How To Get Your First Pull-Up

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Pull-ups are a great compound exercise that works most of the upper body. However, it can be frustrating for many, if unable to do more than dangle and struggle while not going anywhere. That’s not actually bad, by the way! Of course it’s not great athletic performance, but in terms of exercise, “dangling and struggling while not going anywhere” is an isometric exercise that has plenty of benefits of its own. However, for those who would rather go up in the world, personal trainer Meg Gallagher shows the way:

The Only Way Is Up?

Gallagher offers a few methods; the first is simply an improvement on the “dangling and struggling while not going anywhere” method, but doing it with good form. It’s called the…

Hollow body hold:

  • Hang from the bar with legs and feet together.
  • Maintain a posterior pelvic tilt (i.e. don’t let your hips roll forwards, and don’t let your butt stick out more than is necessary by mere virtue of having a butt)
  • Engage your core by shortening the space between your ribs and pelvis.
  • Turn on your abs and lats, with your head slightly behind the bar.
  • Practice the hollow body hang instead of dead hangs to build grip and core strength.

Another method is now moving on from the hollow body hold, and shows that in fact, up is not the only way. It’s called…

Negative pull-ups:

  • Jump up to get your chin over the bar, then slowly lower yourself in a controlled manner.
  • Prioritize negative pull-ups over other exercises to build strength.
  • You can use modifications like resistance bands or feet assistance if necessary to extend the duration of your negative pull-up, but these are “crutches”, so try to move on from them as soon as you reasonably can—same if your gym has an “assisted pull-up” machine, consisting of a moving platform with a variable counterweight, mimicking how a pull-up would feel if your body were lighter.
  • Practice resisting throughout the entire range of motion.

To give a sense of direction, Gallagher offers the following program:

  • On day 1, test how long you can resist the negative pull-up (e.g., 10 seconds).
  • For each session, multiply your time by 2 (e.g., 10 seconds × 2 = 20 seconds total).
  • Break the total volume into as many sets as needed (e.g., 2 sets of 10 seconds or 4 sets of 5 seconds).
  • After each session, add 2 seconds to the total volume for the next session.
  • Aim for 3 sessions per week for 3–4 weeks, increasing by 2 seconds each session.
  • When you reach about 25 seconds, you should be close to performing your first pull-up.

For more on all of this, plus a few other things to try, plus visual demonstrations, enjoy:

Click Here If The Embedded Video Doesn’t Load Automatically!

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  • What is Ryeqo, the recently approved medicine for endometriosis?

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    For women diagnosed with endometriosis it is often a long sentence of chronic pain and cramping that impacts their daily life. It is a condition that is both difficult to diagnose and treat, with many women needing either surgery or regular medication.

    A medicine called Ryeqo has just been approved for marketing specifically for endometriosis, although it was already available in Australia to treat a different condition.

    Women who want the drug will need to consult their local doctor and, as it is not yet on the Pharmaceutical Benefits Scheme, they will need to pay the full cost of the script.

    What does Ryeqo do?

    Endometriosis affects 14% of women of reproductive age. While we don’t have a full understanding of the cause, the evidence suggests it’s due to body tissue that is similar to the lining of the uterus (called the endometrium) growing outside the uterus. This causes pain and inflammation, which reduces quality of life and can also affect fertility.

    Ryeqo is a tablet containing three different active ingredients: relugolix, estradiol and norethisterone.

    Relugolix is a drug that blocks a particular peptide from releasing other hormones. It is also used in the treatment of prostate cancer. Estradiol is a naturally occurring oestrogen hormone in women that helps regulate the menstrual cycle and is used in menopausal hormone therapy. Norethisterone is a synthetic hormone commonly used in birth control medications and to delay menstruation and help with heavy menstrual bleeding.

    All three components work together to regulate the levels of oestrogen and progesterone in the body that contribute to endometriosis, alleviating its symptoms.

    Relugolix reduces the overall levels of oestrogen and progesterone in the body. The estradiol compensates for the loss of oestrogen because low oestrogen levels can cause hot flushes (also called hot flashes) and bone density loss. And norethisterone blocks the effects of estradiol on the uterus (where too much tissue growth is unwanted).

    Is it really new?

    The maker of Ryeqo claims it is the first new drug for endometriosis in Australia in 13 years.

    But individually, all three active ingredients in Ryeqo have been in use since 2019 or earlier.

    Ryeqo has been available in Australia since 2022, but until now was not specifically indicated for endometriosis. It was originally approved for the treatment of uterine fibroids, which share some common symptoms with endometriosis and have related causes.

