We are beyond excited to introduce our first medical advisor at The Carry: Dr. Stephanie Estima. We set out to find someone who wasn’t just respected in the women’s health space, but someone who truly gets us—someone strong, honest, and unafraid to speak her truth.
Dr. Stephanie Estima is a doctor of chiropractic with 19 years of clinical experience and a leading expert in female-centric health span, metabolism, and performance. You might know her as the bestselling author of The Betty Body or from her top-rated podcast BETTER!—or as a frequent guest expert in places like Women’s Health, MindBodyGreen, and Mindvalley.
We’re thrilled to have Dr. Stephanie on board, helping us make weighted vest training smarter, safer, and more supportive for midlife women. Here’s a quick Q&A with Dr. Stephanie to kick things off.
The FAQ
Q: What should women look for in the design of a weighted vest?
A (Dr. Stephanie):
Breast Considerations: Curved/Contoured Shoulder Straps & Chest Fit:
S-curved shoulder straps can prevent straps from cutting into your arms or squashing the chest. Usually straight straps press painfully against breast tissue whereas a curved shape can curve around the bust for comfort.If there is a sternum strap, ideally it should be adjustable and placed about an inch below the collarbone to further customize fit and avoid compressing the chest.Together, this eliminates “boob squish” and shoulder rubbing. It will also allow for free arm movement (without chafing the area where the arm meets the shoulder).
Smaller Spine Considerations: Shoulder & Spine Load Distribution:
The vest should load the weight evenly across the shoulders from the front to the back. The vest shouldn’t just hang from your shoulders - there should be options to distribute the load across the chest (like a sternum strap described above, or a low back or waist cinching). Maybe some optional shoulder pads (that can be removed).It is also important that the vest shouldn't be so long that it hangs and doesn’t “hug” your waist. I believe you may have bungee straps for this on the lateral aspect of the vest, but ensuring that the vest is snug into the waist so it is not flapping in the wind, hitting our low backs, and not utilizing the waist as a way to anchor the vest.
Q: For first-timers, what’s the best way to start using a weighted vest?
A (Dr. Stephanie):
Start Light – 5–8% of Body Weight
When first using a weighted vest, begin with a load around 5–10% of your body weight, leaning toward the lower end (-5–8%) if you are new or have risk factors. For example, if you are new to wearing a weighted vest, and weigh 150 lbs, your starting weight will be 7.5 lbs (5% of your body weight). This allows your tendons, bones and muscles to adapt slowly and safely.
Progression (every 2 weeks or so)
I like to counsel women to increase this load by 1-2% of your body weight every 2 weeks. Practically, this means something like an additional 1-3 lbs of weight added.
Following the example of the 150 lb woman, she might consider, after 2 weeks, to increase the vests weight to 9 lbs (or 6% of her total body weight).
A word on progression (and type A over achievers)
This format should be continued if and only if the current weight feels easy, and you are not sacrificing form with your weighted vest. Most women can, over several months, work up to 10% of their body weight. Our 150 lb Betty can comfortably work up to 15 lbs on her weighted vest after several months of use.
Some (SOME) advanced and athletic individuals can eventually work up to 15% of their body weight but this is, again, if it is tolerated and we are not sacrificing form. Most of the benefits of a weighted vest will be garnered at the 10% level.
Q: What are some helpful milestones for women to follow?
A (Dr. Stephanie):
Here is an approximate goal for our 150 lb Betty in this example:
| Week | % Body Weight | Focus |
|---|---|---|
| 1–2 | 5% | Get used to the vest; practice breathing and posture |
| 3–4 | 6% | Slightly increase weight if form is solid |
| 5–6 | 7% | Check for soreness, maintain technique |
| 7–8 | 8% | Assess joints and low back before adding more |
| 9–10 | 9% | Progress only if you feel strong and stable |
| 11–12 | 10% | Great goal for most — stay here if comfortable |
Q: How can you use a weighted vest in daily life versus workouts?
A (Dr. Stephanie):
We can play around with weight as well when considering daily use or using the vest whilst training.
