STABLE box, bench, table, or chair and watch the video to ensure proper technique. Select an option that allows you to do the 7 repetitions, ideally unbroken, but in no more than 2 sets during the later rounds).

TIP! 7 rounds is a long time. Manage fatigue by slowing your repetition speed and taking strategic short breaks during the jump-rope and the dips.

Workout

7 rounds for time

• 7 dumbbell or barbell thrusters (unbroken)

• 75 single-under jump rope (or 50 double-unders)

• 7 box dips (ideally unbroken, but alternatively, strategically break up into no more than 2 sets as fatigue sets in)

Score: The time it takes to complete 7 rounds of all three movements. Log your time! You may see this workout again for a re-test!

• Alternative: If you are hankering for more volume and lighter weight, try 10 thrusters, 100 single-unders, and 10 dips

Cool Down

I bang this drum a lot because it is SO IMPORTANT, particularly for mid-life women, to dial down the stress response, be kind to your muscles and joints, and promote recovery of the body and the mind. Enjoy this post-workout restorative power yoga sequence! #dontskiptheyoga

15-minute post-workout restorative yoga

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NOW TAKING MEDICAL CLIENTS FROM COLORADO, CONNECTICUT, AND NEW HAMPSHIRE!

..in addition to MA, NY, NJ, PA, CA, FL, OH

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists.

To speak to this need, I launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

When most people think about strength training, they focus on the lifting portion of an exercise—the push-up, squat, or pull-up. But some of the greatest strength gains happen on the way down.

This lowering phase is called an eccentric contraction, often referred to as a negative repetition. During an eccentric contraction, the muscle produces force while it lengthens under load. Think about lowering yourself into a chair, walking down a flight of stairs, or slowly lowering your body during a push-up.

For active, athletic midlife women, negative repetitions are among the most effective—and often overlooked—tools for building strength, improving movement quality, and progressing to more challenging exercises.

Why Do Negative Repetitions Work?

Your muscles are capable of producing greater force during an eccentric contraction than during the lifting (concentric) phase of the same movement. This allows you to challenge your muscles in ways that aren’t always possible with traditional repetitions.

Research has consistently shown that eccentric training can:

• Increase muscular strength

• Promote muscle growth

• Improve neuromuscular control and coordination

• Enhance functional performance

• Build confidence in movements that may not yet be possible through a full repetition

For example, someone who cannot yet perform a full push-up can still begin in the top position and slowly lower themselves to the floor under control. This develops strength throughout the chest, shoulders, triceps, core, and scapular stabilizers while reinforcing proper movement mechanics.

The same principle can be applied to pull-ups, split squats, step-downs, and many other exercises.

Perhaps most importantly, negative repetitions teach control.

Every day life depends just as much on controlling movement as it does on producing force. We lower ourselves into chairs, descend stairs, absorb the impact of landing, and catch ourselves when we lose our balance. These are all eccentric movements, making this type of training highly functional both inside and outside the gym.

How to Perform a Negative Push-Up

Choose a variation that matches your current strength level—a wall, countertop, bench, box, or the floor.

Begin in the top of a push-up position with your body in a straight line from head to heels (or knees if performing a modified push-up). Engage your core and gently pull your shoulders down and back.

Slowly lower yourself over 3–5 seconds, maintaining good alignment throughout the movement. Descend only as far as you can while maintaining control.

Once you reach the bottom, reset by standing back up (or returning to the starting position using your knees or an elevated surface) rather than pressing yourself back up.

Start with 2–4 sets of 3–5 controlled negative repetitions, performed one to two times per week.

Remember: the goal is quality, not fatigue.

Safety Considerations

Because eccentric contractions generate high muscular forces, they can also produce more muscle soreness than traditional resistance training—particularly when they are new to your program.

To minimize soreness and maximize benefit:

• Lower under control—never simply “drop.”

• Stop if shoulder, wrist, or elbow pain develops.

• Begin with only a few repetitions.

• Allow adequate recovery before repeating the exercise.

• Progress gradually by increasing either the lowering time or the number of repetitions—not both at once.

As with any exercise, good movement quality is more important than completing additional repetitions.

Progressions and Alternatives

One of the greatest advantages of negative repetitions is that they can be incorporated into almost any exercise.

Try these progressions:

• Wall Push-Up Negatives

• Countertop or Incline Push-Up Negatives

• Floor Push-Up Negatives

• Assisted Pull-Up Negatives

• Split Squat or Step-Down Negatives

• Parallel Bar or Ring Dip Negatives (for experienced athletes)

The Bottom Line

Strength isn’t just about lifting your body or a weight—it’s about controlling it.

Negative repetitions help bridge the gap between where you are today and the movements you’re working toward tomorrow. They develop strength, coordination, confidence, and resilience while reinforcing high-quality movement patterns that carry over into everyday life.

Sometimes, getting stronger doesn’t mean moving faster or lifting heavier. Sometimes, it simply means learning to own the way down.

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This week, we are continuing our focus on functional, upper-body pushing movements, building strength, stamina, and control.

Today, we will use the push-up negative movement as a PRE-WORKOUT accessory that will serve as a great warm-up for the workout, and introduce an accessory that you can add to other training sessions.

Enjoy!

Warm Up

AMRAP 7 minutes

• 7 up-downs

• 7 push-ups

• 7 air squats

Pre-Workout Accessory

Take 3-5 minutes to find a movement option for the push-up negative.

Start with 2 sets of 5 repetitions with 2:00 of rest in between sets. If you are still feeling strong, do a third set.

Do this accessory a second time this week and twice weekly for 4-6 weeks for real gains in upper body strength! Increase your progression as the movement becomes easier.

Movement Practice

Take 5-10 minutes to select your weights and options for the workout. For the thrusters and pull-ups, select an option/weight that allows you to do 10 repetitions unbroken with confidence during the warm-up. Strive to complete the thrusters and pull-ups in 1-2 sets during the workout. For the burpees over the dumbbell, move steadily at a pace where can you catch your breath. You’ll need it when you begin the next round of thrusters. If you need to step over the dumbbell rather than jump over it, that is completely fine!

Movement options:

• For the dumbbell thrusters, substitute air squats and double the repetitions

• For the pull-ups, use assistance with a band or machine or substitute a heavier bent-over dumbbell row.

• For the burpee over the dumbbell, step over the dumbbell rather than jumping over it. If no dumbbell, substitute a traditional burpee option.

Workout

HOW TO: Perform each of the three movements each round of the repetition scheme. Perform 6 thrusters, 6 pull-ups and 6 burpees over dumbell, then perform 9 thrusters, 9 pull-ups, and 9 burpees, and so on until you complete the repetition scheme.

*The goal of this workout is to pace and move steadily and efficiently. Remember: “Slow is smooth and smooth is fast!”.

FOR TIME:

6-9-12-9-6

• Dumbbell Thrusters

• Pull-ups (video includes scaling options)

• Burpees over dumbbell

Cool Down

Workouts like this one require a thorough cool-down to promote recovery and ready you for the training week ahead. This sequence is AMAZING!!!! #dontskiptheyoga

20-minute Ashtanga Inspired Yoga - Total Body Yoga Flow for Flexibility, Strength, and Peace

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In case you missed it…..

Muscle, Hormones & the Menopause Transition with Carla DiGirolamo, MD, PhD (Episode 253)

As active women, muscle is the engine that powers us through our lives, no matter what sport we love. When we hit midlife and menopause, it can feel like that 8-cylinder engine drops to six—less punch when we hit the gas, even though we’re still training. We may notice less muscle and more body fat when we look in the mirror. Muscle and strength loss during the menopause transition is multifactorial. It’s hormonal changes and estrogen decline. It’s inflammation. It’s symptoms like poor sleep, joint pain, and fatigue. It’s body fat gain. It’s how we recover and fuel. And, of course, it’s aging itself, as both women and men lose muscle with age. Our approach to making and maintaining it has to be multifactorial as well. This week we talk all about muscle and menopause–from basic science to menopause symptoms to hormone therapy–to understand what’s going on under the hood and help keep that engine strong.

NOW TAKING MEDICAL CLIENTS FROM COLORADO AND CONNECTICUT… NH COMING SOON!

..in addition to MA, NY, NJ, PA, CA, FL, OH

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

It is with great excitement that after more than 2 years of preparation, I have FINALLY launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists. We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

Many exercises allow us to compensate for mobility limitations, poor posture, or inadequate core strength.

The Z-Press does not.

Named after legendary strongman Zydrunas Savickas, the Z-Press is performed seated on the floor with the legs extended while pressing a weight overhead. At first glance, it looks like a simple shoulder exercise. In reality, it is a full-body movement that challenges shoulder strength, trunk stability, posture, and mobility simultaneously.