    In addition to Ryeqo, current medical guidance lists other drugs that are suitable for endometriosis and some reformulations of these have also only been recently approved.

    The oral medicine Dienogest was approved in 2021, and there have been a number of injectable drugs for endometriosis recently approved, such as Sayana Press which was approved in a smaller dose form for self-injection in 2023.

    hands taking pill out of contraceptive blister pack
    You can’t take the contraceptive pill with Ryeqo but the endometriosis drug could replace it.
    Shutterstock

    How to take it and what not to do

    Ryeqo is a once-a-day tablet. You can take it with, or without food, but it should be taken about the same time each day.

    It is recommended you start taking Ryeqo within the first five days after the start of your next period. If you start at another time during your period, you may experience initial irregular or heavier bleeding.

    Because it contains both synthetic and natural hormones, you can’t use the contraceptive pill and Ryeqo together. However, because Ryeqo does contain norethisterone it can be used as your contraception, although it will take at least one month of use to be effective. So, if you are on Ryeqo, you should use a non-hormonal contraceptive – such as condoms – for a month when starting the medicine.

    Ryeqo may be incompatible with other medicines. It might not be suitable for you if you take medicines for epilepsy, HIV and AIDS, hepatitis C, fungal or bacterial infections, high blood pressure, irregular heartbeat, angina (chest pain), or organ rejection. You should also not take Ryeqo if you have a liver tumour or liver disease.

    The possible side effects of Ryeqo are similar to those of oral contraceptives. Blood clots are a risk with any medicine that contains an oestrogen or a progestogen, which Ryeqo does. Other potential side effects include bone loss, a reduction in menstrual blood loss or loss of your period.

    It’s costly for now

    Ryeqo can now be prescribed in Australia, so you should discuss whether Ryeqo is right for you with the doctor you usually consult for your endometriosis.

    While the maker has made a submission to the Pharmaceutical Benefits Advisory Committee, it is not yet subsidised by the Australian government. This means that rather than paying the normal PBS price of up to A$31.60, it has been reported it may cost as much as $135 for a one-month supply. The committee will make a decision on whether to subsidise Ryeqo at its meeting next month.

    Correction: this article has been updated to clarify the recent approval of specific formulations of drugs for endometriosis.The Conversation

    Nial Wheate, Associate Professor of the School of Pharmacy, University of Sydney and Jasmine Lee, Pharmacist and PhD Candidate, University of Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Seasonal Affective Disorder (Beyond Sunlight!)

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    For those of us in the Northern Hemisphere, the time of increasing darkness is upon us again. Depending on our latitude, the sun barely rises before it skitters off again. And depending on other factors of our geography, we might not get much sun during that time (writer’s example: the ancient bog from which I write has been surrounded by fog for two weeks now).

    So, what to do about it?

    Firstly, we can make the most of whatever sun we do get (especially in the morning, if possible), and we can of course make some use of artificial sunlight. To save doubling up, we’ll link to what we previously wrote about optimizing both of those things:

    ‘Tis To Season To Be SAD-Savvy

    More ways to get serotonin

    Sunlight, of course, triggers our bodies to make serotonin, and hence we often make less of it during winter. But, there are other ways to get serotonin too, and one of the best ways is spending time in nature. Yes, even if the weather is gloomy, provided there are still visible green things and you are seeing them, it will promote serotonin production.

    Of course, it may not be the season for picnics, but a morning walk through a local park or other green space is ideal.

    On which note, gardening remains a good activity. Not a lot of people do so much gardening after a certain point in the year, but in one way, it’s more important than ever to get some soil under your fingernails:

    There are bacteria in soil (specifically: Mycobacterium vaccae) that work similarly to antidepressants.

    When something is described as having an effect similar to antidepressants, it’s usually hyperbole. In this case, it’s medicine, and literally works directly on the serotonergic system (as do many, but not all, antidepressants).

    See also: Antidepressants: Personalization Is Key!

    While many antidepressants are selective serotonin uptake inhibitors (i.e., they slow the rate at which your brain loses serotonin), Mycobacterium vaccae increases the rate at which you produce serotonin. So, you feel happier, more relaxed, while also feeling more energized.

    See: Identification of an immune-responsive mesolimbocortical serotonergic system: Potential role in regulation of emotional behavior

    ^this one’s a mouse study, but we’re including it because it covers exactly how it works in the brain, which is something that the ethics board wouldn’t let them do on humans, due to the need for slicing the brains up for examination.

    As to how to benefit: touching soil will get you “infected” by the bacteria, yes, even if you wash your hands later. Growing food in the soil and eating the good (including if you wash and cook it) is even better.

