Evidence explainerMidlife Strength & Creatine
Heavy Lifting After Menopause: What the LIFTMOR Trial Found for Bone
In women with low bone mass, 8 months of supervised heavy lifting and impact training raised spine and hip bone density and caused no vertebral fractures. The WHO recommends muscle strengthening on 2 or more days a week.
Key takeaways
- LIFTMOR randomized 101 postmenopausal women with low bone mass to supervised high-intensity resistance and impact training or a low-intensity home program for 8 months [1].
- Lumbar spine bone density rose 2.9% with heavy training and fell 1.2% with the home program; femoral neck density rose 0.3% vs falling 1.9% [1].
- Follow-up imaging found no new vertebral fractures in the heavy-training group and an improvement in upper-back curvature [2].
- The WHO recommends muscle-strengthening activity involving all major muscle groups on 2 or more days a week for adults [3].
The LIFTMOR trial
Women aged around 65 with T-scores below -1.0 did 30-minute supervised sessions twice a week: 5 sets of 5 repetitions at more than 85% of their one-repetition maximum, plus impact loading, for 8 months. The comparison group did a home-based, low-intensity program [1].
Heavy training beat the home program for lumbar spine and femoral neck bone density, femoral neck cortical thickness, height and all functional tests, including timed up-and-go and sit-to-stand [1]. Compliance was 92%, and the only reported adverse event was a minor lower-back spasm [1].
Was it safe for fragile bones?
Heavy training is not traditionally recommended for people with osteoporosis because of fracture concerns [1]. A follow-up analysis of spine scans found no change in vertebral fracture classification in the heavy-training group, and a clinically relevant reduction in thoracic kyphosis; one new wedge deformity appeared in the home-exercise group [2].
Sessions in LIFTMOR were supervised, and women were screened for conditions and medications affecting bone beforehand [1]. Women with osteoporosis should get clearance and qualified coaching before lifting heavy.
How much training
The WHO's 2020 guidelines recommend that adults do muscle-strengthening activities at moderate or greater intensity, involving all major muscle groups, on 2 or more days a week, on top of 150 to 300 minutes of moderate aerobic activity [3].
For adults 65 and older, the WHO adds varied multicomponent activity that emphasises balance and strength training on 3 or more days a week, to improve function and prevent falls [3].
LIFTMOR's twice-weekly, 30-minute sessions fit inside that recommendation [1][3].
Does adding creatine help bone?
In a 2-year trial of 237 postmenopausal women on a resistance training and walking program, adding creatine did not change bone density compared with placebo, though it preserved some hip geometry measures [4]. For muscle, see our creatine guide for women over 40.
Quick answers
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References
- [1]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.
- [2]High-intensity exercise did not cause vertebral fractures and improves thoracic kyphosis in postmenopausal women with low to very low bone mass: the LIFTMOR trial. Osteoporos Int, 2019.
- [3]World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med, 2020.
- [4]A 2-yr Randomized Controlled Trial on Creatine Supplementation during Exercise for Postmenopausal Bone Health. Med Sci Sports Exerc, 2023.