If you have multiple sclerosis (MS), you may look completely fine to your loved ones and colleagues.
Meanwhile, your vision may be so blurry you can’t see your computer screen clearly. Or you have trouble socializing because the entire right side of your body is numb or tingling.
“Just imagine how distracting something like that is,” says Sharon Stoll, DO, a neurologist with Yale Medicine who specializes in MS.
It’s easy to see how these changes can affect your mental health. But MS can affect your mood for a mix of reasons, including changes spurred by the disease process.
Mental health issues are treatable no matter what’s causing them. You may need medication or talk therapy. Work with your doctor to find what’s best for you.
Can MS Cause Depression?
Up to 50% of people with MS may get major depressive disorder at some point. That makes your odds of depression about three times higher than the general public.
For a long time, doctors thought depression was a common response to the stress of life with MS. But there’s growing evidence that the disease changes the brain and immune system in a way that affects how you feel and act.
“With more research, more understanding, and more treatment, we’ve realized it really is part of the disease itself,” Stoll says. “It’s more than just a reactive depression.”
Michelle Heil, 40, found out she had relapsing-remitting MS in her late 30s. She’s finishing up a 2-year treatment on a drug that targets certain white blood cells. These white blood cells play an important role in MS. So far, the lesions are limited to her brain.
Heil, who was diagnosed with bipolar disorder 20 years ago, says she’s noticed and uptick in depressive symptoms lately, such as:
Lack of motivation and energy
Little interest in leaving the house
Difficulty paying attention to more than one thing
Sleep problems
Feeling down or irritable
Along with her neurologist, Heil sees a psychiatrist and a therapist. She urges others to do the same but understands focusing on your well-being takes work.
“You don’t have a lot of energy to give when you have MS, so you put that energy toward getting through the day,” she says. “Mental health gets pushed back to the wayside.”
Unmanaged depression can make it harder to start or stick with your MS treatment. It also raises your odds of other health issues, such as:
Inflammation and immune system problems
Blood vessel diseases
Heart disease
Suicidal thoughts
Death for any reason
Tell your doctor if you have symptoms of depression. Get medical help right away if you think you might hurt yourself.
Can MS Cause Anxiety?
Stoll compares life with MS to the stress of living through the COVID-19 pandemic: It’s unpredictable.
“That big unknown, that is something that MS patients live with on a daily basis,” Stoll says. “And part of treating the disease — and the anxiety and depression — is kind of coaching (people with MS) through this world of uncertainty.”
For example, Stoll says, lesions on your spinal cord can make it seem like your skin isn’t really there. That can trigger feelings of anxiety. “Imagine standing in a group and talking at a cocktail party and you’re holding onto your stomach to make sure your insides aren’t falling out.”
Heil started to have really bad anxiety “all of a sudden” a few years before her diagnosis. Her symptoms got so bad that she had to take medical leave from her job. She thought it was stress. But she wonders if it might’ve been something else: the MS hug.
“It’s like you’re being put in a giant tight bear hug, and you can’t catch your breath. It felt like I was having a panic attack,” Heil says. “But more than likely, I was having a flare-up and that’s how it was presenting.”
Like with depression, Stoll says anxiety may be partly caused by the “reworking and rewiring of your brain” that can happen with MS. But it could also stem from life events. Your doctor can help you figure out the difference and find a treatment to help manage what worries you most.
Can MS Trigger Other Emotional Changes?
Some people with MS also have adjustment disorder — when you have a really hard time adapting to stressful changes in your life. And you’re about twice as likely to get diagnosed with bipolar disorder as the general population.
You or your family may notice that you get moody or angry really fast. That might happen because of changes in your brain, stress, or mood issues like depression.
Heil says she has a hard time controlling her emotional reactions. “When I get upset about something, I get so upset that I basically can’t talk or function,” she says. “It’s like my brain short-circuits and I just start crying. I have an incredibly short temper.”
Less commonly, MS brain lesions can cause pseudobulbar affect (PBA). “It’s inappropriate emotions,” Stoll says. “Somebody is crying for no reason, then minutes or an hour later they’re laughing and they’re ecstatic for no reason or with minimal stimuli.”
PBA can seem like depression, mood swings, or bipolar disorder. But it tends to come on more suddenly than a mood disorder. Some people compare their outbursts to a seizure. Talk therapy isn’t likely to help, but there are medications for PBA.
Where Can I Get Help for Depression and Anxiety?
You can start with your regular doctor. They can look for any other medications or health problems that might be causing your symptoms. But your neurologist will be able to give you better MS-related care.
Ask your doctor to refer you to a rehabilitation psychologist who treats people who have MS.
A therapist can help you accept your diagnosis and find ways to manage problems head on. A method called cognitive behavioral therapy (CBT) may help ease pain, fatigue, anxiety, and depression.
Stoll regularly refers people with MS to counseling. Antidepressants can also be a big help. And there are some depression medications that can also treat nerve pain, headaches, or sleep problems.
“As an MS specialist, I like medicines that are two for one.”
To Heil, mental health treatment is just as crucial as her yearly brain scans and MS medication. But she says her wellness is still a work in progress.
“Nobody gives you a handbook on how to do this stuff, like a top 10 list of things that are guaranteed to make things easier if you have MS.”
In the current pantheon of strongman, Martins Licis is one of the inarguable pillars of the sport. The 32-year-old athlete can boast a World’s Strongest Man (WSM) title to his name (2019) and seemingly finds a way to finish near the top of many contests he features in. With another tentpole competition on the horizon, Licis is training to make his usual waves once more.