The Z-Press can be an excellent tool for developing overhead strength while improving the movement quality that often becomes more important with age.

What Is the Z-Press?

The Z-Press is an overhead press performed from a long-sitting position on the floor.

The athlete sits upright with both legs extended in front of the body and presses a pair of dumbbells, kettlebells, or a barbell overhead without back support.

Because the lower body cannot contribute to the movement, the shoulders, trunk, and postural muscles must do all the work.

How to Perform the Movement

1. Sit on the floor with legs extended.

2. Hold dumbbells at shoulder height with wrists stacked over elbows.

3. Sit tall on the sit bones with the ribs stacked over the pelvis.

4. Brace the abdominal muscles as if preparing for a punch.

5. Press the weights straight overhead until the arms are fully extended.

6. Lower under control to the starting position.

7. Maintain an upright torso throughout the movement.

A useful coaching cue is:

“Grow tall through the crown of your head while keeping your ribs down.”

Why Z-Press?

• Develops Functional Overhead Strength

  Many daily and athletic activities require us to place objects overhead. The Z-Press strengthens the muscles responsible for safe and efficient overhead movement while reinforcing proper mechanics.

• Builds Core Stability

  As we age, maintaining trunk strength becomes increasingly important for balance, force transfer, and injury resilience. The Z-Press requires continuous activation of the core musculature throughout every repetition.

• Encourages Better Posture

  The upright seated position promotes thoracic extension and postural awareness while discouraging excessive lumbar arching. Many athletes find that improving their Z-Press technique carries over to other pressing movements.

• Exposes Weak Links

  The Z-Press quickly reveals limitations in mobility, stability, or overhead control that may otherwise remain hidden during standing exercises. Identifying these limitations provides an opportunity to address them before they contribute to injury.

Safety Considerations

Individuals with significant shoulder pain, rotator cuff pathology, limited shoulder mobility, or difficulty sitting upright with legs extended should modify the movement.

Modifications and Alternatives

If the full Z-Press is not yet accessible, try using a lighter weight or consider these alternatives:

The Bottom Line

The Z-Press is far more than a shoulder exercise. It combines strength, stability, posture, and mobility into a single movement. It offers an opportunity to build resilient overhead strength while identifying and correcting movement limitations that may impact long-term athletic performance.

Sometimes the most valuable exercises are not the ones that allow us to lift the most weight—they are the ones that teach us to move the best.

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Like last week, this week’s workout focuses on upper body and core strengthening using kettlebell swings, plank holds, and incorporating the Z-press - with a cardio/plyometric kicker with the jump rope. Enjoy!

Warm Up

TABATA (8-minute) 20 seconds of work, 10 seconds of rest. You will perform each set of 2 movements for 4 times.

TIP! If you have Spotify, search “Tabata” and you will find some fun playlists for 8 rounds of 20 work / 10 rest intervals.

• Air squats (Perform for 20 seconds, then rest for 10 seconds)… then…

• Easy push-up option (Perform for 20 seconds, then rest for 10 seconds…then back to the air squats)

Once you finish the TABATA, perform 15 weighted Good Mornings

Movement Practice

Each round is ideally performed unbroken or in 2 sets with a quick breath or two of rest in between.

For the kettlebell swing, select a moederate weight where the 12 repetitions can be performed, ideally, unbroken.

For the Z press, select y your movement option with a moderate weight where the 10 repetitions can be done in 1-2 sets.

Lastly, choose single under or double under options if you have a jump rope. If not, jumping jacks suffice. For a little more intensity, try the lateral jump (or step) over a dumbbell.

Workout

AMRAP 15 minutes (As many rounds as possible for 15 minutes). Perform each movement in sequence for as many rounds of the 4 movements as possible in 15 minutes.

• 12 Kettlebell swings - swing to eye-level or overhead (advanced).

• 10 Z-Press

• 60 single under jump rope (or 30 double-unders) - no rope? Try a simulated jump rope

• 20 second plank hold (choose a low plank as shown, or a high plank hold)

SCORE: Number of rounds and repetitions performed in 15 minutes.

Cool Down

Jumpstart your recovery with a little love for those hard-working shoulders with this 20-minute Neck and Shoulder Tension Release sequence from Five Parks Yoga. #dontskiptheyoga

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NOW TAKING MEDICAL CLIENTS FROM COLORADO AND CONNECTICUT… NH COMING SOON!

..in addition to MA, NY, NJ, PA, CA, FL, OH

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

It is with great excitement that after more than 2 years of preparation, I have FINALLY launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists. We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

From the Archives….

Inside Sports Nutrition Podcast: Hormones and Female Physiology with Dr. Carla DiGirolamo - Ep. #69 – Dina Griffin/Bob Seebohar

Fit Womens Weekly Podcast: Should Workouts Change As You Get Older? Dr. Carla DiGirolamo Breaks It All Down - Kindal Boyle

If I could choose one upper-body exercise that almost every active woman should learn, it would be the push-up.

Why?

Because the push-up is far more than a chest exercise. It is a full-body movement that challenges strength, stability, coordination, and muscular endurance all at the same time. Best of all, it can be modified for every fitness level—from the beginner performing wall push-ups to the elite athlete performing deficit or plyometric variations.

What Is a Push-Up?

A push-up is a bodyweight pressing exercise performed from a plank position. During the movement, the body lowers toward the floor by bending the elbows and then pushes back to the starting position.

The primary muscles involved include:

• Pectoralis major (chest)

• Triceps

• Anterior deltoids (shoulders)

• Serratus anterior

• Core musculature

• Glutes and hips for stabilization

Because multiple muscle groups work together, the push-up is considered a compound exercise rather than an isolation movement. It develops strength while also training the body to transfer force through a stable trunk.

How to Perform a Push-Up

Begin in a plank position with hands slightly wider than shoulder width.

Maintain a straight line from head to heels.

Brace the core and glutes.

Lower the body until the chest approaches the floor.

Push through the palms and return to the starting position.

**Avoid allowing the hips to sag

Making Push-Ups Accessible for Everyone

One of the biggest misconceptions about push-ups is that they are an all-or-nothing exercise.

In reality, push-ups exist on a continuum:

Beginner: Wall push-ups, Countertop push-ups, Incline push-ups using a bench or box

Intermediate: Lower incline push-ups, Full floor push-ups, Tempo push-ups with a slow lowering phase

Advanced: Deficit push-ups, Ring or suspension push-ups, Plyometric push-ups, Single-arm progressions

For most women, incline push-ups are often a better starting point than knee push-ups because they preserve the full-body plank position and movement pattern while reducing the amount of body weight being lifted.

Why Push-Ups Matter for Midlife Women

1. Preserve Upper-Body Strength

Women naturally possess less upper-body muscle mass than men, and muscle loss accelerates during and after the menopausal transition. Regular resistance training helps offset these changes and supports long-term physical function.

2. Build Functional Strength

Push-ups train a movement pattern used in daily life: pushing yourself off the floor, getting up from a fall, moving objects, and supporting body weight through the arms.

Research consistently shows that maintaining strength and functional fitness is associated with better mobility, independence, and quality of life as we age.

3. Strengthen the Core

A properly performed push-up is essentially a moving plank. The abdominal muscles, spinal stabilizers, and glutes work continuously to maintain alignment throughout the exercise.

4. Support Bone Health

While push-ups are not a substitute for lower-body impact training, they provide weight-bearing loading through the wrists, arms, and shoulders. Maintaining upper-body strength and loading becomes increasingly important as estrogen declines and osteoporosis risk rises.

5. Provide a Simple Measure of Fitness

Push-up performance reflects a combination of strength, endurance, stability, and body composition. Research has even shown that greater push-up capacity is associated with better long-term health outcomes and lower cardiovascular risk, although this relationship has primarily been studied in men.

Safety Considerations

Push-ups are generally safe, but technique matters!

Be cautious if you have:

• Significant shoulder pain

• Acute wrist injuries

• Uncontrolled osteoporosis affecting the upper extremities

• Recent surgery involving the shoulder, chest, or wrist

Common technical errors include:

• Sagging hips

• Excessive neck extension

• Flaring elbows excessively outward

• Incomplete range of motion

If full push-ups are not yet accessible, elevate the hands and focus on perfect movement quality. Progressing gradually is far more effective than forcing repetitions with poor form.

The Bottom Line

The push-up is one of the most scalable exercises available. Whether you’re performing push-ups against a wall or knocking out sets on the floor, you’re building strength, stability, and resilience.

For active and athletic midlife women, the goal isn’t necessarily to perform the most push-ups. The goal is to continue developing the strength and confidence to do hard things—and the push-up is a great place to start.

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For this week’s workout, the main block focuses solely on the push-up, followed by a core training accessory, and finishing with a short yoga segment focused on the chest and shoulders.

