I used to hammer cardio. I remember going to gym classes and would hear instructors vaguely shout “remember to engage your core” before we squatted, and mostly, no actual instruction would follow.

That was the best of it. The worst of it would be when they told you to suck your tummy in. No, no, no. But at the time, I knew no better.

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It took me to become a PT before I actually knew what it meant. And to be honest, more from the additional learning I did outside of my qualification to really drill it down. Dr Kelly Starrett is the best teacher on this (his book ‘Becoming A Supple Leopard’ gives a beautiful explanation).

The fact that I never knew how to do it properly all those years was probably one reason why my form was consistently shoddy - especially when it came to squats and the like.

“Engage your core.” “Find a neutral spine.” “Brace before you lift.” They are all great instructions, but meaningless if you don’t know what to do. I’ve even heard people being told “imagine that you’re trying to stop weeing.”

Just. Not. Good. Enough.

My guess is that most of those times being told this or whatever other ineffective cue you were given, it never got explained to you in a way that you could actually apply it.

This is a major bug bear of mine. And I will tell you why.

Being able to properly ‘engage your core’ isn’t just a little bit of icing on the cake. It’s not just about making your workouts a little bit fancier, or showing off at the gym because you know your shizzle.

It is actually crucial in protecting your spine. It is essential to ensuring your form. It is key to making your exercise effective.

Many people can get away with not doing it for years if they are not doing serious exercise, but try to do a deadlift or a loaded back squat without proper core engagement, and you can be looking at a serious injury.

Within my monthly exercise plans which are part of my paid subscription, I want my members doing this when they practise their movements.

But even if you don’t subscribe to my paid membership, I want you to be going out to the gym and approaching your routine in a way which keeps you safe, and also which makes your technique more effective.

What bracing and ‘finding a neutral spine’ mean:

Let’s ditch the jargon and the fancy words. It’s much simpler than it sounds.

While all spines are a little different, and some can be a bit hunched at the top (kyphosis) or curved inward at the bottom (lordosis), most people have a spine that has a natural, slightly curved shape. This is neutral.

‘Bracing’ is tightening the muscles around your trunk, front, back, and sides, so that your body and spine stays supported and stable while you move, rather than collapsing, rounding, or over-arching under load.

Those muscles in those places are effectively your ‘core’, and they compress around your spine to protect it when you ‘engage’ it.

You’re not sucking your tummy in, nor are you holding your breath.

What we are aiming for with this action is to form a tension throughout the ‘core’ that protects your spine while you do something with your body.

This applies whether you are lifting a weight, standing up from a chair, picking up a child, or squatting down to look in a cupboard.

The cue I prefer to use:

Like Dr Kelly Starrett, whose coaching on this has influenced a lot of how I teach it, I ask clients to engage their core in a specific order. It’s done in this order so every step sets up the next, and so clients learn a process that helps them remember.

• First, contract your buttocks. Squeeze them properly. The immediate effect of this is to bring your pelvis into alignment under your spine, rather than tilted forward or back, which is the position everything else needs to be built on.

• Then, tighten your tummy as if someone were about to punch you in it. Not sucked in. Not held. Braced, hard, the way you’d instinctively tense if you actually expected impact. You are creating functional core tension here.

• Then, walk a few paces holding that position. Once you’ve fully mastered core engagement, you don’t need to keep doing the walking bit before exercising or doing a lift - but while you’re learning, it helps to build the habit. I get my back class to do this every week. Bracing while standing still is one thing, but you need to practice the skill of bracing while walking, too. As you become accustomed to holding your body in this way, you will start to use the technique more naturally in everything you do, not just during exercise.

Remember, your spine needs protection in your day-to-day activities like bending, lifting and even walking. Posture when walking can make a difference to feeling low back pain or not.

When I talk about “engaging your core” or “finding a neutral spine” in class, this is exactly what I mean.

[Watch my video: How to engage your core]

Common mistakes I see:

Holding your breath instead of bracing. Holding your breath is not a substitute for finding actual core tension, and is a completely different mechanism. If anything, it adds unnecessary strain and cuts off just as soon as you exhale, right when you might still need the support.

“Sucking in” mistaken for bracing. Pulling your stomach in flat actually weakens your ability to brace properly, since it disengages the muscles that create the all-around pressure that is actually needed. Bracing should feel like your whole midsection has firmed up, more of a tense, than a suck. As I said earlier, imagine someone was going to punch you in the tummy. You want it hard, not sucked in.

Over-arching, or under-bracing entirely. Some people compensate for a weak brace by arching their lower back and flaring their ribs instead, which puts unwanted pressure through the spine rather than protecting it.

Why this matters beyond the gym:

As I have said above, this isn’t just a training cue for when you are in the gym or following my exercise plans.

You need to get into the habit of doing this when you go about your day. For example, before you pick up a shopping bag, lift up a box that the courier left dumped on your doorstep, or are putting the grandkids into the bath.

You can even use it when you have a bad cough - believe it or not, many people with weakened tissues in the back actually put their backs out when they cough! (It happened to me years ago, post child-birth, when everything was still very relaxed).

Practise this during all your training, and it will eventually stop being something you have to think about consciously. It becomes the position your body defaults to under load, which is exactly the protection you want for the decades ahead.

Hope this was useful to you? It’s the article I knew I needed to get up here. Please share far and wide because this is so essential for everyone to understand.

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Before you go:

Whether you are an individual or an organisation, if health and wellness is important to you, then please subscribe here for free. Expect a weekly, informative article along my themes of strong backs, strong bones, strong muscles - and follow me for notes with useful daily tips.

Paid subscribers benefit from a new exercise plan every month that is accompanied with videos and includes both beginner options as well as more challenging progressions, free downloads, and depending on your level, check-ins from me or live Q&A!

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Disclaimer:

This content is for educational purposes and isn’t a substitute for medical advice. I am not a clinician. Please check with your doctor before trying new exercises or taking health advice on this page; especially if you have osteoporosis, a diagnosed condition, or any concerns about your health.

This teaching draws on the coaching approach of Dr Kelly Starrett.

There is a lady who comes regularly to my back care class. She frequently shares her experience and progress with the other class members, and I’m always thankful that she does.

“It got worse before it got better,” she’ll tell the newbies.

She isn’t saying it to sound clever, but because it’s true, and she knows it might help. She remembers that after her own first attendance, she was close to not coming back to the class again, and she doesn’t want others to be in that same position. This is a message that is important.

When my class member first joined, she told me she had bad sciatica. It was pain that ran from her lower back, down through her hip, and into her leg. It was the type of pain that made ordinary life, doing things like driving, sitting at a desk, standing in a supermarket queue, into something to be endured instead of lived.

Like many people do, she had tried the usual things. The first being rest - which many think is the key solution. Then painkillers. And just waiting it out - to see if it will go away of its own accord. None of it had helped.

