Dem Bones, Podcast Ep. 48

Description: How ‘Mechanically Nutritious’ is Your Diet?

What is osteoporosis? What about bone mineral density? In this episode, Katy helps us dig deeper into bone health. You’ll learn more about bone shapes, how bones are built and why your bone robusticity depends on a lot more than eating chocolate-calcium-chew-candies.


DANI: It’s the Katy Says podcast, where movement geek, Dani Hemmat – that’s me – joins biomechanist, Katy Bowman, author of Move Your DNA, for discussions on body mechanics, movement nutrition, natural movement, and how movement can be the solution to modern ailments we all experience.


KATY: Good morning.


DANI: How are ya?


KATY: I’m good.


DANI: Excellent.


KATY: I’m standing. I’m standing. (Music: I’m Still Standing) I’m standing – barely – after my long birthday trek of –


DANI: That’s right! You went more than 30 miles, didn’t you?


KATY: Yes, due to emergency survival need we ended up going more like 37 miles.


DANI: I’m sorry, what kind of emergency survival need would necessitate that extra mileage? What?


KATY: The necessitation was brought about by – because we walked – we left the town that we live in and essentially hiked up to the national forest. The last 7 or 8 miles were on the section – we were fortunate in that we have 120 – about 120 miles of what’s called the Olympic Discovery Trail that’s all paved, groomed, laid out pretty well off-road. Very rarely in most of it are you walking on the freeway, and then the areas that we checked were through farms and around different public lands and whatnot, but the last section of it, after we went across the Elwha River, which is the big river here, is what’s called the Adventure Trail. That’s a 25-mile portion of this Discovery Trail. The Discovery Trail is the paved part; the Adventure Trail is the 25 unpaved miles that are up in the mountains, and it’s gorgeous.


DANI: It’s aptly named.


KATY: Yes, it is. And it’s – everything else is kind of flat and groomed, but this was like rambling, we saw nobody – I mean, it was great. However, when we were figuring out where we were going to go and how far we were going to go, we used Google Maps, you know, like everyone, and to see where other roads were going to intersect, because it’s mostly rural. This Adventure Trail, what’s intersecting it are these small – they’re essentially forest roads. Service roads, they’re public roads; they’re not all paved, but they’re fire roads and logging roads and there were only two of them that intersected this entire 9 mile span, so we figured we had to go beyond 30 just to match up with the roads. So we were only going to do, like, 31 ½. A little bit more than 31 ½. And when we got to that 31 mile marker, luckily we had cell service, you know, I was calling my husband, like, okay, we’re almost there, I can barely walk, can’t wait to see you! And he’s like, oh, good, I’m almost there. And then like 5 minutes later was the text – “The roads are closed.”


DANI: Ohh.


KATY: They were –


DANI: Ohhhhh.


KATY: I know.


DANI: Oh, you –


KATY: I know – and it was – so we had already been walking for over 10 hours, the sun was going down, and this was the realization that our exit strategy had been thwarted. So all of these roads were essentially – and it wasn’t, like, my husband –


DANI: That’s actually kind of when it hit Adventure Status.


KATY: You know, that’s when it was like, yeah – a whole other –


DANI: Oh, NOW the adventure has started!

KATY: Yeah, and unfortunately my legs have no more ability to contract! Yeah, so it was the “I can’t come get you,” and there’s no other solution, right? You’re not downtown. You’re not like, you’re in the forest. There are no roads, the sun is going down. You can barely walk, and guess what? You have to walk 7 miles.


DANI: More.


KATY: And because of where we were, hiking back out the trail wouldn’t have taken us to any point where we could interact – and our cell phones were almost dead – that was a sad thing, was like, it was a preparation cluster. It will never happen to me again, because I just – my friend and I were talking about, like, I just got super comfortable with depending heavily on technology. I mean, like, the fact that we had – what would have happened if we had no cell service? Like, we hadn’t even checked if there was cell service. It was ridiculous, but it was a good example of – there’s only one way out of this forest, and that was to turn around and hike 2 more miles when I had already hit my limit – or the limit that I thought.


DANI: Right.


KATY: I thought I had hit my limit but it turns out, in survival, you can muster – and it’s like, no one can come in, there’s only you, and I’m not sleeping here in the woods, like, it’s freezing. And so, yeah. So it turned into an additional – a bonus! A bonus 7 miles. So I actually ended up walking more closer to the 39 miles that would have been a conclusion of my 39th year, but yeah – it was a good – it was a good metaphor.


DANI: It was a good time.


KATY: I’m like, I’m sure someone’s playing a joke on me here, but yeah, it was great. But I’m standing, and I think I’m going to write a blog post about it, because everyone’s like, what shoes did you wear? What was it like?


DANI: Nice.


KATY: I’m like, maybe that’ll be my first blog post in a while because I haven’t had the time. But anyway, what we do have time to do today is talk about bones.


DANI: Bones!


KATY: You know, we’ve done bone episodes before, right? Didn’t we do something on athletes and bone density? I remember talking about – oh, it was the cycling show.


DANI: It was the cycling, we just kind of touched on that.


KATY: Okay, so um, I get a lot of –


DANI: But we’ve never really devoted just one to bones.