On Oct. 17, 2022, Licis shared a video of himself capturing a 455-kilogram (1,003-pound) block-pull deadlift for four reps. Per the caption of his post, Licis apparently had “plenty more in reserve” even after finishing the set. Notably, Licis did not disclose the precise heights of the blocks. However, judging by the video, they appear to be roughly half the height of the 6-foot-3 strongman’s calves when standing straight up. The athlete wore a lifting belt and lifting straps, and completed the set while donning just his socks.
Licis’ unique deadlift training is part of his preparation for the upcoming 2022 Rogue Invitational. The American strongman is the defending champion of the contest that will take place on Oct. 28-30, 2022, in Austin, TX. According to Strongman Archives, it will also be Licis’ first appearance in a formal competitive strongman setting since he finished in second place to Tom Stoltman at the 2022 WSM.
Licis is one of the more decorated and accomplished active strongmen. His 2019 WSM title aside, the athlete has also never failed to qualify for the WSM finals in five appearances. His overall precedent shows that he usually fares well amongst his peers in other competitions, too.
Here’s an overview of the more significant results from Licis’ illustrious career to this point:
Martins Licis | Notable Career Results
2015 America’s Strongest Man — Second place
2017-2018 Ultimate Strongman Summermania — First place
This latest deadlift pull might be an example of Licis ramping up his training as he gets set to compete again. Should the strongman successfully repeat as Rogue Invitational champion, it’ll undoubtedly be another impressive notch in the belt for one of the biggest names in strongman.
Nowadays, Anton and Toby give us quick hugs before heading into school — no drama — but when they were younger, for the first couple weeks of each school year, they would beg, sob, and cling to me until I had to literally peel their fingers off my body. And, every fall, I see a handful of other kids doing the same thing. Even if they love school, that morning drop off can be brutal. Nothing sadder than your child desperately reaching for you while you walk away with a smile plastered on your face, like, “Bye! I’m definitely not dying inside! My heart rate is totally normal don’t worry about it!”
Through the years, I tried different strategies — listing all the fun school activities, sending them with Daddy instead of Mommy, making the goodbye quick and upbeat, reading The Kissing Hand — but none made a huge difference. Until…
One morning, as we approached his school, two-year-old Anton teared up. But instead of giving him a pep talk about the day, I decided to focus on our reunion afterward. “Anton, will you read a stack of books with me tonight?” I asked him.
“Yes,” he said, sniffing.
“Are you sure?” I said. “I would LOVE LOVE LOVE to cuddle and read with you. Do you promise you will read with me???”
“Yes!” he laughed. “I promise!”
And, amazingly, he climbed out of his stroller, patted me goodbye, and toddled into school.
I couldn’t believe how well it worked, but it also made sense to me. By asking your kid to promise to hang out with you, you position yourself as completely reliable — you will definitely be there! Also, you’re giving them the power — since YOU are asking THEM — so instead of feeling out of control, they’ve become decision makers. Talking about the evening also reassures them that 1) school will end, 2) you will reunite, and 3) you will once again be happy together. It all feels very safe and certain.
Another example: Toby: “I don’t want to go to school, I want to stay with you.” Me: “Well, you do have to go, but do you promise me you will play blocks with me afterward?” Toby: “Okay.” Me: “Do you promise? Please please please?” Toby, laughing: “Yes! I will, Mommy!”
Thoughts? Have you done this before? Anything else that helps with separations?
Vincent Macaluso, MD, found out he had multiple sclerosis (MS) when he was in medical school. Today, he treats people who have MS at his clinic in New Hyde Park, NY.
He understands that MS can change the way you think, feel, and act better than most people. He also knows firsthand how hard it can be to explain this to others.
Symptoms like memory problems and depression happen because MS affects the way your brain works. Although these problems can have a huge impact on your life, other people may not always know you have them. Macaluso says it’s common for people with MS to look fine on the outside but not feel fine on the inside.
It can go the other way, too. Tim Vartanian, MD, director of the Judith Jaffe Multiple Sclerosis Center in New York, says family members or co-workers may notice the changes first.
Either way, it’s important to let those closest to you know what’s going on now and what could happen down the road. This helps them better understand any changes they see. They can also offer help when and if you need it.
Cognitive Problems
At some point, more than half the people with MS will have cognitive problems. (Some people with MS call it “cog fog.”) Vartanian says the most common symptoms are:
Slowed thinking
Fuzzy memory
Trouble with executive function — your ability to plan and do things
And sometimes you just might not feel as sharp as you used to.
People with MS can have some or all of these things. But for most, memory problems top the list. Vartanian says MS can affect recent memories or those in the distant past.
For many, though, day-to-day symptoms are often mild. But even minor lapses can be a challenge. (Memory problems are one of the main reasons people with MS stop working.)
To explain how this feels, try putting it in terms others can relate to. You could say, “Remember how upset you were when you couldn’t find your car keys yesterday? As my MS goes on, that could happen to me more often.”
People with MS should work with a doctor called a neuropsychologist who can suggest ways to sharpen the mind. This includes both mental and physical exercises. Things that can affect how well your brain works, like “depression, anxiety, and stress, all need to be addressed head-on,” Vartanian says.
Let your loved ones know things that can help you manage the memory problems that come with MS.
Keep it cool. Damaged nerves don’t work well in the heat. That’s why many (but not all) people with MS think and learn better when it’s cool. To improve focus, spend time with your friends in a cool, quiet place without distractions. (Step away from Netflix!) Let them know that’s the goal in case you forget now and then.
Make to-do lists. Many people with MS say they lose track of bits of paper. Instead, you may use a small recorder you can hang around your neck or the voice recorder on your phone. And let your friends know you’re doing it so they can help.
Set a routine. Put your car keys, phone, and glasses in the same place so you always know where they are. Let your loved ones know where that place is, so if they spot them someplace else, they can put them back.
