Bone Health Boot Camp 2.0

In the wake of the USPTF's updated recommendations for osteoporosis screening to prevent fracture

This month, the United States Preventative Task Force (USPTF) revisited their 2018 recommendations regarding the age at which screening for osteoporosis to prevent fractures should be initiated.

The 2018 recommendations that screening for osteoporosis to prevent fractures should begin at age 65 has come under much criticism due to concerns that delaying screening more than 10 years beyond the average onset of menopause (when the decline in bone density, a significant risk factor for osteoporosis and fracture, accelerates) may miss a critical window of intervention.

The 2025 updated recommendations have not appreciably changed after the USPTF revisited this question citing that the “evidence is insufficient” for supporting earlier screening. The USPTF recommends risk assessment using patient history and the available risk assessment tools (Ex - FRAX) to help inform the decision for earlier screening. However, the recommendations remain vague regarding a “threshold” of risk that warrants earlier screening.

An important point relevant to mid-life active and competitively athletic women is that the studies that are the basis of these recommendations are predominantly performed on the general population, which is largely sedentary whose risk of fracture is different from the athlete. You are more likely to sustain a fracture mountain biking than sitting on the couch, by the nature of the sport. Sadly, the tools for risk assessment, such as FRAX, do not account for athletic activities.

Second, many (if not most) women prefer to avoid traditional osteoporosis treatments such as bisphosphonates (ex - Fosamax) with their litany of side effects. If bone health decline can be caught before it progresses to osteoporosis, preventative measures such as lifestyle modifications, alterations in fitness programs, and dietary changes can be initiated earlier. Further, estrogen-based menopausal hormone therapy is an effective, FDA-approved approach to the prevention of osteoporosis. However, after the age of 60, the risks of initiating menopausal hormone therapy increase, and fewer women will be eligible for this very effective intervention that can help prevent the progression to osteoporosis in the first place.

As a physician (and a menopausal athletic woman) my goal is to keep women performing in their sport and activities into their 9th and 10th decades and using everyday habits, fitness, and nutrition as the foundation of good health with pharmaceutical use when necessary to promote longevity and quality of life. To this end, it is important to know the limitations of medical studies, task force, and medical society recommendations as they may not pertain to the active/athletic midlife female population.

With that, let’s take our bone health into our own hands today and enjoy this week’s Bone Health Boot Camp 2.0. This is a circuit-training style workout that rotates among 3 movements every minute on the minute for 30 minutes. There are several movement alternatives for anyone at any fitness level.

You can moderate intensity by adjusting the total time of the workout (You may only have time for 20 minutes today) and the amount of time you work in the 1-minute interval. Maybe you work for 30 seconds and rest for 30 seconds each minute. Or you can increase the intensity by working for 40-45 seconds and resting for 15-20 seconds. Choose your own bone-building adventure! Enjoy!

Warm-Up

AMRAP 5 (As many rounds as possible in 5 minutes). Perform each movement in sequence for as many rounds as you can in 5 minutes.

• 10 high knee runs Right + Left = 1 repetition.

  • (Alternatives: jumping jacks, high knee march)

• 10 alternating lunges (in place) – body weight

Movement Practice

Test out 15-20 sec of each movement sequentially for 2 rounds. Use this time to select your options/rep numbers for the workout. Select a lighter thruster weight where you can do 15-20 reps in 30-45 seconds. Plan to work between 30-45 sec each minute and rest for the remaining 15-30 sec. Your score at the end is the number of reps you accomplish. So pick rep numbers/movement options and do your best to stick to it!

Workout

EMOM 30 (Every minute on the minute for 30 minutes)

HOW TO: Perform 30-45 seconds of lateral jumps over a dumbbell, rest 15-30 seconds. Then perform 30-45 seconds of dumbbell thrusters, rest 15-30 seconds, then perform 30-45 seconds of weighted box step-ups, rest 15-30 seconds, then start again with the lateral jumps over a dumbbell. Continue moving through all three movements in sequence, every minute on the minute for a total of 30 minutes. Pace yourself! This is a long grind!

Minute 1 – 15-25 lateral jump over a dumbbell.

• Options:

  • Lateral jump over a line on the floor (instead of a dumbbell)

  • 50 single-under jump rope or simulated jump rope reps.

  • 50 jumping jacks or high-knee run/march in place (R+L = 1 rep)

  • Step rather than jump over the dumbbell.

Minute 2 – 15-20 dumbbell thrusters

• Option: Grounded air squat

Minute 3 – 8-12 Weighted box step up (Right + Left = 2 repetitions)

• Options:

  • Box step up without weight

  • Reverse lunge to knee raise (6 right, then 6 left)

See you on the other side!

Cool-Down

8-minute calf and hamstring stretch from Train FTW

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Housekeeping…

Just dropped, Thursday January 16th…..

Join me for my guest appearance on the Fit Bottomed Girls podcast with Alison Helig for a great discussion about our favorite hormone, Cortisol!

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