Hey Team! This week, I want to feature one of the most important randomized controlled trials for menopausal women - the LIFTMOR Trial. "Lifting heavy" is not just the latest social media tagline - it is the foundation of our longevity - and the evidence supports it! I hope you enjoy this summary and this week's workout! Cheers! -Dr. Carla
Women with osteopenia or osteoporosis have traditionally been advised to exercise cautiously and avoid heavy lifting. The landmark LIFTMOR trial challenged that approach by asking an important question: Can postmenopausal women with low bone density safely lift heavy enough to stimulate stronger bones?
What was the LIFTMOR trial?
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 women were assigned to one of two programs performed twice weekly for eight months:
A supervised, 30-minute high-intensity resistance and impact training program
A home-based, low-intensity exercise program emphasizing mobility, balance, and light resistance
The high-intensity program centered 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?
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 favorable 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.
Was heavy lifting safe?
Across more than 2,600 supervised training sessions, only one training-related adverse event occurred: a mild lower-back muscle strain. The participant returned to training and completed the program. No training-related fractures or serious injuries were reported.
These findings are reassuring, but they require context. Participants were carefully screened, the exercises were introduced gradually, and every high-intensity session was closely supervised by qualified professionals. The study was also too small to prove that the program prevents fractures or is safe for every woman with osteoporosis.
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.” It is:
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.
Everyone loves a good heavy day! There’s something very satisfying about moving heavier loads for lower repetitions. But this isn’t your typical “heavy day” where we do 5 sets of 5 and we’re done. Today, we integrate two movements - the dumbbell push press and the front squat. But we don’t stop there - we have a new movement called the “dumbbell bear crawl” performed between rounds of lifting. This movement requires coordination, balance, shoulder stabilization, and core strength, complementing the muscles targeted by the lifts and adding some unexpected intensity!
Movement practice
Take 5-7 minutes to watch the videos, practice the movements, and select your workout weight. Select one set of dumbbells to use for the push press, front squat, and the dumbbell bear crawl. The push press will be what limits the weight selection. This is a heavier weight that you can perform 5 push press repetitions where the movement becomes challenging at rep 3.
Next, watch the video and practice the bear crawl, starting without weight and then adding the dumbbells. For bear crawl modifications, check out this post from the Athletic Aging Archives: Strong on All Fours. If the dumbbell bear crawl is not accessible to you, forego the dumbbells (or use a second, lighter set) and do a simple bear crawl.
Workout
Perform 2 dumbbell push presses, 2 front squats, and a 25-foot dumbbell bear crawl. Then perform 4 push presses, 4 front squats, and a 25-foot dumbbell bear crawl, and so on until you finish the repetition scheme. Your last movement should be the 25-foot dumbbell bear crawl. As the sets get larger and fatigue sets in, break up the sets into smaller sets with a few breaths of rest in between.
A trick to help keep moving efficiently is to make a point to pick up the dumbbells before you really want to at the end of each short rest interval.
For Time:
2 - 4 - 6 -8 -10
Perform a 25-foot dumbbell bear crawl (or simple bear crawl or other modification) after each round of push presses and squats using the same set of dumbbells used for the lifts. Alternatively, you can perform the bear crawl without weight. Click HERE for more bear crawl modifications
Cool Down
Your core is going to need some love after this workout. Jump-start your recovery with this 15-minute full-body stretch sequence.
Yoga Full-Body Stretches for Tension and Sore Muscles
This just dropped…..
You did the workout, you ate “clean,” and your body still isn’t responding the way it used to. So what changed? In this episode, I sit down with Dr. Carla DiGirolamo, a double Board-Certified Obstetrician/Gynecologist and Reproductive Endocrinologist specializing in caring for active and high-performing women, to unpack what’s really happening to active women’s bodies in mid-life and beyond.
We get into why hypothyroidism can be misdiagnosed because of chronic underfueling, what LEA and RED-S are (and why most doctors have never heard of them), hot takes on microdosing GLP-1s and muscle/bone loss for midlife women, and how HRT, testosterone therapy, and IUDs actually fit together. This isn’t a decline — it’s a detour, and it comes with a new playbook.
NOW TAKING MEDICAL CLIENTS FROM COLORADO, CONNECTICUT, AND NEW HAMPSHIRE!
..in addition to MA, NY, NJ, PA, CA, FL, OH
If you are an active woman or competitive midlife athlete who feels abandoned by mainstream medicine, I’m here for you!
Active and athletic midlife women have needs and risk profiles that are different from the general population. These needs often go unmet by the mainstream medical community due to a lack of understanding of fitness and sport and their impact on mid-life hormonal physiology or even a lack of acknowledgment that this dynamic exists.
To speak to this need, I launched my Telehealth Consultation Medical practice focusing on the Reproductive Endocrine needs and Menopausal Care for active, athletic, and high-performing women.
We put your health, fitness, and performance at the center of the equation so that you can achieve your healthiest, highest-performing self!
You will find all my service offerings on my website including a link to my calendar so that you can reserve your place in my schedule!