Lift heavy for strong bones. Is this message helpful?

If you are women of a certain age, you are told to lift heavy for strong bones.  But is this message helpful?   Has it inspired you to rush off to the gym and start deadlifting?

Strength training is definitely having a moment right now. “Lift heavy for strong bones” is everywhere but is it a helpful and effective message?    It is a message sent and received to many.  Young men for instance, but also another very particular group of people: older women.

Here is yet another thing to complicate the picture if you do regular exercise or are contemplating it.     It could even overwhelm you if you are simply trying to decide what your exercise goals are.  Frustratingly though, it is a valid goal.  Extra specially so  if you are post menopausal women, (but yes, for everyone else as well.)

Have I ruined everything by suggesting there might actually be exercise goals?

Ok so the big goals are:

Heart health, feeling better mentally, muscle strength, joint mobility, sleeping better.

You could address these big goals by simply doing some exercise, regularly, including something with a strength element to it.

This is still not addressing what to do for healthy bones.

Lift heavy for strong bones

The LIFTMOR study was ground breaking research done in Australia with the results published in 2017.  It was a randomised control trial that showed statistically significant evidence that a programme of heavy lifting can improve the bone mineral density (BMD) of women with Osteoporosis.   It was a watershed moment, proving that women with Osteoporosis could lift heavy and could show strength and BMD gains.  Liftmor is very often often cited  as evidence by people promoting the lift heavy for strong bones concept.

By heavy I mean, really heavy!   The 4 key Liftmor exercises are

1. Deadlifts: Barbell deadlifts performed from the floor. This movement targets the posterior chain (hamstrings, glutes, and back muscles) to place a high mechanical load on the lumbar spine and hips.
2. Back Squats: Barbell back squats where the bar is placed across the upper back/shoulders. This heavily loads both the lumbar spine and the femoral neck (hip bone).
3. Overhead Press (Shoulder Press): A standing barbell overhead press. This exercise requires full-body stabilization and targets the upper body.  At the same time the load  travels down through the upright spine.
4. Jumping Chin-Ups with Drop Landings: This was the primary impact-loading exercise. Participants explosively jumped up  and reached overhead for a bar, trying to pull the  body higher up with the arms. At the peak of the jump, they released the bar and dropped to the ground, deliberately landing as heavily as comfortably possible on flat feet to create a high-impact ground reaction force that stimulates bone growth.   

I am a regular gym user and I’m too scared to do that last one!

I read this really interesting commentary of the limitations of Liftmor from the point of view of normal people with normal lives and no access to skilled coaching.  It is well worth a read.  The author is not saying Liftmor is pointless, simply that it is not always the right solution for regular people considering strength training.  They are concerned with whether the heavy lifts are truly safe if you have Osteoporosis.

Lift Heavy for strong bones for Men

Men, are you wondering about research for you?  In 2020 the same Australian team conducted their LIFTMOR-M trial in men with low BMD.  It is striking if you search online that there is very little about this study, all the “talk” online is for the study in females.  This may reflect the fact that Osteoporosis is more common in women, but it is not absent in men, and with the increasing use of weight loss drugs that may start to increase.   The research outcome was the same.  Supervised heavy lifting delivered statistically significant improvements in BMD.

To get BMD improvements you have to go heavy and in order to make this safe, both LIFTMOR trials did all the exercise with the supervision of trained people.    In many ways, the big challenge here isn’t the heavy lifting, it is the supervision.  That is pretty much impossible for all but the wealthiest people to attain.

Other Heavy Lifting Influencers

There are loads of people advising us to lift heavy for strong bones.  I’m am  going to chose one, to illustrate the basic shtick:  a US Doctor who is famous for promoting strength training for older women.  She is called Vonda Wright and she recommends 2 weekly sessions of heavy lifting.     Vonda Wright has her own website but there is a clearer more succinct outline of her fitness regime here in  a Women’s health Mag.

This is what Dr Wright recommends

4 x 45-minute walks

On a weekly basis, you need to be spending at least three hours a week walking, broken up into four 45-minute sessions.  Once you’re comfortable with this amount of walking, get your heart rate up really high, by speed walking, jogging or running, then completely recover for two to three minutes  just walking.   Do four rounds of that.

2 x heavy weightlifting sessions

A minimum of twice a week, you must learn to lift heavy.   You want to lift to fatigue. You won’t get there overnight. If you’re just starting with body weight, it may take you six – maybe nine – months, to learn correct technique and to work up.  I have plenty of examples of women starting this in their 60s – there’s no age limit. “Heavy” is an individual thing, and it’s something you work towards.