This simple approach has 2 goals:

1. Finding a push-up option that allows a pain-free range of motion

2. Finding a push-up variation that is challenging, opening the door to building strength and functionality in this movement.

Warm Up

TABATA – 20-sec work/10sec off; 12 rounds, 6 minutes. Perform each movement sequentially for 20 seconds of work, then 10 seconds of rest for a total of 4 rounds of all 3 movements.

• Jumping jacks 20 seconds of work/10 seconds of rest, then…..

• Mountain Climbers 20 seconds of work/10 seconds of rest… then…

• Easy push-up option (select a variation that is easier than your workout option) 20 seconds of work/10 seconds of rest) .. then back to the jumping jacks!

Movement Practice

Watch this video closely, paying close attention to the instruction on the mechanics of execution. I cannot overstate the importance of this step! Once you have reviewed this video, select an option from the above “Modifications and Progressions”.

Practice different options and select one that achieves pain-free range of motion, where you can perform 5 repetitions unbroken, but becomes challenging for repetitions 4 and 5.

Workout

EMOM 3 minutes (Every minute on the minute for 3 minutes)

Strict Push Up:

5-5-5-5-5

5 sets of 5 reps

Options: Find one challenging option for all 5 sets, or progressively challenge yourself by choosing a more challenging option/elevation height with each set.

CORE ACCESSORY

TABATA

Perform each movement in sequence for 20 seconds of work then 10 seconds of rest for 4 rounds of all 4 movements, a total of 8 minutes.

• :20s Superman hold/10s rest.

• :20s Flutter kicks/10s rest

• :20s Oblique Twists/10s rest

• :20s Hollow hold/10s rest

Cool Down

15-minute Yoga for Chest and Shoulders

REFERENCES

Yang J, Christophi CA, Farioli A, et al. Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men. JAMA Network Open. 2019;2(2):e188341.

Mayer F, Scharhag-Rosenberger F, Carlsohn A, Cassel M, Müller S, Scharhag J. The Intensity and Effects of Strength Training in the Elderly. Dtsch Arztebl Int. 2011;108(21):359-364.

Brogno B, et al. Aging With Strength: Functional Training to Support Healthy Aging. Sports Medicine - Open. 2025.

Chulvi-Medrano I, et al. Comparison of the Effects of an Eight-Week Push-Up Program Performed on Stable and Unstable Surfaces. International Journal of Sports Physical Therapy. 2012.

Alizadeh S, Daneshjoo A, Zahiri A, et al. Push-Ups vs. Bench Press: Differences in Repetitions and Muscle Activation. Frontiers in Physiology. 2020.

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NOW TAKING NEW CLIENTS!

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

It is with great excitement that after more than 2 years of preparation, I have FINALLY launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists. We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

From the Archives….

Inside Sports Nutrition Podcast: Hormones and Female Physiology with Dr. Carla DiGirolamo - Ep. #69 – Dina Griffin/Bob Seebohar

Fit Womens Weekly Podcast: Should Workouts Change As You Get Older? Dr. Carla DiGirolamo Breaks It All Down - Kindal Boyle

Last week, we discussed the importance of quadriceps-focused training and highlighted the VMO squat as a valuable tool for building strength and preserving long-term function.

Today, I want to take the next step in that progression by introducing one of my favorite lower-body exercises: the Bulgarian split squat.

While traditional squats remain foundational, most real-world movement occurs one leg at a time.

• Walking.

• Climbing stairs.

• Hiking.

• Running.

• Recovering balance after a stumble.

Even simple activities such as getting out of a car or stepping onto a curb require us to generate force primarily through a single leg.

This is where the Bulgarian split squat shines.

The Bulgarian split squat is a single-leg dominant exercise that combines many of the benefits of traditional squats with the additional challenges of balance, stability, and unilateral strength development.

For active adults, it may be one of the most effective exercises for maintaining lower-body function as we age.

Why Single-Leg Training Matters

Single-leg training helps develop:

• Quadriceps strength

• Hip strength and stability

• Balance and coordination

• Force absorption during landing and deceleration

• Side-to-side symmetry

Research consistently demonstrates that lower-extremity strength and balance are important contributors to physical function, mobility, and fall prevention throughout adulthood.

As we reviewed in Leg Day Essentials - Part 1, the quadriceps remain particularly important because they contribute to:

• Walking speed

• Stair-climbing ability

• Sit-to-stand performance

• Overall mobility

• Activities of daily living

Longitudinal studies suggest that declines in quadriceps strength closely parallel declines in physical function over time.

What Is a Bulgarian Split Squat?

The Bulgarian split squat is performed in a staggered stance with the rear foot elevated on a bench, box, or stable platform.

The front leg performs most of the work while the rear leg provides minimal assistance.

This allows substantial loading of the quadriceps while simultaneously challenging balance and stability.

The movement can be performed with:

• Body weight

• Dumbbells

• Kettlebells

• A barbell

Safety Considerations

Like any exercise, the Bulgarian split squat should be performed within your current strength, mobility, and balance capabilities.

Individuals with significant knee pain, acute lower-extremity injury, uncontrolled balance deficits, or severe hip or ankle mobility limitations may need to begin with modified variations.

Modifications

Balance is often the limiting factor rather than strength. If this is the case, add support with a stable object as seen in panel 3 below. As strength, balance, and confidence improve, progression to Bulgarian split squats may be possible!

During the exercise:

• Keep the majority of your weight over the front leg

• Maintain an upright torso

• Allow the front knee to track naturally over the toes

• Avoid collapsing inward through the knee

• Move through a pain-free range of motion

Mild muscle fatigue and muscular discomfort are expected. Sharp joint pain is not.

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Warm Up

AMRAP 7 minutes (As many rounds as possible in 7 minutes) - low to moderate intensity

• 20 single-under jump rope or simulated jump rope

• 10 alternating lunges

• 10 (light) bent-over barbell or dumbbell rows

Movement Practice

Take 5-10 minutes to watch the video and test out various options for the single-leg squat. If none of these is an option for your abilities, check out the Movement alternatives below to find your best fit for this workout!

For the pull-ups, select the option that allows you to achieve 5 unbroken repetitions confidently but not easily.

Workout

Today’s workout is taken from an excerpt from the CrossFit Gymnastics Training course and from the CrossFit workout library, Workout 230428.

AMRAP 20 (As many rounds as possible in 20 minutes)

• 5 strict pull-ups

• 20 Bulgarian Split Squats (or your selected option) (total of 10 left and 10 right)

  TIP: Depending on your option, you may choose to alternate legs each rep, or do small sets on one side before switching legs. Either way, ensure that you perform the same number of repetitions on both sides.

• 40 double-unders (or 80 single-unders or simulated jump rope)

So, why the pull-ups? It’s a sneaky way to further challenge the core muscles needed for the single-leg squat while allowing the legs to rest!

Movement alternatives

• Lunge with forward lean (use dumbbells or body weight only) - do 5 or 10 repetitions before switching sides. TIP! Keep the front knee in line with the ankle - avoid tracking the knee over the toes

• Walking or alternating lunge in place - body weight only, holding 2 dumbbells by your sides or holding a kettlebell in a “goblet” position at your chest.

• For the pull-ups, sub any of the following:

  • Rack (or seated) pull-ups

  • Band or machine-assisted pull-ups

  • Bent-over barbell or dumbbell rows

Cool Down

Team! This is not one to skip! Your legs are a skeletal muscle powerhouse - and this workout challenged them to a high level. In turn, this requires high-level recovery and it begins with tissue care. Your legs will thank you!

20-minute “follow-along” lower-body foam roll and stretch

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References

Hughes VA, Frontera WR, Wood M, et al. Longitudinal muscle strength changes in older adults: influence of muscle mass, physical activity, and health. J Gerontol A Biol Sci Med Sci. 2001;56(5):B209-B217.

Liao KF, Ku YH, Lin LF, et al. Effects of unilateral versus bilateral resistance training on athletic performance measures: a systematic review and meta-analysis. Front Physiol. 2021;12:745199.

Gonzalez AM, Mangine GT, Fragala MS, et al. Resistance training improves single-leg stance performance in older adults. Aging Clin Exp Res. 2014;26(1):89-92.

Amin S, Baker K, Niu J, et al. Quadriceps strength and the risk of cartilage loss and symptom progression in knee osteoarthritis. Arthritis Rheum. 2009;60(1):189-198.

Papa EV, Dong X, Hassan M. Resistance training for activity limitations in older adults: a systematic review. Clin Interv Aging. 2017;12:955-961.

In case you missed it…..

Why are we all confused about cortisol? Is it good? Is it bad? Is it simply too much of a good thing? Dr Carla DiGirolamo MD, Women's performance endocrinologist, lays out the physiology, data, and practical applications of how cortisol affects our life and health.