Sound the alarm. Use bells and whistles on your phone or computer to remind you to do things. Loved ones can set the same alarms so they can remind you in case you forget what the alarm is for.
Put it on repeat. When someone tells you something, repeat it to them. That way, it’s more likely to stick in your mind — and theirs.
Depression
Depression is one of the most common MS symptoms. It can be hard to discuss. Some people see it as a sign of weakness. Others feel embarrassed or ashamed. And when you’re depressed, it’s normal to want to withdraw from others.
But it’s important to share how you’re feeling with people close to you. Explain that depression is a natural part of the process of MS and it needs treatment, just like any other symptom. It isn’t something you can snap out of. And despite their best efforts, your friends and family probably won’t be able to cheer you up.
Jessica Thomas is a social worker in Greensboro, NC. She has MS, as do many of the people she sees. She says that while a counselor can help manage the emotions of living with MS, people who are depressed may need medication, too. She also notes that people need an MS-free zone — “a part of life or a passion that MS may not interfere with.”
Exercise is a crucial piece, too. It’s important for your overall health and well-being. It also helps almost every aspect of MS and may work better for depression than antidepressant medicine. So you can tell a friend that a workout partner can really help you stay on track.
Also tell those closest to you that these things can help keep depression away:
It’s difficult to walk into a gym and not run into someone trying to develop their posterior chain with set after set of hip thrusts. The exercise has actually been around for a long time, but it’s gotten a surge of popularity in the last 10 years or so, possibly fueled by social media trends and glute-building fascination.
Credit: Jasminko Ibrakovic / Shutterstock
Many gyms even have specialized hip thrust machines, which offer a fixed path of movement and an easier setup than combining a flat bench, barbell, and an assortment of pads or steps. At its core, the hip thrust is a movement with many technical details worth considering. If you want the best results, read on for a full-scale breakdown of this powerful and popular lift.
How to Do the Hip Thrust
Presuming you don’t have access to a hip thrust machine, you’ll need to first gather a barbell (a five-footer will be easier to balance than a standard seven-foot bar), a sturdy flat bench, a bar pad to spare your hip bones once the weights get heavy, and plenty of plates to load.
Step 1 — Set Up the Starting Position
Credit: BarBend / YouTube
Sit on the ground perpendicular to the bench with the center of your shoulder blades resting on the corner of the bench pad. Set your feet a comfortable width apart — that’s probably going to lie somewhere between hip-width and shoulder-width. The loaded barbell should be on the ground with the bar above your knees.
Form tip: Sitting too close to the bench will throw off the trajectory of the bar. Sitting too far away won’t give you any leverage (and will probably make you slide off). Line up the bench with the middle of your shoulder blades as you lean against it in the starting position.
Step 2 — Prepare to Thrust
Credit: Vladimir Sukhachev / Shutterstock
This exercise is a real dance with the physics of movement. Roll the bar over your hips and position the bar pad across your hip bones or lower abs. Place your hands on either side of the barbell, well beyond shoulder-width, with your palms down. Your hands are there to support and stabilize the bar, not to lift the weight.
Walk your feet several small steps toward your glutes and bend your knees. The bar should be cradled in your lap. Your thighs and torso should form a V-shape. Now you’re in position to thrust.
Form tip: To do a successful hip thrust, your upper back must function as the axis of rotation as you transfer power from your feet through your hips and into your upper body. Take time to fine-tune your foot width and stance to determine the most powerful and most effective starting position for your individual body.
Step 3 — Press and Squeeze
Credit: Vladimir Sukhachev / Shutterstock
Grip the bar tight and brace your abs. Squeeze your glutes and drive your feet through the ground. Lift your hips to shoulder-height. Aim to create a “tabletop” position from your shoulders straight to your knees.
In the top position, your glutes, hamstrings, core, and upper back should be firing on all cylinders to control and stabilize the weight.
Form tip: Make sure your feet are far enough away from your body to promote 90-degree angles at your knee joints in the top position. If your feet can’t stay flat on the ground, or if you can’t reach a near-horizontal body at the top, your stance needs to be adjusted.
Step 4 — Lower with Control
Credit: Vladimir Sukhachev / Shutterstock
Pause for one second at the top and slowly lower your hips until the plates are hovering just above the ground.
Your glutes may or may not touch the ground in the bottom position depending on your leg length. Control the descent and don’t allow your body to bounce off the ground.
Form tip: Lower the weight slowly and be aware of where the ground is. Avoid bouncing the plates and rebounding into the next rep. Feel muscular tension and be in control of the movement at all times.
Hip Thrust Mistakes to Avoid
The hip thrust is prey to common errors that can lead to an inefficient, ineffective lift. Similar to deadlifts, leg presses, and squats, the hip thrust allows you to go relatively heavy, so it’s important to iron out the technical kinks before loading up. To do so, avoid these pitfalls.
Back Hyperextension
It’s extremely common to see this movement performed with most of the work being done by the lower back rather than the glutes and hamstrings. This happens when your glutes aren’t strong enough to posteriorly tilt the pelvis — tucking your hip bones “down and back” and your tailbone “up and forward.” If your pelvis can’t tilt properly, your glutes can’t be fully recruited (1).
Credit: MIGUEL MARTINEZ FRIAS / Shutterstock
This may not be an issue when the muscles are under extremely light loads, but things get real once there’s a significant challenge placed upon them. Always be patient with the load to ensure proper technique is maintained.
Once your pelvis can’t achieve a posterior tilt, your gluteal muscles become less and less involved in the lift, leaving the lumbar spine (lower back) in extension. This inefficient position stresses lower back muscles even more and is an unfavorable load-bearing position for the spine.
