x
Site Logo

Tag: bone health

Mini Pause #93: If getting up hurt this morning, this is for you.

Posted on by stephanie-estima

TL;DR

If your first few steps in the morning suddenly feel like you’re walking on knives… congrats! You have what I am lovingly calling a sleeping injury.

You know, something that popped up out of the blue in midlife that would have never happened in your 20s before your body needed an engraved invitation to function at a bare minimum?

Welcome to the era where collagen turnover moves at the speed of continental drift and your fascia files a formal HR complaint every time you dare to stand up.

Today, we’re talking specifically about plantar fasciitis (or more accurately, plantar fasciopathy).

WHY

Your fascia doesn’t track macros. It tracks load, repetition, and how many times you’ve sprinted in bad shoes while late for school pickup. You can stretch, eat your protein, lift heavy weights, and still wake up one morning unable to walk to the bathroom without cursing the gravitational pull that requires you to be vertical.

Plantar fasciitis is the #1 cause of heel pain and ranks in the top 10 issues women deal with in perimenopause and menopause.

Under a microscope, chronic plantar heel pain shows collagen wear-and-tear (“fasciosis”) rather than classic inflammation. Your fascia is the exhausted overworked intern of your musculoskeletal system – underpaid, under-rested, and starting to crack. PubMed

Women are the chosen ones. Perimenopause is like a years-long endurance test to see what we’re really made of… at least that’s what I’m telling myself because there HAS to be a reason we’re playing whack-a-mole with our midlife ailments!

Here’s the kicker (because I know you’re loving all this great news): As estrogen falls, your tendons and fascia lose elasticity and resilience.

Estrogen normally keeps collagen supple and tissues hydrated. Without it, those tissues become stiffer and slower to repair – so any repeated load (heels, chasing kids, strength training) can push your fascia past its limit. With no warning. PubMed Central+2BioMed Central+2

Babies, Parties, and Ugly Shoes

If you’ve had kids, pregnancy, post-partum, and perimenopause make a charming tag team. Weight gain in pregnancy plus ligament laxity (relaxin) flattens the arches and can permanently lengthen the foot, raising plantar‑fascia strain. PubMed Central+1

I remember my foot went up an entire size in the 2 years following the birth of my children! Add in years of narrow shoes or heels, and, well… you get the picture. PubMed Central+1

Now, ya girl here loves her a good pointy heel in a dress when the time and occasion call for it. So I’m not saying never wear heels! I’m just saying, can we choose shoes with a wide base (where the toes are) and no heel most of the time?

It's like our diet. It's not like you can never have chocolate. It’s no problem when your diet is made up of primarily good protein, fruits, and veg.

I have recently discovered a brand of shoes, Saguaro (use code BETTER for 10% off!), that are both cute and inexpensive (my fave combo!) that I am using for everything – leg day, walks, and my Z2 stairmaster cardio days.

Now, usually functional footwear is ugly (sorry not sorry), but these are so good I even have buy-in from my husband, who, if you know him, has a pretty sizeable sneaker collection.

Put Ya Dang Feet Up

Other big risk factors for plantar fasciitis are obesity, long hours on hard floors, and tight calves (reduced ankle dorsiflexion).

And again, women are over‑represented in many standing occupations like nurses, waitresses, flight attendants, etc, so get yourself some good shoes ASAP. PubMed

 

HOW

In my clinic, the telltale sign of plantar fasciitis was tenderness at the medial calcaneal tubercle (inner side of the heel bone). Or, I could reproduce the pain – and risk an ear-piercing scream from my patient – by lifting the big toe back for the windlass test. NCBI

Once that was confirmed, we started rehabbing.

Fix Your Footwear

  • If your shoes taper like a carrot, they’re strangling your fascia. Swap out the narrow ballerina flats with a wide-toe box. Minimize heel wearing for now.

Stretch It Out

  • Do that windlass stretch. Sit down, cross the sore foot over the other knee, grasp the toes, and pull them up. Hold for 10-20 seconds, 10 reps, 2-3x/day. PubMed+1

Load It Slowly

  • You can’t ice your way out of a load problem. Do high-load heel raises with your toes on a towel (for dorsiflexion). Do 3 sets of 8-12 reps at a slow tempo and add weight as tolerated. PubMed
  • You can add intrinsic foot work like short-foot holds (press the ball of your foot down without curling your toes) or towel curls to support the arch, which acts as your fascia’s bodyguard. PubMed Central

Help It Along

  • Use kinesiotape for the first 3-7 days to unload the fascia. You’ll likely need a practitioner’s help. BioMed Central
  • Wear circulation socks if morning pain is brutal. I like the ones from Incrediwear (use code DRSTEPH20 for 20% off)
  • Do some gentle rolling with a lacrosse or yoga ball

 

NOW

Here’s your 2-week Mini Pause protocol for plantar fasciitis:

Days 1-3

  • Switch to a wide toe box shoe for everyday life (code BETTER for 10% off)
  • Do the windlass stretch 10× (10–20 s) morning & evening and roll foot 1–2 minutes after stretches. PubMed
  • Apply taping if first‑step pain is high and re‑tape every 48–72 h for up to one week. BioMed Central
  • Sleep in circulation socks (code DRSTEPH20 for 20% off)

Days 4-7

  • Start high‑load heel raises with towel under toes: 3×/week, 3×8–12 slow reps (add a backpack or weighted vest for load). PubMed
  • Add short‑foot holds (10×10 s) daily. PubMed Central
  • Avoid long static standing and any heel‑dominated shoes. OUP Academic

Week 2

  • Keep stretching daily; continue heel‑raise progression.
  • If mornings are still rough, try a night splint for 2–4 weeks. MLTJ

Still >5/10 pain with first steps after 2–3 weeks of consistency?