At her second class, she told me the pain had been much worse after coming the previous week. She was understandably apprehensive about continuing. Her husband had assured her that it was likely due to it being the first time. I’m glad he did. Because then I got the chance to reassure her that this was likely the case.

She came back for the third time - having noted that the pain she felt was just slightly better after her second class. From there, the improvements started to be very noticeable.

Now, she is a regular class member, and one of the champions of the class. She has seen a dramatic reduction in pain. And she wants to let others know about it.

Why sciatica gets worse before it gets better when you start exercising:

Time for some good old fashioned honesty. I think the fitness industry does a disservice to people by promising magical results too quickly. Or by showing all the ‘befores’ and ‘afters’, but skipping the gritty bits in the middle.

Regarding sciatica specifically, it happens when the sciatic nerve - which runs from the lower back right through the hip, down the back of the leg and to the foot, becomes compressed, ‘pinched,’ or inflamed.

It can happen for many reasons - commonly due to a vertebral disc problem, or degeneration in the spine (which is very common as we age, and there’s not a lot we can do about it apart from address the tissue creep, which I talked about in my article on prolonged sitting and back pain).

Osteoporosis as well can be indirectly linked to sciatica, when spinal fractures, and the vertebrae compression that results, can cause nerve impingement.

The pain can radiate from the back and the whole way down the leg, and it can be extremely severe in some cases.

Sciatic-like symptoms can even result not from the spine, but from issues like hamstring tendinopathy, as I know myself from personal experience. I get sciatica mildly when I have a hamstring tendinopathy flare. I also have osteoarthritis in my spine which is a culprit.

But due to my training, I know what I can do, and what I should be doing when it isn’t flared up.

For people new to purposeful exercise, it’s entirely usual for a deconditioned body to ‘feel it’ after spending time in new movement patterns that it isn’t used to.

When someone has been in pain for a long period, they understandably can spend a lot of time ‘guarding’ themselves against further pain. They do this by avoiding certain positions and doing less. So, when they do new movements, the nerves and tissues are often irritated and over-sensitive. Even with a selection of carefully chosen, appropriate movements.

This doesn’t mean the movement is wrong or shouldn’t be attempted. It is just worth understanding that this is a recognised pattern of how sciatica responds. Especially as it can make all the difference as to whether a person continues or not with the exercise. Exercise that in time, will make the problem and the pain better, not worse.

How sciatica responds to movement:

Movement of course helps to increase blood flow to the muscles and the nerve itself. This is why so many people who attend my back class (bearing in mind they don’t just attend because of sciatic pain) often report that they feel better straight after the class - because blood flow has helped reduce pain.

Over time, the movement and the impacts from it help to relieve the inflammation. Nutrients are delivered to the tissue for repair, and the tiny stresses that are placed upon the tissues as they are exercised also result in adaptations that make them stronger.

The discs in your spine, which act as shock absorbers between the vertebrae, respond to load in a similar way. Movement helps them draw in fluid and nutrients, which supports their health over time, where prolonged stillness tends to do the opposite.

In fact, prolonged stillness doesn’t just fail to help, it can actually starve those tissues of the nutrients and lubrication they need. It is part of why ‘resting’ makes the problem so much worse, the longer it goes on.

Like everything with the body, we ‘use it or lose it’. Where joints and tissues are not used, the body stops sending lubricating fluid there. Why lubricate a joint that isn’t moving?

There’s a nerve-specific component to what is going on, as well. Gentle, repeated movement helps a nerve that’s become a little “stuck” to the tissue around it to regain its ability to glide freely again. This is why targeted movement, not rest, is now the standard recommendation for most sciatica.

The bed rest that used to be advised to help sciatica and low back pain decades ago is very archaic and outdated. We need to kick that idea right into the dust.

Of course - knowing all of this isn’t going to make it any more comfortable to get through that worse-before-better week, but it does help with reframing it. It’s not that your body is telling you to stop, but that your body is trying to help you heal.

It can take courage to tread the path that works:

As you read earlier, my class member returned the week after her first, and the week after that. She only doesn’t come now if she’s on holiday.

I think this is really crucial to the story. When she made the decision to return, she didn’t have any proof it would work. I’d mentioned to the class members it might feel worse if this was the first time they were working their bodies, so she had my word. And her husband had tried to give her some positive encouragement.

But ultimately, this lady just felt she had to try something new. What she’d previously been doing - no proactive movement that was directly targeting her back problems - obviously wasn’t working for her.

Her pain point had become too great not to persist. Of course, she’s now absolutely glad that she did.

Now, she barely notices the pain. There are occasional twinges, and it depends on what she’s been up to. But overall, she frequently reports that she’s seen huge improvements in her day-to-day life.

This is priceless, really. When someone has started being pain-free more than they were in pain - what a dramatic difference to their quality of life.

If you’re feeling pain right now:

If you’re dealing with sciatica, or any longstanding low back pain, and you’ve tried moving and found it made things feel worse initially, I don’t want you to read this and think you simply didn’t try hard enough.

Nor do I want you to think that gritting your teeth through any and all discomfort is automatically what you should be doing. That’s not what this is about, and it’s very important to get proper guidance before starting.

This advice particularly stands if your pain is severe, if you have any numbness or weakness, or if it’s been going on for a long time without you ever being assessed.

Take note of this latter point especially. Whether you’re here to follow my advice, or want to attend a class locally to you, or generally just want to start moving more, if you have never had a professional assessment of the origin of your back pain or sciatica, I urge you to get an appointment booked in right now.

But if you’ve been told by your doctor or medical consultant that movement should be part of the way through for you, since the overall advice for sciatica is to stay active, then I’d like you to take this following advice, based on my class member’s experience:

• A short flare in the first week or two of appropriate movement is a known, common pattern, not automatically a red flag:

• It’s most likely that your body is responding to the activity and sensory input that it hasn’t received in a while.

• Most cases of sciatica truly do improve substantially within four to twelve weeks with the right conservative approach:

• This is an evidence-backed timeframe, not just me trying to give you hope. If you’re a week or two in, you are not yet in a position to assess whether it’s working.

The exercise needs to be the right kind:

Doing it alone, from a random video you found with no context, so often doesn’t work as well as doing it within a proper class or purposeful programme. It’s generally a mix of movement needed, rather than “one perfect exercise”, and this mixture needs to practised over time (though please see the note further down regarding ‘directional preference’).

If it’s getting worse past that initial early timeframe, or you notice new numbness or weakness, then you need to go back to your doctor and be reassessed:

Persistence isn’t the same as ignoring your body. You should not push through regardless if your symptoms get dramatically worse, or new symptoms occur.

Movements that can offer relief:

In the meantime, I can offer you a couple of temporary relief options. But remembering what I said about “one perfect exercise” not being the answer. Most sciatica cases need a more holistic approach with several exercises (for example in my case, due to hamstring tendinopathy, I have to do hamstring strengthening exercise as part of my overall routine).

