Strength & Stability: Exercise Programming for Bone Health & Muscle Preservation in Menopausal Women – Part 1

Credit

Handouts/Brochure

Speaker

Elizabeth Frey, FCAMPT, MCISC (MANIP), MSc. PT, MSc, BPHE, BSc, MCPA Related seminars and products

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Elizabeth Frey, FCAMPT, MCISC (MANIP), MSc. PT, MSc, BPHE, BSc, MCPA

Liz holds a BSc and BPHE from Queen’s University; a MSc in Exercise Physiology from the University of Toronto, a MSc (PT) from McMaster University, and a MCISC (Manip) from University of Western Ontario. She is a member of the CPA and a fellow of the Canadian Academy of Manipulative Physical Therapists (FCAMPT). Liz is also a Contemporary Medical Acupuncture provider.

Liz is a clinic owner and practicing physiotherapist with a specialty in pelvic health physiotherapy. She is an instructor for Rocktape® Canada, a clinical lab facilitator at the University of Toronto, and a clinical supervisor for physiotherapy students.

As an orthopaedic and pelvic health physiotherapist, Liz integrates her over 10 years of clinical expertise to provide a unique whole-body approach to wellness. Liz’s practice focuses on helping women navigate pregnancy, menopause, and everything in between. Her care model addresses the underlying dysfunction causing injury and provides education to help prevent future re-injury. Her patient-centered approach empowers her patients to set goals, balance muscular dysfunction, and work toward optimal health. She does all of this through hands-on techniques, comprehensive education, and tailored progressive exercise programs.

Personally, as a busy mother of three children, the health habits that don’t slip for Liz are mindset and exercise – it is her positive outlook and passion to stay strong and mobile as she ages that are a few of her defining features.
 

Speaker Disclosures:
Financial: Elizabeth Frey is the owner of PhysioPlus Health Group, an instructor with Rock Tape, and has an employment relationship with Fringe. She is a mentor with Orthopedic Division. She receives a speaking honorarium and recording royalties from PESI, Inc.
Non-financial: Elizabeth Frey is a member of the Canadian Academy of Manipulative Physiotherapy and the Women’s Health Division of the CPA.

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Objectives

1. Interpret bone health assessment data (including DXA T-scores, Z-scores, Trabecular Bone Score, and FRAX scores) to accurately stratify fracture risk and determine appropriate exercise intensity levels for postmenopausal women.
2. Interpret validated muscle health screening tools (SARC-F questionnaire, grip strength dynamometry, and Timed Up and Go test) to identify sarcopenia risk and fall risk in midlife and older women.
3. Apply evidence-based exercise prescription principles (specifying intensity, volume, and frequency parameters for resistance, power/plyometric, cardiovascular, and balance training) that address the specific physiological changes of menopause including accelerated bone loss, sarcopenia, and metabolic dysfunction.

Outline

Section 1: The Science of Menopause - Understanding Bone & Muscle Changes

• The Musculoskeletal Syndrome of Menopause: hormonal impacts on bone, muscle, cartilage, and fat
• Bone biology in midlife: Wolff's Law, Mechanostat Theory, and the RANKL/OPG pathway
• Trabecular vs. cortical bone loss patterns and the critical menopausal window (2.5% annual BMD decline)
• Sarcopenia and dynapenia: estrogen's role in muscle mass, strength, and neuromuscular function

Section 2: Clinical Assessment - Stratifying Risk & Evaluating Function

• Bone health assessment tools: DXA scans, T-scores, Z-scores, Trabecular Bone Score (TBS), and FRAX
• Muscle health screening: SARC-F questionnaire, grip strength testing, and Timed Up and Go (TUG)
• Identifying red flags, contraindications, and medical clearance requirements
• Assessing exercise readiness: motivation, beliefs, barriers, and current activity levels

Section 3: Evidence-Based Exercise Prescription Principles

• Resistance training: optimal parameters for bone and muscle (≥70% 1RM, 2-3x/week, compound movements)
• Power/plyometric training: maintaining fast-twitch fibers and bone strain through explosive movements
• Cardiovascular training: HIIT/SIT for metabolic health vs. limiting excessive Zone 2 cardio
• Balance, mobility, and core stability: fall prevention and movement quality enhancement

Section 4: Translating Research to Practice

• High-intensity and high-volume resistance training improves BMD and muscle hypertrophy
• Multicomponent training frequency (3x/week) optimizes metabolic and body composition outcomes
• Resistance training reduces visceral fat and systemic inflammation in postmenopausal women

Target Audience

• Doctors of Chiropractic
• Registered Nurses
• Nurse Practitioners
• Physician Assistants
• Physical Therapists