Avoid it: When you’re doing the hip thrust, think about driving the bar backward over your head, rather than up toward the roof. This will cue your pelvis into the right pelvic tilt motion. It will also encourage your glutes to be activated through the concentric (lifting) portion of each rep.
Feet Too Close or Too Far
People falter when they start the movement with their feet too close to their glutes because it makes the movement rely just as much on knee extension as it does on hip extension. Doing so may “feel” comfortable initially, but a couple of things actually go wrong here.
It’s much easier for your heels to come off the ground when your feet are too close. This can add pressure to the knee joint capsule and isn’t a friendly position for lifters who have a history of knee injuries. More knee extension also means more quadriceps involvement and less work for the glutes and hamstrings.
Credit: enjoysun24 / Shutterstock
Pressing with your feet too far forward will limit your leverage, which reduces the amount of weight you can move. It also makes it more difficult to remain flat-footed in the bottom position, which means you either neglect the lower portion of the range of motion (which reduces muscle recruitment) or you lift your toes (which decreases overall stability).
Avoid it: The 90-degree angle rule should be respected when performing hip thrusts. Namely, at full extension (in the top position), your knees should create a 90-degree joint angle to balance efficient power output, muscle recruitment, and joint health. Before beginning your set, take the time to step your feet the ideal distance away from the bench, and from your glutes in the bottom position, to create a solid framework to reach the right joint angles.
Insufficient Range of Motion
As a whole, using a short range of motion can be a problem many lifters struggle with. This may be due to taking too many liberties with loading or it could simply be chalked up to poor exercise technique. In either case, an incomplete range of motion is responsible for decreased muscle-building and less strength gains. (2)
Credit: Jasminko Ibrakovic /Shutterstock
Understand the anatomy and biomechanics of the body. In the hip thrust, your hips can and should go into deep flexion (bending at the hips). Hip extension (opening your joint and straightening your legs) comes from properly using your glutes and hamstrings — the deeper in flexion they begin, the more they’re recruited and the more work they can do.
Hanging out in the mid-range of each rep and avoiding a full descent and full lockout may create some constant tension on the muscles, but it doesn’t do anything for building healthy muscles and joints. The hip extensors will be most involved at the top of this lift because that’s where mechanical tension is highest. For that reason, actually reaching a full lockout at the top is ideal.
Avoid it: Aim to lower your hips almost to the floor on each rep and bring them to a “tabletop” lockout position with your thighs running parallel to the ground. This will be the longest and most effective range of motion for the exercise.
How to Progress the Hip Thrust
While the standard hip thrust can accommodate all strength levels, some inexperienced lifters may need to build up to handling external load. On the other end of the spectrum, more experienced may eventually need an increased challenge beyond another weight plate. Here are the best options.
Bodyweight Hip Thrust
Certain exercises can be performed with identical technique regardless of external load while other movements use a weight as an integral part of their performance. For example, a pull-up is performed the same with or without added resistance, but performing a kettlebell swing without holding a kettlebell won’t allow the lifter to learn proper technique and doesn’t recruit the same musculature.
The hip thrust falls into the first category because the fundamental movement and muscle recruitment will be the same with or without a loaded barbell. For lifters unable to manipulate a standard barbell, or those still developing muscular coordination and building a mind-muscle connection, performing unweighted (bodyweight-only) hip thrusts can be an effective way to build very basic levels of strength while learning form which will directly carry over to the barbell movement.
Single-Leg Hip Thrust
Training with unilateral (single-leg) lower body movements can contribute to greater strength, power, and muscular development than focusing solely on bilateral (double-leg) training. (3) The single-leg hip thrust can be used with bodyweight-only or with added load, as a means of increasing the stability challenge and getting a greater overall training effect from relatively less weight.
For lifters who can’t tolerate excessively heavy loading, the single-leg hip thrust challenges the glutes, hamstrings, and core while putting the involved joints under lower stress than the bilateral movement.
Benefits of the Hip Thrust
Strength
The hip thrust, being a barbell movement which targets the powerful glutes and hamstrings, allows lifters to train with heavy weights. The involved muscles, along with the beneficial leverage of the movement, allow the hip thrust to potentially be one of the heaviest lifts in your exercise arsenal. This makes it an ideal alternative to the deadlift for building strength in the posterior chain (glutes, hamstrings, and lower back).
The hip thrust can support and build lower body strength which carries over to strength movements like the squat and deadlift, as well as creating a more stable base for overhead pressing movements.
Hypertrophy
Lifting relatively heavy weights for higher total volume with higher reps can be great for increasing the size of the target muscles. (4) Especially if deadlifts or squats aren’t agreeing with your individual leverages when it comes to making muscles grow, hip thrusts can be a worthwhile choice. One key reason the hip thrust circled back into the recent limelight was exactly because it was re-discovered to be a highly effective glute-builder. (5)
Credit: Dmitrii D / Shutterstock
Targeting the quadriceps on the front of the thigh is often the goal for a muscular lower body, but the glutes and hamstrings contribute to a more aesthetic and well-rounded set of legs. Few physique-conscious lifters would say no to having a better looking set of glutes, and the hip thrust is a fast-track.
Joint-Friendly Training
The hip thrust enables a lifter to move relatively heavy loads with minimal compression on the spine. This is because the force angle is horizontal in nature, compared to squats and deadlifts which apply vertical forces to the spinal column.
This makes the hip thrust a viable option for anyone with a history of back or shoulder issues which would otherwise prevent them from holding a barbell on their back or support a front-loaded, lower back-stressing deadlift.
Muscles Worked by the Hip Thrust
The hip thrust is predominantly a glute exercise. If building a great looking and powerful backside is on your list of goals, the hip thrust should find a spot in your weekly routine. Beyond the glutes, the hip thrust trains much of the lower posterior chain. This includes the lower back and hamstrings. The calves are even worked statically, to a small degree, to support your body.
