What is the LIFTMOR study in laymen’s terms?

If you have been diagnosed with osteopenia or osteoporosis, there is a good chance you have been told some version of this:

Walk more.
Use light weights.
Avoid falling.
Be careful.

None of that advice is wrong.

But it is incomplete.

The LIFTMOR studies are important because they challenged one of the long-standing assumptions in osteoporosis care: that people with low bone density should avoid heavier lifting.

In simple terms, LIFTMOR asked this:

Can carefully supervised, heavy resistance training and impact training improve bone strength and physical function in people with low bone mass?

The answer was encouraging.

Across both the women’s and men’s LIFTMOR studies, supervised high-intensity resistance and impact training improved important measures of bone, strength, posture and physical function. The key word, however, is supervised. This was not random gym training. It was structured, coached and progressed carefully.

What does LIFTMOR stand for?

LIFTMOR stands for:

Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation.

The original LIFTMOR trial was performed in postmenopausal women with low bone mass. The later LIFTMOR-M trial looked at middle-aged and older men with osteopenia and osteoporosis.

Both studies used a training style called HiRIT, which stands for:

High-intensity Resistance and Impact Training.

In plain English, that means challenging strength exercises and carefully controlled impact work.

But it does not mean throwing people under a heavy barbell on day one.

That is the part people often miss.

What did the women’s LIFTMOR study involve?

The women’s LIFTMOR trial included postmenopausal women over 58 years of age with low bone mass. Participants were randomised into either a supervised HiRIT group or a lower-intensity home exercise group.

The HiRIT group trained for 8 months, twice per week, for around 30 minutes per session. The programme used key compound exercises such as the deadlift, squat and overhead press, alongside impact loading. The study protocol used 5 sets of 5 repetitions at heavy loads once the participants had progressed into the full programme.

But they did not start there.

The first month focused on bodyweight and low-load variations so the participants could learn the movement patterns safely. The researchers reported that all participants were able to perform the four fundamental exercises within two months.

That is a very important detail.

The load was earned.

What did the women’s study find?

The results were meaningful.

After 8 months, the HiRIT group improved lumbar spine bone mineral density by 2.9%, while the control group lost 1.2%. At the femoral neck, the HiRIT group essentially maintained BMD with a small 0.3% improvement, while the control group lost 2.0%.

At first glance, some people might look at those numbers and say:

“Is that it? A few percent?”

That is a fair reaction.

But with bone, context is everything.

If one group gains 2.9% at the spine while the other loses 1.2%, that is not just a 2.9% story. It is a 4.1% difference between the direction of adaptation and the direction of decline.

At the femoral neck, a 0.3% improvement might sound tiny, but compare it with a 2.0% loss in the control group. That is a 2.3% relative difference over only 8 months.

In osteoporosis, sometimes “holding the line” is a win.

Especially at the hip.

The researchers themselves noted that the femoral neck BMD response was modest and largely reflected maintenance, but they also found superior changes in femoral neck bone mineral content and cortical thickness. That matters because cortical bone is a major contributor to femoral neck strength.

So the message is not simply, “LIFTMOR made everyone’s bones dramatically denser.”

The better message is:

LIFTMOR shifted the trajectory.

Instead of losing bone, participants maintained or gained at clinically important sites.

That is powerful.

What about strength and function?

This is where LIFTMOR becomes even more clinically useful.

Osteoporosis is not just about a scan number.

A DEXA scan matters, but fracture risk is also influenced by strength, balance, posture, reaction time, muscle function and falls risk.

In the women’s LIFTMOR trial, the HiRIT group improved leg extensor strength by 37.1% and back extensor strength by 36.3%. They also improved timed up-and-go, five-times sit-to-stand, functional reach and vertical jump measures compared with the control group.

That matters enormously.

A stronger person is not just a person with better gym numbers.

A stronger person is often better able to get out of a chair, climb stairs, recover from a stumble, hold posture, lift safely, and move with confidence.

For people with osteoporosis, that may be just as important as BMD itself.

Was it safe?

In the women’s trial, compliance was high at 92% in the HiRIT group. Across more than 2600 training sessions, there was one minor adverse event: a mild lower-back muscle strain that caused the participant to miss two sessions before returning to training. No fractures or major adverse events were observed during the intervention.

That is encouraging.

But again, we need to interpret this honestly.

The study participants were screened. They were supervised. They were taught technique. The programme was progressed. The researchers also stated that the trial was not powered to prove safety for every possible person with osteoporosis, and they recommended caution when applying the findings beyond the study population.

So the takeaway is not:

“Everyone with osteoporosis should lift heavy on their own.”

The takeaway is:

Heavy loading may be both useful and well tolerated when the right person is screened, coached and progressed in the right environment.

That is the key.

What did the men’s LIFTMOR study add?

The LIFTMOR-M trial is important because men are often under-represented in osteoporosis research.