No doubt you have seen Dr. Vonda in the news and on social media. She is an absolute force when it comes to promoting an empowering message about how women can thrive during midlife. Check out her new best-selling book “Unbreakable: A Woman’s Guide to Aging with Power”.

NOW TAKING NEW CLIENTS!

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

It is with great excitement that after more than 2 years of preparation, I have FINALLY launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists. We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

Squatting is a foundational functional movement involving the largest muscles of the body. We have discussed them at length in this newsletter multiple times, which speaks to their importance.

The back squat is a balanced or posterior-chain dominant squat pattern that distributes load among the glutes, hamstrings, quadriceps, and spinal stabilizers. This movement pattern is excellent for total body strength, power production, athletic development, bone loading, and muscle mass preservation.

The quadriceps are important for stair descent, hiking downhill, landing mechanics, pickleball and tennis movement, skiing, running, and recovering balance. Quadriceps strength has been associated with:

• Walking speed

• Stair-climbing ability

• Sit-to-stand performance

• Overall mobility

• Activities of daily living

Longitudinal data suggest that changes in quadriceps strength track closely with changes in physical function over time. Individuals who lose quadriceps strength tend to demonstrate greater functional decline.

Because squats are a complex movement that recruit muscles throughout most of the body, there is value in supplementing squat work with other, more isolated, quadriceps-dominant exercises.

According to the peer-reviewed literature, the benefits of quadriceps-dominant training include:

• Improved physical function

• Reduced risk of falls

• Better knee health and reduced osteoarthritis burden

• Improved force absorption and deceleration capacity

• Enhanced gait performance

Today, I want to highlight a squat variation called the VMO Squat - also known as the “Quad squat”.

What Is a VMO Squat?

The VMO squat is a knee-dominant squat variation designed to increase quadriceps loading through increased forward knee translation and upright torso positioning.

How to Perform a VMO Squat

The movement can be performed with body weight, dumbbells, kettlebells, or barbells.

Setup

• Elevate the heels using wedges, plates, or a slant board

• Use a relatively narrow stance

• Keep the chest upright

• Allow the knees to travel forward naturally

Descent: Lower slowly while maintaining full foot contact, controlled knee tracking, and upright posture

Bottom Position: Descend only as deep as mobility, control, and comfort allow. You can set up a STABLE target such as a bench or a chair behind you to maintain your pain-free range of motion.

Safety Considerations

The VMO squat is not appropriate for everyone immediately.

Individuals with acute knee injury, significant patellofemoral pain, advanced osteoarthritis, meniscal irritation, or poor ankle mobility may need modifications or gradual progression.

Helpful strategies include:

• Starting with body weight only

• Using a reduced range of motion

• Slowing the tempo

• Holding onto support initially

• Gradually increasing depth

Below are some examples of ALTERNATIVE quadriceps-dominant exercises that provide similar benefits of VMO squats are not accessible for you:

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Today’s workout will incorporate the VMO squat as a post-workout accessory. Accessory work can be a game-changer for enhancing the stimulus of your main workout block. For strength-building, consider incorporating this accessory 1-2x per week, progressively adding small amounts of load as tolerated over a 4-6 week period.

Warm-Up

AMRAP 5 minutes (As many rounds as possible in 5 minutes)

• 10 Jumping Jacks

• 10 Air Squats

Workout

Part 1 - Lift Heavy

This workout is ideally performed with a heavier barbell taking it off the rack. If you do not have a barbell and are using dumbbells, do these repetitions as 2:2:1 tempo repetitions (2 count down, hold at the bottom for a 2 count, then rise for a 1 count). All 6 repetitions should be performed unbroken, building in weight across all 5 sets.

Every 2 minutes for 5 sets

6-6-6-6-6 (If you are doing tempo repetitions with dumbbells, perform 4 repetitions each set)

Heavy barbell Front Squat - 6 repetitions

TIP!: “Heavy” does not mean that you sacrifice mechanics! Watch the video and maintain the strictest of form and do not compromise safety! Some wiggle-room is allowed as fatigue sets in, but it should never get ugly.

(Alternative: Dumbbell Front Squat at a 2:2:1 tempo x 4 reps per set)

Part 2 - VMO Squat Accessory

Rest 5-7 minutes after completing part 1

If you have any knee or ankle discomfort, take a few minutes to use a chair, bench, or step to find the limits of your pain-free range of motion. Add some light load (kettlebell or dumbbell) if desired. If this movement is not accessible to you, consider one of the options above.

Every 2 minutes x 4 sets - Set a timer and on time zero, 2, 4, and 6 minutes, perform 8-10 repetitions. Use the remainder of the 2-minute interval to rest. All repetitions should be unbroken.

Cool-Down

15-minute Deep Stretch for Hips - Slow Flow Yoga sequence

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References

Frontera WR, Hughes VA, Lutz KJ, Evans WJ. A cross-sectional study of muscle strength and mass in 45- to 78-year-old men and women. J Appl Physiol. 1991;71(2):644-650. doi:10.1152/jappl.1991.71.2.644

Bean JF, Kiely DK, LaRose S, Goldstein R, Frontera WR, Leveille SG. Are changes in leg power responsible for clinically meaningful improvements in mobility in older adults? J Am Geriatr Soc. 2010;58(12):2363-2368. doi:10.1111/j.1532-5415.2010.03155.x

Segal NA, Glass NA, Torner J, et al. Quadriceps weakness predicts risk for knee joint space narrowing in women in the MOST cohort. Osteoarthritis Cartilage. 2010;18(6):769-775. doi:10.1016/j.joca.2010.02.002

Øiestad BE, Juhl CB, Eitzen I, Thorlund JB. Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2015;23(2):171-177. doi:10.1016/j.joca.2014.10.008

Skelton DA, Kennedy J, Rutherford OM. Explosive power and asymmetry in leg muscle function in frequent fallers and non-fallers aged over 65. Age Ageing. 2002;31(2):119-125. doi:10.1093/ageing/31.2.119

NOW TAKING NEW CLIENTS!

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

It is with great excitement that after more than 2 years of preparation, I have FINALLY launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists. We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

In case you missed it…..

Tune in to my guest appearance with the awesome and amazing Selene Yeager where we review the latest medical literature addressing the the role of laboratory testing in managing menopausal hormone therapy.

This week, I want to build upon last week’s introduction to hip extension through the kettlebell swing with a slightly more complex movement that expands hip extension into a total body movement. Enter the sumo-deadlift high-pull.

Part deadlift, part explosive pull, and part conditioning tool, the SDHP combines lower-body power with upper-body coordination in a single movement pattern. When coached correctly and loaded appropriately, it can be an efficient way to train strength, muscular endurance, and metabolic conditioning simultaneously.

This movement also highlights something increasingly important with aging: the ability to generate force quickly and transfer that force efficiently through the body.

What Is the Sumo Deadlift High Pull?

The SDHP begins in a wide “sumo” stance with the hands gripping the weighted object (typically a barbell, kettlebell, or dumbbell) inside the knees. From the floor, the athlete drives through the legs and hips, stands explosively, then continues the momentum upward by pulling the elbows high and outside until the weight reaches approximately chest or collarbone height.

The movement is sequential:

1. Hip and knee extension

2. Force transfer through the trunk

3. Upper-body pull

Done correctly, the arms are not initiating the movement—the hips are.

The Mechanics: The power comes from the lower body

The SDHP is fundamentally a hip-dominant movement. The glutes, hamstrings, quadriceps, spinal erectors, core musculature, traps, and upper back all contribute.

The wider sumo stance changes the mechanics compared with a conventional deadlift. Research on sumo deadlift biomechanics demonstrates that the wider stance generally allows for:

• A more upright torso

• Reduced forward trunk lean

• Shorter bar travel distance

• Reduced lumbar shear stress compared with conventional pulling mechanics

How to find your sumo-width stance: Start with your squat stance with your feet at shoulder-width distance. Then, with each foot, move one heel-to-toe length wider.

For many women—particularly those with longer torsos, shorter arms, or good hip mobility—the sumo position may feel mechanically more comfortable than a narrow-stance deadlift.

The “high pull” portion adds an explosive upper-body component that recruits the traps, deltoids, rhomboids, and scapular stabilizers while demanding timing and coordination. The movement, therefore, becomes less about isolated strength and more about integrated athletic movement.

Physiologic Benefits for Midlife and Older Women

One of the most valuable aspects of the SDHP is that it trains multiple physiologic qualities simultaneously.

1. Power Production

Power—the ability to produce force quickly—declines earlier and faster than maximal strength with aging. That matters because power is closely tied to athletic performance, fall prevention, agility, and functional independence.