Glutes
Strong, developed glutes are a powerhouse for athletic ability, healthy hip function, and a balanced physique. Hip extension — bringing your legs backward in line with your upper body — is a fundamental movement controlled by the glutes, and the hip thrust trains this pattern directly.
Hamstrings
When the exercise is performed properly, your glutes should be the prime movers and first muscle to fatigue. However, your hamstrings are closely involved as secondary movers. Your hamstrings are highly active in the transition from the bottom portion of the repetition into the press toward lockout.
Core
Your abs and lower back play a small but significant role for general stability throughout each repetition. With your shoulder blades pinned to the bench, it’s essential that your core is stiff, strong, and constantly engaged to transfer power from your feet to your trunk. Without an active core, you’ll be unable to achieve lockout and your target muscles will be undertrained.
How to Program the Hip Thrust
Programming the hip thrust can accommodate a variety of training goals and workout plans. Here are some of the most effective ways to incorporate this adaptable exercise.
Heavy Weight, Moderate Volume
The hip thrust can be performed as the first movement in your workout. Given its capacity to be loaded fairly heavily, it can be used as a primary movement for any lower body workout. Four to six sets of four to six repetitions with a very challenging weight is a good place to start.
However, remember that it’s not wise to go hard and heavy with multiple “primary” lifts in a strength- or size-focused workout because your energy, focus, and form won’t last. Choose a main lift you’d like to focus on, and treat the remaining movements as “accessories” to that lift.
Moderate Weight, Higher Repetition
When using the hip thrust as a secondary or accessory movement, be sure to contrast the heavy lifting you did in the first exercise (likely a squat or deadlift) with relatively higher rep work with lower weight in the hip thrusts. Not only will this ensure your spine’s safety and the use of good technique while fatigued, but it will also spare your central nervous system of too much output over the course of your workout.
Performing the hip thrust after squats or deadlifts is fair game because it won’t be doubling down on spinal compression to compete with the first lift you chose. Try three to four sets of 10 to 15 reps squeezing a strong peak contraction on every repetition.
Hip Thrust Variations
You may not have a barbell, bench, bar pad, and plates to properly load and safely perform standard hip thrusts. If that’s the case, the question then becomes, “What will best simulate the same training effect as the loaded hip thrust?” Here are the answers.
Deficit Single-Leg Hip Thrust
In the absence of weights, bodyweight training can be used with a deficit and paired with unilateral movement. This can come in handy for creating a surprisingly challenging level of effort for any lifter.
The use of an elevated platform combined with a single-leg hip thrust allows for a greater range of motion and increased muscle recruitment. Though no external weight is being used, the deficit and increased time under tension requires a much greater effort than a standard bodyweight hip thrust.
Glute Bridge
Another effective alternative to the hip thrust would be doing a glute bridge. This serves a role for anyone without a bench, but also for anyone who may not yet have the technique to use the relatively long range of motion that a classic hip thrust requires. A glute bridge essentially cuts the movement in half by starting in a supine position on the floor rather than supported on a bench.
The general performance is virtually the same as a hip thrust, but your hips begin in a less flexed position, meaning fewer opportunities for other muscle groups to contribute to the concentric (lifting) movement. A lifter will “bridge up” on their shoulders, while keeping the bar across their hips as their glutes press away.
Kettlebell Swing
One more hip thrust alternative works the same movement pattern using a much lower load, but requires much more concentric velocity. It’s the popular kettlebell swing. The swing is performed standing vertically, but the weight travels between your legs in a horizontal path. This keeps your glutes and hamstrings as the true drivers of the weight and delivers the same benefits as the hip thrust.
The swing also involves a more rapid rate of contraction, meaning there’s less time to perform each rep. Your technique must be on-point in order to reap the benefits of this movement, since there’s much less of an available window to get tight, brace, and feel each rep.
Step-Up
A surprisingly effective hip thrust alternative doesn’t actually look like a hip thrust at all. The step-up is another way to do a loaded version of a hip extension pattern, while paying special attention to your knee position and involvement by keeping a vertical shin position.
Loading a step-up with dumbbells in your hands or with a bar on your back is equally acceptable. Angling your torso slightly forward on each repetition allows your glutes to work even harder by extending the hip from a position of deeper flexion.
FAQs
Can I use a dumbbell for hip thrusts?
In general, a barbell will be easier to balance and stabilize than a dumbbell. Because the diameter of the dumbbell is much larger than a barbell, it will sit differently in your hip crease and will likely interrupt your range of motion in the bottom position. Barbells will also allow you to go much heavier than any dumbbell you’ll find lying around the gym.
Ideally, use a straight barbell, either the standard seven-foot bar or shorter five-foot bar. You might also find an EZ-curl bar to sit more comfortably on your hips due to the angled handles, especially if you don’t have a bar pad. You can also consider using the Smith machine if you set up the bench properly and find an effective foot position. However, if you must use a dumbbell, be sure to use a complete range of motion, reaching your hips toward the ground and achieving a full contraction at the top.
Can I do the hip thrust and deadlift in the same workout?
If your goal is building major size and strength in your glutes and hamstrings, a one-two punch of deadlifts and hip thrusts can be a great approach if it’s programmed properly. Choose one of the movements as the main lift and hit it with heavy weight and low reps, and follow it up using the second exercise with a relatively higher rep range and moderately heavy weights.
In Thrust We Trust
The hip thrust definitely has some constraints, such as the learning curve of technique and potential hip discomfort from the weight itself, but this efficient movement also allows for good versatility in your program. It belongs in any routine designed to improve the strength and size of your posterior chain, while also carrying over to other lifts. The hip thrust is one of those few “can’t go wrong” movements that can satisfy a massive crowd of lifters. You’ll be glad you added it to the mix. Your spine will thank you, too.