Before you try these, you need to do a quick self-test. Notice what your body is already saying to you.

• Does sitting or bending forward ease the pain, or make it worse?

• Does standing or gently arching your back ease the pain, or make it worse?

Whichever direction the pain gets worse or better is going to make your decision as to which exercise to try. In physiotherapy, this is called ‘directional preference’ and is based on the McKenzie method.

Option 1: If bending forward eases the pain (flexion relief):

Knee-to-chest stretch:

>Lie on your back and gently draw one knee up toward your chest, hugging it there for 20-30 seconds, then switch sides. This opens up the space around the lower spine, which tends to help when standing or arching backwards is causing the aggravation.<

This pattern is often associated with spinal stenosis or facet joint irritation, where extension (arching back) narrows the space that the nerve passes through, and flexion (curving the back) opens it back up.

Option 2: If standing or arching back eases the pain (extension relief):

Prone press-up:

>Lie face down and place your hands under your shoulders. Gently press your upper body up, letting your hips stay on the floor, like the early phase of a yoga cobra stretch. Hold briefly, then lower down with control.<

This pattern is often associated with a disc-related cause, where prolonged sitting or bending forward increases pressure on the front of the disc, and extension can help ease pressure off the nerve.

If you’re finding this helpful, you’ll probably know someone else who also will! Please share!

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An important caveat: These options only work if you are going off what your body is telling you in the directional preference test. If trying either movement makes the pain worse, or sends it even further down your leg, stop immediately (see my note earlier about any numbness or weakness needing a proper assessment).

Going back to the lady in my class with sciatica, she is now one of the biggest advocates for the class. I often spot her speaking to new members to let them know how life has changed for her.

This is amazing, and exactly why I do what I do.

Before you go:

Whether you are an individual or an organisation, if health and wellness is important to you, then please subscribe here for free. Expect a weekly, informative article along my themes of strong backs, strong bones, strong muscles - and follow me for notes with useful daily tips.

Subscribe now

Share for rewards:

I have recently set up a reward scheme for referrals! Freebies at different tiers when you share! Please participate and start sharing Becoming Unbreakable to gather referrals for rewards (the first tier needs only 2 referrals!).

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Disclaimer:

This content is for educational purposes and isn’t a substitute for medical advice. I am not a clinician. Please check with your doctor before trying new exercises or taking health advice on this page; especially if you have osteoporosis, a diagnosed condition, or any concerns about your health.

FREE: Your 4 Week Bone Foundations Programme (worth £37):

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Hi everyone,

This is our anchor workout for September, the one to come back to again and again this month rather than chasing something new each session.

Whether you’re brand new to structured exercise or you’re already fairly active and just want a proper framework, this has been developed for you. Every movement has two levels, so wherever you’re starting from today is exactly the right place to start.

You can build on the levels if you require something more demanding, and the ‘Want more?’ suggestion will show you how.

A couple of things before you dive in. Don’t skip Foundation out of pride, nobody’s watching, and starting where your body actually is, is what makes this sustainable long-term. And don’t judge this after one go either. It’s a month-long anchor for a reason, so give it until week three before deciding how it feels.

Simple but functional

Sit-to-stands, presses, and rows aren’t glamorous, and I make no apology for that. They’re the exact movement patterns that keep you independent as you age: getting up off a chair or the floor without needing to think about it, carrying your own shopping, catching yourself if you trip rather than falling.

For bone health specifically, this matters even more than it might seem. Bone responds to load, actual, weight-bearing, “my muscles are working hard” load, not gentle movement alone. Every exercise here is a reason to keep creating more bone tissue rather than losing it. This is the unglamorous stuff that actually works, which is exactly why I keep coming back to it, for you and for me.

Read more

When I got my bone scan referral, I was fortunate. I had a student doctor the day I contacted my surgery about my risk concern.

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I was 52, and considering HRT due to menopause ‘madness’. Okay, I am being flippant - but let’s just say I felt like I was losing my brain.

(Quick note: HRT gave me my brain back, yay!)

I also had a suspected foot fracture. If you’ve read my free guide on bone health myths, you’ll know that I twisted my ankle in a STEP class, and while the movement was minor, the injury was substantial.

I was aware that HRT can stabilise bone tissue loss, and since I believed I was at risk, with osteoporosis in the family (there is a strong genetic link), I was getting in touch with my GP to look at my options.

My lucky day

As I say, I was given an appointment with a student GP. So, I brazenly requested a DEXA scan because I wanted an ‘assessment’ of my bone health, before making a HRT decision.

Based on the familial risk, he referred me. It’s a good job, because it turned out I was right to be concerned - the result came back that I had osteopenia, with a -1.3 overall T-score (although, I have since found out that the T-score doesn’t tell you everything, and there are other metrics that we can look at, as I discovered in this Substack article).

If it had been my own GP I’d have seen on that day, she would not have referred me for the scan. She actually told me that herself before looking at my records, admitting to a systemic gatekeeping issue she probably shouldn’t have been. True story.

What typically happens…

Most women - since we proportionately suffer far more from low bone density - do not get as lucky. The shoddy thing about osteoporosis is that it is usually diagnosed at a stage when medical management through prescription medicine appears to be one of the only treatment options.

Not only does it tend to be diagnosed when treatment (as well as reversal) options become limited, data from the Royal Osteoporosis Society tells us it is often when multiple fractures have already occurred.

I know from emails I’ve received from women, that once multiple fractures have occurred, life can be very difficult indeed. Severe pain, loss of independence, body and posture deformity, and loss of height are just some of the factors that make their lives miserable.

Aince I began writing and educating on bone strength and health, and launched my free guide, I have had many emails - all telling a similar sad story.

We certainly need to get assessed sooner, if any risk factors apply.

Before your next GP appointment:

If these apply to you, here are a few things worth mentioning to your doctor:

• A family history of osteoporosis or fractures

• An early menopause or surgical one

• A previous fragility fracture (a break from a fall from a minor event)

• Long-term steroid use

• A BMI that’s been persistently low

• Long term smoking or excessive alcohol use, especially if combined with any of the above

None of these mean you have osteoporosis. They’re simply worth speaking about, because a GP can only act on what they know to ask about. Remember, I got referred because I asked, not because anyone prompted me to.

Please do share this post if you’re so far finding it helpful, as others might, too.

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Menopause and bone loss is a long established fact

In the first decade after menopause, women lose bone tissue at roughly the rate of 1.5 to 2.5% a year. This is a well-documented acceleration and the health systems know about it. Yet still, by the time most women have a DEXA scan, it’s an osteoporosis diagnosis they get - not an osteopenia one.

One of the things we need to be doing is educating women to be more aware and sooner. Whether their doctor will listen is another matter (and I’m saving my thoughts about this for another article) - but any woman in her 30s or upwards should be doing something now about her bone health.