Book a doctor’s visit (chiropractor or physical therapist preferred if you have one!) to confirm the diagnosis, optimize loading, and look at more aggressive care.

Bottom Line

Plantar fasciitis isn’t a forever injury. It’s a tissue tolerance problem. Basically adaptive biology in a bad mood.

Load it right, support it smartly, and remember that the goal is to future-proof your facia so your next decade isn’t spent limping before coffee.

 

Sending you soft heels,

Dr. Stephanie

 

WHAT I'M LOVING THIS WEEK

BiOptimizers Magnesium Breakthrough¹

A few years ago, I hit that “tired and wired” era. I’d be at the clinic treating patients all day, squeeze in my training, be full-on with the kids, and then collapse into bed exhausted after winning bedtime battles… and then… nothing.

My brain would rev like a Formula 1 car. I’d wake up in the morning and feel sore as hell from my workout and be completely demotivated to get out of bed, let alone back to the gym.

As a practitioner, it was a lightbulb moment. I need magnesium, and I needed it fast.

Ever since, I have taken magnesium nightly after dinner – non-negotiable. Within a week of starting, I wasn’t clenching my jaw. I wasn’t waking up at 3 AM replaying my to-do list. My muscles were ready to go crush a lift.

Now, not all magnesium is created equally. Most supplements only cover one or two forms, which is like giving your body a screwdriver when it needs a toolbox.

I use Magnesium Breakthrough from BIOptimizers because it has all seven forms of magnesium I want.

For women in midlife, cortisol is a moving target, and sleep feels like an Olympic event. Magnesium is your ticket to downshifting your nervous system without wine or willpower. It’s like an exhale in a capsule.

Try BIOptimizers and get a good rest. Be sure to use code ESTIMA for 15% off.

 

Attn: Grace Hybrid Pads2

Periods and bladder leaks… excuse me, but why did nobody warn us about this absolute faceplant of a combination?!

Perimenopause can lead to the return of high school-level period chaos, like the encore performance no one wanted. Add in some post-baby, midlife pelvic floor weakness, and you’ve got yourself a real party.

But period products aren’t made to absorb bladder leaks and the bladder leak products don’t deal with the menstrual cycle needs, and honestly… who wants to feel like they’re in a diaper in their 40s?!

Attn: Grace’s Hybrid Pads have become my default recommendation for women who whisper about bladder leaks or wild periods that have never met a calendar they couldn’t defy.

I absolutely love the women behind Attn: Grace because they treat midlife bodies like the sophisticated, powerful, sometimes unpredictable systems they are. They are all about keeping dignity as a top priority.

I want you to feel cared for, not managed or shoved to the side. You deserve these shockingly comfortable pads that keep all the toxins far away.

Try Attn: Grace’s Hybrid Pads now, and check out their full collection to get exactly what you need for the body you have right now. Use code ESTIMA20 for 20% off your first order on attngrace.com

 

Manukora Honey

When I was deep in postpartum recovery, I became obsessed with immune resilience and gut repair. The clock had started on 20+ years of kids counting on me to show up, and getting sick was not something I would have time for anymore.

I dug into the research (some people scroll Instagram, I scroll PubMed – don’t judge) and found that my kale and kombucha weren’t going to be enough anymore. I needed honey… and not just any honey. Manuka honey.

Manuka honey is unique because it contains methyglyoxal (MGO), a compound that gives it antimicrobial and anti-inflammatory power. Clinical data backs it to support wound healing, oral bacteria balance, and stronger gut mucosa.

Sign. Me. Up!

I keep a jar of Manukora MGO 850+ Manuka Honey on my counter and guard it like liquid gold. If I’m feeling ambitious, I’ll stir a spoonful into a cup of tea or a bowl of oatmeal. If I’m any level of rundown, I’m SO not above just downing it straight off the spoon.

The taste is WILD… earthy, floral, and caramel-y. It’s like medicine that forgot to taste like a punishment.

Every batch of Manukora honey is tested for purity and MGO levels, and every jar has a scannable QR code that traces it right back to the hive.

Biohacking on a spoon? Get yours now to save up to 31% plus $25 worth of free gifts with the Starter Kit, which comes with an MGO 850+ Manuka Honey jar, 5 honey travel sticks, a wooden spoon, and a guidebook!

 

🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

 

 

Disclaimer: The information included in a newsletter, email, or on drstephanieestima.com is intended solely for educational purposes. It does not replace a direct relationship with your licensed medical provider and is not intended to diagnose, treat, cure, or prevent any disease.

Affiliate Disclosure: Products mentioned in a newsletter, email, or on drstephanieestima.com, may be part of an affiliate agreement in which Dr. Stephanie Estima receives a small commission on the sale of an item you purchase.

Notes:

1. Use code ESTIMA for 15% off

2. Use code ESTIMA20 for 20% off your first order

 

 

Mini Pause #90: How to Heal the Vibes

Posted on by stephanie-estima

Well, Bettys, after the Mini Pause about vibration training a couple weeks ago, you had questions. I absolutely love it when my inbox lights up after a Mini Pause because it tells me how much the topic resonated with you.

Two of you (and no joke – both were named Amy!) sent in questions about how I personally use my vibration plate and how to set the dials for midlife bodies with real-life challenges.

So, let's get into it. Vibration training isn't just a fancy washing machine. It's science-backed, joint-friendly, and surprisingly powerful for tendons, ligaments, bone health, and even the pelvic floor! (We haven't talked about the last one yet, so make sure you read to the end!)

WHY

Oooh the science of the shake.

