Osteopenia and osteoporosis can change the conversation about exercise. They don't have to end the conversation about getting stronger.
By Jordan Morino, PT, DPT | Nevada Physical Therapy Midtown, Reno, Nevada
Women often hear that getting older means becoming more fragile. Be careful. Avoid heavy weights. Do less.
But your body is still capable of adapting. During and after menopause, resistance training offers a practical way to build strength, support bone health, and stay prepared for the activities you love.
Your bones are living tissue
Bones continually remodel throughout life. The forces created by muscle contractions and weight-bearing activity help provide a stimulus for adaptation.
Changes in estrogen during menopause can accelerate bone loss. Osteopenia describes bone density below the normal range; osteoporosis involves a greater reduction and increased fracture risk. These terms help guide care, but a bone-density result alone does not tell the whole story of your physical capacity.
Your strength, training experience, health history, and goals all matter when deciding where to begin.
Women with low bone density can train
The LIFTMOR trial studied 101 postmenopausal women with low bone density. One group completed closely supervised resistance and impact training twice weekly for eight months. The program included squats, deadlifts, overhead presses, and impact exercise.
Compared with the low-intensity home-exercise group, the supervised group had better bone-density outcomes at the lower spine and hip, along with improvements in strength and physical performance. Training was well tolerated in these screened participants under close supervision.1
This is encouraging evidence for a carefully progressed program. It is not a prescription for everyone to start with heavy lifting or jumping on day one. The starting point should fit the person, and the challenge can grow as their skills and capacity develop.
Your diagnosis can inform your training. Your goals can still include getting stronger.
LIFTMOR results after eight months
Average percentage change from baseline. Supervised training: 49 women. Low-intensity home exercise: 52 women.
Outcome
Supervised resistance and impact training
Low-intensity home exercise
Lower-spine bone density
+2.9%
-1.2%
Hip bone density (femoral neck)
+0.3%
-1.9%
Hip outer-bone thickness (femoral neck cortex)
+13.6%
+6.3%
Leg strength
+35.2%
+8.1%
Five chair rises (improvement in test time)
11.6% faster
1.7% faster
Source: Watson et al, 2018 (reference 1). Group averages are shown; individual responses varied. Chair-rise percentages describe faster performance. These changes do not establish fracture-risk reduction.
Strength matters beyond the scan
Bone density is an important part of bone health. So is the ability to move through everyday life: stand from a chair, climb stairs, carry groceries, get off the floor, or enjoy a hike.
In LIFTMOR, improvements included measures of leg strength and physical function. The study supports these benefits; it did not establish that the program prevents fractures.1
The goal of training is broader than a better number on a scan. We want women to build capacity for the things that matter to them.
Find your starting point
You don't need lifting experience to begin. You need a starting point, a plan, and guidance that helps you progress.
At Nevada Physical Therapy, our Comprehensive Fitness Assessment uses objective testing to help you understand your current strength and physical performance. Depending on your history and what is appropriate for you, testing may include knee extension strength, hip abduction strength, an isometric mid-thigh pull, and a countermovement jump.
We explain the results, discuss your goals, and identify what to work on next. These tests measure performance; a DXA scan is used to assess bone density.
Objective testing provides a baseline for progress.Building strength can be an empowering experience.
If you have osteoporosis, a previous fracture, or other medical considerations, we take that history into account when selecting exercises and progressing your program. Exercise can complement other bone-health care, including medication when indicated.
Coaching helps establish technique and confidence.The challenge can grow as skills and strength develop.
Take the next step toward getting stronger
Schedule a Comprehensive Fitness Assessment at Nevada Physical Therapy Midtown. We'll help you understand where you're starting and develop a plan that supports your goals.
Questions? Call 775.507.4210
1413 S. Virginia St. | Reno, NV 89502
References:
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;33(2):211-220. doi:10.1002/jbmr.3284.
Walker MD, Shane E. Postmenopausal osteoporosis. N Engl J Med. 2023;389(21):1979-1991. doi:10.1056/NEJMcp2307353.
Photos illustrate services and training at NVPT. They are not presented as study participants or individual treatment outcomes.
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