And what about the fellas?

I don’t want to leave them out. Even while men are far less likely to get osteoporosis, with around 80% of cases being women, they can still be diagnosed with it.

Because of the fact that the medical profession also assume them not to be at high risk as women, they can slip through the net even more easily.

At least half of men with osteporosis have an underlying condition which causes it, and the Royal Osteoporosis Society produce some good information on the topic to help men learn more.

One in five men over the age of 50 will break a bone due to osteoporosis, so the figure is not insignificant.

Get started on prevention, scan or no scan

Multiple recent meta-analyses (2025) confirm that resistance training measurably improves bone mineral density at the spine, hip, and femoral neck in postmenopausal women, with high-intensity training three times a week showing consistent benefit.

So what this means is, if you know yourself to be currently reasonably healthy - don’t wait for a scan, or a diagnosis, to begin a training programme that protects your bones. Honestly, you can’t afford not to.

It’s a well known statistic that one in two women over 50 will suffer a fragility fracture during their lifetime, as I talked about in my article about osteoporosis being an insidious disease - and if you have already fractured, as explained above, your options are thin on the ground.

I’m not a doctor, and I can’t comment on whether anyone’s individual treatment plan is right or not, but I am a prescriptive exercise coach - I’m qualified to train people with osteoporosis, and to have doctors refer them to me for exercise programmes.

And I urge you - please just start training. In which case, you may never need a scan - never mind a scan that comes too late.

Before you go:

Whether you are an individual or an organisation, if health and wellness is important to you, then please subscribe here for free. Expect a weekly, informative article along my themes of strong backs, strong bones, strong muscles - and follow me for notes with useful daily tips.

Subscribe now

Share for rewards:

I have recently set up a reward scheme for referrals! Freebies at different tiers when you share! Please participate and start sharing Becoming Unbreakable to gather referrals for rewards (the first tier needs only 2 referrals!).

Share Becoming Unbreakable

Please leave a comment:

Did you enjoy this article? Was it helpful? I really want to hear from you. Please don’t go without leaving a comment - I’d like to get to know my readers better!

Leave a comment

Disclaimer:

This content is for educational purposes and isn’t a substitute for medical advice. I am not a clinician. Please check with your doctor before trying new exercises or taking health advice on this page; especially if you have osteoporosis, a diagnosed condition, or any concerns about your health.

Hi everyone,

I’m so excited to share this news!

I’ve been busy, busy, busy, setting something up behind the scenes, and yes, I’m sure you guessed already what it is. I’ll tell you now though, my brain has been on fire getting all the ideas in place!

You’ve probably noticed the free articles here are just that, free, and they always will be. That’s not changing.

Every Tuesday, you’ll get a proper, honest piece from me on bone health, back care, or building a body that lasts. The whole thing - not a taster with the rest locked behind a paywall halfway through - if it’s free, you get all of it.

Stay free forever if that’s what suits you, my Tuesday published article will be there.

But I have been asked by people: “what should I actually be doing, week to week to build strength?” Reading about it is one thing. Having a working structure and a plan is another. So I’ve put one together.

What’s new?

I’m launching a paid tier for anyone who wants more than the articles - it will be an ongoing, structured way to actually build strength. You can subscribe from today, and the first monthly plan will arrive on 1st September, and then at the beginning of each month.

How cool is that? Should you choose to upgrade to paid, here’s what you’ll get:

Paid Subscribers: £8 per Month, or £88 Annually:

• A new strength anchor workout every month, built specifically for bone-loading, with two levels (Foundation and Building) so it works whether you’re just starting out or are already active.

• A monthly audio check-in from me, a couple of weeks into the month, when you’ve had time to get into the plan. It will be part pep-talk, part-progress check.

• The Posture Reset Guide, a short, practical guide to standing taller and protecting your spine, yours from day one.

This tier is for you if you want a proper plan to follow, not just something to read. Choosing Annual just means paying once and saving over the year, everything else is exactly the same.

The Unbreakable Core: £165/year

Everything above, PLUS:

• Access to The Unbreakable Vault, growing every month you’re a member!

• My full 4-Week Bone Foundations Programme yours for FREE (usually £37).

• Two async chat days a month with me, one early on to ask questions before you start, one towards the end to check in as the month wraps up.

• A monthly live Q&A with me, in the middle of the month.

• An automatic 10% discount on any future courses/products I launch during your membership, including any retreats I host.

This tier is for you if you want to help build something from the ground up, and get first access to everything I create along the way. As well, this is amazing value.

Why I’m doing it this way:

I didn’t want to lock my writing behind a paywall. My articles are the reason you’re here, and I think good information should stay accessible.

What’s worth paying for though is structure, a plan you can follow, a place to ask questions, and my time. That’s what being a paid member offers you.

I know from experience as a personal trainer that people need plans. They also need to be held accountable (my check in can help with that), and they need proper guidance to get things right (your monthly programme will have video instruction within it, and if you’re an annual member or founding, you’ll be able to ask me questions via the methods open to you).

And there may be some little extras along the way. I can be quite a spontaneous kinda gal, because I’m also growing this organically.

If you’d like to join:

You can subscribe from today, right from the subscribe button. Your first monthly plan will land on 1st September, along with everything else in your tier. And if you’re happy as you are, reading the free articles every week, nothing changes for you at all. I’m just as glad you’re here either way.

Thank you, as always, for reading.

Andrea

PS. Just a quick reminder - everything you’re getting when you become a paid member - depending on which tier you opt for - will arrive with you at the beginning of the month!

Are you a gym bunny, doing classes every week? Or out in the countryside, cycling every weekend? Or in the fast lane at the pool, splashing everyone with your front crawl? Doing all this and telling yourself it's protecting your bones?

I used to think exactly the same thing. It turned out I was wrong, and the reason why really surprised me.

If you read my story, you’ll have found out that for years before I was diagnosed with osteopenia, I was pretty much a ‘cardio queen’. With full gusto, I pounded the studio floor at my local gym several times a week.

I absolutely loved my Zumba, STEP, swimming and - best of all - SPIN. I would try to get to spin a couple of times a week. Pilates as well, if I could get booked in (it was always full!).

I totally believed that I was building both strong muscles and probably, if I’d bothered to think about it, strong bones. Bearing in mind, I was also doing heaps of hill hiking.

I was so fit that when I hiked up Ben Nevis in July 2021 it actually felt really easy. The photo heading this article is me at the top of Nevis. What a day!

This was all ‘weight-bearing’ exercise, wasn’t it? Well, as I found out - nope.

When ‘weight-bearing’ isn’t ‘weight-bearing’

I might have been bearing my own weight as I hiked up mountains or held an isometric Pilates move, but it wasn’t doing the job I believed it to be doing.

