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Osteoporosis and Strength Training for Women: What the LIFTMOR Trial Proved

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Sep 13
5 min read
Coach guiding a woman through a supervised barbell lift at StrongHer Training

For a long time, the standard advice for a woman diagnosed with osteopenia or osteoporosis was to be careful. Walk, do some light resistance bands, avoid anything heavy. The intention was good. The problem is that bone does not get stronger in response to being careful. It gets stronger in response to load.

In 2018 an Australian research team published a trial that changed the conversation. It is called LIFTMOR, and if you have been told your bone density is low, it is worth understanding exactly what it found and, just as importantly, how it was done.

What LIFTMOR did

The trial, led by Watson and colleagues (2018) and published in the Journal of Bone and Mineral Research, enrolled 101 postmenopausal women with an average age of 65, all of whom had osteopenia or osteoporosis. Half were assigned to a home-based low-intensity programme. The other half did something that would have made many clinicians nervous: eight months of high-intensity resistance and impact training, twice a week, thirty minutes per session, fully supervised.

The lifting group performed three barbell lifts, the deadlift, the back squat and the overhead press, for five sets of five repetitions at more than 85 percent of their one-rep max. They also did jumping chin-ups with drop landings to provide impact loading through the spine and hips. This was not a gentle programme. It was heavy, deliberate and progressive, and every session was coached.

What it found

At the lumbar spine, the lifting group gained 2.9 percent bone density while the control group lost 1.2 percent. At the femoral neck, the part of the hip most vulnerable to fracture, the lifting group gained 0.3 percent while the control group lost 1.9 percent. Functional measures such as strength and posture improved as well.

And safety? Across eight months of heavy lifting in women with low bone density, the study recorded one minor back spasm. No fractures. No serious injuries. The intervention that many would have assumed was too risky turned out to be both effective and safe when properly supervised.

Has it held up?

One trial, however well designed, is never the whole story. A 2025 review in Current Osteoporosis Reports by Kumar and colleagues looked at the body of evidence for high-intensity resistance and impact training, often shortened to HiRIT. Their summary: this approach produces lumbar spine bone density gains in the range of 2 to 4 percent and is safe when it is supervised and progressed carefully. A replication study, MEDEX-OP, found a smaller gain of around 1 percent, which is a useful reminder that the exact size of the effect varies.

The same review is honest about what remains unproven. We do not yet have trials showing that HiRIT reduces actual fractures, only that it improves bone density and function, which are strong indicators but not the same thing. We also do not know how durable the gains are if training stops. And there are women for whom impact loading should be avoided or modified, including anyone with a recent fracture or severe vertebral osteoporosis. This is precisely why we screen carefully and why every lifter at StrongHer works under a coach.

The impact component specifically is supported by a 2023 meta-analysis by Ng and colleagues covering 28 randomised trials and nearly 3,000 participants. Impact loading improved bone structure, and the effect was most consistent in postmenopausal women. Bone responds to being asked to absorb force.

Strength and function matter even when the scan does not move

A common worry is, "What if my bone density does not change much?" A 2026 meta-analysis by Zhou and colleagues in Frontiers in Public Health looked at twelve trials of resistance training in older adults with sarcopenia, average age 72. The consistent finding was large gains in strength and physical function even when muscle mass barely changed. Programmes ran two to three times a week for eight to 26 weeks.

Why does that matter for osteoporosis? Because the thing that breaks a bone is usually a fall, and the thing that prevents a fall is strength, power and balance. The Kumar review notes that balance programmes cut falls by around 23 percent when done for 1.5 to 3 hours a week over at least three to six months. Building strong legs, a stable trunk and quick reactions is bone protection whether or not your next DEXA scan shows a big change.

Power may matter most of all

A 2025 study in Mayo Clinic Proceedings by Araújo and colleagues followed about 3,900 adults aged 46 to 75 and compared muscle power, the ability to produce force quickly, with mortality. Women in the lowest power tertile had roughly 6.9 times the mortality hazard of those in the highest. Interestingly, grip strength alone was not significant once other factors were accounted for. This is observational data and cannot prove cause, but it is one reason our programming includes controlled power work, not only slow heavy lifting.

That aligns with the 2025 guidance from the International Conference on Frailty and Sarcopenia Research, summarised by Izquierdo and colleagues: progressive resistance training is the cornerstone of exercise for older adults, it should include power and balance elements, and it should be individualised and supervised.

How we apply LIFTMOR at StrongHer

We do not hand a new member a barbell loaded to 85 percent on day one. Neither did LIFTMOR. The women in that trial went through a supervised ramp where technique came first and load was added gradually. That is our model too. In our small groups of up to six, every lift is watched. Squat, deadlift and overhead press are the backbone of what we teach. Impact work is introduced only progressively, only when it is appropriate for you, and never after a recent fracture.

Karen, our owner, is a nationally ranked powerlifter and a licensed massage therapist. She has spent her career learning what heavy lifting looks like when it is done well, and what it looks like when bodies are pushed the wrong way. Supervision is not a luxury in this kind of training. It is the ingredient that made it safe in every trial we have cited.

What this means for you

  • A diagnosis of osteopenia or osteoporosis is not a reason to avoid lifting. In the right setting it is a reason to start.

  • Expect a technique-first ramp of several weeks before loads get heavy. The heavy part is where the bone benefit comes from, but it is earned, not rushed.

  • Two supervised sessions a week for eight months produced the LIFTMOR results. Consistency over a long stretch is what matters.

  • Impact work is part of the picture for many women but must be individualised. Tell your coach about any fracture history.

  • Strength, power and balance gains protect you from falls even before your scan changes.

Please bring your doctor into this. Share your DEXA results with your coach, keep any bone medication or hormone therapy your clinician has prescribed, and treat training as a partner to that care rather than a replacement. If you have had a recent fracture or severe vertebral osteoporosis, you need medical clearance before any impact work.

We are building strong women, not simply exhausted ones. If you have been told your bones are thinning and you want to do something about it, book a free 15-minute fit call and we will talk through your situation, or come in for a $25 New Member Trial session at our Fort Mill studio.

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