References
Queiroz, B. C., Cagliari, M. F., Amorim, C. F., & Sacco, I. C. (2010). Muscle activation during four Pilates core stability exercises in quadruped position. Archives of physical medicine and rehabilitation, 91(1), 86–92. https://doi.org/10.1016/j.apmr.2009.09.016
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Veterans living in areas with poor broadband speed were less likely to use video telehealth after the onset of the COVID-19 pandemic, pointing to potential disparities in access.
The study, published in JAMA Network Open, used administrative data for patients enrolled in Veterans Health Administration primary care to analyze visits at 937 clinics before the pandemic (October 2016 to February 2020) and after the onset of the pandemic (March 2020 to June 30 2021).
Researchers then determined whether broadband speed was inadequate, adequate or optimal based on data reported by internet service providers at the census-block level.
Overall, the study included nearly 7 million veterans: Some 38.7% lived in a census block with optimal broadband, 54.5% had adequate broadband and 6.7% lived in a block with inadequate broadband.
Patients living in optimal broadband areas had increased video telehealth visits after the beginning of the pandemic compared with those in inadequate areas. The increase was highest in areas with optimal broadband speed and lower rankings in the Area Deprivation Index, meaning the least socioeconomically disadvantaged neighborhoods.
Veterans living in a census block with optimal broadband speed were younger and more likely to be Black, female and live in an urban area compared with those who lived in inadequate broadband blocks.
“Overall, total primary care visits did not change, with telephone visits and, to a lesser extent, video visits replacing in-person visits. This finding was consistent across areas of differential broadband availability; however, veterans with optimal vs. inadequate broadband participated in 1.33 times more video primary care visits, representing 16 additional video visits per 100 patients per quarter,” the study’s authors wrote.
“Because the VHA intends to offer both in-person and virtual visits in an ongoing effort to optimize access to care, these findings highlight the role of area-level broadband availability in limiting virtual video care.”
WHY IT MATTERS
The researchers noted some limitations in the study. They didn’t differentiate visits that began with a video visit that moved to a phone visit due to technology challenges, or take into account variations in demand for telehealth in different markets, physician familiarity with video telehealth, or patients’ health conditions.
It also didn’t take into account mobile service, which the study’s authors note is usually reported by coverage areas instead of census blocks or technology types, like 5G, instead of speed ratings. They added that patient preference and quality of care should be considered in future research.
Though the rates of in-person, telephone and video visits were similar across broadband speeds pre-pandemic, video visits soared after the pandemic’s onset. Researchers said those living in inadequate broadband areas relied on telephone visits and returned to in-person care more quickly.
“These findings quantify a healthcare access disparity and underscore the necessity of internet access for primary care in a digital age. At the same time, these methods can help healthcare systems serving broad geographic areas make access more equitable. Rural areas, especially, would benefit from telemedicine, even when there is not a pandemic restricting in-person care,” they wrote.
“Further research should investigate the factors associated with a patient’s preference for telemedicine in primary care, along with facilitators and barriers to obtaining care via their preferred mechanism.”
William Bonac has been a mainstay in the Men’s Open division for a few years. Yet, despite the bodybuilder’s consistency and a career-high second-place finish in 2019, he’s never quite been able to reach the summit of the Mr. Olympia. A recent demanding training session centered around his chest might be an integral step forward in shifting his fortunes this late fall.
On Oct. 14, 2022, Bonac posted a video to his YouTube channel where he quickly shredded up his chest as part of his formal prep for the 2022 Mr. Olympia on Dec. 16-18, 2022, in Las Vegas, NV. With the athlete seeking to capture his first-ever title at the prestigious contest, it seems he’s pulling out all the stops.
Here’s a quick overview of Bonac’s recent “Olympia prep” chest workout.
Cable Crossover
Bonac begins his routine with some cable crossovers. He warms up for a set before putting the pedal to the metal. Notably, Bonac doesn’t actually cross the cables in a downward motion but straight ahead across his chest.
Smith Machine Incline
For the next segment of his workout, Bonac performs an incline bench press on a Smith machine. The bodybuilder clarifies that he appreciates the incline movement more because he thinks it helps balance his physique well.
“I do [incline] because it’s for my upper chest,” Bonac explains. “I do them because mine is undeveloped. It doesn’t match with the total of my chest. I need to bring it up more. When you train chest, you need to hit it from every angle, you understand. I want the ball over here [directs to chest] so that I can put a glass on it. I use most of my strength and energy for the incline.”
Smith Machine Flat Bench Press
Following the incline press, Bonac stays in the Smith machine and lowers the bench to a flat setting for a classic bench press. The hard-training lifter explains that performing multiple exercises in one machine is a time-saving strategy.
Smith Machine Decline Bench Press
After appropriately working the upper and middle parts of his chest, Bonac quickly shifts to giving his lower chest some attention with some sets of a decline bench press on the Smith machine. For Bonac, he appears to appreciate cycling through slight variations of these different chest exercises.
Standing Machine Chest Fly
After moving on from the Smith machine, Bonac performs a few sets of pectoral flys on a standing chest machine.
Diamond Push-Ups
To close his workout, Bonac elects to rep out some diamond push-ups — a more challenging variation of the traditional push-up, where an athlete’s hands come together to form a diamond shape. This last piece for Bonac appears to be more about getting a quality pump rather than pushing himself to the limit. Especially since he apparently finished this workout with limited pain.
“Normally, when I train my chest, I have a lot of pain and joint pain in my elbows,” Bonac said. “At this moment, since I started my off-season prep, I don’t have any issues with that anymore. I’m pretty happy with that.”