KATY: One full show to bones. So that’s what this one’s going to be, right? This one’s going to be –


DANI: Yep.


KATY: Let’s talk about bones. I think that – and of course, like most of the stuff that we do, it’s not going to be like a show on osteoporosis as much as bigger context. That’s what I like so much about what you and I get to talk about is – what is osteopenia and osteoporosis, bone loss, but – these are just the words that we talk about it with because of our insurance, you know, and how things get paid. So I think let’s start with how bones are shaped and that bones are shaped by how you move. And I have said this a lot – your bones are an autobiography. You are writing your autobiography in your bones right now, and if you have an area of low bone density – and it would be something that you would only know if you had had a DEXA, which is a particular type of scan, or a bone density test. There are other –


DANI: Oh, okay.


KATY: There are other ways to estimate it. Bone density – or low bone density or osteopenia. It’s really a site-specific situation. Osteoporosis and osteopenia, in the way that the terms are used – it’s not like you have a bone disease. You don’t have a – you do not have a problem with how your bones are regenerating. It’s a site-specific lack – go ahead.


DANI: And that’s really important, I think, for us – I’m so glad we’re going to dig into that, because it is interpreted as just a disease.


KATY: Sure. Because it’s a diagnosis.


DANI: With no mechanics to it – yeah, I think that’s what I would love to get into; it fascinates me.


KATY: Well, yeah, the whole, “I have osteoporosis.” I’m like, okay, well, osteoporosis is really just a word given for, you know, a mathematical measure or statistical measure of how your bone density compares in one particular area to other people’s. It’s not a condition where your body stops generating bone. So –


DANI: We know that it’s not just a disease; it’s how you’ve been moving, and I think a lot of people think, well, it’s nutrients, too. You know, I just didn’t get enough nutrients and we know that you need both the movement and the nutrient, but let’s just kind of dive into it and focus on the fact that – not focus on the fact, but bring up the fact – that osteoporosis and osteopenia are touted as “women’s’” disease, but all sorts of people can get it – men.


KATY: Well, yes. Children.


DANI: And kids. Yep.
KATY: And I think that it has been kind of touted as, like you need more calcium or more vitamin D, because that’s the issue, right? If you have low bone mineral density, then it’s like, well, you just need more of the minerals that go into bones, so just eat more of those. And in some cases, in developing countries or people who have significant nutritional deficiencies, it could be that you have all of the signals of “build bone” and none of the nutrients to build it. You definitely need both, but –


DANI: Okay.


KATY: That being said, you cannot lie in bed and eat all the minerals. Those minerals don’t go into your bones. They’re not being stuffed into your bones; they’re being used to keep up the density because you need it. If you don’t use your bones – so it’s not efficient to have heavy, strong bones that are not supporting you. So you have to kind of think about bone density and bone robusticity, which we’ll talk about more as a response to the way that you are behaving. And yes, it’s always like – it seems to always be like, like your grandma. Like, your grandma’s got osteoporosis, right?


DANI: Right.


KATY: Not Lance Armstrong.


DANI: Right.
KATY: Right? Who – and like a lot of – actually, I don’t know about him, specifically, but a lot of people at that competitive level will have osteoporosis in their hips because they don’t do any weight-bearing activity. Yes, they’re pushing and pulling and they are doing resistance exercise, but that’s different than their body does not need to be strong enough to support their weight, and so 1) bone health is much bigger than bone mineral density. Bone mineral density, or bone density – which is often how it’s called or referred to – is the cheapest, most simplest measure. So that’s why it’s been kind of teased out. What also is of importance is their shape. So yes, density, but also their shape, and shape – those two things together make robusticity. And if you’re talking about bone health, robusticity is really where you want to focus.


DANI: Let’s talk about that. Like, how – that they are built, first of all. Bones are built, and it’s not just eating a chocolate calcium chew that does it.


KATY: No? Dangit!


DANI: I know, they’re so good, right?


KATY: Do you remember that commercial? It was like, that commercial with like – I was a kid and I remember there was this commercial where everyone was eating chocolate caramels, and that was like healthy bones, and I was like, something is awry. What is going on here?


DANI: Oh my gosh, you were a kid, like, those are still – those are still a thing.


KATY: Maybe a teen? I just remember when they came out.


DANI: Yeah, I think so.


KATY: It’s like candy – they will take candy for their health! All right.


DANI: I’m in!
KATY: Chocolate chews.


DANI: Okay, let’s talk about how bones are built, and what forces mean to their robusticity. And then what are things we can do – like, first, let’s talk about how bone cells are made, because this is so cool. So cool.