There is evidence to show that exercises like brisk walking, swimming, and jogging may help to limit bone loss, but such activities do not provide the mechanical load needed to stimulate bone tissue growth enough to combat accelerated loss.

Not that I got into fitness specifically to build bone. I mostly hadn’t thought about it, to be honest. Though I would do a little smug nod to the idea that I was exercising in a ‘bone-friendly’ way, whenever something came up in conversation, or whatever.

I actually got into fitness because I had begun working as a funeral celebrant. If there’s one thing that working in the funeral industry teaches you, it is that life can certainly be short. Especially if you don’t look after yourself.

What the dead can teach the living

Getting into funerals in 2017 was a bit of a wake-up call - “this could happen to you if you don’t start looking after yourself” is the message I was receiving. Loud and clear.

I wasn’t in the best of shape at that point in my life. I was overweight, and while I did enjoy walking (I always have, especially as I’ve always had dogs), and dancing too, I was definitely not ‘fit’.

I had met the man who became my husband just a couple of years previously, and we had LOVED food, and snacking. As well as beer and wine. I put on a few ‘happy in love’ pounds.

But in my funeral work, I was being repeatedly shown that poor lifestyles can equal early death. As a fairly consistent reminder, you’d have to be made of stone, or fully head-in-the-sand, to not take note.

Putting the work in

I got disciplined. I joined a local gym and started attending classes. I’ll never forget going to my first ‘Legs, Bums and Tums’ and, shamefully, had to leave the class after ten minutes because I was unable to keep up.

Even that ten minutes left me with three days of severe DOMS (delayed onset muscle soreness), too! Hard to believe I was ever like that now, as DOMS is a very rare occurrence for me, and only happens when I’ve had a training break.

But I persisted, and ultimately, I built a very strong cardiovascular system, along with amazing endurance for distance and hill walking.

What I didn’t realise was that it should have been only a part of my overall health routine. I had no idea at the time how important strength training was.

And because I had no idea, when it came to me getting my bone scan, part of me was convinced that I’d be told that I had nothing to worry about.

I was shocked with the report. I had osteopenia. What?

What I got wrong

Here’s the thing - cardio work builds your heart and lungs. That’s why it’s called cardio. It’s absolutely essential to a healthy active life, but it’s not the only thing we need.

There’s some impact included, but the body quickly adapts to the type of low-level impact provided.

Research shows us that bone needs impact, or to be heavily pulled against by the muscle (resistance), in order to grow new bone tissue.

Not only that, the stimulus has to keep changing - and be ‘continuously novel’. The stimulus should be in the form of mechanical load providing resistance.

Since some of the foundational theory on this was published, a stack of evidence-based literature through the years continues to support this.

Like anything though, you only know it if you know it. When I started out as a fitness newbie, I didn’t really understand that strength training was a necessity. Particularly as a woman in her early 40s.

Let’s face it, the fitness messages that we women generally receive - and only more recently has it started changing - are all about “do cardio, lose weight, punish yourself for eating the cake”. Am I right, or am I right?

I mean, there’s a whole article there in itself, and I shall probably get it written at some point, but suffice to say - it took an osteopenia diagnosis to get me to understand this.

So what did I do?

Well, if you’re new here and this is the first article you’ve read of mine, I’ll give you the good news - I turned my diagnosis around. My follow up scan 3.5 years later showed I had a significant increase in bone mineral density and that I had normal BMD again.

Because I embarked upon a dedicated strength training programme and was consistent with my new exercise routine, I had started to rebuild bone.

It was helped by changing my nutritional intake and also by lifestyle improvements, as well as HRT, but all the evidence points to it being the actual strength training that would have made the real difference.

The other aspects that I changed will certainly help to stabilise bone loss, or reduce the rate at which it is lost, but they are not alone usually enough to make a significant increase (which in my case, it was).

Some evidence shows HRT can help slow bone loss, and in some cases modestly increase density, but again, the studies show that targeted strength training is actually the thing needed to make a significant difference.

(Note: HRT is a personal decision to make with your GP or menopause specialist, not something I can advise on directly.)

Quick check: is your routine actually loading your bones?

If you can say yes to most of these, you’re likely on the right track. If not, it might be worth a rethink.

• I include some form of resistance work, weights, bands, or progressively loaded bodyweight, not just cardio.
  

• I’m working large muscle groups against actual resistance, not just holding a position or moving at a steady pace.
  

• What I lift or the resistance I use has increased over the past few months, not stayed the same.
  

• My routine changes regularly, rather than repeating the exact same pattern every session.
  

• I could point to at least one exercise in my week that has felt challenging by the last couple of reps.

  ---

So, what does ‘targeted strength training’ look like?

Well, it can depend. It’s all relative to where you’re starting, and whether your body is always used to some patterns of exercise or not.

Resistance training is the umbrella term for training that involves the muscle pulling against a form of resistance, and therefore training both the muscle and stimulating the bone. Strength training is a form of progressive weight training that falls under this umbrella.

An effective strength training programme involves several exercises that will load your muscles on a total-body basis, done in 30-45 minute sessions, two to three times a week.

The focus should be on loading the whole body, exercises that work the posterior chain (back, glutes, legs), chest, hips, shoulders and arms.

Your focus should be on progressive overload - lifting or loading weights that increasingly get heavier the stronger you become.

For beginners, this may even be starting with simple bodyweight exercises or even some isometric holds - I have a 4 Week Bone Foundations Programme which is perfect for those who are new to this.

I hope you found this article useful, and has given you some awareness of how bone-friendly your own exercise-routine currently is. Please let me know?

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I really want to hear from you. What did you think of this article? Was it relevant to you? Was it helpful? Please don’t go without leaving a comment - I’d like to get to know my readers better!

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How many hours do you sit at a desk during your working day? Does your butt stay glued to the chair more than your feet ever get to tread the carpet? Or do you incorporate movement into your seated day?

While you think about the answers, please take a moment to subscribe for free, and then I shall continue:

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The desk job dilemma

It’s long been established that prolonged sitting is bad for backs, but a recent 2025 study among office workers found that static sitting behaviour is more strongly associated with low back pain, than sitting which incorporates movement.

In my years as a full-time freelance journalist, I sat more than I moved. I was usually so foot-to-the-pedal with work, that I didn’t get up except for tea breaks and to walk the dog. Sometimes, in very busy periods or on a deadline, I could be at my desk for 10 hours.

Combined with the stress that sometimes a freelance journalist life could bring, my lifestyle ultimately played havoc with my bio-mechanics.

No gain, lots of pain

My shoulders and neck were sore all the time. Tension knots in my upper back and around my shoulder blades were hard to undo, even by the toughest and most painful deep tissue massage.

I had repetitive strain injury in my wrists. This could be agony at times. Affecting such a small part of the body, RSI sure made a big noise. I got it in my hands, too, from using my mouse.