Bonac faces tall odds to topple two-time reigning champion Mamdouh “Big Ramy” Elssbiay for his first-ever Mr. Olympia title. However, with a physique hovering around 265 pounds from his last check-in of the offseason, along with this taxing chest workout — Bonac might be in a prime position for an upstart performance on the Las Vegas stage.
Eyenuk received $25 million in Series A funding to expand access to its AI-powered eye-screening technology that enables autonomous detection of diabetic retinopathy (DR) during a patient’s regular exam.
The recent raise was led by AXA IM Alts and joined by new and existing investors, including A&C Foelsgaard Alternativer ApS, T&W Medical A/S, KOFA Healthcare and Kendall Capital Partners. It brings the company’s total funding to $43 million.
The Series A raise includes approximately $6.2 million previously raised in convertible notes converted to Series A securities.
WHAT IT DOES
The company’s EyeArt AI software, which received 510(k) clearance from the FDA in 2020, allows for autonomous DR screening, including retinal imaging, DR detection and immediate reporting during a patient’s regular examination. After the patient’s fundus images are captured and submitted to EyeArt, results are provided via a PDF report in less than 30 seconds.
The announcement follows a study published in September in Ophthalmology Science where researchers compared general ophthalmologists, Eyenuk’s EyeArt Artificial Intelligence (AI) system and retina specialists for detecting more than mild DR (mtmDR). Results showed the AI system had higher sensitivity for detecting mtmDR than general ophthalmologists or retina specialists.
Eyenuk will use the recently garnered Series A funds to expand its AI product platform with additional disease indications and accelerate the company’s global commercialization.
MARKET SNAPSHOT
In August, AI-enabled diagnostics company Digital Diagnostics, formerly IDx, which also offers an AI-backed eye care system to detect diabetic retinopathy, announced it scored $75 million in a Series B funding.
Its IDx-DR system detects diabetic retinopathy, which can cause vision loss and blindness in people with diabetes. The IDx-DR product received FDA De Novo clearance in 2018.
Google has also been exploring using AI for diagnostics in developing its product for detecting diabetic retinopathy called Automated Retinal Disease Assessment (ARDA). In March, the tech giant provided updates on its healthcare tools, noting it would continue research on ARDA to determine whether photos of the outside of the eye could detect disorders.
For years, George Kramb, who’s 29 and lives in San Diego, CA, thought he had a severe case of dry skin.
“I had dry skin basically my whole life. It was always flaky, irritated, and even got to the point of cracking,” he says. Sometimes, in the winter, his fingers were so cracked and dry that he couldn’t open his hands.
Kramb tried over-the-counter ointments like Aquaphor, Cetaphil, and Gold Bond. “I used practically every single lotion and ointment that CVS sells, and nothing worked. It would offer temporary relief but didn’t address the underlying problem,” he says.
What Kramb didn’t know was that he didn’t just have dry skin. He had atopic dermatitis. “It wasn’t until I was a teenager and saw a dermatologist that I got a proper diagnosis,” he says.
What Is Atopic Dermatitis?
Atopic dermatitis (AD) is a skin condition where itchy rashes come and go. It’s usually associated with some type of allergy.
“Unlike dry skin, AD is a chronic inflammatory disease,” says Annabelle Garcia, MD, a board-certified dermatologist and owner of Sonterra Dermatology in San Antonio, TX. “Symptoms often appear as a rash on your skin. In its moderate-to-severe form, AD can cause constant itching, which can lead to cracking and bleeding of the skin.”
Common AD skin symptoms include:
Dry, discolored skin
Itching
Painful or sore skin
Rashes that may ooze fluid or bleed from scratching
Sleep problems from itching
Thick, hardened skin from scratching
Experts don’t know exactly what causes AD, but it may be related to your genes and environment. If you or your family members have asthma or allergies, you’re more likely to get AD.
“Atopic dermatitis typically begins in childhood but can appear at any age,” Garcia says. For some people, it tapers off when they get older. Others have it their whole life. AD may get better at times and then flare up at other times.
How Is AD Different From Dry Skin?
AD is more than dry skin. “While both dry skin and AD can make your skin flaky, AD can also include red or dark rashes and persistent itch that can lead to oozing and bleeding skin lesions,” Garcia says.
If you have AD, you may have an itch-scratch cycle. Your rash is itchy, so you rub or scratch your skin. That causes more irritation and itching, so the cycle of itching and scratching keeps going.
With AD, a chronic condition drives your symptoms, Garcia says.
Getting the Right Diagnosis
Atopic dermatitis can be difficult to diagnose, Garcia says. Your rash may look like psoriasis or poison ivy. If you have dark skin, it may be less noticeable, and it may take longer to get the right diagnosis.
If you have an itchy rash, see your doctor. “It’s important to know if you’re living with AD so you can take the necessary steps to control your skin health and find a proper treatment,” Garcia says. Topical creams may help with dry skin symptoms, but you might need a stronger treatment to target the cause.
Kramb had a feeling his dry skin could be AD because some flare-ups were severe. “My theory was confirmed when I met with the dermatologist, they prescribed my first steroid ointment, and it did wonders,” he says.
Treating AD
Finding a treatment that works for you is a process. If one doesn’t work, your doctor may recommend another.
It took Kramb a while to find the right mix. He tried a range of over-the-counter and prescription treatments, but they didn’t help. Later, he found that steroid ointments and creams work best.
Kramb says learning that his dry skin was atopic dermatitis inspired him to help others. He created PatientPartner, which helps people who have similar health conditions connect so they can learn from each other.
“A lot of people are nervous and scared to share their health conditions with others,” Kramb says. “I wanted to create a safe place for them to share with one another so they can learn and build a community.”
