Dr. Vonda Wright Shares the Longevity Habits You’re Not Thinking About (and That You Can Start Doing Today)

Ask Dr. Vonda Wright about aging and she’ll tell you that most of what we’ve been taught to believe about getting older—namely, that muscle loss, pain, and a gradual slowing down is inevitable—is wrong.

As an orthopedic surgeon, researcher, and author, Dr. Wright has spent years studying the musculoskeletal system and seeing patients, and it’s taught her that strength, mobility, and vitality aren’t just for the young. They are attainable for everyone.

Now, Dr. Wright is on a mission to shine a light on the biggest factors that contribute to aging with vitality. (Hint: It’s all about daily habits that are doable for all of us.) She’s also passionate about helping women in midlife understand the musculoskeletal syndrome of menopause, a term Dr. Wright coined to describe the often-overlooked impact of menopause on a woman’s muscles, joints, and bones. Her ultimate goal: To bring awareness to these physical changes so women can take proactive steps to stay strong and pain-free as they age.

The best part? Dr. Wright’s science-backed strategies can help all of us, no matter our sex or life stage, make a positive and lasting impact on our health.

A CONVERSATION WITH VONDA WRIGHT, MD

Tell us a bit about what inspired you to become an advocate for women’s health.

I’m an orthopedic sports surgeon, so my entire career has been focused on keeping people mobile. My North Star has always been this: If I save your mobility, I am going to save you from the ravages of chronic disease.

My first career in medicine was as an oncology nurse. I took care of women in the late 80s and early 90s who were in the struggle of their lives. The oncology technology was not quite as good back then. People were in the hospital one week a month for six months. As the nurse taking care of the same women and families, it affected my perspective on women’s health, women’s suffering, and the importance of women as decision makers.

I am also the mother of a blended family of six children, and so I am critically aware of how my choices make a generational health impact.

I think most of us have heard of generational wealth, but what’s generational health?

The analogy is from the financial world, where we talk about what bank accounts to establish so that by the time our kids are 30, they’re millionaires. That’s generational wealth.

When I say generational health, it’s all about making decisions to optimize your health and setting that example for our kids. Here’s what we know: The 10 months of pregnancy can predispose your child’s health for their lifetime, which means it matters how young women prepare their bodies to carry children. But it doesn’t stop there, because only part of our generational health has to do with our genes. From the minute our kids are born, they learn from us through the habits they see us build and the steps we take for our health that become our norm. That is what it means to build generational health.

The reason I started focusing on women with my live events and charitable work was because if you want to improve or change something, who do you teach? You teach the women. Because they will change generations behind them. My own children and grandchildren will learn from me as an example. We have the power to change health in one generation in this country if we would just do it.

Let’s geek out on the musculoskeletal syndrome of menopause (MSM), which is nomenclature you created. What is MSM and why does it happen?

I started noticing women coming into my clinic with very specific and related symptoms, and they needed a way to explain what was happening to them. Then, when I saw what the OB-GYNs had done when they re-named “vaginal atrophy” to the Genitourinary Syndrome of Menopause (GSM). They were able to put multiple symptoms in one basket, so to speak, which enabled conversation that in turn enabled studies that enabled research. I thought, “We have got to do that for what I’m seeing in women when they hit midlife.”  

The musculoskeletal symptoms I see in women at midlife and beyond are all related to the mechanism of estrogen receptors.

Hormones circulating through our bodies are just a ball of potential. They have to connect with a receptor on the cell surface or in the middle of a cell called the cytoplasm. Estrogen receptors sit there waiting to receive estrogen. When they receive estrogen, that leads to all the amazing downstream actions that estrogen has on the body.

These receptors are everywhere. We have estrogen receptors on all of our muscle, our bones, our ligaments and tendons, our adipose tissue, our immune system. Before menopause, those estrogen receptors are filled with estrogen. After menopause, there’s suddenly no estrogen in those receptors. This causes inflammation, loss of muscle mass, loss of bone density, cartilage degradation, and redistribution of fat tissue. All of these things lead to musculoskeletal disease in women, and ultimately, fracture and frailty.

Let’s break down inflammation. When estrogen dips, why is inflammation so common?

First, it’s important to remember that inflammation is actually a very helpful, normal process in our body that we need. You sprain your ankle, it swells up, the blood rushes to it, that’s a good thing! That is your body responding to your injury and helping to heal you. What’s supposed to happen is that once inflammation has helped you heal, it goes away. That is not what happens in chronic inflammation, which is the kind that causes disease.