The SDHP trains rapid hip extension, similar to jumping, sprinting, or Olympic lifting derivatives, but often with a lower technical barrier.

2. Metabolic Conditioning

Because the SDHP uses large muscle groups across the entire body and can be cycled continuously, it creates a substantial cardiovascular and metabolic demand.

This makes it useful in interval-style conditioning workouts where maintaining muscle mass and power output are priorities—not just calorie burn.

3. Posterior Chain Strength

The posterior chain—glutes, hamstrings, spinal erectors, and upper back—is critically important for posture, sprinting, lifting capacity, and long-term musculoskeletal resilience.

Many mid-life women are quadriceps-dominant from years of running, cycling, or group fitness classes. Hip-dominant pulling patterns like the SDHP can help restore balance.

4. Coordination and Force Transfer

The SDHP teaches “core-to-extremity” force transfer: generating power from the lower body and transmitting it through a stable trunk into the upper body.

That quality is foundational not only in sport, but also in everyday athletic movement.

Important Safety Considerations

The SDHP is effective—but it is not universally appropriate for everyone.

The most controversial aspect of the movement is the top position, where the shoulders move into internal rotation with the elbows elevated. Some clinicians and coaches argue that this position may increase the risk of shoulder impingement in susceptible individuals.

This does not automatically make the movement “dangerous,” but it does mean exercise selection should match the individual.

Women with:

• Existing shoulder impingement

• Limited thoracic mobility

• Poor shoulder internal rotation

• Cervical discomfort

• Poor trunk control under load

may not tolerate the movement well.

Technique errors also matter. Common problems include:

• Pulling with the arms too early

• Rounding the lumbar spine

• Letting the bar drift away from the body

• Excessively loading the shoulders rather than driving through the hips

For many women, lighter loads with crisp mechanics are far more effective than maximal loading.

If the SDLHP is not accessible to you in any of its modifications, the kettlebell swing in part 1 of this series is a fine substitution.

Practical Takeaway

The sumo deadlift high pull is best viewed as a power-conditioning movement—not simply a strength exercise.

When programmed intelligently, it can improve:

• Hip power

• Whole-body coordination

• Work capacity

• Posterior chain strength

• Athletic movement quality

But like many explosive exercises, the benefit depends entirely on execution.

If the shoulders dislike the movement, there are excellent alternatives—including kettlebell swings, high pulls from hang positions, trap-bar pulls, or medicine-ball power work.

The goal is not to force a movement.

The goal is to preserve power, athleticism, and resilience as long as possible.

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Warm Up

AMRAP 7 (As many rounds as possible in 7 minutes)

• 7 up-downs

• 7 air squats

• 7 easy push-ups option

After the 7 minutes, perform 10 weighted good mornings. You can either use a barbell/PVC pipe or hold a light dumbbell or plate to your chest.

Movement Practice

If you are performing this movement for the first time, it is highly recommended to perform the mechanics of this movement without any weight (just your two hands or a PVC pipe, broomstick, or similar object). When you feel confident in the movement, add a light kettlebell (5-15 lbs) or empty barbell. As you continue feeling proficient, slowly increase the load.

Review the video links that follow before trying the SDLHP:

• The first part of this movement is a deadlift. It is very important to get this part of the movement right to keep your lower back protected. Be sure to keep your back straight- your legs, glutes, and hamstrings are doing the lifting, NOT the muscles of the lower back.

• Next, review the sumo deadlift high pull progression video paying close attention to the mechanics tips in the text.

• Practice! At first, you may want to do a deadlift, pause, then the high pull. This is ok! As you practice and become more familiar with the movement, the two parts of the lift will flow together. Don’t pull too soon! Be sure you are fully extended at the hips (standing up straight) before pulling the bar up.

  • The “shrug” then the “pull” happens the second the hips fully extend. When the hips are extended with some speed or “pop” this begins to move the bar upward which signals the start of the pull. The upper extremties simply guide the bar upward.

TIP! When setting up for the SDLHP, set your eye gaze to a point on the ground 10 ft in front of you. You do not want to be looking straight ahead as this will hyper-extend the neck. Keep the neck neutral by setting your gaze as above.

For the push-ups, the workout calls for the hand-release push-up, however a standard push-up with or without elevation can be substituted. The hand-release version has the added benefit of building strength at the lowest point of the movement (chest touching the floor), which is often a “weak spot” of upper body strength.

Below is a list of movement options. Take 5-10 minutes to find the option that is right for you. If you want to “Geek-out” on a deep dive into push-up variations and mechanics, check out this awesome article: A Fresh Take on the Lowly Push-Up from the CrossFit library.

• Hand-release push-up

• Strict push-up

• Elevated push-up - The elevation can be slight with a couple of plates on the ground, it could be a flat bench, or a STABLE chair or table as in the video. If shoulder pain or mobility is an issue, performing push-ups against a wall is also an option.

TIP! If possible, avoid doing the push-ups with the knees on the floor. This disengages some of the core activation, which is a target of both the SDLHP and the push-up.

Workout

We have 3 levels of this workout today! Beginner, Intermediate, and Advanced

Beginner

5 rounds for time

• 8 SDLHP - Two hands only/PVC pipe/broomstick

• 8 elevated push-ups

Intermediate

8 rounds for time

• 10 SDLHP (10-35 lb kettlebell, 25-55 lb weighted barbell)

• 12 hand-release/elevated/strict push-ups

Advanced

8 rounds for time

• 10 SDLHP (65# barbell)

• 12 hand-release push-ups

Cool-Down

Let’s show our back, hips and hamstrings some love with this 7-minute follow-along stretch segment from Train FTW.

For your yoga fix, try this 15-minute yoga flow class from Five Parks Yoga

NOW TAKING NEW CLIENTS!

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

It is with great excitement that after more than 2 years of preparation, I have FINALLY launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists. We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

In case you missed it…..

Tune in to my guest appearance with the awesome and amazing Selene Yeager where we review the latest medical literature addressing the the role of laboratory testing in managing menopausal hormone therapy.

Muscle power is essential during midlife and beyond. One of the greatest power-generators exists through hip extension.

Power declines with age - especially during the menopause transition - often faster than maximal strength. This matters because power is what allows strength to show up quickly.

Strength helps you lift.

Power helps you react, jump, accelerate, climb, catch yourself, and move dynamically.

How do we tap into this power reservoir? Enter the kettlebell swing.

The kettlebell swing is one of the most useful “bridge” movements in strength and conditioning: simple enough to learn with good coaching, but powerful enough to train strength, coordination, conditioning, and athletic power in one pattern.

Its value is that it trains hip extension—the ability to drive the hips forward forcefully—which underlies so many athletic and daily movements: climbing stairs, jumping, sprinting, hiking uphill, lifting from the floor, getting out of a chair, and generating whole-body power.

What Is the Kettlebell Swing?

The kettlebell swing is a ballistic hip-hinge movement. The bell travels backward between the legs as the hips flex, then forward as the hips extend explosively. In the classic shoulder-height swing, the bell rises to approximately chest or shoulder level—not because the arms lift it, but because the hips project force into the bell.

That distinction matters.

A good swing is not a squat with a front raise. It is a loaded hinge followed by rapid hip extension. Biomechanical research shows that kettlebell swings create a hip-hinge pattern with rapid muscle activation and relaxation cycles, involving substantial low-back and hip muscle activity.

The Mechanics: Hinge, Load, Snap, Float

The swing can be thought of in four phases:

1. Hinge: The hips move back while the spine stays neutral. The knees bend slightly, but the movement is not knee-dominant.

2. Load: The hamstrings, glutes, and posterior chain lengthen under tension as the bell moves behind the body.

3. Snap: The athlete drives the floor away and extends the hips powerfully.

4. Float: The bell rises from momentum. The arms guide the bell; they do not lift it.

This is why the swing is so useful as a teaching tool. It reinforces the difference between hip flexion/extension and squatting, and it teaches force transfer from the lower body through a braced trunk into the upper body.

Female-specific biomechanics research supports the idea that swing style and load influence hip extension demands. In trained young women, kettlebell mass and swing variation affected hip joint kinetics, reinforcing that the swing is meaningfully loaded through the hip when performed correctly.

Physiologic Benefits

The swing offers several benefits that are particularly relevant for active and athletic women in midlife and beyond.

• Posterior chain strength. The glutes, hamstrings, spinal erectors, and upper back all contribute to the swing. This helps build strength in the muscles that support posture, lifting, running mechanics, and hip stability.

• Power development. Because the bell accelerates through hip extension, the swing trains explosive strength in a relatively accessible way compared with Olympic lifts.

• Metabolic conditioning. Kettlebell swings can create a significant cardiovascular demand. Research on the oxygen cost of kettlebell swings shows that they can be metabolically challenging, especially when performed in intervals.