Then came the back pain. Gnawing across my lower back. It drove me mad as I struggled all day to reposition myself in a way that it wouldn’t hurt.

After sleep, some days I’d wake up feeling like the aches had eased. However, after a couple of hours back at my desk, the nerve twinges were pinging again, and the knots were balling tighter.

Sound familiar? Well, if it’s any consolation, I no longer have low back pain. Admittedly, I sit nowhere near as much as I used to. But my posture and body are so much stronger now. This means that the longer periods I am sitting (like when writing this) are far more tolerable.

Quite a bit changed for me - not just my working life altogether, but my whole outlook to health and to what actually is a fitness routine.

Before we go on, let me unpack a few need-to-knows about why prolonged sitting - and static sitting especially - is a big old pain in the back.

The silent creep, pelvic tilt and ‘sleepy’ glutes

Have you ever heard of tissue creep? In simple terms, it is the lengthening and stretching of tissues such as muscles, tendons, and ligaments, when they are being forced into a continual position over time.

Sitting slouched in one position for hours on end means a low-level load is placed on the tissues in the back for a long period. Over time, this causes connective tissues to weaken and misalign, leading to muscle imbalances, strain and pain.

Combine this also with the fact that the body elsewhere is in a rigid position that it is not meant to be in for hours on end. Our bodies were made to move, not to be still.

The pelvis tilts backward when we sit. Over an extended duration, there is a load on the lower spine that isn’t being supported in the same way as if we were standing or moving. This load can cause issues in the lower vertebrae and muscles around the pelvis and lower back, further contributing to the incidence of low back pain.

Then we also have the fact that our glutes (the big muscles in our bums) - being sat on instead of being strengthened, start to weaken from disuse. One of their key jobs though, is to support the spine, so we need them strong. As I tell my back class participants, of all the muscles in the body that are most important to the back, it’s probably the glutes.

Ultimately, most people with low back pain that comes from prolonged sitting will likely have a combination of these disrupted biomechanisms going on. You might not know which exact part of the internal machinery is causing the most issue, but your body will certainly tell you where the most stress is.

To put another spanner in the works - sitting for long stretches doesn’t just affect your back. There’s a growing body of research on what it does to your heart, too, and this is even for people who exercise regularly. I’ll come back to this properly in a future piece.

So, how do we fix it?

The good news is, for the majority of people, a holistic approach to spine hygiene and back strengthening generally works. The body moves together in all its amazing ways, and isolation of individual parts in a treatment plan is usually not necessary, or only for very rare cases.

Overall, I’ve generally gone for a ‘total body’ approach in most areas of my client programming - because it corrects imbalances and stops them developing, as well as the fact that every part of our body needs another part to also work properly.

However, before we delve into the physical - what about the environment we’re actually working in?

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Ergomonics matter (but not as much as movement)

Going back to my experience, in those days where I was suffering substantially. I managed my setup. Gel rest for my arms, mouse pad with a rest. I bought a specialist ergonomic chair.

I even trained myself to use my mouse left-handed as well as right-handed, so I could switch over when I needed to rest one hand. I also bought wrist splints to sleep in at night, which helped to immobilise my wrists and forearms to give them rest.

It offered some light relief, and did make a difference to my working day. Especially investing in a proper chair. Of course, now, standing desks are an option - in my old school journalist days, they were relatively unheard of. Although, I don’t have one, because it would mean a lot of reorganising of my space.

As well, new evidence shows us that it is our movement patterns that matter more - breaking from a static position frequently is more beneficial than either sitting or standing statically.

In fact, standing statically for many hours also causes load to be placed on the lower back, and can contribute to lower back pain. So standing desks are not the magical solution we imagined.

All of these ideas - ergonomic chairs, wrist splints, gel rests - are only part of a solution to a bigger problem. Like putting scaffolding up around a house that’s cracking. The scaffolding will only hold it so long, you have to get down to the foundations to fix it.

So, what movement can help?

Firstly, anyone who is already appropriately strength training two or three times a week with a total body approach is going to be in a better position. Anything we do that keeps the muscles supporting the spine healthy and activated is obviously going to help reduce our chance of low back pain.

I use the word ‘appropriately’ above, though. I’ve had clients who started the gym without knowing what they’re doing. They go and attempt a macho deadlift way beyond their capacity. Hey presto - they put their back out. Well, I could have told you that was going to happen.

However, I can’t emphasise enough that getting into an actual strength training routine that is right for your body, where it’s at, is going to help you no end. If you subscribe to my publication, you will learn how I value strengthening over stretching, always.

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I’m aware though that not everyone reading this is going to start strength training in the gym, or even at home. You want a few practical tips that will help you each day.

Become the tea runner (and other practical advice)

Maintaining a regular shift in posture is key to reducing the low back pain that comes from sitting. Active breaks take the pressure off the spine. Move for a few minutes at least every 30 minutes.

What kind of movement counts? Any that is practical! Get up, and jog or march on the spot. Run up and down stairs a few times. If you work from home or are in your own office, you have more options.

Do a few squats, star jumps and strong retractions of the arms and shoulders.

Keeping the blood pumping is also important, as noted above regarding cardiovascular health. But blood flowing into the tissues around the spine will also help reduce pain.

Find more ways to be active during the working day. Use any phone call as an opportunity to stand and walk. Become the tea runner in the office. Offer to do errands when the opportunities arise in a bid to move more.

For wrists and hands, try prayer presses. Put the hands together at the chest as if praying, and press really hard for a few seconds. Do a few reps, followed with some hand rotations at the wrist. Have a break from typing, and if you can, try a mouse hand swap.

‘Reactivate’ your glutes and release your pelvis!

Once you’ve finished your desk day - get into the habit of doing two key exercises:

1. Cossack lunge - this is my favourite for opening the hips and helping to reposition the pelvis after a long day of sitting. It strengthens the legs and works wonders for the hip flexors. It’s a variation on the cossack squat, not as deep and easier for beginners. Because it’s a more demanding one to master, I’m giving you a video demonstration to help.
   
   Do about 20 altogether (10 each side) and focus on form - you may well feel a lot of relief from the pressure of sitting after doing just a few of these, too.
   
   NOTE: This is a fairly demanding exercise for newbies. If you have limited balance or hip mobility, try holding a chair when doing it. An alternative can be alternate side lunges - stepping into a side lunge, stepping back to the middle, then stepping into a lunge on the other side. Taking your time to pause in the middle, rather than trying to move quickly from one side to the other.

   

2. Glute bridge - a number one exercise for glute strengthening. Lie down on a mat or carpet, palms positioned downwards, knees bent, heels close to the bum. Squeeze the bum while pushing the body up, so the belly button is high. Keep squeezing for a few seconds, then relax and lower. Do 5-10 reps for 2 sets.

   
   NOTE: As you get stronger, you can hold a weight at your lap to add load.