KATY: Well, bone cells are made by your body. But bones are created by the activity of bone cells. Like, you have bone cells that build bone, and you also have bone cells that remove bone. Your – like, your skeleton is constantly forming. It’s being shaped and broken down, and shaped and broken down – I’m going to say a lot of this is in Move Your DNA. So to get a – to get a smoother presentation of bone robusticity and a lot of cool examples, Move Your DNA is better, plus there’s not a lot of discussion of chocolate chews in it. Free podcast! That’s how it goes. But it’s like – so gosh, where do I start with weight? Well, like, everyone has a weight. Right? So if you step on a scale, that’s your weight. So theoretical weight – mass times gravity, your mass times gravity – it’s just like, this is your weight. It always weighs the same. It’s like, well, but that’s whole body thinking. That’s single body thinking, thinking about yourself as a single body. Each one of your cells is actually a scale within itself, and so weight is really relative to the scale that’s measuring it. So one example that I use is that if you stand on that scale, it’s like, okay, there’s my weight – but if you stand on 2 scales, if you have a scale underneath each foot, and we use this in biomechanics where we’re measuring pressure or we’re measuring where you’re carrying your weight on your body, you can have a scale under your right and one under your left that are not connected, and you can have more weight on the right scale than the left scale. So even though your theoretical weight is the same, you can carry more of your weight on one hip, right? So if you’re standing and you shift your weight from side to side, what does that mean? It means that if I’ve got all my weight – with the exception of a teeny, tiny bit – on my right leg, my right leg is more weight bearing than my left leg. I’ve got the same “weight” – I’m putting weight in air quotes – but that’s really theoretical reduction. Weight is relative to the scale that’s measuring it. So if every one of your cells is a scale, how you carry your body in space is going to affect the weight that is placed on every single one of your cells. And so if we think of, like, let’s imagine that in that last example, each hipbone was its own scale. So if I carry constantly my weight on my right leg versus my left, what you would expect to see is less bone in the hip that is less weight bearing. That make sense?


DANI: Right.


KATY: If my spine is curved –


DANI: That makes sense.


KATY: forward all the time, you’re going to see bone loss in the vertebrae in my spine that no longer have the other vertebrae stacked above them. And so for a long time, and still, really, I think, hyperkyphosis, or that forward curve of a dowager’s hump or whatever you want to think about that kind of – again, thinking about grandma and her osteoporosis – that idea of oh, you have low bone density – the bones aren’t able to support the weight of the spine, and so your spine starts curling forward. That’s one way of looking at it. Another way of looking at it – and this was like cutting edge research I think when I was in graduate school. I’ll have to find that source; I posted it on Facebook years ago, and I’ll see if I can dig it up for the show notes, where the first kind of introduction of the idea of going, well, it’s actually been more biologically plausible that you’ve had this curvature in your spine for some time, and that’s why you’re correlating the curve to the low bone density, meaning that you had a particular posture, and that over time you stopped loading the bone, and that’s why you see the curve and the bone loss go together.


DANI: Oh, okay.
KATY: Anyway, so you have to think about all of your cells as something that are sensing and then adapting or responding to the weight that you’re placing on them. There’s lots of other forces; there’s tensile forces and pushing and pulling and twisting, but if you can figure it out for weight and just think about how every single cell is responding to the twists and the turns and the way that you’re using your body, that’s – it’s easiest to do with weight. And then from there you can go on to all the other types of forces, but essentially your bones are creating a shape – that includes density – robusticity – that matches the behaviors that you do, so that you can continue to do those behaviors more and more efficiently. So you can hold yourself up with more musculature, but that takes more energy than if you just make your bones stronger, where that weight can be held more by the non-active parts of your body. So that – it’s just kind of a call and response. You just –


DANI: Yeah, and that’s a good time to just bring up – do you talk about osteoblasts and osteoclasts in Move Your DNA?


KATY: No, not particularly, because I don’t know if it’s – I don’t know if it’s that super helpful. I think osteoblasts and osteoclasts are secondary to understanding how bone works, and yet it’s been made primary. It’s like, here’s how bone works: it works on this level. And I’m like, well, I’m more interested in the mechanical signals that drive osteoclasts.


DANI: Okay.


KATY: I mean, I’ve written about them before – I’ve written about them on the blog, you know, where a lot of bone building medication aren’t really – so, the way I always remember, osteoblasts: building. Osteoclasts: chewing down. Consuming.


DANI: Mm-hmm.
KATY: So a lot of bone saving pharmaceuticals don’t really – they’re not increasing the amount that bone is being built; they’re just decreasing the amount of bone that’s being broken down. So they can’t – there’s not a medication that’s creating – there’s no chemical – there’s no chemical pharmaceutical drug that has been able to stimulate or to recreate what is a mechanical input, right? That makes sense. It’s a mechanical input, so there hasn’t been a chemical that has yet to do a mechanical input. However, since the breaking down of the bone, you can halt cellular activity because that’s chemical, and so they’ve been able to stop that. So a lot of times, people will stop bone loss, but they’re not really building their bone back up. So it’s kind of – it’s kind of like – it’s semantic word play that it’s – like, the way that it’s presented.


DANI: Right.


KATY: It saves your bone! But it’s like, well, but breaking down your bone is natural, so all you get is a lot of old bone. And that’s not what you want, either.


DANI: Right.


KATY: You want new, fresh bone and in order to do that you require some mechanical signals.


DANI: Mechanical.


KATY: So I don’t really want to talk about it too much more because I feel like these other ideas are the precursor to figure out the details of how it works, where there’s a lot of people who got the details but they don’t understand the driving system, so then there are these things, like, let’s just stop down the chewing down of the bone! And it’s like, but – but – building and chewing and building and chewing is normal. You need this – you need to find a good relationship between the two; not just to slow down your natural breakdown so that rebuilding can form. Let’s talk about why the rebuilding isn’t happening.