Learn to lift your own body weight.

Every woman should be able to do 11 push ups. Regular push ups (not on your knees). You can build up to that. Some of my clients started out with 51% body fat. They couldn’t hold a plank and couldn’t walk around a track. Over three months, we met twice a week, doing a variety of weight-bearing exercises. They then not only completed a 3.2-mile walk-run, they could hold a plank for two minutes.

Balance: Work on balance every day.

This is all good advice, but is it the right advice?

Or, is it the right advice at the right time for the right person?  That sounds picky but hear me out.

Lift heavy for strong bones might be the ideal, but I think it is important to call out all the reasons why we might not reach those ideal levels of training.

Why you might not manage the “right” or “ideal” amount of strength training for strong bones.

Time

We are talking about suggesting significant amounts of time spent on exercise, to a population of older women. Ok, some are retired but some are still working, caring, volunteering, sorting out grandchildren and generally “keeping house”.      This isn’t a simply a toss up between exercise vs idly watching Race Against the World or England v DRC.   This a real problem of multiple demands on our time.

Money

A gym membership costs money.  To hire a skilled coach to help you with heavy lifting costs a lot of money.   And pretty much everyone who intends to start deadlifting will need coaching.      Inevitably, for most people, doing complex and demanding lifts in the gym with a coach is simply too expensive.  I go to an excellent budget gym every week and see what happens when people lift when they don’t know what they are doing.   Mostly it’s young fit bros and they are doing serious damage to their bodies.  If you are older, weaker, have Osteoporosis or have misalignments or asymmetries in your body, it is very risky indeed.

Vonda Wright says that we should look upon this as investment in yourself.  Yes, and having a mortgage is also investment in yourself but it doesn’t make it affordable does it?

How fit you are when you start

If you are unfit and on the weak side, how on earth do you deal this messaging?   It is incredibly off putting because it feels unattainable, impossible, scary and then you might just get depressed or put off because you can’t live up to those goals.

Injuries you might have.

Obvious but real.     You might need access to skilled coaching to help with significant modifications to exercise.  Even I am being rather ableist here and assuming you can do things like, for example, walk unaided.

If you have a diagnosis of Osteoporosis.

Where does this fit in?    The diagnosis is bad enough, and generally comes post fracture.   “Where do I start?” is not factored in enough.  Ditto,  “is this safe”  need to be part of the convo, as  they say.

A general dislike of hard exercise.

This is very real and relevant.  If you hate something are you really doing to stick at it?

Understandable Excuses

Where do I even start?

More on that story later.

Being put off by the messaging.

Take one of Vonda Wright’s comments from above: “Every woman should be able to do 11 push ups”.    For so many people, this messaging is totally off putting.  Every woman?  How many women over the age of 60 or even 50 do you know that can do that?  After all, if it is so attainable, why aren’t we attaining it?   There should be at least a few women that can do it?  Where are they all?  California perhaps.

Also, why 11?   What a bizarre number. What is wrong with a nice round 10.  Is 10 pointless, or easy,  and 11 more likely to give you BMD improvements?   The only time I’ve ever seen women do “a few” full press ups is when I used to attend fitness conventions and most of them were with crap technique and thus pointless.

How about aim to “hold a plank for 2 minutes”.  Why?    Well I suppose it is 2 minutes not spent doom scrolling, having a quick ciggie or eating rubbishy food.   It’s enough to make you crave a crisp sandwich.    I bet if you gave Vonda Wright a crisp sandwich (with white bread and salad cream) she’d probably react like the Wicked Witch of the East when Dorothy poured a bucket of water over her.

Being put off by the images that accompany the messages. 

Generally unattainable images of slim, toned perfection.  Not a hair out of place,  no hair in the wrong place.  Everyone is always smiling broadly aren’t they.  Having “such fun!”.     I can just about deadlift my bodyweight.  Not whilst smiling though.

Take a look at the pictures in this same article: Women’s health Mag.    The top picture isn’t even a real exercise. because the angle of pull on the dumbbells is wrong.  And the deadlift?    God give me strength (lol).    How on earth is this helping?  Does she look like a post menopausal women who needs to do strength training.   The lady on the right is more normal, but not post menopausal and not old (not even a little bit) .  Most of you reading this are in the UK.  Which of you goes for a walk with a bare midriff, no coat, and staring at a phone?

Scroll down and you’ll see the same old bollocks.  Kylie with her surgically enhanced face,  and Trinny, who I can only assume has been on weight loss drugs.   She looks like just another celebrity thin person.  And there’s a 62 year old (that is the USP of the picture) who is likely to be on steroids to reduce her body fat levels.