You can wear the weighted vest for everyday activities - like walking, groceries, housework, picking up the kids, etc. Here I would say because the duration is longer, you can modify the vest to be at the lower weight range (say 5-6% of your body weight). The goal with daily weights is gentle, cumulative loading on the body.
When you are adding the vest for a focused training session (plyometrics, weight training, or jump training), after working your way up to 9-10% of your body weight, you can train at this higher because the duration is typically limited to around an hour. The goal with using the weight vest in a structured exercise session is to increase the intensity of the workout (if it is appropriate and tolerable without sacrificing form).
Q: How can you best determine the weight of your vest?
A (Dr. Stephanie):
The other option you can think about is determining the weight of your vest by your fitness level.
Beginners
Keep sessions short at first (maybe 10-20 minutes of vest use) and prioritize learning how the added weight affects your balance and gait.
I often counsel women to start by simply wearing the vest during a warm-up or on flat (or as flat as possible) ground walks before integrating it into more complex or structured exercises. It’s normal for a beginner to feel muscles like the calves, quads, and lower back “working harder” with even a light vest. Muscle soreness is ok, but do watch out for any sharp pain (which could be joint pain). Your joints should never feel sharp or hurt. Beginners should avoid high-impact moves (no vest jogging or jumping right away) but focus on low-impact conditioning (walking, basic strength exercises) until a strong foundational base is built.
Intermediate
As an intermediate, introduce the vest to a wider variety of exercises: wear it during brisk walks, light jogging, bodyweight strength circuits (squats, lunges, push-ups), or even hiking.
You’ll have a sense of how the vest feels by now, but continue to check in and evaluate your form (which, I feel is the MOST IMPORTANT variable here!).
A common intermediate mistake is increasing weight too quickly due to excitement & enthusiasm; check your ego at the door and stick to the plan of gradual, progressive overload with a long enough runway for not just your muscles but the often forgotten structural elements (ligaments, tendons and bones) to adapt too and prevent injury. It is the injury to these structures that take us out. Muscles heal pretty quickly, relatively speaking!
Intermediates can also play with training variables: for instance, instead of adding weight one week, try increasing the speed or duration of your vest workout at the same weight. We often forget that weight is but ONE of MANY variables of progressive overload.
Speed and/or duration augment adaptation in your soft tissues. If you notice any specific weak links (say your knees feel achy), strengthen those areas without the vest (through targeted rehab exercises) before piling on more weight.
Athlete
Advanced users can incorporate weighted vests to their sport training.
For example, a runner might do hill sprints with a light vest to improve power, a CrossFit athlete might do pull-ups with a 20 lb vest.
Athletes should periodize vest training – use cycles of a few weeks on, then unload (either reduce vest weight or omit it) to allow recovery and prevent overuse injuries.
Form is everything: an athlete may push to fatigue with a vest, but NEVER EVER SACRIFICE TECHNIQUE (e.g. if doing weighted box jumps, land with good mechanics and stop when form falters).
Also, be mindful of total load on the body: if you’re doing heavy barbell squats and wearing a vest, your spine sees the sum of those loads.
Generally, use the vest to replace or augment a weight, not simply to add on top of an already heavy load (for instance, you might wear a vest to do bodyweight squats instead of holding a heavy barbell – both increase leg load, but combining might be excessive). Athletes often benefit from cross-training with the vest (e.g. a cyclist might use weighted stair climbs to build leg power). Given their higher capacity, athletes can push the envelope on vest weight, but should do so only with solid foundational strength and preferably under the guidance of a coach.
Q: What do you recommend for bone density training in women 35+?
A (Dr. Stephanie):
This is going to be dependent on fitness level and if there are any pre-existing conditions like osteoporosis. I’ll break these down by category.