DANI: Well, let’s talk about, like, that. Like shape of that, because when the first things that you hear if you do – if you want to fight off osteoporosis or if you have it or whatever, is that you have to do weight bearing exercises. So then, immediately, somebody picks up some dumbbells – no, really, though, and they start doing that, because in their mind, that’s a weight bearing exercise.


KATY: It’s just an extrapolation. It’s just a misunderstanding, or – it’s not a misunderstanding as much as it’s a small understanding. You know, about weight being a whole body thing.


DANI: Well, I mean, I guess we should define that.


KATY: Well, which part?


DANI: Well, I guess –


KATY: What’s weight bearing exercise?


DANI: Well, what creates that – well, no. But what creates that shape? Like, why is osteoporosis so concentrated in places like hips or wrists or ribs? You know, like, what is it? It’s not – that’s not just the place where the minerals like to leech out of our body in those 3 places, like, why is that prevalence there in those places?


KATY: Well, okay, so –


DANI: I guess we’d need to go back to shape, right?


KATY: Right. It’s back to robusticity. Okay, so let me – let me explain it using an example, because that’s what I do. So bone robusticity includes the density and the shape of a bone – more specifically, or like, in geek-speak, bone robusticity is structural buttressing. It’s the – it is – it’s taking a skeletal element and it’s creating a shape that the use of the building requires. So – and this is what’s in Move Your DNA, I’m like, okay, if you look at a cadaver, everyone who has taken anatomy should be able to go, “that’s a femur, that’s a calcaneus.” And even across the animal kingdom, bones have such a similar shape that it’s very easy to identify what is what. But you have to think of the femur as a category of shapes, really. So there is something that we, as anatomists, and anyone who has taken anatomy, there are similar features. There are these main features that you can identify – however, every single bone has its own snowflake shape, so in Move Your DNA, I talk about baseball pitchers, right? So baseball pitchers, because of the action of their pitching arm – these are professional pitchers – because of the way that they are – and this is in Whole Body Barefoot, too – but applied to why a lot of people have lower leg turnout. When they’re throwing the ball, they’re not only throwing the ball. They are throwing the cells in their arm. This is so important to get! When you move your body – if I grab a ball, and I’m winding up – in fact, everyone’s movement break is to pretend like you’re pitching a ball. I’m just like, I don’t even know how to pitch a ball, but like, I kind of have a ridiculous overhand going. So I’m throwing over and over again, right? But my throwing involves my arm kind of reaching back behind me. I’m throwing my cells back behind me! And then I’m throwing them forward. I’m not only throwing the ball; I’m not only moving the arm. I’m moving all the cells within the arm. I’m squishing the air resistance – all these things which I know, because I’ve seen high-level physicists write about, you know, it’s like, cells can’t feel gravity. This is the overall understanding is that these forces are so small that they don’t make any difference, because they have to not make a difference when you’re doing a physics problem. But the fact of the matter is, cells do feel it, and that’s the newer realization, and it’s going to take a long time before everyone goes, “Hey!” Throwing your legs when you’re walking – because of the gait pattern – can make a bunion. It’s just throwing them. You’re throwing your cells, and eventually they hear that input, or they sense that input enough that they begin to take a new shape. So bone robusticity is how – it’s really how most data is gathered regarding populations that have moved historically over the planet. Looking at their, like, the remains of different people at different times, it’s very easy to see how people have moved. So I am reading a paper right now that Machiko, one of our fans, emailed me.


DANI: Oh, yeah, yeah.


KATY: She’s great. I’m going to read – where is it?


DANI: She’s great – she always has fun stuff.


KATY: It is called…


DANI: I see you, Machiko!


KATY: It’s like Romper Room. Oh my gosh, what am I reading?


DANI: Can you not find it?


KATY: Okay, hold on.


DANI: [Sings Jeopardy! theme]


KATY: Okay. “Evidence for genetic and behavioral adaptations in the ontogeny of prehistoric hunter-gatherer limb robusticity.” Say that five times fast. So that’s the title.


DANI: That’s okay.


KATY: So what it’s talking about is – it’s just breaking down how bone robusticity is different between mobility types, so people who primarily locomoted over land or people who had a lot of aquatic mobility, people who used canoes – a lot of paddling – because their bones look different. You have people who have what they would call more robust lower legs and hips compared to aquatic – I don’t know, mobilized – people who just traveled via water or who were on the water paddling every day.


DANI: Right.


KATY: They had a lot more upper body –but it’s not only that, it’s also their foraging strategies and the food availability. So I thought one thing that was pretty interesting was where they were saying that there was one particular island where they weren’t doing quite a lot of paddling; however the types of foods that were available there based on the remains of, you know, I guess maybe the skeletons that were around this group of people – they knew what they were eating – required so much physical processing with the arms. So they would find that in order to make a certain food edible, the amount of upper body work it took –


DANI: Like pulling and pounding?