Vibration training works because it taps into something called the tonic vibration reflex. Basically, that means you recruit muscle without needing heavy loads. This is certified gold when joints, tendons, or injuries limit your options. PMC

The strongest evidence shows vibration helps:

  • Ligament recovery after injury or surgery
  • Chronic tendon pain (patellar and Achilles tendinopathy)
  • Knee osteoarthritis – the #1 disability in older adults
  • Balance in older adults (fewer falls = fewer fractures)
  • Lymphatic health when paired with manual therapy PubMed

And for women in midlife? Add bone support, joint comfort, and pelvis floor activation to that list. Medical Journals

You'll generally see vibration therapy talked about in one of two ways:

Whole-Body Vibration (WBV): You stand or squat on a platform. Key things to note are going to be frequency (Hz), amplitude (mm), time (seconds/set, sets/session), and posture or position (knee angle, stance).

Local Vibrotherapy: A localized device that is going to deliver gentle mechanical signals to a specific body area (used in some lymphatic and pelvic-floor contexts).

For our purposes today, we're talking about the WBV vibration plate. I get into all my specific recommendations below.

HOW

For those of you asking how I use vibration, I've laid out my preferred methods below. I use my PowerPlate most often following a sprinting session as recovery for my tendons and ligaments. I set it at a moderate frequency (~30 Hz), and just stand there for 9 minutes while I shake it off.

I will also pair this with Kegels and pelvic floor exercises (see below!) during this time too. It's surprisingly very hard to do this!

Here's how I use vibration training myself, and how you can tailor it to your goals:

Ligament Injuries (like ACL or ankle sprains)
Vibration training is helpful for ligament injuries because the oscillations “wake up” fibroblasts (collagen-producing cells) to remodel along the correct lines of stress, helping the ligament to safely adapt to new loads.

  • Frequency: Start low (10-20 Hz) and progress toward 20-30 Hz as tolerated.
  • Position: Knees bent ~20-30°
  • Exercise: 6-8 sets x 60-90 seconds each. Rest 60-90 seconds in between sets.
  • Schedule: 3-5 x per week

Tendon Injuries (Patellar or Achilles Tendinopathy)
Dark Roast Bettys: Based on this RCT, pain and function improved similarly to heavy-slow resistance training, which is great if you are unable to train. If you can train, I would combine the two. PMC

Patellar Tendon

  • Frequency: ~30 Hz
  • Position: Static knee angle ~50°
  • Exercise: 10 sets x 60 seconds. Rest 60 seconds between sets.
  • Schedule: 3 x per week for 12 weeks

Achilles Tendon

  • Frequency: ~30 Hz
  • Position: Slight hip/knee flex with heels on the platform edge for a stretch.
  • Exercise: 6-10 sets x 45-60 seconds. Rest 45-60 seconds between sets.
  • Schedule: 3 x per week for 12 weeks
  • **Pro Tip: Pair this with progressive calf loading on non-vibration days for even better results.

Bone Health (Osteopenia/Osteoporosis Prevention and Support)
We can use the vibration plate to provide safe, frequent mechanical signals for bone remodelling.

Dark Roast Bettys: A 2023 meta-analysis favors higher frequency and cumulative dose at low magnitude; a 2021 RCT using ~10min/day reported microstructural benefits. I strongly believe that this needs to happen alongside training, and, of course, paired with protein, vitamin D, calcium, impact, and regular walking. PubMed

  • Frequency: ~30 Hz
  • Position: Standing
  • Exercise: 10 minutes per day
  • Schedule: Most days of the week

Knee Osteoarthritis
Don't give up on movement if your knees are stiff! The vibration plate can be used to reduce pain, improve mobility, and support strength.

Dark Roast Bettys: Meta-analyses show vibration training and exercise improve pain and function more than exercise alone. Medical Journals Sweden

  • Frequency: 20-30 Hz
  • Position: Mini-squat holds (20-30°) and side-step holds.
  • Exercise: 5-10 sets x 45-60 seconds. Rest 45-60 seconds in between each set.
  • Schedule: 2-3 x per week

Pelvic Floor Training (Stress Incontinence and Strength)
No one wants to talk about it, but we need to work our pelvic floors. We can (and I do!) use the vibration plate to improve activation when traditional pelvic floor exercises are tough to feel. If the program below isn't hitting it for you, try it in a sumo squat stance or with your knees on the platform.

Dark Roast Bettys: WBV improved pelvic-floor strength and quality of life similarly to supervised PFMT at 4 weeks and 3-month follow-up. Use cues to co-contract the pelvic floor during sets. PMC+1

  • Frequency: Start at 30 Hz, then progress up to 40 Hz over time.
  • Position: Standing (or kneeling) kegels.
  • Exercise: 15-20 second hold x 15-20 reps. Rest 5-10 seconds in between each set. Follow with quick contractions of 2-second hold + 1-second release x 20-30 reps.
  • Schedule: 3 x per week
  • Pro Tip: Imagine you're gently pulling a blueberry up and into your vagina. Strange visual, I know, but it's incredibly effective.

General Dial Guide
A couple of notes to write down on a sticky note near your vibration plate:

  • Low (10-20 Hz) → circulation, early rehab
  • Moderate (20-35 Hz) → tendon and balance work
  • Higher (35-45 Hz) → advanced strength and balance
  • Knees always softly bent. Never locked.

Contraindications for Vibration Therapy:
It is GRAS (generally regarded as safe), but if you are pregnant, have a fresh fracture, severe disc disease, uncontrolled cardiovascular disease, epilepsy, bone tumors, or a major head injury, these would automatically preclude you from participating in vibration therapy. As with anything, you MUST clear any new activity with your primary healthcare provider before starting. PMC

NOW

If you've got a vibration plate collecting dust (or on your Black Friday list!), here's your homework:

  • Beginners: Stand quietly at 20-25 Hz for 5 minutes. Knees bent, breathing steady. See how you feel.
  • Intermediate: Add mini-squat holds or a tall kneel position.
  • Curious? Try one pelvic floor session on the platform. Trust me. You'll feel it.