Beginners
Types of Movements
Start with simple weight-bearing activities. I love including brisk walking on flat ground, walking up a gentle incline or a few stairs, sit-to-stand exercises (chair rises), and basic bodyweight moves like quarter-squats or wall squats with support. These functional movements are familiar and low-impact. You can also do everyday tasks (housework, outdoor walks) wearing the light vest to increase overall weight-bearing time. Avoid any jumping or jerky motions at this stage–keep impact low to slowly load and graduate the structural elements to adapt.
Frequency (Sessions/Week): A great place to start is 2–3 sessions per week, each separated by a rest day.
For example, wear the vest on walks or exercises every Monday, Wednesday, Friday. This allows recovery and adaptation. As you adjust, you may increase to ~4 sessions/week or incorporate the vest into short daily walks, since daily use has been associated with better long-term bone outcomes. Even on “off” days, light vest use during routine activities is fine if it doesn’t cause fatigue or joint pain.
Intensity (Vest Load, Duration, Impact): Total Vest Weight: ~5% of body weight or less to start. For many women this is ~4–8 pounds (including the vest’s own weight). If you have osteopenia or joint issues, you might start as low as 2–3% body weight (e.g. a 150 lb woman starting with ~3–5 lbs).
Session Duration: Aim for about 20–30 minutes per session at first. This could be a 20-minute walk with the vest.
Impact Level: Keep impact low. Walk. don’t jog. The vest itself will gently increase the impact of each footstep by adding weight to your frame, which is enough to begin stimulating bone without overloading structural elements.
Progression Over Time: After 2–4 weeks, if you find the current routine easy, gradually increase the challenge.
Options for progressive overload:
- Add a small amount of weight (1–2 lbs) to the vest once the initial weight feels easy.
- Increase the duration of walks (up to 30–40 min) or add an extra day per week.
- Introduce new exercises carefully: for example, progress from a partial squat to a deeper squat, or from a few stair steps to a full flight of stairs.
Intermediate
Types of Movements:
Good options include: brisk walking or hiking (add hills or uneven terrain for more challenge), and stair climbing (e.g. climbing several flights or using a step aerobic platform for repeated step-ups) or cardio equipment with the weighted vest..
You can also start incorporating strength exercises ( e.g. squats, lunges, glute step-ups onto a higher step or box, calf raise, and toe raises, wall or knee push-ups, and planks) all performed while wearing the vest for extra resistance
You can also begin to test and incorporate balance exercises (e.g. standing on one leg, or heel-to-toe walks) with the vest to train stability.
Impact activities: At the intermediate stage, you may introduce brief bouts of mild impact if tolerated. For example, doing 10 gentle heel drops (rising up onto toes then dropping heels to the floor) or a set of small hops in place (only if your joints are healthy) can start to stimulate bone without excessive risk. Another idea is “stomping” exercises – e.g. stamping each foot firmly on the ground 10 times – which have been shown to help increase hip bone density in older adults when done regularly.
Frequency: Aim for about 3–4 weighted vest sessions per week.
For example, you might do vest workouts on Monday, Wednesday, Friday, and an additional weekend day. At least two of these should incorporate strength exercises, while one or two could be more cardio/impact focused – mixing it up helps target bone in different ways.
Intensity: By this stage, you may be using around 5–10% of your body weight in the vest, depending on your comfort and strength.
Session Duration: Target 30–45 minutes of exercise per session. For instance, a session might include a 10-minute brisk walk warm-up (with vest), 20 minutes of mixed exercises (squats, lunges, step-ups, calf raises, etc.), and 5–10 minutes of balance or stretching drills.
Effort Level: The effort should feel moderate to somewhat hard. During cardio portions (hiking, brisk walking), you might be breathing heavier but still able to speak in short sentences. A RPE of 6-7/10.
We are so honored to have Dr. Stephanie Estima guiding us as we build the future of strength training for women—by women. Stay tuned for more insights from Dr. Stephanie in future posts, and if you’d like to learn more, check out Dr. Estima’s podcast or grab a copy of The Betty Body.
Ready to get started on your own journey? Look out for more resources at thecarry.co and follow us on Instagram @thecarry.co along with the ever so incredible, @dr.stephanie.estima!