KATY: Yes, exactly. Heavy labor in the upper body to make something – I want to say, “palatable,” but it’s not palatable. It makes it edible.


DANI: Right.


KATY: So yeah.


DANI: It still could have sucked, but at least they could eat it.


KATY: It had all that – exactly. They weren’t mashing up garlic and chives and there’s no white wine.


DANI: It needs a bit more salt!


KATY: So, that’s really interesting to me. Your skeleton, again, this is their biography. You are seeing a lot – that’s how they know about handedness in bow hunters, and if people used spears vs. bows, because you know what those motions are: you can recreate a mathematical model based on the – ok, well, this muscle has to be here, this muscle attaches here, so if they’re using this muscle repetitively, you’re going to see a different shape on the right arm vs. the left arm. Even though they are both humeri – humerus is the name for the upper arm bone – even though you’re looking at two humeri on the same person, they have the same shape depending on how you’re evaluating shape. If it’s the shape of a humeri, awesome. If you’re looking at muscular attachments, though, you will see that a used arm has a different robusticity. It’s bigger, it’s stronger, it was generating more force. On the pitchers – the baseball pitchers – they actually put curves in their upper arm bones, meaning their upper arm bones began to twist!


DANI: Wow, that’s right.


KATY: In the same way, because again, they’re throwing their cells. So they are actually – they twisted their arm bone – not their arm bone with its same shape rotating back in the socket. Meaning the lower arm had rotated relative to the upper arm. They had put a twist within the bone themselves. They will be identifiable as pitchers when you’re looking at their skeleton based on the story that’s in their bones, if you will. I love bones. I’m such a bone geek.


DANI: It’s so cool. And it’s kind of – I mean, I feel bad or it’s just sad that this information – okay, so they’ve applied it on people they’re digging up, essentially. They can tell what they did, but then that translating into the general public’s knowledge of how to, you know, create bone robusticity – it’s really hard to say. Robusticity. Robusticity. But that knowledge or understanding of how to create that; it doesn’t translate. It translates into chocolate chews. Calcium chews instead of, “you are how you move.” Because that –


KATY: There’s no one – it’s no one’s job. That’s because – I’ve made it my self-appointed job, but that’s not really – there’s no one selling bone robusticity. Although, is that really the case? I mean –


DANI: Well, I don’t know – I mean, it’s just –


KATY: People have said to like, I think again, it’s just the vehicle – the understanding is there: here’s how bone works. Here are the populations. So like you were saying, what about people with their ribs, wrists, spine, certain vertebrae in the spine –


DANI: Mm-hmm.


KATY: And the hips. Specifically, the neck of the femur or your thigh bones. Those are your areas of greatest risk for bone loss, meaning that when you look at our population of people, that’s where the way we move is most likely to generate areas that fracture. So that’s what that means. What do we know? People know they’re supposed to be doing – okay, so earlier on we were going to clarify this idea of weight bearing exercise.


DANI: Yes.


KATY: I do think that it is understood quite well that people need weight bearing exercise to improve the health of their bone. What’s not understood is what weight bearing exercise is –


DANI: Correct.


KATY: Because weight bearing exercise is considered always as a whole body phenomenon. I remember meeting a woman a long time ago – a young woman who had – and actually, now that I think about it, there’s a few people – who had osteoporosis in their spine in their 30s, in their late 20s and their early 30s. They’re runners, and they’re like, but I’m doing weight bearing exercise! And that’s when I had to say: your WHOLE body is doing weight bearing exercise relative to a scale that you are running across. Relative to the cells in your lumbar spine, you are not doing weight-bearing exercise. Running is not weight bearing exercise to all of the spots in your body. It’s only relative – it’s only weight bearing between your feet and that which you are running on, which is the ground. Or if you were on a scale – if you were standing on a scale, your body would show your weight. If you were running across the scale, the scale would show 2-3Gs, 2-3 times your weight. So if you weigh 150 pounds when you are standing on a scale, then what’s between – it’s essentially the soles of your feet are experiencing 1G. When you run the soles of your feet experience 2 to 3 g, but that does not translate to the area in your spine receiving 2 to 3 g and that’s the problem right there, is that it’s not understanding that that weight is relative to the scale that’s sensing it, and you have scales everywhere in your body. The way that you move can – is dictating where your bone goes. Slapping on a weight vest does not mean that your hips are experiencing more weight.




KATY: If you have a curved spine or you wear your hips out in front of you, or you slightly bend your knees or you rib-thrust, adding a weighted vest to your torso does not translate to greater weight bearing status of your hips. Even though you’re wearing a scale underneath your feet, it would be. So what you see on a scale as far as weight goes is not distributed everywhere throughout the body.


DANI: That’s heavy stuff, man.


KATY: Thanks for helping me flesh that out.


DANI: That was good. That was really good, thank you. That’s exactly what – what I was hoping you would do. Yay!


KATY: You’re so good. You’re like, you’re like a snake charmer. You’re like, okay, [sings snake-charming music] and what can I do? I’ll just keep talking! Yeah, that’s the big – that’s the misunderstanding right there, is that whole body weight bearing exercise is not site-specific weight bearing exercise.