Men get osteoporosis too.
Men fracture too.
Men lose strength too.
And men also need evidence-based exercise options.

The LIFTMOR-M trial included middle-aged and older men with low bone mass. The study compared supervised HiRIT with machine-based isometric axial compression training and a control group who continued usual activities. The men trained twice weekly for 8 months.

The HiRIT group improved lumbar spine BMD by 4.1%, compared with 0.9% in the control group. Trochanteric BMD improved by 2.8% in the HiRIT group, compared with -0.1% in the control group. HiRIT also improved lean mass, timed up-and-go, five-times sit-to-stand, back extensor strength and leg extensor strength compared with control.

That is a strong result.

It suggests that this style of training is not only relevant to postmenopausal women. It may also be a valuable model for men with low bone mass when delivered appropriately.

Again, are those BMD changes “big”?

This is where we need to be honest.

In the world of bone density, most exercise changes are not huge. We are often dealing with small percentages.

But small percentages can matter when the alternative is decline.

The women’s study showed a spine BMD gain of 2.9% compared with a 1.2% loss in controls. The men’s study showed a spine BMD gain of 4.1% compared with 0.9% in controls.

So the practical question is not just:

“How much did BMD go up?”

The better question is:

“What would likely have happened without the loading stimulus?”

Because for many people with osteopenia or osteoporosis, the realistic goal is not always dramatic reversal. Sometimes the first goal is to stop sliding backwards.

To maintain hip BMD when it might otherwise decline is valuable.

To improve spine BMD while also improving strength, posture and physical function is very valuable.

To train someone so they are less likely to fall, more able to recover, and less fearful of movement is clinically meaningful.

That is why I think LIFTMOR is so important.

Not because the numbers are magical.

But because the whole direction changes.

What does LIFTMOR not mean?

LIFTMOR does not mean everyone should do the exact same exercises.

It does not mean every person with osteoporosis should start jumping.

It does not mean heavy lifting is automatically safe for everyone.

It does not mean technique is optional.

It does not replace medical treatment, nutrition, calcium, vitamin D, falls prevention, medication where appropriate, or specialist care.

And it definitely does not mean people should copy the protocol from the internet and try it unsupervised.

The women’s LIFTMOR paper specifically highlighted that the graduated introduction of loading, close supervision and technical coaching were key elements, and the authors did not recommend the protocol be undertaken unsupervised by people with low bone mass.

That point needs to stay front and centre.

Why LIFTMOR matters for Bone Health Studio

For me, the value of LIFTMOR is not that it gives us a script to copy.

The value is that it gives us permission to think differently.

For too long, many people with osteoporosis have been treated as fragile.

But the body is adaptable.

That does not mean we ignore risk. It means we respect risk while still building capacity.

At Bone Health Studio, this is central to the Bone Builder approach.

We are not trying to turn everyone into powerlifters.

We are trying to help people learn how to lift, brace, hinge, squat, step, balance and load progressively in a way that suits their body.

For one person, that may eventually look like a barbell deadlift.
For another, it may start with a kettlebell from a raised box.
For another, it may begin with sit-to-stand strength, balance work and careful movement education.

The principle is the same.

The entry point is individual.

The bottom line

In laymen’s terms, the LIFTMOR studies showed that people with low bone mass may be capable of far more than they have often been told.

In women, supervised HiRIT improved spine BMD, maintained femoral neck BMD compared with loss in controls, and produced large improvements in strength and function. In men, LIFTMOR-M showed meaningful improvements in spine and trochanteric BMD, lean mass, strength and function compared with usual activity.

The changes in BMD may look small if we compare them to muscle gains or fitness improvements.

But bone changes slowly.

And when the alternative is gradual loss, maintenance or small improvement becomes a big deal.

That is the real message.

Not reckless lifting.
Not fear-based avoidance.

But structured, supervised, progressive loading.

Learn to lift well.
Start at the right level.
Progress carefully.
Respect the diagnosis.
Build strength.
Build confidence.
Build capacity.

That is why LIFTMOR matters.

References

Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. 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. Journal of Bone and Mineral Research, 2018.

Harding AT, Weeks BK, Lambert C, Watson SL, Weis LJ, Beck BR. A Comparison of Bone-Targeted Exercise Strategies to Reduce Fracture Risk in Middle-Aged and Older Men with Osteopenia and Osteoporosis: LIFTMOR-M Semi-Randomized Controlled Trial. Journal of Bone and Mineral Research, 2020.

Harding AT, Weeks BK, Lambert C, Watson SL, Weis LJ, Beck BR. Effects of supervised high-intensity resistance and impact training or machine-based isometric training on regional bone geometry and strength in middle-aged and older men with low bone mass: The LIFTMOR-M semi-randomised controlled trial. Bone, 2020.

Harding AT. LIFTMOR-M: Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation for Men. Griffith University thesis, 2020.