• Grip and trunk integration. The swing requires the hands, lats, trunk, hips, and legs to coordinate as one system. This makes it more “athletic” than many isolated machine-based exercises.

• Functional carryover. The hinge-to-hip-extension pattern shows up everywhere: deadlifting, jumping, hiking, picking up heavy objects, and transitioning from low to high positions.

Safety and Movement Modifications

The swing is powerful, but it should be earned. Common errors include squatting the bell, lifting with the arms, overextending the lower back at the top, letting the bell drop too low, or losing trunk tension.

For beginners or anyone with back sensitivity, check out this kettlebell swing progression video. Start with a kettlebell deadlift, then a hike pass, then short sets of swings. The goal is crisp mechanics, not fatigue-driven volume.

Other movement modifications include:

• Use a light kettlebell: Kettlebells are available in weights starting at 5 pounds.

• Adjust the height of the swing: The “Russian" swing takes the bell to eye level, where the “American” Swing takes the bell overhead - this is an advanced level option. The swing can further be modified to swing to the level of the abdomen or chest.

Practical Takeaway

The kettlebell swing is foundational because it teaches one of the most important athletic skills: generating power from the hips.

For midlife women, this is not just about performance in the gym. It is about preserving the ability to move with strength, speed, confidence, and resilience in real life.

Before progressing to more complex movements, the kettlebell swing builds the base: hinge mechanics, hip extension, trunk stiffness, posterior-chain power, and whole-body coordination.

In Part 2 of this series, we will increase the complexity with the sumo-deadlift high-pull. Stay tuned!

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Today’s workout targets hip extension with the jump and the kettlebell swing. The overhead alternating lunge creates fatigue in the legs and targets core stability. There are several movement alternatives to choose from if any of these movements is not completely accessible to you. Enjoy!

Warm Up

AMRAP 7 Perform each movement in sequence for as many rounds of the 3 movements as you can in 7 minutes.

• 10 air squats

• 10 light kettlebell swings

• 10 box step-ups

Movement Practice

Take 5-10 minutes to select weights/options and practice the movements you will do for the workout. Select options/weights that allow you to confidently do 5-10 repetitions unbroken.

For the box jump, select a STABLE box at a height where you can confidently jump and move at a steady pace with only a couple of breaths of rest after 5-10 repetitions. For experienced athletes, the suggested box height is 20 inches (50 cm).

For the kettlebell swing, select a moderately heavy weight and swing to eye level (“Russian”-style swing). For experienced athletes, the recommended kettlebell weight is 35 lbs (16kg).

For the single arm overhead alternating lunge. Select a weight that allows you to do 10 total repetitions (5 each side) unbroken. If this movement is new to you or challenging, select a light object to hold overhead such as a shoe or a can of beans. Holding a single arm in this position is more important than the weight used. For experienced athletes, the recommended dumbbell weight is 20-25lbs (12-14kg)

Movement Alternatives

Box jump alternative: Squat jumps for height. If you cannot tolerate any impact perform dumbbell or barbell thrusters.

** For this workout, the box step-up is not an optimal scale because the goal of this movement is to be “explosive” in the hip extension to train power in the muscles that execute this movement.

Kettlebell swing alternative: Double dumbbell swing. If you have a barbell and are proficient with Olympic weightlifting, substitute a hang power clean.

Single arm overhead alternating lunge: If holding a single arm without weight overhead is not accessible to you, perform the alternating lunges holding a single dumbbell by your side, switching arms as needed.

Workout

AMRAP 16 (As many rounds as possible in 16 minutes)

Repetition scheme: 2-4-6-8…. and so on adding 2 repetitions per round.

HOW TO: Perform 2 box jumps, 2 overhead lunges, 2 kettlebell swings, then 4 box jumps, 4 overhead lunges, 4 kettlebell swings, then 6 box jumps, and so on. Continue with as many rounds as you can on a 16-minute clock. Your score is the total rounds and repetitions. (Ex: completed the round of 14 and 15 repetitions into the round of 16.)

• Box jumps

• Single overhead dumbbell alternating lunges (Switch arms as needed. Alternate legs with each repetition)

• Kettlebell swings

Cool Down

Show your hips and legs some love with this 20-minute Yoga Flow for Hips from Yoga with Adriene. The best results gained from training start with recovery. #dontskiptheyoga.

References

McGill SM, Marshall LW. Kettlebell swing, snatch, and bottoms-up carry: back and hip muscle activation, motion, and low back loads. J Strength Cond Res. 2012;26(1):16-27. Available at: https://pubmed.ncbi.nlm.nih.gov/21997449/

Lake JP, Lauder MA. Kettlebell swing training improves maximal and explosive strength. J Strength Cond Res. 2012;26(8):2228-2233. Available at: https://pubmed.ncbi.nlm.nih.gov/22580981/

Farrar RE, Mayhew JL, Koch AJ. Oxygen cost of kettlebell swings. J Strength Cond Res. 2010;24(4):1034-1036. Available at: https://pubmed.ncbi.nlm.nih.gov/20300022/

Watts CQ, McCarty CW, Keogh JWL, et al. Effects of kettlebell load on joint kinetics and global lower-extremity biomechanics during the kettlebell overhead swing. Sports (Basel). 2022;10(12):203. Available at: https://pubmed.ncbi.nlm.nih.gov/36548707/

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NOW TAKING NEW CLIENTS!

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

It is with great excitement that after more than 2 years of preparation, I have FINALLY launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists. We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

In case you missed it…..

Tune in to my guest appearance with the awesome and amazing Selene Yeager where we review the latest medical literature addressing the the role of laboratory testing in managing menopausal hormone therapy.

Hey Team! 
I just landed in Rhode Island after a 5-day stint that involved moving my son out of his dorm at UCF in Orlando, FL, followed by a cross-country drive. So this week, I have chosen a popular post from the archives to remind us that the road to fitness takes many forms. I hope you enjoy this re-post, and I'll be back next week with new content! 
Cheers!
-Dr. Carla

One of the most beautiful things about the Human condition is our ability to adapt to changing environmental conditions. This ability is one of the reasons why we have been in existence for the last 300,000 years! So, when we are training for overall fitness and longevity, we need to keep changing things up to keep our muscles, bones, and nervous system in a constant state of dynamic change and adaptation.

We sometimes experience the flip side of adaptation that causes frustration, and that is the fitness plateau. We have all been in that situation when we are working hard on a fitness program that used to work, but no longer does. Once we have done the troubleshooting and ruled out things like fueling imbalances and inadequate sleep and recovery, the next place to look is the program itself, and the last time you made any significant changes.

You may have noticed that in the Athletic Aging Weekly Workout Series, we don’t repeat workouts very often, unless it is a strength or performance retest of a “benchmark workout”. This is deliberate, keeping consistent with the principle of maintaining a constant state of adaptation. Not only is there variation in movements and energy systems (heavier lifts vs cardiovascular stimulation), but there is variation in intensity as well.

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This week’s workout mixes it up in all directions! There are movements that may be new to you, like the plank pull-through and the sit-through (a.k.a the hip escape in the Les Mills BodyCombat world), a full body focus, and a lower “zone 2” or “conversational intensity”.

Today’s session is a modification of an awesome workout from Train FTW. As always, if these movements are not accessible to you, there are modifications for every fitness level. Enjoy!

Warm-Up and Movement Practice

Cardio movement options include bike, row, and run. If these options are not accessible to you, substitute an easy stair climb/step-up or another cardio machine (i.e arc trainer, elliptical, etc.). Ideally, select two different options for the workout, however, it is fine to select just one option for all three rounds. These cardio segments are to be done at a lower intensity (zone 2) level that is “conversational”.

To warm up, select one cardio option and go for 50 seconds at an easy pace and 10 seconds at a hard pace for a total of 5 minutes.

Watch the movement demo videos below and select your movement options for the workout. Take 5-10 minutes to practice each movement and select weights as appropriate.

• Plank pull-through or Plank Shoulder tap (Knees or toes for both options)

• Dumbbell front rack walk

• Sit-through or bear crawl

• Over-under carry

• Oblique twist (Option: no weight)

• Duck walk - body weight (Advanced option: Duck walk holding a light to medium kettlebell) or Inchworm

Workout

3 rounds

• 3:00 Bike

• 1:00 Plank pull-through (Alternative: Plank shoulder tap)

• 100 ft double dumbbell front rack walk

1:00 rest

3 rounds

• 3:00 row

• 1:00 sit-through (Alternative: 100 ft bear crawl)

• 50 ft / 50 ft over-under carry

1:00 rest

3 rounds

• 3:00 bike

• 30-second weighted oblique-twist

• 50 ft duck walk (Alternative: 50 ft inchworm)

Cool Down

This is a really nice, gentle full-body stretch sequence to round out today’s workout. Even though it was a lower-intensity day, effective tissue care ends with a good stretch! #dontskiptheyoga

15-minute Full Body Stretch

A Hot Topic that Keeps Heating Up…..