KATY: And osteoporosis is a site-specific disease, so – I just got a text from a neighbor and she was like, my mom has osteoporosis, and I’m going to have her walk a mile on the treadmill. Or she walks a mile on the treadmill, but what else should she do? And I’m like, well, 1) is she walking in heels, in a heeled shoe? Because if your hips are out in front of you because you have a heel on, you could be taking the weight off of your hips just by the shoes that are underneath of your feet.


DANI: That’s so important to know.


KATY: It’s just geometry. It’s geometry and a little physics, and a little biology. And we call it biomechanics.


DANI: That’s awesome.


KATY: Anyway.


DANI: Bones are interesting, and I like that thought about every little cell has a scale, you know.
KATY: [sings] Every little scale….right, sorry.


DANI: Every little cell wears a backpack.


KATY: It’s true.


DANI: I know, it’s a good way to look at it. And it increases the – go ahead.


KATY: Every cell is also wearing your shoes.


DANI: Yes, yes! Yes.


KATY: I feel like I’m not even writing anything original anymore. I’m just changing the body part. I’m like, every cell is wearing a backpack. Move Your DNA. Every cell is wearing your shoes. Whole Body Barefoot. I just change the nouns.


DANI: That’s awesome. Well, I like that focus on it, because a lot of times when you read – I mean, there’s so many research articles out there, but so many times it does just focus on the areas that they’re studying, the nutrition and the vitamin D. The sunlight. And they don’t really talk about more modern physical activities.


KATY: We have a – we don’t see ourselves – again, this is a common theme. The filter through which research is done is not looking at us as a particular type of human. Like, we’re just calling ourselves humans. This is what humans do. So I’m like, well, it makes a difference for the questions that you ask when you don’t see yourself as “the model human” and instead see yourself as a set of behaviors. You know what I mean?


DANI: Mm-hmm.


KATY: So it wouldn’t, maybe, occur to someone – so to people who are doing the bone robusticity research are usually physical anthropologists. They might be biomechanists who are working in physical anthropology, but an anthropologist’s entire filter is that there are lots of different types of humans. Their cultural competency is very high when you’re an anthropologist. If you’re a physiologist, you might not have the same background in how different people behave on this planet right now. Cultural competency is huge and it’s probably lacking quite a bit in the sciences across the board. It’s just not – like, if you’re a physical scientist or any kind of science, if science was your field, you probably didn’t take a whole lot of cultural competency or cultural classes, right? That’s the problem with education – that’s the problem with education, it’s like, I just did math and science, so I studied this. And if you don’t have a filter that, like, if you haven’t traveled quite a bit and studied humans of different types, you are just given human anatomy and a human anatomy textbook that was filtered entirely through a western human’s perspective. You’re going to ask questions, you’re going to ask questions with that narrow scope.


DANI: Right.


KATY: And so that’s all that’s happening.


DANI: Sure.


KATY: But the great thing about the Internet –


DANI: I know.


KATY: Is that’s all changing. Plus also that you can stream Top Chef. That’s the other good thing about the Internet.


DANI: No, but it’s true – and it’s important. I used to get so annoyed that doctors didn’t know stuff about biomechanics when I started studying your work, but then you just had a really good point: how can you – you cannot do that all. They cannot be expected to know all that, and you have to give them a break, and take personal responsibility.


KATY: Well, why would – that’s like saying that I should know a lot about medicine and veterinarian science and English.


DANI: Well, I think you should –


KATY: Why don’t you know more medicine? Why don’t you know more medicine? It’s like, why doesn’t –


DANI: That’s a good point. And that’s often a question when people start learning this stuff in classes, they’ll say, well, why didn’t my doctor never told me that? And I just say, you know, why should they be responsible for all that?


KATY: But that’s also a cultural – that is a particular cultural perspective of authority where your doctor is supposed to know every single thing about the human body, and not just medicine.


DANI: Right.


KATY: You’ve transposed medicine over everything there is to know about the human body. If I need my life saved, you bet I’m going to someone who specialized in saving lives. But that’s different than getting all of my body information from a particular field that is, you know, supposed to keep you alive. It’s just different – it’s a different field, but we’ve only created a few fields in our academic system, so there really isn’t, like, it’s you. It’s just you. It’s you! It’s you. It’s you! And you’re listening. So you are slowly gathering data about it. So well done.


DANI: Well, I’ve got a couple of disturbing facts. Just in the USA, by 2020 – where are we, 2016 now? It’s expected that the incidences of – the cases of osteoporosis will be up to 14 million just in America. And there is projected to be over 47 million cases of low bone mass. And I found this really interesting: by 2050, the worldwide incidence of hip fracture in men is projected to increase by 310%.


KATY: Do they think there’s going to be less, or are they just trying to diagnose it more?


DANI: Well, I just – I don’t know. They’re going on what they’ve got now and how fast it’s growing.


KATY: And also how many more people there’ll be.


DANI: And how many more – the population increase. But when we talk about – so, okay, we know that the four main places that osteoporotic fractures – is that how you would say that? –


KATY: Fracture risk, yeah.


DANI: Well, a fracture but I got osteoporotic –


KATY: Just mumble it.


