Replicating the LIFTMOR Trial for Osteopenia and Osteoporosis

Has your spouse ever told you about how great something is over and over, always falling on deaf ears, but then a 3rd party mentions this same thing and how amazing it is, and suddenly you’re all ears?

I am 100% guilty of this. Eric, my wonderful work and life partner, has lifted weights since before we met – at home, at the gym, in our driveway, and in various CrossFit settings. He’s an enthusiast. He’s politely suggested throughout the years that I may find benefit in doing so too, and I’ve always pushed back stating that I’m very happy with my low-impact bodyweight exercises such as walking and yoga, thank you very much.

I carried on with my self-righteousness right up until June 2024, when I attended the Bone Health and Osteoporosis Foundation’s Annual Symposium to learn how I could help my many patients with Osteopenia and Osteoporosis. And I’ll be damned, one of the main, proven ways to prevent bone loss is lifting weights – lifting heavy weights to be precise.

I came home with my tail tucked between my legs and divulged my new knowledge to my patient spouse. I told him that the latest research is showing that bone mass can actually be improved when a patient with osteopenia or osteoporosis lifts very heavy weights and does high-impact exercise (i.e. jumping). I know he was doing his best not to look smug in that moment.

The groundbreaking LIFTMOR Randomized Controlled Trial’s¹ results were published in 2019 in the Journal of Bone and Mineral Research. This trial flipped the paradigm of osteoporotic people being too fragile to lift heavy weights on its head. 101 postmenopausal women with either osteopenia or osteoporosis (collectively known as low bone mass) were recruited and randomly assigned to 2 different groups. One group received low-intensity exercise, and the other group received high-intensity resistance and impact training (HiRIT), the exact details of which I will describe later in this post. Each group performed their exercise regimen twice per week for 30 minutes for eight months total.

Bone mineral density was measured via DEXA Scan both before the trial began and after the exercise regimen was completed 8 months later. All results were in favor of the high intensity and impact training: bone mineral density scores in the lumbar spine and femur (thighbone) were significantly, statistically higher in this group versus the low intensity group at the end of the trial. AND there was only 1 adverse event reported in the high intensity group: one participant missed 2 sessions due to minor lower back spasms. So much for osteoporotic people being frail!

So I got to thinking about all this amazing research, about the high incidence of Osteopenia and Osteoporosis in those who have scoliosis, and personally being a thin Caucasian female (all 3 of those things increase my risk for osteopenia/osteoporosis) who’s on the brink of Menopause. I decided to embark on a personal LIFTMOR Trial journey, for myself and for my patients.

Doctors won’t prescribe DEXA Scans before the age of 60, unless there is an underlying systemic issue or pertinent medical history that would necessitate one earlier. This is a problem for me because I’m 39 years old, decades away from being eligible for a DEXA. Luckily there’s a company right here in the DC metro area called Composition ID that offers cash-pay DEXA Scans to measure body fat, lean mass, and bone density. Two days from now I will go to their Tysons Corner location for a DEXA Scan to obtain my pre-LIFTMOR bone density scores.

Then….I will start my LIFTMOR experiment. Here’s what it will look like:

• Twice per week on non-consecutive days, I will do these 4 exercises, circuit style, for 30 minutes total:

One High-Impact Exercise: Jumping Chin Ups

This is a very specific jumping technique for low bone mass: holding onto a chin up bar, I will squat down, then jump up high, then land hard on my entire foot (very opposite of how I typically train patients to jump as a physical therapist i.e. “like a ninja”, landing quietly on their feet to absorb shock with the big muscles of the legs and the core.). To build bone, we need to land hard on the feet to stimulate osteoblasts, the cells that produce bone. I will do 5 repetitions for 5 sets. See the video of a Jumping Chin Up for a visual.

Jumping Chin Up

Three High-Intensity Resistance Training Exercises:

Overhead Press

Deadlift

Squat

Overhead Press, Dead Lift, and Squat. These three exercises will be performed at 85% of my 1 rep max. A 1 rep max is the heaviest weight one can lift for just 1 repetition, so if my 1 rep max is 100 pounds, I need to be lifting at least 85 pounds for the exercise. I will do each of the 3 exercises for 5 reps and 5 sets, always focusing on good form. My Rate of Perceived Exertion, a 6-20 point scale, should be 16 or higher.

After 8 months of this routine, I’ll head back to Composition ID for my post-trial DEXA Scan to re-examine my bone mineral density scores. My objective is to fend off any impending Osteopenia or Osteoporosis that so often comes with Menopause.

Wish me luck and stay tuned!

References:

1. 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. J Bone Miner Res. 2018 Feb;33(2):211-220. doi: 10.1002/jbmr.3284. Epub 2017 Oct 4. Erratum in: J Bone Miner Res. 2019 Mar;34(3):572. doi: 10.1002/jbmr.3659. PMID: 28975661.