When women come to see me struggling with performance in perimenopause and menopause, they are often concerned about their fluctuating or absent reproductive hormones and the chaos this creates.

But often it is not the reproductive hormone pathways that are creating the chaos - it’s the hormone pathways of the stress response system. Check out this podcast appearance with the awesome and amazing Selene Yeager, where we discuss how fueling and recovering are your best defense against a stress response system gone rogue!

NOW TAKING NEW CLIENTS!

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

It is with great excitement that after more than 2 years of preparation, I have FINALLY launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists. We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!

If there’s one movement that bridges the gap between performance, longevity, and injury prevention—it’s the plank.

At first glance, it looks simple. Static. Even passive.

But physiologically? The plank is anything but.

Plank variations offer one of the most efficient ways to build core strength, spinal stability, and movement resilience—all without excessive joint stress.

What the Plank Actually Trains

The “core” is not just your abs. It’s an integrated system of muscles that stabilize the spine and pelvis, including:

• Transversus abdominis

• Internal and external obliques

• Rectus abdominis

• Erector spinae

• Pelvic floor and diaphragm

These muscles work together to control force transfer through the body, which is critical for everything from lifting weights to running to simply maintaining posture.

Planks train this system isometrically—meaning the muscles contract without changing length. That distinction matters.

Unlike dynamic core exercises, planks emphasize:

• Endurance of stabilizing muscles

• Neuromuscular coordination

• Spinal control under sustained tension

Why Planks Matter for MidLife Women

As women move through perimenopause and menopause, several physiologic changes occur:

• Loss of muscle mass (sarcopenia)

• Decline in neuromuscular efficiency

• Increased risk of low back pain and injury

Core stability becomes a limiting factor—not just strength.

Research consistently shows that core stabilization exercises like planks improve neuromuscular control and spinal stability, making them foundational in both performance training and rehabilitation settings (Hibbs et al., 2008).

A Brief but Important Distinction: Stability vs Movement

Planks are fundamentally different from dynamic core exercises like the kettlebell swing or hollow rocks. As an isometric exercise, the plank trains the core to resist movement—building sustained tension, spinal stability, and neuromuscular control. In contrast, dynamic movements involve repeated shortening and lengthening of muscle, emphasizing force production and movement efficiency.

Electromyographic research shows that isometric exercises like planks preferentially activate deep stabilizing muscles critical for spinal protection, while dynamic exercises generate higher peak forces but rely on that underlying stability to be performed safely (McGill, 2010; Ekstrom et al., 2007).

In practice, this means planks build the foundation, while dynamic core work expresses that strength through movement.

Why Isometric Strength Matters for Longevity

Isometric training—like planks—builds:

• Postural strength

• Joint stability

• Tendon resilience

• Time-under-tension endurance

Unlike repetitive flexion-based movements, planks:

• Minimize excessive spinal loading

• Train the body to resist unwanted motion (anti-extension, anti-rotation)

• Reinforce safe mechanics under fatigue

This becomes increasingly important for reducing injury risk in both training and daily life.

The Power of Plank Variations

Here’s where planks become a true performance tool. Different variations shift demand across the core:

Research shows that these variations can increase muscle activation and neuromuscular demand, making them far more than a static hold.

How to Program Planks Effectively

For women over 40, the goal is not just “holding longer”—it’s building capacity with quality.

Start with:

• 20–30 second holds

• 2–4 sets

Progress by:

• Increasing time (up to ~60 seconds)

• Adding variations rather than just duration

• Introducing instability or controlled limb movement

Key cue:

Think “brace and breathe,” not “hold your breath and survive.”

The Takeaway

Planks are not a filler exercise.

They are a high-value, low-risk, performance-enhancing tool—especially for women navigating the physiologic shifts of midlife.

They train what matters most:

• Stability before power

• Control before intensity

• Endurance before output

Build the foundation well—and everything else gets stronger on top of it.

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Today’s workout has a “Plank Challenge” integrated into a combination of dynamic movements that target the core musculature in different ways.

Warm Up

If running, rowing, or biking, perform 3 minutes at an easy pace.

Then….

TABATA (20 seconds work/10 seconds rest) x 3 rounds (6 minutes total)

• Up downs or jump rope

• Air squats

• Elevated Push ups (elevated or strict)

• Ab mat or traditional sit Ups (knees bent, feet anchored)

Movement Practice

Watch the video links for the workout movements and alternatives and take 5-10 minutes to practice each movement in sequence for 4-6 repetitions at low intensity for 2 rounds. Select your options for the workout during this practice time.

Movement substitutions:

• Run/Row substitution: 400m bike or10 up-downs or 60 single-under/30 double-under jump rope.

• Dumbbell front squat substitution: Goblet squat with a single dumbbell or kettlebell or air squat.

• Kettlebell swing substitution: double or single dumbbell swing, or 10 hip bridges with or without weight.

Workout

4 Rounds for time. Perform each movement in sequence. Note that there is 1 minute of rest between rounds.

• 200m run or row

• 10 dumbbell (2 dumbbells) front squats

• 10 strict or elevated push-ups

• 15 Kettlebell swings- eye level (advanced: overhead swing):

• 10 Hollow Rocks

• Accumulate 1:00 plank hold

  • If you need to rest before the minute is up, the rest DOES NOT count toward the 1 minute. Resume timing when you resume the plank until you have accumulated 1 full minute of plank time.

• REST 1 minute

SCORE: Total time to complete the 4 rounds plus the 1 minute of rest in between rounds.

Cool-Down

Jump-start your recovery with this 20-minute deep stretch yoga sequence from Five Parks Yoga

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References

McGill SM. Core training: evidence translating to better performance and injury prevention. Strength & Conditioning Journal. 2010;32(3):33–46. doi: 10.1519/SSC.0b013e3181df4521.

Ekstrom RA, Donatelli RA, Carp KC. Electromyographic analysis of core trunk, hip, and thigh muscles during 9 rehabilitation exercises. J Orthop Sports Phys Ther. 2007;37(12):754–762.

Hibbs AE, Thompson KG, French D, et al. Optimizing performance by improving core stability and core strength. Sports Med. 2008;38(12):995–1008.

McGill SM, Marshall LW. Kettlebell swing, snatch, and bottoms-up carry: back and hip muscle activation, motion, and low back loads. Journal of Strength and Conditioning Research. 2012;26(1):16–27. doi: 10.1519/JSC.0b013e31823a4063.

Calatayud J, Casaña J, Martín F, Jakobsen MD, Colado JC, Gargallo P, Juesas Á, Muñoz V, Andersen LL. Trunk muscle activity during different variations of the supine plank exercise. Musculoskeletal Science and Practice. 2017;28:54–58. doi: 10.1016/j.msksp.2017.01.011.

TAKING NEW CLIENTS!

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

It is with great excitement that after more than 2 years of preparation, I have FINALLY launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists. We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website, including a link to my calendar so that you can reserve your place in my schedule online! Looking for a more Human encounter? Call Mary, my awesome and amazing assistant at 754-262-5674 (M-F 9a-5p ET)

In Case You Missed It…..

Check out this awesome podcast where the awesome and amazing Selene Yeager interviews Dr. Casey Francis, my personal Performance Physical Therapist from Pompano Beach, FL, about how this discipline of physical therapy can help women of all ages and athletic levels, but especially those in mid-life. Later in the show, I make a quick appearance to talk about my injury rehab and experience working with Dr. Casey.

The masses (including myself) spend a lot of time discussing the benefits of weight training. As often happens when something goes viral, we can get caught up in an implied narrative that we need to DO THIS AT THE EXCLUSION OF everything else and lose sight of the other valuable fitness modalities that we have available to us.

Now, please make no mistake. There is no substitute for the stimulus we receive from weight training. But females are masters of physical adaptation, and our bodies crave variation to improve fitness. So the more variations we have, the more opportunities we have to supplement our weight training efforts with other modalities, and promote the adaptations required for fitness gains.

Enter body weight training.

Bodyweight training is having a well-deserved moment—and for good reason. For midlife women, it represents an effective, accessible, and sustainable way to build strength, preserve muscle, and support long-term health.

But to fully appreciate its value, we need to define it more broadly than most people do.

What Is Bodyweight Training?

Bodyweight training includes any exercise where your own body mass provides the primary resistance. While many people think of push-ups and squats, the reality is much more comprehensive.