DANI: Ok, [mumbles] fractures: spine, hips, wrists, and –


KATY: Ribs.


DANI: Ribs. Yeah. Why – I mean, I think I know why, but can we talk about why is that so prevalent in those 4 places? Or do you want to –


KATY: Well, I mean those are – I mean, those are going to be – those are areas, they’re areas for the most part where things are already pretty thin. So a lack of use is going to make it mechanically most susceptible, right? So if you take the entire skeleton and reduce its bone mineral density, where it’s going to be most at risk for fractures will be the areas that are thinnest. So it isn’t to say that those bones – like, people say, well, that’s just thin, where you’re designed to fracture or however they want to phrase it, it’s like, well, no, those are the areas that if you don’t move hardly at all, which we don’t, will mechanically be at greatest risk.


DANI: Okay.


KATY: Why, though, also – that’s like, whole body. Whole body reduction. But site-by-site, gosh, I covered hipbone density in my first foot book.


DANI: Mm-hmm.


KATY: But I really say, if everyone is wearing positive heeled shoes, everyone is going to have – like, their hip’s weight bearing status is going to be lower just geometrically. And when you – and I of course, there’s hidden kyphosis is something else that I talk about a lot, which is that we all have this – again, I think a lot of this is in Move Your DNA – I think that most of us have hyperkyphosis but we mask it through rib shearing and thrusting our pelvis. So those two things right there are going to be makers of low bone density in the hip joints as well as the vertebrae. You’re going to be significantly altering the loads, plus you’re also going to be overloading particular vertebrae. You’re going to be under loading some of them and overloading some of them. As far as ribs go, if anyone’s been ever following a lot of my work, you’ll find that I talk also a lot – this is in Diastasis Recti – how little the rib cage actually moves. So breathing is a phenomenon where your thoracic cavity, where you beat on it if you were doing Tarzan – that part of your body has to increase in size in order to drop the pressure in order to get more air to come into it, so you have a few different ways of increasing the size of it. Your diaphragm can drop down, which is usually how it’s explained. Just breathe, your diaphragm just drops down and air comes in. It’s like, well, you also have in between every single one of your rib bones, muscles that open the ribs – they kind of flare out all around you, right?


DANI: So cool.


KATY: So –


DANI: And you can feel that, too.


KATY: You can. Some people can. Some people don’t have much of it at all. So if you’ve lost that mobility; if your internal and external intercostals, which are the muscles in between the ribs – those are practically, they’re just atrophied and not working in most people. And when people come, I’ll do a lot of breathing type work where they’ll go into a spinal twist so that their abdomen can’t inflate, and I’ll have them in some position where the only way of really increasing the size of their container is by using their muscles between the ribs, and they can’t even take a breath because there’s no mobility there. They’re thrusting their ribs; they’re doing all kinds of weird things, holding their stomach in and whatnot. All of that over time plus a lack of really using the upper body well, and very – through different rates of breath, you know, on the daily basis are you exerting and breathing deeply, and shouting and all these different natural movements – you just get atrophied muscles in between the ribs, and that’s what’s pulling on the ribs there. So some bones have a job of bearing weight, like your hips. The ribs don’t really bear weight. They’re being pushed and pulled by the activity of the muscles around the area of your thoracic cavity, which don’t do very much. Wrists I would say, once again, you’re just – keyboarding is not weight bearing exercise, you know, so – hanging and, again – hanging – tensile loads are really good for building bones, too, it’s not just compression.


DANI: That’s good to know.



KATY: Tension. Push and pull. Push and pull.


DANI: Push and pull.


KATY: Because it’s still going to have to stay strong to resist pulling. Pulling is something that can potentially fracture – so if you pull gradually, right, all this is transitioning to better bone density – your body responds.


DANI: It’s true. Well, if you notice, people that have problems being on all fours like in an exercise class or whatever, so they avoid that because it hurts, but really – it’s never going to get any stronger if you don’t have that load on it.


KATY: I took a yoga class full of young people – younger than me, I’m 40 now, so they are young people.


DANI: Forty!


KATY: And the number of people on their fists instead of their wrists – the number of people shaking out their wrists due to fatigue, and the main difference – and I knew a lot of them and what their movement behaviors were, the main difference is that they don’t do hanging upper body. Their way of using their wrists is keyboard to full on downward dog – like, full-on weight bearing.


DANI: Right.


KATY: Like, they don’t have a very – of all the things that the wrists can do: pushing and pulling and swinging, all of these other 360 degrees and types of loads, all they do is just bear down on their wrists.


DANI: Uh-huh.


KATY: And I was like, man!


DANI: I have a new saying: it’s wrists for wrists.


KATY: What?


DANI: Fists for wrists, everybody? If you have pain, fists for wrists. Now it’s just wrists for wrists.


KATY: Wow, that required context, because I was like, is that a version of tit for tat? I don’t even know! All right, so yeah – getting into quadruped and being on your hands and knees is painful, like, that’s a sign that you aren’t loading your wrists regularly and well. So make that a priority.


DANI: Which brings us right into what are some changes that we can make to increase the robusticity of our bones? Some basic – for those troubled areas?


