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Tag: plyometrics

Mini Pause #89: PEACE & LOVE for your ligaments

Posted on by stephanie-estima

You asked for it: more on ligaments. My heart did a little pitter-patter when the response to my last Mini Pause was a resounding YES.

Most people overlook them, but I love ligaments. They're the unsung heroes that literally hold us together. While muscles are like a bouncy, eager puppy ready to play, your ligaments are more like the loyal family dog: slower to adapt, but dedicated to being there for you 24/7.

WHY

Ligaments connect bone to bone, stabilizing your joints like a seatbelt and giving your body that sixth sense of where it is in space (proprioception).

They don't get much blood flow, which means they heal and adapt slowly. Ligament injuries can take months, even years, to fully remodel. In midlife, with our lower estrogen causing slower collagen turnover, the process can be even longer.

Translation: We need to give these tissues extra care, patience, and respect.

HOW

Here's what the science says about taking care of your ligaments:

Progressive Loading, but Slowly

Deep breath. We need some patience with these ligaments of yours. We want to apply progressive tension over the course of months. Yes, “months” with an S.

Start with isometric holds, then move into heavy-slow resistance, followed by eccentrics, and only later into plyometrics, deceleration, and balance drills.

This stepwise approach tells your fibroblasts (the cells that rebuild collagen) how to lay down stronger fibers along the right lines of stress. Ligaments will remodel along lines of stress of the movement, not necessarily along the original architecture of the ligament, so form and slow progression are key.

Bad movement pattern habits can accelerate injury risk and take years to unlearn and relearn.

Nutrition

Collagen is not the be-all-and-end-all for muscle protein synthesis, but there's good data supporting collagen supplementation for ligament health.

I know, I know. Every online fitfluencer wants to tell you that collagen is garbage, and in the context of muscle, there is an argument to be made that it's not worth your money.

But stay with me. Studies show an increase in circulating markers of collagen synthesis in human ligaments when we ingest ~15 g of gelatin (or collagen peptides) plus vitamin C 30-60 minutes before short bouts of loading. PMC This is undeniably helpful while training, rehabbing an injury, or preventing an injury.

So, its an and/both approach. It's wise to supplement with both protein that will upregulate muscle synthesis AND collagen to support ligaments.

Post-Injury

Okay, so you got injured. You went for a PR right after a PR. Or your coffee hit just right one morning, so you jumped right into track sprints, and now your knee feels wonky. Been there, done that, got the rehab notes to prove it.

First off, let me just exhale a giant ARGUHHGHHHHHH of frustration with you. It is SO annoying to feel like you're being punished for doing something positive for your body. I don't want you to get discouraged. Let's put together a plan to get you back to business.

Remodeling and coming back stronger is going to look something like this:

A few days of inflammation. Then a few weeks of proliferation. Then, a few months to a year (or more) of remodeling and maturation. PMC+1

PEACE & LOVE, not RICE

You've heard about Rest, Ice, Compression, and Elevation for injuries, but the British Journal of Sports Medicine has a new acronym for you:

Protection, Elevation, Avoid Anti-Inflammants, Compression, Education (PEACE) followed by Load, Optimism, Vascularization (cardio), and Exercise (LOVE).

In PEACE, we want to protect the joint and compress it.

To ease discomfort, I'll often wrap the injured joint or compress it to manage swelling. I love the knee compression sleeve from Incrediwear, and I use it pretty regularly post-sprinting as a preventative measure. It'll work well if you're acutely injured as well.

In LOVE, we want to nix old ways of thinking and actually load the ligament as soon as possible. British Journal of Sports Medicine

You can do this by starting with isometrics, then slowly moving to load-bearing exercises and eccentrics, and eventually gently resuming higher-impact activities.

The Midlife Caveat

For women in midlife like us Bettys, estrogen matters and will most certainly impact your healing time.

Higher estrogen can reduce ligament stiffness and alter collagen turnover. Our knee laxity fluctuates across the cycle, and therefore, so does risk. (I wrote about this in The Betty Body.)

In perimenopause and menopause, lower estrogen will impair collagen turnover and healing, making the months monthier and the years yearsier. It just takes longer to heal without the anabolic influence of estrogen.