Depressingly, not all slop is AI generated.    Content curators, influencers, journalists and people selling you stuff are also very good at churning out very real, predictable celebrity slop.

Things even I won’t allow as excuses.

“Exercise is not for me”.

Not good enough.  It is for everyone.

“I’ll hope for the best”.

That fracture: “maybe it’ll never happen”  or “it’s inevitable”.   But supposing it does?

I’m ok, I walk 10, 000  steps per day.

Walking won’t cut it.  It is the bare minimum of movement, not an exercise regime.  Interestingly, and thankfully,  the 10,000 step backlash is upon us.  Better to walk just 7,000 steps and devote the time you save to strength training.   There is now an evidence base for 7, 000 steps being a good target for health and the BBC summarised it here.

Where do I start?  Advice on exercise for strong bones from the real world.

Think about where you are starting from,  how much time and money you have, and what to want to achieve.  The latter point is the most important.  You can plan around the rest.

If you are totally sedentary  then start with regular walking or a gentle exercise session.    If money is the issue then the cheapest classes are run by third sector organisations and the Council.   I teach 2 Pilates classes, one of which is chair based, that cost just £3, with allowances made for people who cannot pay that.   In Leeds, check out third sector groups like the Royal Voluntary Service for low cost classes.

You need to consider: what can I genuinely manage and stick too?  These are the defining characteristics of your regime, not how many press ups you can do.  Is it 30 minutes per  week?  60? A few short bursts?   What is achievable?

You may not be able to do the most effective regime of heavy lifting for strong bones.  Focus instead on what you can manage.

If you really want to lift heavy for strong bones, then first of all, join a gym and hire a Personal trainer.    This costs a significant amount of money assuming you can access someone in the right place at the right time.

If you can’t afford the PT then be very careful indeed with the App or website that you use to guide you with technique.       I’ve been around gyms for a couple of decades now and most people’s alignment and exercise form is dire.  Young ‘uns can get away with it for longer but if you are older, you risk injury.  BE CAREFUL.

Exercises to start with if you are aiming to lift heavy for strong bones.

Can’t deadlift? Learn to squat really really well first, and use a band instead of a bar.

 

Things I offer here in Leeds

I teach a regular Exercise for Osteoporosis class here in Leeds and those easier options I’ve outlined are the kind of thing we do week in week out.  I also teach 1:1 sessions in my home studio and aim for more heavy lifting.   I do have a background in PT and gym instruction and I’ll get you doing a deadlift if that is what you want to aim for!

Should we worry about protein and supplements for strong bones?

This is out of the scope of my article although definitely part of the talk around strong bones.    I lack knowledge and frankly  don’t know what to do myself.  The evidence is so contradictory but the messaging is very much there isn’t it.  Mostly around eating more protein, but endlessly around supplements. Calcium vs not Calcium.  Do we need Magnesium?  It never ends.    Supplements are very expensive indeed and suppose they are unnecessary?

I have a very complicated relationship with the Protein question due to severe IBS and being an aspiring vegan.  These factors mean that I can’t just  “eat more protein”.    ‘It’s more complicated than that, just like trying to navigate lifting heavy when you don’t have the time, knowledge or money.

Supposing  we don’t do enough?

I ask myself this question  all the time.  I can handle the messaging because I am skilled enough to know how to do all of the Liftmor exercises.  My problem is time.  I honestly can’t do any more right now.      After 3 years on Alendronic Acid, I have another 2 years to go before I am entitled to an NHS re-assessment of whether the drugs have worked.  Or in my case, drugs + strength training.  I may pay for a DEXA.   If my BMD has plateaued or declined I might think differently about my current regime.

There are so many other variables though,  so will we ever know if we are doing enough or the right thing?    Other obvious  variables are sleep, diet, alcohol consumption, supplements, stress, chronic diseases.

How about the intersection of the exercise on your body specifically?  Our bodies are unique and and come with a unique back story. Who’s to say that a particular regime will suit your body.

Do your best.

What else can you do?  Also you will benefit from the placebo effect. This is one of the most powerful effects in medicine.  It is immensely significant and powerful.  If you believe you are doing yourself some good then you are doing yourself some good.

“The journey of 1000 miles begins with the first step” is never more true than in this case of thinking about exercise and lifting heavy and bones and muscles and everything else besides.

Try to think about a manageable chunk of movement based activity (if that sounds better then exercise) and make it a habit.

Good luck!