KATY: The answer is if you want to increase the robusticity of your bones in a particular area, you need to move in a way that uses that area more. So it’s everything that – everything that I’ve already said? Transitioning to whole body barefoot is also transitioning your body to better bone density. Fixing your diastasis recti is also fixing your bone density. I’ve written the books with particular titles, but I’m not really ever targeting – I put “fix diastasis recti” because that’s how people need to hear it.


DANI: Sure.


KATY: But it really is all this way of moving kind of repairs the entire system. You’re just a system.


DANI: Well, to be fair, you do put “whole body” in all those titles, too.
KATY: I do. I had to, like, I’m like, okay, I will write this book if you let me put “whole body” in the title because you’re not just fixing any single thing. The entire system is flourishing, and you’re reading these stats about these huge incidences, and it’s like, you can look at it in one way, which is – oh my goodness, we have an epidemic, like a disease epidemic on our hands. And that’s the way that it’s portrayed, it’s portrayed as a huge epidemic of disease, but that’s like, that’s like having a whole bunch of people who didn’t eat for 3 days voluntarily saying that there’s an epidemic of hunger, you know what I mean?


DANI: Right.


KATY: It’s just like, if you call – what did we call hunger? We know hunger as like, you just need to eat. Hunger’s just how you feel when you don’t eat. It’s not a disease. If you – and if you looked at the, how your stomach behaves, you know, when you’re on a lack of food – if we started calling those things a disease and started looking for some sort of tablet to decrease stomach acid production, and can I get something to, you know, calm my mind when hunger creeps up – we’re treating these things like diseases rather than, like, if it’s a side effect of not moving. It’s like, well, let’s just talk about the way that is. It’s okay if you still can’t move, but you don’t want the issue to be portrayed as something different than it is, which is – you have to move. There’s a baseline of eating, there’s a baseline of moving, and we are not meeting it. The end! You know.


DANI: Yeah.


KATY: Or the beginning. The beginning.


DANI: Tru dat. Yeah. It’s just finding a boundary and moving on from it.


KATY: Yeah, so anyway – start with Whole Body Barefoot. That would be my thing, is start with Whole Body Barefoot.


DANI: Okay.


KATY: This is the best way to work through my books: Whole Body Barefoot, because I think that if anyone just read that, they would be shifting their whole body kind of everywhere. Move Your DNA, and then Diastasis Recti. Those would probably be getting you pretty golden. You’d feel pretty good.


DANI: Excellent.


KATY: All right. Is that it?


DANI: Did you know that you kind of sound like Amy Poehler? Because I started listening – I’ve read Move Your DNA 3 times, and every once in a while you’ll bring something up and I’ll be like, was that even in there? I thought, you know what, on my morning walks, I’ll start listening to it, because sometimes you just are taking information in a little bit differently oratorally, or aurally, than reading it. And I’ve picked up all this stuff, but you sound a lot like Amy Poehler.


KATY: Only one other person has told me that from a long time ago.


DANI: Everybody’s probably thinking it, just one other person besides me had the guts to say something. That’s awesome, though, it’s fun to listen to. And again, it’s fun to listen to because 3 times I’ve been through it but just in 2 days I’ve picked up all sorts of stuff, like, when was that in the book? Yeah, very interesting. It’s like an everlasting gobstopper of information.


KATY: I know, it’s pretty ridiculous.


DANI: Just keeps coming. And speaking of everlasting awesomeness – can I tell them what’s going on in May?


KATY: Yes.


DANI: For reals?


KATY: Yes. For reals.


DANI: I’m so excited.


KATY: Do it.


DANI: Everybody – so I live in Boulder, CO, which is a pretty cool place, and my friend Katy is coming to Boulder on May 21st.


KATY: Yeah!


DANI: And she’s been here before, but I’m going to show her some cool stuff while she’s here. But she’s also, we’re going to do like a meet & greet, record a podcast at this really cool bookstore, it’s really well known. It’s called, aptly, the Boulder bookstore, but yeah. I hope you all can make it. There’ll be more information on the website and we’ll put some stuff in show notes as we get it – we’re still kind of figuring everything out, but put that on your calendar. Save the date! May 21st.


KATY: Come see us! It’s a save the date! Oh my goodness!


DANI: Oh my god, it’s an STD! That is so cool.


KATY: Did you just say STD?


DANI: I did.


KATY: You’ve been waiting to slip that in.




KATY: Oh my gosh.


DANI: Anyway, that’s – this was fun. I love bones. Thank you for making me think differently about bones.


KATY: Yes. And thank you for having bones, because this podcast could be very hard to do if you did not have a skeleton.


DANI: I’m so happy I do.


KATY: Well, thank you all for listening. For more information, books, online classes, etc., you can find me at, and you can learn more about Dani Hemmat, bone-haver and osteoblast coach movement warrior, at


DANI: Bye, everybody!


We hope you find the general information on biomechanics, movement, and alignment informative and helpful. But it is not intended to replace medical advice, and should not be used as such.




Whole Body Barefoot



FIRST EDITION Move Your DNA: Restore Your Health Through Natural Movement


DR Book:


Wet Bones (good for challenging common bone assumptions):


Fun Osteoporosis Resources: (not really)



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