This is why I will die on the hill of technique. Your ego is your enemy in the gym and on the track. I will absolutely insist that you develop neuromuscular control and year-round strength and balance. Frontiers+1

NOW

The overarching principle of PEACE & LOVE is to protect the ligament, compress it, and return to activity as soon as possible.

The following is an example of how I might structure this for rehabbing a ligamentous injury. This is for demonstrative purposes only on how I might progress through a program:

  • Angle-Specific Isometrics
    30-45 second holds x 3-5 sets x 3-5x/wk initially

    Start these as soon as possible and do them at positions that lightly tension the target ligament. It's good for pain modulation and early load tolerance. If available, I would do these on a vibration plate.

  • Heavy-Slow Resistance (HSR)
    6-8 controlled reps x 3-5 sets x 2-3x/week; ~3-5 seconds down, 1-2 seconds up

    These exercises will build tendon-muscle unit capacity and apply a steady collagen stimulus across joint angles.

  • Eccentrics
    8-12 slow reps x 3-4 sets x 2-3x/week

    Do these exercises to improve strain tolerance and control. I would also incorporate vibration plate training with these eccentrics.

  • Plyometrics & Deceleration

    Once foundational strength and balance are solid, start adding in hops, land-and-stick, and cutting mechanics. Gradually increase the speed and directional variability.

  • Balance and Proprioception

    Start adding in single-leg stance progressions, with eyes open or closed. I'd likely incorporate vibration plate training here, too.

  • Movement Quality

    Focus on tracking knees over toes, hitting soft landings (triple flexion), and maintaining trunk/hip control. Mobility training becomes super important here.

  • Nutrition

    Supplement with gelatin/collagen + vitamin C 30-60 min pre-load, and make sure your total daily protein intake is 1.6-2.2 g/kg of body weight to support remodeling. PMC

I've kind of been itching to talk more about arthritides like osteoarthritis, rheumatoid arthritis, and psoriatic arthritis. How about you? What should we get geeky about next?

 

 

Sending you PEACE & LOVE,

Dr. Stephanie

WHAT I LOVE THIS WEEK

My Secret to Maintaining Skin Health As I Age

Read more about the role of maintaining the skin barrier as we age. 

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References:

01 Zonari, A., et al. Journal of Cosmetic Dermatology, 2025

02 Zonari, A., et al., npj Aging, 2023


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

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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

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🌟 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. 👟

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  • 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.

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

Mini Pause #12: The Power of Plyometrics

Posted on by stephanie-estima

Plyometrics for the Win! Improve Your Bone Density, Balance, Coordination, Muscle Growth & Insulin Sensitivity

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

Plyometrics help to drive bone density, balance, coordination, and muscle growth. They help to improve insulin sensitivity–and make you feel like Wonder Woman!

WHY

Let’s continue the Mini Pause series on type 2 fiber training. Last week I spoke about Speed Training (Mini Pause #11 if you missed it!). This week I want to dive into plyometrics, which uses burst and explosive power.

Plyos are another way to train fast-twitch muscle fibers, and like speed training, these can also be done with high or low impact.

We spoke last week about the anabolic and hormonal effects of speed training. Training the top end of your cardiometabolic capacity matters as much as training our bottom end (Zone 2). Plyometrics presents an awesome opportunity to train type 2 fibers and preserve power and neural recruitment.

WHAT

Plyometrics have been shown to drive several desirable results in the body namely:

Stronger Bones & Connective Tissues

In women of all ages, burst activities like jumping and plyometrics have been shown to improve bone density [*] and reduce the incidence of lower-body injury in female athletes [*]. This has also been demonstrated in menopausal and post-menopausal women [*], as well.

Considering women are most likely to develop osteopenia and eventually osteoporosis, this should be the biggest motivator for the preservation of bone health as you age.

Better Coordination & Proprioception

Technically, there are a lot of things happening when you initiate a jump:

  • the neural recruitment of desired muscles via the efferent motor nerves,
  • your joint position sense in the starting position,
  • your brain predicting where you will end up in space at the end position,
  • the kinetic energy stored and released in the muscle cell,
  • the muscle sensors detecting stretch and deformation as you jump,
  • and, of course, the flexibility of the joints being used to work through their full range of motion.

