BONEMORE Study on OsteoStrong: What It Really Shows About Osteogenic Loading

We all want an easy lever for bone health.

Something simple. Something fast. Something you can do once a week for 15 minutes and see your numbers go up.

That is the promise behind osteogenic loading, and that is why OsteoStrong and bioDensity keep getting attention.

A new study was released, and it is already making noise. This one is called the BONEMORE (BoneMOR) study.

So is this the study that finally proves osteogenic loading works?

Or is it another study that sounds strong, but falls apart when you read the details?

Let’s walk through what the study did, what it found, and what I think matters most.

First, what is osteogenic loading?

Osteogenic loading is the idea of creating a strong bone signal using very high force in a short time.

At an OsteoStrong visit, you use four machines (they call them the Spectrum machines). The goal is to hit a “growth trigger,” which is a target load based on your body weight.

The pitch is simple:

• high force
• short sessions
• low time
• less skill than heavy lifting
• “impact-like” stimulus without jumping

That is the theory.

The big question is whether it works in real people, in real life, with real bones.

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What is the BONEMORE (BoneMOR) study?

This study came out of Sweden and was designed as a randomized controlled trial over 9 months.

It compared two groups:

• OsteoStrong group: once per week, around 20 minutes, using the OsteoStrong machines plus a warmup with whole body vibration
• Exercise group: a twice-per-week program (60 minutes per session) with
  • one day of bodyweight circuit training
  • one day using gym machines at a high effort level (they estimated 75 to 80% of 1-rep max)

This is what is called a non-inferiority design. That means the goal was not to prove OsteoStrong was better. The goal was to prove it was not worse than the exercise plan.

The published paper describes the trial as women aged 65–79 with osteopenia or osteoporosis and 194 total participants.

Quick note on “non-inferiority”

This kind of design can make sense. But it only works well if the comparison program (the exercise plan) is known to work.

If you compare something to a weak plan, being “not worse” does not mean much. Even the paper’s conclusion notes that the lack of effect from the exercise program limits interpretation.

What did they measure?

They measured three main things:

1. Bone Material Strength Index (BMSi)
   This is measured using a device called an OsteoProbe, and it uses a small indentation test on the shin bone.
2. DXA (DEXA) bone density
   Spine and hip.
3. Bone turnover markers
   Including P1NP and CTX (plus other markers).

They also looked for vertebral fractures with imaging at the end.

What is BMSi and why it is controversial

BMSi is supposed to be a measure of “bone quality.” It is not a scan.

It is a small test done on the front of the shin. It requires a small “stab” incision so the device can do the test.

Here is my concern.

Any time you break skin, you accept risk. Even small risk.

So if you are going to use a tool like this widely, it needs to give great data. And the data around BMSi is still debated.

There are studies looking at whether BMSi predicts fracture, but it is not the same as measuring your hip or spine directly.

That matters because most life-changing fractures happen at the hip and spine.

The BONEMORE results (simple version)

Here is the clean takeaway.

There was no meaningful difference between OsteoStrong and the exercise group on the main outcomes.  

1) BMSi (primary outcome)

• Between groups: no significant difference
• Within the OsteoStrong group: BMSi increased about 2.9%, but this sits right at the threshold of “barely meaningful”
• Bottom line: the main comparison did not show a clear win

2) DXA bone density

Changes were tiny.

OsteoStrong group:

• spine -0.3%
• right hip -0.5%
• left hip +0.6%

Exercise group:

• spine +0.8%
• hips basically flat

All of these are inside normal DXA noise. They are not big enough to call a true change in most settings.

3) Bone turnover markers (P1NP, CTX)

No meaningful change.

They were basically unchanged across time and across groups.

The “growth trigger” result that makes no sense

This is one of the weirder pieces.

You would expect people who hit the growth trigger to do better.

But in this trial, the subgroup that hit 100% of target loads did not show meaningful changes, while the subgroup that fell short showed small improvements.

When results flip like that, it usually means one of two things:

• the effect is not real (noise)
• the outcome tool is not stable enough
• or the study is not controlling key variables

Safety: what happened?

This is important.

A lot of people worry about safety when they start any bone plan.

In the exercise group, there was a wrist fracture from a fall during the program.

In the OsteoStrong group, there were no fractures reported during sessions, but two vertebral fractures were seen on imaging at the end, with no clear cause reported.

That does not prove OsteoStrong caused them. We do not know when they happened.

But it is a reminder: fractures can happen quietly, and the population being studied is already at risk.

The biggest problems with this study

This is where I think the BONEMORE trial misses the mark.

1) They did not control for hormones

This is a major issue.

Hormones can change bone turnover and fracture risk. Not asking about hormone therapy is a big hole in the data.

If you do not control for HRT, you cannot confidently say what caused what.

2) They allowed people on bone drugs

They allowed anti-resorptive drug users as long as they had been stable.

That creates a mixed group.

Bone drugs can flatten turnover markers. They can also change how bone responds to training.

If you want a clean answer, you study:

• no-drug people, or
• everyone on the same drug, or
• you stratify hard and power the study for that split

3) The exercise program was not the right comparison

If you want to compare OsteoStrong to exercise, compare it to a program that has proven bone results.

The “LiftMOR” style work is the type of comparison that would be more meaningful.

Here, the comparison program may have been too weak, which makes non-inferiority less useful.  

4) 9 months is short

Bone is slow.

If you want to see real differences in DXA, 12 months is a better minimum, and 24 months is stronger for lifestyle changes.

So… should you do OsteoStrong?

Here is my honest take.

This study does not make me say, “Everyone should quit OsteoStrong.”

It also does not make me say, “This proves OsteoStrong works.”

What it does show is this:

• OsteoStrong did not clearly beat an exercise plan
• DXA barely moved
• turnover markers did not shift
• and key variables were not controlled  

When it might still make sense

OsteoStrong may still be a tool for some people, especially if:

• you will not do resistance training any other way
• you need a weekly structure to show up
• you use it as a small part of a bigger plan
• you can afford it and it does not replace better levers

When I would not rely on it

I would not use OsteoStrong as your “main plan” if:

• you are not lifting weights
• you are not eating enough protein
• you are not doing impact or simulated impact in a smart way
• you are not addressing hormones when needed
• you are not measuring progress with labs and imaging

Because those levers are still the core.

What I would do instead (or alongside)

If you want the best odds, focus on the big rocks first.

Here are the basics I recommend for most people:

• Resistance training (heavy enough to matter, safe enough to repeat)
• Impact or simulated impact (heel drops, small jumps, vibration, or osteogenic loading if appropriate)
• Protein at a level that supports muscle
• Vitamin D and K2, plus minerals based on your needs
• Hormone evaluation when appropriate
• Tracking with imaging and labs over time

OsteoStrong can sit inside a program like this.

But it cannot replace it.

If you want help putting your plan together

If you are still trying to figure out what is right for you, come to my free masterclass. We walk through the biggest mistakes we see and how to build a plan that is realistic and safe.

And if you want deeper support, community, and ongoing guidance, join us inside The OsteoCollective.

Related reads for internal linking

If you are building your bone plan, these topics pair well with this one:

• REMS vs DEXA scans
• Bone turnover markers (P1NP and CTX)
• Creatine for bone and muscle
• DHEA and bone density
• HRT and bone health

Medical disclaimer

This content is for educational purposes only and is not medical advice. Do not use this information to diagnose, treat, or replace medical care. Talk with your physician or qualified clinician before starting or changing exercise, supplements, hormones, or medications, especially if you have osteoporosis, fractures, or other medical conditions.