   

Make the rest of your time active

DO NOT come home from work and simply sit down again. Spend some time moving. Unless of course you want a lifelong low back pain problem to develop.

Do the above exercises. Go for a walk, go for a short run, do some cleaning, get some cooking done. Do some structured strength training.

If there’s something you want to watch on TV - either do it standing up, or sit on the floor instead of the sofa.

Dr Kelly Starrett, a very well respected physical therapist, advises we should sit on the floor for 20-30 minutes daily. It combats the rigid postures of being substantially chair-bound.

Keeping the movement patterns flexible and flowing during the working day will help immensely. However, if you have developed a lot of tissue creep and imbalances due to sitting for many years, then consider starting a back strengthening programme.

What happened to me?

Did I become a changed character and start doing all this type of exercise during my working day? Nope. I knew none of this back then.

As it turned out, the shift in the media world as print journalism moved online meant I had to adapt and reevaluate my career. It moved in new directions and I wasn’t sitting anywhere near as much as I used to.

I also got into fitness, and a more ‘on the go’ working life combined with the aerobic activity took away my back pain and RSI problems.

But now, since I have returned a little more to desk work, I do of course practise all that I preach.

Once I completed my Level 4 Low Back Pain Management Through Exercise qualification, I also now offer back care programmes for organisations, to help their workplace teams.

I would love to know if this advice has helped you. Please comment if it has?

Before you go:

Whether you are an individual or an organisation, if health and wellness is important to you, then please subscribe here for free. Expect a weekly, informative article along my themes of strong backs, strong bones, strong muscles - and follow me for notes with useful daily tips.

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Disclaimer:

This content is for educational purposes and isn’t a substitute for medical advice. Please check with your doctor before trying new exercises or taking health advice on this page; especially if you have osteoporosis, a diagnosed condition, or any concerns about your health.

My 4 Week Bone Foundations Programme

Not sure where to start with your bone health? Are you a beginner, or have allowed the wheels to get a bit rusty?

The 4-Week Bone Foundations Programme is designed to help you build a solid foundation for your bone health, no matter your current fitness level. It’s simple and straightforward.

Take a look RIGHT HERE and see if it sounds right for you.

At only £37, it costs less than the price of an average PT session. Win-win.

For organisations (UK based):

Musculoskeletal problems are one of the leading causes of sickness absence in the UK, with back conditions accounting for a significant proportion of all work-related musculoskeletal disorder cases reported to the Health and Safety Executive.

As well as days lost to absenteeism, there’s presenteeism to consider: employees who are in work, but operating at a fraction of their capacity. It’s difficult to be productive while managing pain at their desk, in their driving seat, or on the assembly line.

Where staff are spending hours sitting or in one position doing repetitive movements, being incapacitated by a ‘bad back’ is a very real risk - and yet, it’s largely preventable.

I offer a ‘Back at Work’ programme. You can find the details and grab my one-page summary document RIGHT HERE.

My FREE Guide: Bone Health Blind Spot

It’s free, so why not grab yourself a copy? A 16-page guide giving you the low down on what exercise works and doesn’t work for strong bones.

All I need is your email. CLICK HERE.

Thank you so much for being here.

Whether you are an individual or an organisation, if health and wellness is important to you, then please subscribe here for free. I’m all about strong backs, strong bones and strong muscles.

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Welcome to Becoming Unbreakable. I’m Andrea. In a moment, I’ll tell you my story of how I became unbreakable. Before I do, if you would like to become unbreakable too, please subscribe for free here:

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A little introduction

For around fifteen years, I was a full-time freelance journalist, substantially writing for the Guardian. I even had a 6 month column there on blogging.

I then spent many years as a funeral celebrant, and still love to do this. But my path changed dramatically after a medical diagnosis.

In September 2022, I was diagnosed with osteopenia - the precursor to osteoporosis - AKA ‘brittle bones’.

It was a baffling moment. I had been solidly into fitness for half a decade by this point. I did Zumba, STEP and SPIN each week. I went swimming. I did at least 10,000 steps a day. I hill hiked.

Frailty ain’t fitting…

I did not want to lose my independence to osteoporosis, and become fragile and fractured. But if I wasn’t already doing ‘enough’, what else did I need to do?

Note: No tangible guidance was offered by the medical professionals other than calcium supplements (which I didn’t take) and I was left to work out for myself how to change my outlook.

Upon learning that the kind of exercise I’d been doing wasn’t actually ‘weight-bearing’, I wanted to learn properly how to strength train.

Not one to do things by halves, I became a qualified personal trainer.

Gimme the low-down

I actually wanted the knowledge for myself. I was hoping that through training, I may in the least halt the progression of my condition.

Stabilising the osteopenia would have been a great result for me.

I didn’t just start strength training. I set about making some lifestyle changes - changing my diet, becoming more disciplined around sleep, and the biggie, mostly giving up alcohol.

Yup. That was a tough one! I had thoroughly rocked hedonism as a youth, and into my midife, I loved a weekend wine just like the next peri-menopausal woman relieved another week was through.

Guess what? Personal training became my career. But ‘bootylicious’ was out.

Glutes are for power, not pants

It dawned on me my real interest was in helping people with health conditions.

For me personally, I didn’t give a toss about training to look good in hot pants. I cared about making sure that my old lady body, when she arrives (not there yet!), can kick ass.

I then became even more qualified. I got all fancy obtaining a Level 3 Exercise Referral and a Level 4 low Back Pain Management Through Exercise.

I used to suffer incredibly with back pain with my butt at a desk all day in my journalist career, so I knew how valuable this knowledge-broadening would be.

Officially “unbreakable”.

In May 2026, I had a follow-up DEXA scan to see where my bones were at. I was astounded to discover that my bone density had returned to normal.

I had put in the hard work, and I won. My bones were strong again.

The training, nutrition and lifestyle programme I had designed for myself had done the job. It continues to do so, too - because this is a lifetime commitment. Ain’t never gonna give it up.

Which brings us here. Everyone should be unbreakable. And I am on a mission to teach others how to do this - whether it’s their bones or their backs. But likely - both - as if you work on one you’re usually working on the other.

Who is Becoming Unbreakable for?

My focus is both on bone health, back care, and muscle strength.

I teach back care classes in the community, and offer a back health programme for workplaces. I run commissioned sessions for local organisations, including a commissioned short course to a local council.

I offer bone strength programmes to individuals, and write guides and newsletters on osteoporosis prevention through lifestyle, exercise and nutrition.

Here on my Substack platform, I will be sharing helpful advice, education and information in these key areas - strong backs, strong bones, strong muscles.

These are the essential components to becoming unbreakable.

Whether you are an individual or an organisation, if health and wellness is important to you, then please subscribe here for free. Expect a weekly, informative article, and notes with useful tip and shares.