A well-rounded bodyweight training system includes:

• Strength movements: push-ups, pull-ups, squats, lunges

• Locomotion: walking, running, hiking, stair climbing

• Power-based movements: jumping, hopping, bounding, skipping

• Isometric control: planks, wall sits, hangs

• Multi-planar movement: lateral lunges, crawling, rotational patterns

• Skill and control work: yoga flows, Pilates-based core training, balance work

Together, these movements train strength, power, coordination, mobility, and control—qualities that become increasingly important as we age.

Why Bodyweight Training Matters More After 40

As physiology shifts in midlife, our training priorities evolve. Bodyweight training aligns exceptionally well with what we need most.

It builds real-world strength
Bodyweight training improves your ability to move your own mass through space. Getting up from the floor, climbing stairs, catching yourself during a misstep—these are all expressions of functional strength.

It preserves lean muscle mass
Muscle loss (sarcopenia) begins as early as the fourth decade. Bodyweight exercises—especially when progressed appropriately—can provide sufficient resistance to stimulate and maintain muscle.

It supports bone health
Movements that involve impact—such as running and jumping—create mechanical loading that is particularly effective for maintaining bone density. This becomes critical in the peri- and postmenopausal years.

It enhances joint health and mobility
Bodyweight movements require joints to stabilize through natural ranges of motion while simultaneously producing force. This integrated demand supports both mobility and long-term joint resilience.

It improves neuromuscular coordination
Many bodyweight exercises are skill-based. Whether it’s controlling a pull-up, stabilizing in a plank, or transitioning through a yoga flow, these movements reinforce the connection between the nervous system and muscular system—an essential component of balance and fall prevention.

It emphasizes relative strength
Your ability to move your own body is one of the most meaningful indicators of function and longevity. Push-ups, pull-ups, and controlled squats often tell us more about real-world capability than machine-based strength measures.

A Complete System, Not Just a Few Exercises

One of the most common misconceptions is that bodyweight training is limited or “basic.” In reality, it is a highly adaptable and scalable system.

For example:

• A push-up can range from a wall variation to a deficit or single-arm version

• A squat can progress from a box squat to a single-leg squat

• Jumping can evolve from low-impact step-offs to more dynamic, reactive movements

• A plank can become a highly demanding full-body stability challenge

Even yoga and Pilates—often thought of as separate disciplines—fit naturally into this system by developing control, stability, and movement precision. These elements enhance the effectiveness of more strength- and power-based movements, creating a more complete and resilient athlete.

What Does the Research Show?

The literature consistently supports the benefits of bodyweight and resistance-based training, particularly in women and aging populations:

• Bodyweight resistance exercises can produce significant improvements in strength and muscle hypertrophy, comparable to traditional resistance training when properly progressed

• Resistance training improves muscle mass, metabolic health, and cardiovascular outcomes, all of which are critical for long-term health

• Impact-based and resistance training strategies improve bone mineral density and physical function, especially in postmenopausal women

• Calisthenics-based training enhances neuromuscular function, balance, and coordination, which are key for maintaining independence with age

Importantly, these adaptations remain robust well into midlife and beyond.

The Bottom Line

Bodyweight training is not a simplified version of training—it is a foundational system for strength, movement, and longevity that offers:

• Functional, transferable strength

• Preservation of muscle and bone

• Improved balance and coordination

• Scalability across all fitness levels

• Minimal equipment with maximal return

But if I’m weight training 3-4x per week, how do I fit it all in???

• If you have never lifted weights before, body-weight training can build a great base of functionality to help you hit the ground running when you start training with weights.

• It adds variety to your weight training program. If the bench press is part of your weight training routine, you can add push-up sessions and their many variations to your routine. Having a separate day of plyometrics sprinkled into your sessions or isometrics on a de-load day fits nicely with any weight training routine, as does running, hiking, and other options in the locomotion category.

• It also provides great options if you are de-loading (active recovery days or weeks), traveling, or pressed for time, because many body weight movements can be done with no equipment and minimal space.

• Provides a wide variety of scalable options during injury recovery.

The key is to think beyond isolated exercises and instead embrace the full spectrum:
strength, power, locomotion, stability, and control.

Train your body to move well, not just lift well.

Because ultimately, the goal isn’t just fitness—it’s capability, resilience, and longevity.

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This week, we are featuring the classic, body-weight, CrossFit benchmark workout - “Cindy” and to that, I have added a twist with a locomotion movement of choice (walk with or without a weighted vest, run, bike, or row - or even swim if you are so inclined!)

Warm Up

3 minutes of your locomotion option of choice at an easy pace

then…

AMRAP 5 (As many rounds as possible in 5 minutes). Perform each movement in sequence for as many rounds and repetitions as possible in 20 minutes.

• 10 air squats

• 5 easy push-ups (Use an elevated push-up if strict push-ups are not accessible to you).

• 5 V-ups. See the linked video for modifications

Movement Practice

Select your options for the workout. For the air squats, be sure to identify your pain-free range of motion if you have knee or mobility issues. Set up a box or bench as a target, if needed. Otherwise, if you have no limitations, ensure that your hips break parallel and that you achieve this depth consistently.

Select your push-up option. If you cannot do strict push-ups easily, set up a stable box or bench at an elevation that allows you to do 5-10 unbroken repetitions confidently. ** Try to avoid doing push-ups from your knees, as this disengages the core muscles.

Select your pull-up option. Last week’s post, “Pull-Up Power,” reviewed the mechanics of the pull-up and the many options available for all fitness levels. Select an option where you can do 3-5 repetitions at a time confidently.

TIP! This is a very high-repetition volume workout. Fatigue will set in very quickly, so it is important to select movement options that you can do confidently and easily for several rounds. Take short rests as needed while pacing and as fatigue sets in. It is not unusual to be doing single repetitions at a time toward the end.

Workout

Pace yourself!

5 minutes of your locomotion choice at an RPE of 7-8. Note your total.

Proceed immediately into AMRAP 20 (As many rounds as possible in 20 minutes)

• 5 pull-ups (your selected option)

• 10 push-ups (your selected option)

• 15 Air squats

Immediately following the 20-minute AMRAP, go straight into another 5 minutes of your locomotion choice with the goal of meeting or exceeding your total prior to the AMRAP.

Your score: Total rounds and repetitions, including your locomotion total for both rounds.

MODIFICATION: If you wish to reduce the repetition volume, perform the AMRAP for 10 or 15 minutes instead of 20 minutes.

Cool Down

This workout was a long grind, so it deserves a thorough cool-down that helps return your stress response system back to baseline.

Try this 20-minute Quick Escape to “calm you down and reconnect you and yourself with your space”. Brough to you by Five Parks Yoga

REFERENCES

Kotarsky CJ, Christensen BK, Miller JS, Hackney KJ. Effect of progressive bodyweight squat training on muscle strength and hypertrophy. Int J Exerc Sci. 2018;11(3):965–978.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10439966/

Kikuchi N, Nakazato K. Low-load bench press and push-up induce similar muscle hypertrophy and strength gain. J Exerc Sci Fit. 2017;15(1):37-42.
https://pubmed.ncbi.nlm.nih.gov/29541130/

Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women (LIFTMOR trial). J Bone Miner Res. 2018;33(2):211–220.
https://asbmr.onlinelibrary.wiley.com/doi/10.1002/jbmr.3284

Nikander R, Sievänen H, Heinonen A, Daly RM, Uusi-Rasi K, Kannus P. Targeted exercise against osteoporosis: a systematic review and meta-analysis for optimising bone strength throughout life. BMC Med. 2010;8:47.
https://pubmed.ncbi.nlm.nih.gov/20663158/

Borde R, Hortobágyi T, Granacher U. Dose–response relationships of resistance training in healthy old adults: a systematic review and meta-analysis. Sports Med. 2015;45(12):1693–1720.
https://link.springer.com/article/10.1007/s40279-015-0385-9

Carter SE, Draijer R, Holder SM, Brown L, Thijssen DHJ, Hopkins ND. Breaking up sedentary time with calisthenics improves neuromuscular function: a randomized crossover study. Med Sci Sports Exerc. 2022;54(7):1155–1162.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9653850/

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TAKING NEW CLIENTS!

If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!

It is with great excitement that after more than 2 years of preparation, I have FINALLY launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.

Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists. We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!

You will find all my service offerings on my website, including a link to my calendar so that you can reserve your place in my schedule online! Looking for a more Human encounter? Call Mary, my awesome and amazing assistant at 754-262-5674 (M-F 9a-5p ET)

This just dropped…..

Check out this awesome podcast where the awesome and amazing Selene Yeager interviews Dr. Casey Francis, my personal Performance Physical Therapist from Pompano Beach, FL, about how this discipline of physical therapy can help women of all ages and athletic levels, but especially those in mid-life. Later in the show, I make a quick appearance to talk about my injury rehab and experience working with Dr. Casey.