Oct. 17, 2022 – Does Instagram make new moms feel inadequate? Yes, suggests a new study that warns images of new mothers on social media may drive body dissatisfaction and feelings of not being good enough.
Lead researcher Megan Gow, PhD, a National Health and Medical Research Council early career fellow at the University of Sydney Children’s Hospital Westmead Clinical School, says she wanted to find out if Instagram images reflected the actual population of postpartum women.
“We were concerned images would be idealized, placing postpartum women, who are already a vulnerable group, at increased risk,” she says.
The findings, published recently in the journal Healthcare, suggest social media may not be the right platform to target health messages to new moms.
A Vulnerable Time
The months after an infant’s birth are a vulnerable time for new moms. Women contend with huge hormone shifts, sleep deprivation, and a major life change — all while caring for a new child.
A 2021 Nestle study found 32% of parents feel isolated, while a 2017 online poll in the United Kingdom found 54% of new moms felt “friendless.” And according to the American Psychological Association, up to 1 in 7 new mothers will face postpartum depression, while 9% will have posttraumatic stress disorder, according to Postpartum Support International.
The pandemic may have worsened the isolation new mothers feel. A May 2022 study in the Journal of Psychiatric Research found U.S. rates of postpartum depression rose in the first year of the COVID-19 pandemic.
While new motherhood was stressful enough in the analog age, women today must contend with social media, which increases feelings of isolation. A June 2021 study published in Frontiers in Psychologysaid social media users between the ages of 26 and 35 reported higher rates of loneliness. That’s in line with Gow’s study, which noted 39% of Instagram’s monthly active users are women between the ages of 18 and 44. And nearly two-thirds of them – 63% — log onto the platform daily.
“The postpartum phase can feel very isolated, and being vocal about the postpartum shifts that all mothers go through helps set expectations and normalize the experience for those of us who are postpartum,” says Catie de Montille, 36, a mother of two in Washington, DC.
Instagram Sets the Wrong Expectations
Instagram sets unreasonable expectations for new mothers, Gow and her colleagues found in their study.
She and her fellow researchers analyzed 600 posts that used #postpartumbody, a hashtag that had been posted on Instagram more than 2 million times by October 2022. Other hashtags like #mombod and #postbabybody have been used 1.9 million and 320,000 times, respectively.
Of the 600 posts, 409 (68%) focused on a woman as the central image. The researchers analyzed those 409 posts to find out if they reflected women’s post-childbirth reality.
They found that more than 9 in 10 posts (91%) showed women who appeared to have low body fat (37%) or average body fat (54%). Only 9% showed women who seemed to be overweight. And the researchers also found just 5% of images showed features commonly associated with a postpartum body, like stretch marks or scars from cesarean sections.
Women need to be aware that “what is posted on Instagram may not be realistic and is not representative of the vast majority of women in the postpartum period” Gow says.
The images also did not portray women as physically strong.
Gow’s team examined 250 images for signs of muscularity. More than half, 52%, showed few or no defined muscles. That finding came even though more than half of the original 409 images showed women in fitness attire (40%), underwear (8%), or a bathing suit (5%).
According to Emily Fortney, PsyD, a licensed clinical psychologist in Sacramento, CA, the study shows that health care workers must work harder to set expectations for new moms.
“This is a deeper issue of how women are overall portrayed in the media and the pressure we face to return to some unrealistic size,” she says. “We need to be encouraging women to not focus on photos, but to focus on the postpartum experience in an all-encompassing way that includes both physical and mental health.”
Childbirth as an Illness to Overcome?
While retail brands from Nike to Versace have begun to show a wider range of female shapes in advertisements and on the runway, postpartum women seem to be left out of this movement. Gow and her fellow researchers referred to a 2012 study that examined images in popular Australian magazines and concluded these photos likened the pregnant body to an illness from which women needed to recover.
The images posted on Instagram indicate that belief is still pervasive. The images of postpartum women in fitness clothes suggest “that women want to be seen to be exercising as a means of breaking the ‘hold’ that pregnancy had on them or ‘repairing’ their postpartum body,” Gow and her fellow researchers say.
New Orleans resident Sydney Neal, 32, a mother of two who gave birth to her youngest child in November 2021, said social media helped shape her view of what “recovery” would be like.
While Neal said some celebrities like Chrissy Teigen, a mother of two, have “kept it very real” on Instagram, she also “saw a lot of women on social media drop [their weight] quickly and post as if they were back to normal much faster than 6 months.”
Body-Positive Tools for New Moms
Gow is continuing to study this topic. Her team is currently doing a study that will ask women about social media use, how they feel about their bodies, and how their beliefs change after viewing images tagged with #postpartumbody. (Women with children under the age of 2 can access the survey here.)
Because of the unrealistic images, Gow and her team said Instagram may not be a good tool for sharing health information with new moms.
But there are other options.
The Washington, DC-based de Montille, whose children were born in 2020 and 2022, used apps like Back to You and Expectful, and she follows Karrie Locher, a postpartum and neonatal nurse and certified lactation counselor, on Instagram. She said these tools focus on the mind/body connection, which “is better than focusing on the size of your jeans.”
Women also should be able to turn to trusted health care professionals.
“Providers can start speaking about the romanticization of pregnancy and motherhood starting in prenatal care, and they can start speaking more about social media use and the pros and cons of use specifically in the perinatal period,” says Fortney. “This opens the door to a discussion on a wide range of issues that can actually help assess, prevent, and treat perinatal mood and anxiety disorders.”
Neal, the mother of two in New Orleans, said she wished her doctor had talked to her more about what to expect after giving birth.
“I don’t really know how to crack the body image nut, but I think starting in a medical setting might be helpful,” she says.
