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Women's Fitness Podcast
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Women's Fitness Podcast
Behaviour Change and Bone Health with Dr. Ruth White
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Episode Summary
Dr Ruth White has been a physiotherapist for nearly 40 years. She went on to complete a Master's in pain and a PhD in behaviour change, and now applies both to bone health. Ruth shares the story behind her own osteoporosis and osteopenia diagnosis at 57, what she wishes she had known sooner about scans, protein and lifting, and how the COM-B model of behaviour change helps fitness professionals support women with low bone density.
If you work with women in menopause or perimenopause, this one is packed with practical guidance you can use with clients this week.
In This Episode
- Ruth's path from physio to pain clinic to behaviour change to bone health.
- The difference between osteopenia and osteoporosis, and why peak bone density in our 30s matters.
- When to have a DEXA scan. Ruth's personal view is that if you are old enough for a breast scan, you are old enough for a bone scan, and a family history or stress fracture is a good reason to get a baseline earlier.
- How DEXA, body composition scans (like Evolt) and ultrasound bone quality scans differ, and why a density number is useful but is not the whole picture.
- Why an active woman who trains and eats well can still end up with low bone density, including the roles of protein, calcium and diet culture.
- Why information alone does not change behaviour, and how Ruth uses the COM-B model (capability, opportunity, motivation, behaviour).
- Physical capability: starting with sit to stand, then progressing slowly, and the research showing two challenging half-hour sessions a week can build bone after menopause.
- Meet the three bone cells: Clive the Cleaver (osteoclast), Cilla (osteocyte) and Bella (osteoblast), and why Bella needs a genuinely challenging load before she shows up.
- Psychological capability: the fear of being fragile, and knowing when a client needs a psychologist or psychiatrist on her team.
- Opportunity: asking whether it is the right time for a woman to prioritise her bones, and how group training can widen access.
- Motivation: habit versus reflective motivation, and the question Ruth asks: are we going to do it today or tomorrow?
- Acceptability: is what you are offering acceptable to the person in front of you?
- Pelvic floor dysfunction and impact training: screen for it, and do it sensitively.
Key Takeaways
- Get a baseline bone scan earlier than the routine schedule if you have risk factors.
- Bones respond to challenging load. Two good sessions a week can build bone even after menopause.
- Start where the client is. Sit to stand is a great first check for every client.
- Fear is a capability issue. Know your professional limits and refer on when needed.
- Meet clients where they are on motivation. You do not need to work harder than the person in front of you.
Quote to Share
"Information is to behaviour change as spaghetti is to a brick."
Find Ruth
- Website: buildbehavioursbuildbones.com.au
- Instagram: @behaviourandbones
- LinkedIn: Ruth is running a series on how bone type differs across the arms, lumbar spine, femur and femoral neck
About Women's Fitness Education
Want to work with women in exercise? Women's Fitness Education is different because women's health is built in. Every student receives my four women's health courses as part of the Certificate III and IV in Fitness.
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