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The LIFTMOR Randomised Controlled Trial

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The LIFTMOR trial results are overwhelmingly good, delivering a groundbreaking shift in how medical professionals approach exercise for bone health. Published in the Journal of Bone and Mineral Research, the LIFTMOR Randomized Controlled Trial proved that high-intensity resistance and impact training (HiRIT) safely increases bone density in postmenopausal women and men with osteopenia or osteoporosis. Women with osteopenia or osteoporosis have traditionally been advised to exercise cautiously and avoid heavy lifting. LIFTMOR  challenges this approach, by asking an important question: Can postmenopausal women with low bone density safely lift heavy enough to stimulate stronger bones?

Core Study Design

LIFTMOR stands for Lifting Intervention for Training Muscle and Osteoporosis Rehabilitation. This randomized controlled trial included 101 postmenopausal women with an average age of 65. All had osteopenia or osteoporosis at the hip, spine, or both. The LIFTMOR trial was a high-quality research investigation of exercise for postmenopausal women with low bone mass.

  • Participants: 101 postmenopausal women with osteopenia or osteoporosis (average age 65).
  • Intervention: High-Intensity Resistance and Impact Training (HiRIT).
  • Comparison: A low-intensity home-based exercise control group.
  • Frequency: Twice weekly for 30 minutes, over an 8-month period.

Key Exercises Used

  • Barbell deadlifts
  • Back squats
  • Overhead military presses
  • Jumping chin-ups with drop landings (for impact loading) 

The Core Results

Prior to this trial, medical guidance typically restricted individuals with low bone density to gentle, low-impact movements out of fear of causing fractures. The trial compared an 8-month, twice-weekly program of heavy compound lifting (at 80–85% of 1-repetition maximum) against a low-intensity, home-based routine.

The findings dramatically favoured the heavy lifting group:

  • Functional Performance: Participants showed vast improvements in stature (height retention), back and leg strength, and functional balance metrics, which directly reduces fall risks.
  • Exceptional Safety: Under expert supervision, there were zero fractures and only one reported minor adverse event (a temporary lower back spasm) during the primary trial.

The Caveat: “Good” Comes With Strict Conditions

While the data itself is highly positive, physical therapists and bone health experts emphasize that the protocol is only “good” if executed under specific parameters:

  • Expert Supervision is Mandatory: The exercises utilized—barbell back squats, deadlifts, overhead presses, and jumping chin-ups with flat-footed landings—carry high structural risks if alignment is lost.
  • Prior Screening: The original trial rigorously screened participants to filter out severe comorbidities. Undertaking this exact protocol at home without an assessment or professional coaching introduces a high risk of vertebral compression fractures or joint strain.

The high-intensity program centred on four movements: the deadlift, back squat, overhead press, and a jumping chin-up with a drop landing.

After an initial period focused on learning proper technique, the three resistance exercises were performed for five sets of five repetitions at greater than 80–85% of one-repetition maximum. In practical terms, these were genuinely heavy loads—not light weights performed for many repetitions.

What did the researchers find?

  • Bone Density: The HiRIT group gained roughly 3% to 4% in lumbar spine bone mineral density and about 2% in the femoral neck (hip), whereas the control group continued to lose bone density.
  • Physical Function: Marked improvements occurred in functional performance, dynamic balance, and muscular strength (gains of 25–35%).
  • Safety: The high-intensity regimen was well-tolerated with high compliance and virtually no serious adverse events under professional supervision.

After eight months, lumbar-spine bone mineral density increased by approximately 2.9% in the high-intensity group. In contrast, the low-intensity group lost about 1.2%.

At the femoral neck, bone density was essentially maintained in the high-intensity group, increasing by approximately 0.3%, while the control group lost approximately 1.9%. Preventing the expected decline at the hip may itself be an important benefit.

The high-intensity group also demonstrated favourable changes in femoral-neck cortical thickness. Cortical bone forms the strong outer shell of bone and contributes substantially to the hip’s ability to tolerate loading.

More than stronger bones

LIFTMOR also produced substantial improvements in physical function. Leg and back-extensor strength increased by approximately 35–36%, and participants improved their sit-to-stand ability, functional reach, mobility, and vertical-jump performance.

This matters because fracture risk is influenced by more than bone density. Strength, balance, mobility, and the ability to recover from a misstep can all affect the likelihood of falling—and whether a fall results in injury.

The Bottom Line

The LIFTMOR trial helped overturn the assumption that women with low bone density should train only with light weights. Its message is not simply “lift heavy.”