Remember: vibration training isn't a replacement for progressive overload. Weights > plates, like I've said before. But for women in midlife, it's a smart complement – especially if you're managing joint pain, ligament injuries, or bone density issues.

So, are you shaking things up yet? If you've tried it, tell me how it felt. Blueberry cues and all!

 

Warmly,

Dr. Stephanie

WHAT I LOVE THIS WEEK

Just Thrive

Gut health affects literally everything. Your energy, sleep, mood, brain function, immune system, and even how well you absorb nutrients from food.

The one stat that will never not blow my mind: Up to 95% of your serotonin is actually made in your gut, not your brain.

Okay, great. You're taking probiotics, so you're good, right?

Yikes. Not so fast. Most probiotics are dead on arrival. They can't survive your stomach acid, which means they can't do their job.

I've switched to probiotics from Just Thrive because they're clinically proven to arrive 100% alive in your gut. Way, way, way more bang for your buck.

It's so hardy that the probiotics goodness survives coffee and even the blender, and it's good enough for the whole family.

If your gut's been giving you grief, or you just want to optimize your body with better digestion, less bloating, and steadier energy throughout the day, Just Thrive is worth a try.

Use code BETTER for 20% off.¹

LVLUP

Did anyone warn you that perimenopause would absolutely wreck your gut? No one told me!

If you're suddenly dealing with bloating, reflux, and random food sensitivities, I promise you: It's not all in your head.

As estrogen and progesterone decline, they directly impact gut motility, microbiome balance, and your gut barrier integrity.

A compromised gut lining wreaks havoc on your ability to absorb nutrients. It cranks up inflammation and worsens hormonal symptoms because you're not able to detoxify well.

I've been impressed with LVLUP Health's Ultimate GI Repair.

It's a clinical-grade formula with peptides like BPC-157 and GHK-Cu that actually repair the gut lining, plus larazotide to seal leaky gut, and tributyrin and zinc L-carnosine to calm inflammation.

This isn't your average gut supplement. It targets root causes, not just symptoms.

If perimenopause has your gut in chaos, use code DRSTEPHANIE for 15% off when you try LVLUP.

🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

1 Just Thrive ships worldwide. Code BETTER will work for all orders and first-time subscriptions. Terms and conditions may apply.

 

Mini Pause #88: Can vibration protect your bones and tendons?

Posted on by stephanie-estima

Have you ever seen those vibrating platforms tucked away in the corner of the gym? It might look gimmicky, but I promise it's not a shakeweight situation. Research shows that whole-body vibration (WBV) is actually a goldmine for your tendons, ligaments, and bones.

I had one in my clinic for years, and it was a staple in rehab and prehab. I still use it every day.

It is right for you? Hop in my Jeep, keep your arms and legs inside the vehicle at all times, and please do not feed the animals any of your emergency granola.

We're going on a nerd safari!

WHY

Midlife comes with a few big realities:

  • Tendons heal slower
  • Joints feel stiffer
  • Bones aren't as forgiving as they used to be
  • Injuries take longer to recover
  • Bone density is a group project, and you're stuck doing all the work

I hate to be the one to bring you all this delightful news, but I love you too much to keep the truth from you.

WBV (remember: whole-body vibration) is a gentle wake-up call to your tissues. It's a way to stimulate healing and repair without pound-pound-pounding on your poor joints.

For women in midlife navigating perimenopause and menopause, this can be a game-changer.

HOW

Here's the science of how WBV works:

  • Tendons and Ligaments:
    Vibration creates micro-stretching at the cellular level, stimulating fibroblasts (cells that make connective tissue) to make more collagen (the scaffolding of these tissues). It also boosts nitric oxide (NO), which helps improve blood flow to areas that rarely get it. Over time, tendons actually stiffen in a good way, making them stronger and more resilient.
  • Bones:
    WBV acts like mini-impact training. Vibrations activate bone-building cells (osteoblasts), improve fluid flow through bone canals (for my dark roast Bettys, if you want to go down the rabbit hole of the lacunar-canalicular system, that is what I'm referencing), and even suppress the cells responsible for breaking done bone. It's like sneaking in bone density training without jumping, sprinting, or lifting heavy. But psst… don't stop lifting heavy!
  • Balance and Neuromuscular Control:
    WBV triggers rapid muscle contractions, sharpening your stability. More balance means fewer falls, which translates to fewer fractures. Even if you're not tippy right now, it's smart to get on top of it before your tippy years hit.

In my clinic, I used a plate to help rehab Achilles or patellar tendinopathies, rotator cuff injuries, chronic ankle or knee sprains, and osteoarthritis with joint stiffness.

Aside from acute injury, the women who will benefit most from WBV are those with tendon pain, osteopenia, osteoporosis, joint pain, or anyone who can't yet tolerate high-impact training.

NOW

So, should you and your girlfriends all Secret Santa vibration plates to one another this year?

I'm a big proponent of a vibration plate, and I use my Power Plate every day. In my weekly training, I am doing a lot of high-impact activities like sprinting and weight lifting, so vibration helps prevent injuries and improve tissue tolerance.

The connective tissue and bone benefits overlap because the same signals of mechanical load, nitric oxide release, IGF-1, and collagen synthesis are shared across tissues. WBV is like giving your musculoskeletal system a gentle “shake” that wakes up repair pathways without over-stressing them.

Now, WBV is not a replacement for progressive overload (weights > plates). But it's an incredible add-on or bridge. Here's how I'd recommend using it:

  • Use it during rehab if your tendons, ligaments, or joints aren't ready for a heavy load yet.
  • Layer it into your bone-health strategy if you're at risk of osteoporosis.
  • Add it as a primer to improve circulation, healing, and balance before lifting or sprinting.

