Bone Health… It’s Time to Lift HEAVY!!!

Lifting heavy weights can often seem daunting, especially if you’ve been told you have low bone mineral density or osteoporosis. Traditionally, people with osteoporosis were advised to avoid heavy lifting or intense exercise due to fear of injury, however, recent research has challenged this approach, showing that high-intensity resistance training (HiPRT) is not only safe but highly effective for improving bone health. 

What is High-Intensity Resistance Training?

High-intensity resistance training involves lifting heavier weights (around 80–85% of your one-repetition maximum) for fewer repetitions with good technique and supervision. It aims to place enough mechanical load on the bones to stimulate adaptation and strengthening.

The LIFTMOR Trial: Ground-breaking Evidence

The LIFTMOR (Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation) trial, conducted in Australia, is one of the most significant studies in this field. This randomised controlled trial, published in Osteoporosis International (Watson et al., 2015), investigated the effects of high-intensity resistance training on bone health in postmenopausal women with low bone mass.

Key Findings from the LIFTMOR Trial:

✅ Participants performed supervised, high-intensity exercises such as deadlifts, overhead presses, and jumping chin-ups with drop landings twice a week for 8 months.

✅ The HiPRT group showed significant improvements in bone mineral density (BMD) at the lumbar spine (2.9% increase) and femoral neck (0.3% increase) compared to a control group who did low-load exercises.

✅ There were no serious adverse events, highlighting the safety of this program when supervised and performed with correct technique.

✅ Participants also improved muscle strength, posture, and functional performance, reducing fall and fracture risk.

Why is High-Intensity Training More Effective?

Bones need a strong enough stimulus to adapt and grow stronger. Low-load or light exercises may maintain bone mass but often aren’t sufficient to build new bone density. The LIFTMOR trial showed that lifting heavier weights with proper form provides the necessary mechanical load to stimulate osteoblast activity (bone building cells), promoting bone formation and strength.

Is High-Intensity Training Safe for Osteoporosis?

The LIFTMOR trial demonstrated that with professional supervision and gradual progression, HiPRT is safe, even in women with osteopenia or osteoporosis. Important safety considerations include:

✔️ Learning correct lifting technique before progressing to heavier loads ✔️ Avoiding unsafe movements like rapid twisting or forward spinal flexion under load ✔️ Individualising programs based on medical history, fracture risk, and current fitness levels

Implications for Practice

The findings from the LIFTMOR trial support the inclusion of high-intensity resistance training in osteoporosis management guidelines. Programs like these can:

✅ Increase bone density ✅ Improve strength and balance ✅ Reduce falls and fractures ✅ Boost confidence and independence

Exercise professionals, including physiotherapists and exercise physiologists, play a critical role in safely implementing HiPRT programs tailored to each individual.

Conclusion

The LIFTMOR trial has changed the way we view exercise for osteoporosis. Heavy weights have often been associated with body builders and athletes, but studies like this show the importance of appropriately prescribed and supervised high-intensity resistance training. Feeling the burn, getting a sweat on and challenging your body could be the answer to building stronger bones, preventing fractures, and improving your quality of life!

References

1. Watson, S. L., Weeks, B. K., Weis, L. J., Harding, A. T., Horan, S. A., & Beck, B. R. (2015). High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: the LIFTMOR randomized controlled trial. Osteoporosis International, 26(12), 3349-3356. https://doi.org/10.1007/s00198-015-3263-2

2. Beck, B. R., & Daly, R. M. (2020). Exercise and bone health across the lifespan. Advances in Experimental Medicine and Biology, 1228, 309-329.