That’s a lot! When you train your neuromuscular system through jumping, you improve your balance and coordination, and your proprioception (which is your unconscious sense: it is how you know where your joints are without looking at them).

As women age, in combination with osteopenia, they also lose joint position sense, which can contribute to tripping and falling.

Anabolic / Muscle Growth

Plyometrics have demonstrated a strong signal for muscle growth [*]. So whether you are training plyometrics alone, or combining with resistance training [*], this is a great way to continue to build muscle in your 40s, 50s, and beyond.

Insulin Sensitivity

Power and burst training both have been shown to help improve insulin sensitivity [*]. The short burst of explosive power drives insulin receptors normally hiding in the cell to the cell surface to be able to acquire more glucose for energy production.

You Feel Like Wonder Woman!

I don’t know about you, but when I can jump onto a plyo box or complete squat jumps, I feel like a beast. And isn’t that at least part of the point of power training? To make you feel…. well… powerful? I walk just a little bit taller when I finish.

HOW

Plyometrics can be done both at higher and lower impact levels. If you are uneasy jumping or nursing an injury, rebounders are a great option as they absorb most of the ground reactive forces of landing. You also can perform plyometrics in a swimming pool.

Beginner

  • Bunny Hops: Standing with your feet slightly apart, knees are not locked out, find a hallway or a corridor, and “hop” or “jump” as high as you can while traveling forward slightly. Just in time for Easter! Feel free to practice this on your easter egg hunts.

Intermediate

  • Bunny Hop Switches: This is essentially a one-legged Bunny Hop that alternates between the left and the right foot. Lift your left leg (bending the knee so it’s as high as your hip) with the right leg on the floor, hop four times on the right foot, and then switch legs. Repeat down the corridor.

Advanced

  • Box Jumps: You know now that being advanced is just mastering the basics and executing them well. This plyo is essentially a “giant” bunny hop with height and flexion. Start with a low box (they start as low as six inches). Stand in front of the box. Bend your knees deeply and pause at the bottom to remove all kinetic energy from the Achilles. Explode up and land on the box with both feet.

NOW

Add plyos to your next workout after you’re warmed up. I typically add them onto the end of a weight training workout that is not legs. If I’m training shoulders or back, I can insert a quick 10-minute plyo finisher at the end.

Question of the Week

Q: What is your go-to lunch?

I don’t like to have to think too hard about lunch. I usually throw together a salad that has a good amount of protein and fat. I prep lots of different salad items on a Sunday so I can toss them together for the week. I try to think about my food from the following verticals: fiber, protein, fats, and carbs. I organize my fridge shelves to support each of these goals.

  • Base: I have glass Tupperware in my fridge with pre-cut lettuce. I like crunch, so usually this is a cabbage or coleslaw mix. Romaine hearts also make the cut, and if I’ve run out of all of the above, then I take sauerkraut from the jar and use that!
  • Protein: This is usually slow-cooked pulled chicken that I spice with Lebanese spices, but this could be ground beef or turkey, or leftover protein from dinner the night before.
  • Carbs: I love to add potatoes or rice. And I love them cold. The other thing I’ve been enjoying lately is my homemade sourdough croutons. When my sourdough bread gets stale, I cut it up, marinate with olive oil and salt, and bake the pieces at 325F for 8 to 10 minutes.
  • Fats: Bacon bits, ranch salad dressing, olive oil, avocados, or nuts.
  • Herbs: I really love dried herbs, and I’m pretty liberal with their use. Herbs de Provence, Zaatar, Everything but the Bagel, sesame seeds, Rosemary leaves, Herbamare…. I love it all!

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: Embr Labs

Conversation in the Bettyverse often lands on thermoregulation during perimenopause and menopause. You’re either too hot (flushes!) or too cold. I’ve been searching for a solution for you and finally found it in the Embr Wave 2.

You wear this device on your wrist. (I love mine in rose gold because it looks like a gorgeous bracelet!) The Embr Wave 2 stimulates the nerves that sense temperature, so with the push of a button, you can change how hot or cold you feel. Consider it your personal thermostat.

Learn more about its science at https://embrlabs.com. If you're intrigued, use code DRSTEPHANIE for 15% off.