It's like a little love note to your muscles, tendons, and bones that says, “I see you. I'm taking care of you. I want you with me for the long haul.”

I'm curious. Have you ever tried standing on a vibration platform? Did it feel like a helpful tool, or just like a fancy washing machine?

 

Shake it up, baby.

Dr. Stephanie

 

P.S. Have you saved your spot for the first session of my YES coaching program? I'm offering the first live coaching session completely free, and when you sign up, you'll unlock a special discount code for the rest of the program.

YES is my framework for optimal muscles, metabolism, meals, hormones and more in midlife. It's a deep dive into the protocols I use for myself and my clients.

Together, we'll explore how to build bone density and protect it for decades ahead, why your hormones, recovery, and metabolism need a seat at the table, and how to eat like you're building something (because you are!).

Oh, and we'll be doing a full session on the truth about cardio. Let's make sure you're doing what's most effective and not wasting your time.

YES makes you a mega-promise: No quick fixes. We're building a foundation that will carry you powerfully through midlife and beyond.

Sign up for the first live coaching session of YES, totally free here.

WHAT I LOVE THIS WEEK

The Sleep Technology That Ended My “Sleep Divorce”

Read my full story about the way this affected my marriage.

For two years, hot flashes kept me and my husband in separate bedrooms. I tried every trick in the book. Cooling pillows, fans, even ice packs. But nothing worked consistently until I started using Eight Sleep's Pod 5 with Hot Flash Mode. I'm not exaggerating when I say it changed everything.

The Pod 5 uses precision temperature control to keep my side of the bed icy-cool while keeping his side warm. When a hot flash hits, I can tap the app and instantly activate the emergency cooling. It often prevents the flare before it fully wakes me up.

Clinical data shows Pod 5 reduces hot flashes by 52%, but here's what it actually gave me:

  • One extra hour of quality sleep per night
  • Mornings where I actually feel like myself
  • My marriage. No joke.

For the first time in years, we're comfortably sleeping in the same bed all night long.

If hot flashes or night sweats are stealing your peace, this is the solution I trust.

Get $350 off and free 30-day returns on the Pod 5 Ultra with code DRSTEPHANIE.¹

Sweet dreams, Betty!


The Protein That Actually Tastes Like Food (Not Powder)

Why do most protein powders taste like chalky disappointment? I've tried countless brands that promise “great flavor” that are actually barely edible.

The only protein powder you’ll find in my kitchen is Equip’s Prime Protein.

It's a 100% grass-fed beef isolate with the same nutrient profile as 4 ounces of steak. I’m talking about protein, collagen, and micronutrients that support joint health and recovery. The beef source means better amino acid absorption compared to plant proteins and none of the dairy allergens that can trigger gut issues.

I blend Prime into my morning smoothies, mix it into my protein oats, and bake with it all the time. The chocolate flavor makes incredible protein muffins that taste like dessert. It even passed the taste test with my kids.

Okay, now here’s the really fun news. Until September 23, your code DRSTEPHANIE gets you exclusive access to Equip’s flash sale on Prime Protein and Prime Bars.

Your blood sugar, your gut, and your taste buds all got together and told me you’re going to love it.²

The Recovery Secret That's Been Hiding in Plain Sight

There's a product that has come out of the woodwork and completely, unexpectedly revolutionized my post-workout routine.

It's Incrediwear's bamboo charcoal-infused gear, and I'm not messing around when I say it has flipped my recovery on its head.

After aggressive pickleball sessions or sprint intervals, my knees used to ache for days. Now, I slip on their knee sleeve immediately after training and that lingering soreness is dramatically reduced.

The science is fascinating. The bamboo charcoal fibers increase blood flow at the cellular level without compression. You're getting faster healing, reduced inflammation, and you don't have to worry about feeling squeezed like a sausage.

Their socks have become a non-negotiable for travel and recovery days to keep my circulation flowing naturally. I'm not above wearing them to bed, either!

With Incrediwear, better circulation is working behind the scenes. It's not magic – it's science. It's smart fabric technology supporting what your body already wants to do: heal and recover efficiently.

Try Incrediwear with code DrSteph20 for 20% off. Your joints will thank you!³

🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

1 Ships to US, Canada, UK, Mexico, EU, and Australia Terms and conditions may apply.

2 Ships worldwide. Code valid on first-time orders or first subscriptions (unless a special sale is running). Terms and conditions may apply.

³ Ships internationally. Terms and conditions may apply.

 

Mini Pause #68: Why Plyos Are Essential for Women Over 40

Posted on by stephanie-estima

🌸 SPECIAL MOTHER’S DAY GUIDE

This Mother’s Day, I want to remind my fellow mamas and all of my Bettys of something incredibly important: you deserve to be deeply nourished.

With this in mind, I’ve put together a Mom’s Day guide that will show you how to give yourself the most luxurious day possible. I’m also including free goodies and extra discounts on my self-care favs so you can pamper yourself without guilt.

Whether you follow it step-by-step or are simply inspired to take a few moments for yourself, believe that you deserve ALL of it! Today and every day. Here’s your 24-hour guide for resting, recharging, and treating yourself like the Queen you are.

Why Plyos Are Essential for Women Over 40

TL; DR (Too Long; Didn't Read)

Plyometric exercises—jumping, bounding, explosive movements—are crucial for women over 40.

They enhance muscle strength, improve bone density, boost metabolism, and increase joint stability, helping you age actively and vibrantly.

In this issue, you’ll find a sample beginner, intermediate, and advanced plyo routine to suit you.

WHY THIS MATTERS

As we age, especially if we are not intentional during perimenopause and menopause, women will naturally experience declines in muscle mass, bone density, and joint stability.