With appropriate screening, progressive loading, excellent technique, and qualified supervision, postmenopausal women can train at high intensity—and may meaningfully improve bone density, strength, and physical function. For more info or one to one consults please reach out ..

References:

https://pubmed.ncbi.nlm.nih.gov/28975661

https://pubmed.ncbi.nlm.nih.gov/30861219

https://pubmed.ncbi.nlm.nih.gov/29125144

https://pubmed.ncbi.nlm.nih.gov/36310762

The Science of Stress

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The Science Connecting Health and Emotions

The science of stress reveals that our emotions do not directly cause illness, but the biological systems controlling our emotional and stress responses share pathways with our immune and cardiovascular networks, influencing our vulnerability to burnout and disease.

In the 1950s that Austrian Canadian physician and physiologist Hans Selye pioneered the notion of stress as we now know it today, drawing the scientific community’s attention to the effects of stress on physical health and popularizing the concept around the world.

Since ancient times humans have felt intuitively that emotions and health are linked, and there had always been speculation about this notion. But without compelling evidence, it had been impossible to say for sure that such a connection really exists and especially how it works. Dr. Esther Sternberg in her groundbreaking work was pivotal in helping to solve this mystery. Through experiments it revealed the physical mechanisms; nerves, cells, and hormones, used by the brain and immune system to communicate with each other. She described how stress can make us more susceptible to all types of illnesses, and how the immune system can alter our moods.

Sternberg explains how our understanding of these connections in scientific terms is helping to answer such crucial questions as “Does stress make you sick?” “Is a positive outlook the key to better health?” and “How do our personal relationships, work, and other aspects of our lives affect our health?”

In the immeasurably revelatory The Balance Within: The Science Connecting Health and Emotions (public library), published in 2001, Sternberg examines the interplay of our emotions and our physical health, mediated by that seemingly nebulous yet, it turns out, remarkably concrete experience called stress.

“The same parts of the brain that control the stress response … play an important role in susceptibility and resistance to inflammatory diseases such as arthritis. And since it is these parts of the brain that also play a role in depression, we can begin to understand why it is that many patients with inflammatory diseases may also experience depression at different times in their lives… Rather than seeing the psyche as the source of such illnesses, we are discovering that while feelings don’t directly cause or cure disease, the biological mechanisms underlying them may cause or contribute to disease.”

“Members of certain professions are more prone to burnout than others — nurses and teachers, for example, are among those at highest risk. These professionals are faced daily with caregiving situations in their work lives, often with inadequate pay, inadequate help in their jobs, and with too many patients or students in their charge. Some studies are beginning to show that burnt-out patients may have not only psychological burnout, but also physiological burnout: a flattened cortisol response and inability to respond to any stress with even a slight burst of cortisol. In other words, chronic unrelenting stress can change the stress response itself. And it can change other hormone systems in the body as well.”

Esther Sternberg

The Biology of the Stress Response

  • Hormone release: Stress activates the hypothalamic-pituitary-adrenal (HPA) axis, releasing cortisol, adrenaline, and norepinephrine into the bloodstream.
  • Physical changes: Heart rate and blood pressure increase to supply energy to muscles for a fight-or-flight reaction.
  • Brain impact: Chronic activation shrinks the prefrontal cortex and overworks the amygdala, reducing our capacity to regulate future stress.

Emotions, Burnout, and Disease Susceptibility

  • Immune suppression: Long-term negative emotions and unmanaged stress keep cortisol high, which suppresses immune cell function and raises infection risks.
  • Inflammatory links: “The same parts of the brain that control the stress response … play an important role in susceptibility and resistance to inflammatory diseases,” as noted by The Marginalian.
  • Cardiovascular strain: Persistent adrenaline and cortisol damage blood vessel linings, increasing the likelihood of high blood pressure and heart attacks.

A wealth of evidence supports that “emotions and health are one.” Sternberg reminds us that our brains have maps of our relationships. Loss, loneliness, rejection, isolation, disappointment, fears, anxiety and stress all affect our molecules and nerve pathways to cause disease and pain. To achieve this balance, Sternberg identifies healthy food, clean water, exercise, rest; however, she adds love, acceptance, belief and spirituality. A fine menu of nourishment!

Our perception of stress, and therefore our response to it, is an ever-changing thing that depends a great deal on the circumstances and settings in which we find ourselves. It depends on previous experience and knowledge, as well as on the actual event that has occurred. And it depends on memory, too.

Esther Sternberg