Estrogen is a huge anti-inflammatory, acting directly in the immune system by coordinating with a molecule called the inflammasome. The inflammasome is this multiprotein complex that activates and processes a bunch of pro-inflammatory cytokines. If we don’t have the dampening effect of estrogen helping to control the inflammasome, we get this uncontrolled release of all these inflammatory cytokines. I often say it’s like a nuclear bomb going off. There’s all this inflammation being spewed around in an uncontrolled way. Estrogen assists in decreasing inflammation and without it, we just get red and hot all over.

What are some of the most common symptoms of MSM?

Number one is frozen shoulder. This is when out of nowhere, you wake up and your shoulder is in pain and in a matter of a week, it doesn’t move. And women are tough; they don’t know why their shoulder is hurting, but they push through the pain and wait it out. But what happens is that over time, you’ll stop using that shoulder, and then you won’t be able to move your shoulder—which is why it feels “frozen.” 

Number two is total body pain, which is called arthralgia. This is when you go to the doctor and say, “My whole body hurts,” and 40 percent of the time a doctor will tell you they don’t know why. This is one reason women walk away from those doctor visits thinking they’re crazy.

Other symptoms of MSM include arthritis (for example, all of a sudden, your knees might hurt, oftentimes because of the cartilage degradation that happens as estrogen declines) and osteoporosis. We never think about our bones until they fracture. But that’s a shame, especially for women. When a woman falls and breaks her hip, 50 percent of the time she will not return to pre-fall function—meaning she won’t be able to climb the stairs to her office, carry the groceries into her house, or oftentimes she won’t be able to live alone anymore. And 30 percent of the time, she dies.

Finally, another common symptom is muscle loss. When estrogen walks out the door, we build muscle less efficiently. Our muscle-derived stem cells stop replicating, and we lose muscle.

How do you treat MSM?

When you present with one of the symptoms of MSM, the first decision every woman has to make is regarding hormone replacement therapy. But here’s the key: You have to make this decision from an educated perspective. You cannot make this decision based on the newspaper tabloids, or based on what your Aunt Gertie says, or based on what some uninformed doctor who never had the opportunity to learn about midlife and menopause has to say. You need to make this decision based on science. Educate yourself and then talk to your clinician, because estrogen can be the salve that soothes all of this.

That said, hope is not lost if you decide not to do hormone replacement therapy. Lifestyle factors can play a really big role.

First, anti-inflammatory nutrition is crucial. The four tenets I want you to focus on are as follows:

1. Eat green leafy vegetables

2. Aim for one gram of protein per ideal pound of body weight a day

3. Cut out all added white sugar (and know that you must read the back of all processed food labels, because just when you think you’ve got your healthy Greek yogurt, may see there are 9 grams of added sugar in it!)

4. Consume plenty of fiber

Second, move your body. If you’re in pain, the temptation is to be sedentary and rest. But that’s going to make you rust out. If we keep moving, we keep our joints mobile and we ultimately feel better. Can’t walk? Get in a pool with chest-high water and use the buoyancy of the water to get some movement in. Or try biking or using a rower or another low-impact cardio machine. We are always able to keep moving—and we must.

Third, lift weights—and build up to lifting heavy weights. It’s the one thing that’s going to preserve us. If you have one hour a day to move your body and no other time, lift weights. And know that it’s crucial to lift heavy enough to stimulate muscle protein synthesis. What is heavy? Every woman’s heavy is different. You have to play with it in a weight room or hire a trainer if you don’t feel like you can do that exploration safely on your own. I can biceps curl 15 pounds until tomorrow, but I can only curl 25 pounds four times. So, my heavy for biceps curls is 25 pounds. Somebody else’s heavy might be 10 pounds right now, and that is OK. You will gradually build up over time.

Finally, sleep. We must value our sleep. I used to say stupid things like, “I’ll sleep when I die.” Now I know that if I don’t sleep, I’m going to die because I won’t be able to do any of the things that I just listed.

Where do we start?

My suggestion is to focus on one or two steps that feel doable starting today. Maybe that means cutting out sugar and taking a walk every day. Then, layer on other habits like lifting weights and eating more greens. The goal is for all of this to become your lifestyle. You want all of these healthy strategies to feel like they are just part of the way you live.

Dr. Wright is a double boarded, fellowship trained orthopedic surgeon with subspecialty certification in sports medicine. She is an internationally recognized authority on active aging and mobility. To learn more, visit drvondawright.com.