Incorporating plyometric movements into your routine helps combat these age-related changes, making daily activities easier and reducing the risk of injury.

WHAT PLYOS DO FOR YOUR BODY

💪 Muscle Strength and Power: Plyometrics build powerful muscles by targeting type 2B fast-twitch muscle fibers. These are primarily responsible for explosive, powerful movements.

  • These muscle fibers are the first to degrade with age, significantly impacting power, strength, and quick reaction times. Plyometric training has an anabolic effect, stimulating muscle growth and enhancing overall muscular strength and power.

  • Enhanced proprioception (body awareness) from plyometric movements further supports muscle strength by improving neuromuscular coordination, reducing the risk of falls, and promoting mobility.

🦴 Bone Health: Explosive movements stimulate osteoblasts, the cells responsible for bone formation, thereby enhancing bone strength. This action counters osteoclasts, the cells responsible for breaking down bone.

  • During perimenopause and menopause, women experience a shift favoring osteoclast (bone breakdown) activity, leading to decreased bone density and increased osteoporosis risk. By promoting osteoblast activity through plyometric exercises, women can significantly mitigate these effects and maintain stronger, healthier bones.

💥 Metabolism Boost: High-intensity plyometric workouts increase calorie burn during exercise due to their demanding nature, and they continue to elevate metabolism afterward through a process known as Excess Post-exercise Oxygen Consumption (EPOC). This mechanism helps the body recover by replenishing oxygen stores, repairing muscle tissues, and removing metabolic waste, resulting in sustained calorie burning even after the workout has ended.

HOW

Beginner Program (once a week):

  • Box or Step Jumps: 2 sets of 5 reps at a moderate height (this will depend on your height)

  • Jumping Jacks: 2 sets of 10 reps

  • Squat Jumps: 2 sets of 5 reps, focusing on a gentle landing

Intermediate Program (twice a week):

  • Box or Step Jumps: 3 sets of 10 reps, moderate height

  • Skater Jumps: 3 sets of 10 reps each side

  • Squat Jumps: 3 sets of 10 reps, increasing explosiveness

Advanced Program (2-3 times a week):

  • High Box Jumps: 4 sets of 8-10 reps at a challenging height

  • Skater Jumps with Speed: 4 sets of 15 reps each side

  • Tuck Jumps: 4 sets of 8 reps, aiming for maximum height

Increase intensity and reps gradually based on your fitness level and comfort.

NOW

➡️ Ease into It: Begin gently and focus on proper form to prevent injury. This step is everything, and the key is proper form. If you’re unsure, start with the beginner program, even if you have some experience with plyometrics.

➡️ Combine with Strength Training: Incorporate plyometric moves 1-2 times weekly, balanced with strength training. Remember, weightlifting should be the foundation of your fitness program.

➡️ Consistency and Recovery are Key: Regular, moderate plyometric workouts bring sustained health benefits. When you first start, you may notice yourself feeling more tired afterwards, or your muscles, such as your calves, may be unusually sore—this is normal and expected! You might consider giving yourself a lot of recovery time in the first few weeks as your muscles are remodeling and building new type 2b fibers. Slowly graduate up from there. Pinky promise?

What I Recommend

HOW TO SUPPORT MIDLIFE GUT HEALTH CHANGES

Midlife hormonal changes can wreak havoc on your gut health. LvlUp’s Ultimate GI Repair combines powerful gut-healing peptides, including BPC-157, Larazotide Acetate, and KPV, with gut-nourishing natural ingredients, such as zinc L-Carnosine, EMIQ, Quercetin, and Tributyrin, to soothe your changing digestion.

Learn more about LvlUp peptides at https://lvluphealth.com/DRSTEPHANIE and use code DRSTEPHANIE for 15% off.

HOW TO GET MORE GREENS IN YOUR DIET

One of my favorite products just got a major upgrade! To help meet my nutrition goals, I regularly drink AG1 because it’s simple and effective. And now, the new AG1 Next Gen is backed by four new human clinical trials, which have been shown to address common nutrient gaps, increase healthy gut bacteria, and promote gut health.

AG1 Next Gen is optimized for absorption and impact, featuring added vitamins and minerals, and an enhanced probiotic blend. It’s more comprehensive than ever, helping to support your immune health, gut health, energy, and more.

If you haven’t yet tried AG1, it’s a great time to subscribe. When you use my link, you’ll also get a FREE bottle of AG D3K2, an AG1 Welcome Kit, AND 5 of the upgraded AG1 travel packs with your first order! Go to DrinkAG1.com/stephanie to get started.

🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

Mini Pause #67: Natural Ways to Boost Bone Density

Posted on by stephanie-estima

TL; DR (Too Long; Didn't Read)

Maintaining bone density naturally becomes crucial as we age due to shifts in bone metabolism.

Osteopenia, the gradual loss of bone density, is a decades-long process that accelerates significantly during perimenopause and menopause, increasing the risk of osteoporosis.

Bones are dynamic tissues consisting of cortical (outer shell) and cancellous (inner, marrow-rich) bone, both of which change significantly with age.

Increasing bone density through strength training, plyometrics, walking, and adopting nutritional strategies is essential for maintaining overall health, regulating metabolism, and achieving optimal body composition.

WHY

Bone density naturally declines as we age because osteoclastic activity (bone breakdown) outpaces osteoblastic activity (bone formation). This process accelerates dramatically during perimenopause due to hormonal changes, particularly declining estrogen levels.

Estrogen supports bone density by inhibiting osteoclast activity (reducing bone breakdown) and promoting osteoblast activity (enhancing bone formation), thereby maintaining a balanced bone remodeling process.

Bones aren't just structural; they actively secrete hormones such as osteocalcin. This influences metabolism, insulin sensitivity, muscle function, and overall body composition.