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Disclaimer and safety note:

This content throughout this publication is for educational purposes only and isn’t a substitute for medical advice. I am not a clinician. Please check with your doctor before trying new exercises or taking health advice from within these pages; especially if you have osteoporosis, a diagnosed condition, or any concerns about your health.

Here’s the answer to the title in a nutshell: osteoporosis is an insidious disease because it is a silent condition. You often don’t know you have it until it’s too late.

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Osteoporosis is often known as ‘brittle bone’ disease. It occurs when we lose bone tissue. There is no pain associated with it, aside from when it’s very advanced and is causing other complications in the body, such as fracture of the spine causing pain.

You won’t notice changes in your health as a result of having low bone density.

There are no symptoms in the early stages, when it matters the most to catch it.

For most people, they know they have the disease when they have a fracture which may come about from a very minor incident. Or even worse, they will know when they break a bone.

80% of people with osteoporosis are women. The key reason being our different hormonal constitution. Menopause, when oestrogen drops, is a major time of bone density loss.

As well, women tend to have smaller, thinner bones than men to start with.

One in two women over the age of 50 will suffer a fragility fracture during their lifetime, but by the time it happens, they are already often in advanced bone disease.

This means if you are female and reading this, you absolutely must take note - because there is a strong chance that it will happen to you.

Men can have osteoporosis too, though. Since it is a lot rarer, they do tend to get missed from screening - and for that reason, it can mean they are even more at risk of going unnoticed until in very advanced stages.

According to the World Health Organisation, osteoporosis is a serious global health concern. Yet, it is a disease that in many cases, is largely preventable - even while being so prevalent.

Why is it such an issue?

Part of the problem is that people view ‘brittle bones’ as an ‘old person’s disease’, not understanding that the work to prevent it happening actually needs to be done decades before.

People find it hard enough to pay attention to their health for the things they can notice changing, never mind the things they can’t. So even if they are aware that low bone density may come to haunt them when they are older, they won’t act now to prevent it.

There are also people who think they are doing the right things but might not be quite hitting the mark. This was me before I actually got diagnosed with the stage that occurs before osteoporosis sets in - osteopenia (which is now reversed).

This is the exact reason why I created my free ebook The Bone Health Blind Spot, which explains a little more about what osteoporosis is, and when it comes to exercise, what does and doesn’t work for bones, and for prevention.

Your bones need you to be their advocate - because they only speak for themselves when it’s often too late.

If you enjoyed reading this, please subscribe here for free. Expect a weekly, informative article, and notes with useful tip and shares.

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There are some things that are obvious when it comes to bone health, and others that are less obvious.

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One very powerful secret ingredient in our bone health armoury is getting consistent, quality sleep. 

I used to teach my PT clients the whys and hows of good sleep habits, because sleep impacts on so many aspects of health.

Unsurprisingly, there’s also a link between bone health and poor sleep, too.

A study on aging carried out in England found that getting less than 6 hours a night, or more than 9 hours a night, is associated with higher osteoporosis risk and lower bone mass density. The balance between bone formation and bone breakdown is disrupted by bad sleep.

Not a revelation, really. I mean, consistent poor sleep (including sleep that is influenced by alcohol or sleeping tablets - making it ‘sedation’, rather than ‘sleep’) is linked to poorer health outcomes overall.

When sleep functions are disrupted, everything is…

There are three key ways in which sleep affects our bones, and they are also the ways in which sleep affects other aspects of our health. They are via disruptions in our circadian rhythm, our hormone regulation, and our cellular repair (with cellular repair being one of the key functions of sleep overall).

A growing body of research including night shift workers as subjects, is showing us that messing with our circadian patterns also impacts upon on our bones. We know already that even mild disruptions to our ‘body clocks’, like jetlag from flying or having consistent late nights on weekends, can cause health issues.

Hormone dysregulation is also a well known result of poor sleep. It impacts our appetite, our cortisol levels, and even reproductive function. Since healthy hormone regulation is also important for healthy bone tissue - you guessed it, consistent hormone imbalance can play havoc with our bone growth and repair.

As well, it is during deep sleep that our bone tissue gets repaired - as cellular repair occurs throughout the body at this time.

With all this in mind, can you imagine what the body of a menopausal woman is going through?

She is in the middle of a hormonal whirlwind, with oestrogen tanking, and her sleep is disrupted anyway because of that. Plus, she is likely to be sleep deprived either because of the hormonal imbalance, or the stress of dealing with menopause, or with hot flashes, or all of them.

The problems are compounding, so it is no wonder that menopausal women are most at risk of having low bone density and becoming osteoporotic.

So, how do we try and get better sleep?

It can be a difficult one to tackle because many people with very disrupted sleep are so anxious about bedtime that this in itself imposes a hurdle upon getting a restful night. However, these are my suggestions as a starting point:

1. Speak with your doctor to see if you have any deficiencies that might be impacting upon sleep, or if there is another physical cause. Dr Stasha Gominek says that vitamin D deficiency can be a key cause of poor sleep (but get tested before taking any supplements willy nilly). Of course, menopausal imbalances may also be the root cause - ask your doctor about options.
   

2. Avoid sources of stress before bedtime or during the evening. This includes getting involved with social media arguments on your phone and watching anxiety-inducing documentaries. In fact, turn your phone off at least an hour before bed to avoid the ‘blue light’ impact (which will awaken your brain).
   

3. Get your circadian rhythm into check. Do this by getting out into the daylight within the first 20 minutes of waking, perhaps having your morning cuppa on the doorstep or in the garden. Get an evening walk in as dusk is falling. Keep the lights dim in the home before bed, and as above, avoid the blue light of devices before bed.
   

4. Eat regular, protein-rich meals and stop eating at least 3 hours before bed. Protein is great for bones, for satiety, and for muscle growth and repair. It will keep you full and the older you get, the more you need it. Not having a full stomach before bed means rather than your body having to digest food during your sleeping hours, it can simply do the repair job it needs to do.
   

5. Avoid alcohol at night time. I know, I know - you think a glass of wine helps you sleep. But it really doesn’t. It sedates you. Your brain doesn’t go into the deep restorative sleep it needs, and you essentially become sleep deprived while believing you’re sleeping. Alcohol also raises cortisol levels the next day, which contribute to the poor sleep pattern even further. If you want to keep booze in your life, go for a weekend lunch out and have a glass then, instead of in the evening.
   

6. If you wake during the night - DO NOT LOOK AT YOUR PHONE OR THE CLOCK! The block capitals are necessary. I can’t stress how important this is. Avoid the temptation to restimulate your brain, and avoid the temptation to check the time. Instead, try some deep breathing. Imagine a dark pool that you are sinking into, and keep breathing yourself further into the pool. See if the relaxation can help you switch back off.
   

I hope this helps. It’s my mission to help more women get their bone health in check before they discover their bone health is already impaired. Sleep is more important than we realise for our bones, so it’s worth working on.

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