WHAT

  • Cortical Bone: Dense outer shell providing structural support.

  • Cancellous Bone: Porous, spongy interior housing bone marrow, essential for metabolic and structural roles.

As we age, cancellous bone density decreases, making bones more susceptible to fractures.

Bone-derived hormones like osteocalcin regulate metabolism by enhancing insulin secretion and sensitivity, promoting glucose uptake by muscle tissue, increasing energy expenditure, and improving overall metabolic health and body composition.

Bones are the scaffolding of the body, but they are also active endocrine organs.

HOW

Practical ways to increase bone density naturally:

  • Strength Training: Increases mechanical load on bones, stimulating osteoblastic activity. Aim for consistent, progressive resistance exercises. 💪

  • Plyometrics (Jumping Exercises): Improves bone density through high-impact activities, encouraging stronger bone formation. Examples include jump squats, box jumps, jumping jacks, skipping rope, and squat jumps. I personally love to do plyos on a step (complete with my leg warmers and off-the-shoulder top). ‼️

  • Walking: Regular weight-bearing activity is gentle yet effective for maintaining and improving bone density. 👟

    • Try Magnesium Breakthrough and use code ESTIMA to get 10% off.

    • For vitamins, click HERE and you’ll get an automatic pop-up box discount for 25% off.

    • Getting enough protein is easy with 8 flavors of grass-fed beef isolate goodness. Click HERE and use code BETTER to get 20% off.

  • Nutrition: Ensure adequate intake of magnesium, vitamin D, vitamin K2, and protein to support bone formation. 🦴

  • Sunlight Exposure: Enhances vitamin D synthesis, crucial for calcium absorption and bone health. ☀️

NOW

➡️ Choose one of the above that you are currently not doing and start integrating these bone-strengthening practices into your routine immediately.

➡️ Schedule regular strength and plyometric training sessions, daily walks, and supplements into your calendar or set reminders on your phone! This is one of my best tips for remembering to get all these little habits dialled in.

What I Recommend

TAME STRESS WITH THE RIGHT COLLAGEN

Stress does number on your body. Cortisol, the primary stress hormone, directly breaks down collagen, leading to deterioration of skin and connective tissue. Chronic stress not only accelerates collagen breakdown but also disrupts skin barrier function, leading to increased water loss and dryness. High stress elevates cortisol, promoting glycation, which causes collagen fibers to stiffen, resulting in skin wrinkles and dullness over time.

That's why you want a bioactive collagen that effectively counters the effects of stress!

  • Avoid Heat Degradation: High temperatures can break down collagen into less effective amino acids, reducing digestibility and bioavailability. Heat degradation creates cross-links within the collagen structure, making it more gelatin-like, less soluble, and harder for the body to absorb. This is why controlled low-heat processing, like Health Nag’s patented laser technology, preserves collagen’s full bioactivity and effectiveness.

  • Choose Hydrolyzed: Non-hydrolyzed collagen is ineffective because it’s too large to be absorbed. Hydrolyzed collagen is broken down into small peptides that cross the gut lining and are bioavailable to support collagen synthesis in skin, joints, and other tissues. Hydrolysis is key for any collagen to exert real benefits.

🍏 Health Nag’s collagen offers the most unique gel form I’ve seen on the market. And wow!—the delicious green apple flavor doesn’t disappoint. And just in time for spring and summer, Health Nag launched its bioactive collagen jelly in individual packets. Super convenient when you’re on the go or traveling! Learn more and try it HERE. Use code DRSTEPHANIE to save 10%.

KICK-START YOUR PERFORMANCE, ENERGY & FOCUS

I’ve been turning to ketones regularly in the morning before my workouts. Ketone-IQ gives me the fuel I need to power my favorite strength moves in the gym. Check out these mainstay benefits:

  • Appetite Control: Helps manage hunger by promoting a state of satiety. (Pro tip for my Bettys who find it hard to eat before early morning workouts.)

  • Energy & Focus: Provides a fast and steady energy source that crosses the blood-brain barrier. (I have the energy to focus on my workout and also maintain mental clarity to plan and think through my workday.)

  • Performance & Recovery: Enhances physical endurance and speeds up recovery by supporting mitochondrial function. (I don’t cut corners when it comes to recovery, but I do like the benefits of recovering more quickly and efficiently.

💥 Try Ketone-IQ (with or without caffeine) in several flavors: peach or green apple for me, please! Visit https://ketone.com/STEPHANIE to get 30% off your first subscription order. No code needed; discount automatically applied at checkout.

🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

Mini Pause #21: How Caloric Deficits Impact Your Bones, Muscles & Tendons

Posted on by stephanie-estima

TL;DR (too long, didn't read)

Caloric deficits impact the trajectory of women’s bone density and muscle mass. Caloric deficits also can impact women’s height, ability to build muscle, and menstrual cycle. We must reframe our thinking from being as skinny as possible to being as strong as possible.

WHY

Oh, look! I have more to say about chronic caloric deficits. Hold my beer.

Just kidding. I never drink the stuff. But… I have been thinking about chronic caloric deficits and the impact it has on a woman over her lifetime. Specifically, I want to talk about not getting enough calories in and how seriously it affects your bones, muscles, tendons, and joints, and injury risk.

Last week, I touched on the idea that eating in a caloric deficit can have deleterious effects not only on your gainz, but also on other important areas of female health like menstruation, bone health, brain health, and hormone production.

Let’s tuck into this a bit.

WHAT

One of the things I couldn’t shake after writing last week’s Mini Pause #20 is that most of us have been on some kind of diet for all of our lives. That means that for many women, we have been trying in some form or another to starve ourselves skinny. So at best, we have underestimated our calories thinking we are in a deficit, and at worst, we’ve fostered a real, chronic caloric deficit that impacts organ function and tissue remodeling and maintenance.

I wanted to expand on last week’s newsletter because it has real consequences on our body’s ability to function normally.

Most obviously, chronic caloric restriction is going to affect the regularity and cadence of our menstrual cycle. I write about this extensively in The Betty Body and why women are still getting periods (no matter how irregular they may be).

If your body fat percentage is too low, you run the risk of depriving yourself of ovulation, which is the main point of your menstrual cycle. In doing so, you also deprive your body of progesterone. This sex hormone is only produced when you ovulate.

Progesterone has wide-sweeping effects on the body like promoting good sleep, calming anxiety centers in the brain down, and supporting thyroid function–all three of which perimenopausal women tend to struggle with.

But there are other, perhaps more deleterious effects of prolonged caloric deficits, such as the effects it has on your bones and muscles.

Young women who under-eat and have lost their menstrual cycle as a result of over-dieting are at risk for developing irreversible damage to their skeletal system because 90% of our bone mass peaks at about 18 years of age [*]. This means that without adequate nutrition, a teenager who is undereating will impair her bone strength; change the architecture of the bone itself, causing it to have a higher affinity for bone fractures; and can even change her final height [*]. It puts this young woman at a higher risk of vertebral fractures throughout the rest of her life, even if she resumes normal eating patterns.

Having seen my fair share of vertebral fractures in my clinic, this is something you want to avoid at all costs. It is painful and disruptive, and the rehab is incredibly difficult from both a physical and mental point of view.

Amenorrheic episodes (months without ovulation) also impact your anabolic hormones like estrogen. Without a regular menstrual cycle, you would be considered hypoestrogenic, which is not too dissimilar to what we see in the final stages of perimenopause and menopause.

In both age groups, we see a fraying of the bone architecture, an increased susceptibility to fractures, and reduced bone strength. We want bones that are more “bendable” to withstand the forces on them. The more brittle and less “bendy” a bone is, the more likely it is to snap.

The other deleterious effect chronic caloric deficits have are on our body’s ability to repair and grow new muscle tissue. Muscle is so much more than aesthetic, as you know. Undereating is associated with impaired myofibrillar and sarcoplasmic muscle protein synthesis [*], compared to training with optimum energy availability.

Being on a chronic diet for YEARS is going to measurably impact your muscle mass, bone density, injury risk, and organ health. And it will catch up to you eventually.

HOW

I wish I could snap my fingers and wake us all up from the collective spell of wanting to be skinny, but the truth is, each of us will have our own paths to this awakening. What I can say to the well-intentioned woman (possibly the one reading with a touch of cynicism who gets what I’m saying intellectually but emotionally still desires to be small) is that your worth is not what the scale says.

If you have a lot of muscle mass, you are likely going to be heavier than whatever arbitrary number you have in your head. That number by the way has been subtly implanted from reading Cosmo, Teen Cosmo, and whatever other junk we grew up reading.

Think deeply about the images of thinness growing up. Women in perimenopause know this intimately because if you are around the same age I am, you grew up with Kate Moss and the advent of the grunge and heroin-chic look.

I distinctly remember as a teenager who was studying fashion magazines, that my body was just not built like the girls on these pages. I have thighs that are always going to touch. I have hips made for childbearing. I am just built differently.

Of course, these physical qualities have been in vogue as of late, which also just goes to show you the standards of beauty are always changing. So find the beauty in your own damn self and stop looking for external validation. Love your freckles, your scars, your hair color. Because soon stars will take out their BBLs, strong Roman noses will be the new ideal, and thin eyebrows will be back.

Point is–the house always wins. So be the house. Not the player.

NOW

  • Play India Arie’s “Because I Am a Queen”
  • Think about your relationship with food and dieting and what messages your daughters and sons are receiving. Is it good? Bad? Neutral
  • Contrast that with how you would like to show up for yourself, your family, and your community.
  • Can you experiment with eating a little more? What if you started with simply 100 calories more of protein? Could you make that work?

Q: I know I need more calories in my luteal phase. Can I increase fat? Or do I need to add more carbs?

Short and to the point for Divie3 from Instagram today.

Yes, if you are hungrier you definitely need more calories. I usually recommend something like 10 to 15 percent more than you are eating in your follicular phase. The first thing is to make sure your protein intake is adequate. Typically something like 1g of protein/per ideal pound of body weight. After that you can dial up fat or carbs; whatever tickles your fancy!

YOUR TURN!

I’ll be answering your questions every week right here in the Mini Pause! Let me know what’s on your mind. I’ll be checking for both questions and feedback at support@drstephanieestima.com.

What I Recommend: Red Light Therapy

I’ve added another component of light therapy to my recovery practice. (Yes, that's really me lying on it in the photo).

While my Bettys know how much I rely on science when it comes to all things wellness, I’m going to admit that the PEMF Mat by Bon Charge both soothes and energizes in ways I wasn’t expecting–and I loved it right away.

It’s a pulsed electromagnetic field mat that works with your body’s natural magnetic field and uses bioactive wavelengths combined with red and near-infrared light. An additional far-infrared light component warms your body.

You can use the PEMF Mat during yoga, stretching, or grounding while lying down. You can even read a book or take a nap. The Mat’s programming allows you to choose sleep, grounding, focus, or meditation and relaxation.

And ever searching for ways to be more efficient, I combined my Red Light Face Mask and Red Light Neck & Chest Mask with time on the PEMF Mat. It’s a triple win for wellness. Speaking of triple, the PEMF Mat now comes in three sizes: a sitting pad, a demi size, and the full size.

View the entire Red Light Therapy Collection here and use code DRSTEPHANIE to save 15% off sitewide.