    Boost the other “happiness chemicals”

    Serotonin is just one “happiness hormone”, other feel-good neurotransmitters that are just as important include dopamine and oxytocin.

    Dopamine is most associated with being the “reward chemical”, so it pays to do things that you find rewarding. If you’re stuck for ideas, engaging in small acts of kindness is a sure-fire way to get dopamine flowing and lift your own mood as well as theirs.

    See also: 10 Ways To Naturally Boost Dopamine

    Oxytocin, meanwhile is the “cuddle chemical”, and can be triggered even if you have nobody to cuddle*. If you do, by the way, make it at least 20–30 seconds, as that’s generally how long it takes to get oxytocin flowing.

    *Vividly imagining it has much the same effect, since the brain can’t tell the difference. Alternatively, looking at pictures/videos (your choice) of small cute animals tends to work for most people also.

    For more on these things, check out: Neurotransmitter Cheatsheet

    Take care!

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  • How To Leverage Attachment Theory In Your Relationship

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    How To Leverage Attachment Theory In Your Relationship

    Attachment theory has come to be seen in “kids nowadays”’ TikTok circles as almost a sort of astrology, but that’s not what it was intended for, and there’s really nothing esoteric about it.

    What it can be, is a (fairly simple, but) powerful tool to understand about our relationships with each other.

    To demystify it, let’s start with a little history…

    Attachment theory was conceived by developmental psychologist Mary Ainsworth, and popularized as a theory bypsychiatrist John Bowlby. The two would later become research partners.

    • Dr. Ainsworth’s initial work focused on children having different attachment styles when it came to their caregivers: secure, avoidant, or anxious.
    • Later, she would add a fourth attachment style: disorganized, and then subdivisions, such as anxious-avoidant and dismissive-avoidant.
    • Much later, the theory would be extended to attachments in (and between) adults.

    What does it all mean?

    To understand this, we must first talk about “The Strange Situation”.

    “The Strange Situation” was an experiment conducted by Dr. Ainsworth, in which a child would be observed playing, while caregivers and strangers would periodically arrive and leave, recreating a natural environment of most children’s lives. Each child’s different reactions were recorded, especially noting:

    • The child’s reaction (if any) to their caregiver’s departure
    • The child’s reaction (if any) to the stranger’s presence
    • The child’s reaction (if any) to their caregiver’s return
    • The child’s behavior on play, specifically, how much or little the child explored and played with new toys

    She observed different attachment styles, including:

    1. Secure: a securely attached child would play freely, using the caregiver as a secure base from which to explore. Will engage with the stranger when the caregiver is also present. May become upset when the caregiver leaves, and happy when they return.
    2. Avoidant: an avoidantly attached child will not explore much regardless of who is there; will not care much when the caregiver departs or returns.
    3. Anxious: an anxiously attached child may be clingy before separation, helplessly passive when the caregiver is absent, and difficult to comfort upon the caregiver’s return.
    4. Disorganized: a disorganizedly attached child may flit between the above types

    These attachment styles were generally reflective of the parenting styles of the respective caregivers:

    1. If a caregiver was reliably present (physically and emotionally), the child would learn to expect that and feel secure about it.
    2. If a caregiver was absent a lot (physically and/or emotionally), the child would learn to give up on expecting a caregiver to give care.
    3. If a caregiver was unpredictable a lot in presence (physical and/or emotional), the child would become anxious and/or confused about whether the caregiver would give care.

    What does this mean for us as adults?

    As we learn when we are children, tends to go for us in life. We can change, but we usually don’t. And while we (usually) no longer rely on caregivers per se as adults, we do rely (or not!) on our partners, friends, and so forth. Let’s look at it in terms of partners:

    1. A securely attached adult will trust that their partner loves them and will be there for them if necessary. They may miss their partner when absent, but won’t be anxious about it and will look forward to their return.
    2. An avoidantly attached adult will not assume their partner’s love, and will feel their partner might let them down at any time. To protect themself, they may try to manage their own expectations, and strive always to keep their independence, to make sure that if the worst happens, they’ll still be ok by themself.
    3. An anxiously attached adult will tend towards clinginess, and try to keep their partner’s attention and commitment by any means necessary.

    Which means…

    • When both partners have secure attachment styles, most things go swimmingly, and indeed, securely attached partners most often end up with each other.
    • A very common pairing, however, is one anxious partner dating one avoidant partner. This happens because the avoidant partner looks like a tower of strength, which the anxious partner needs. The anxious partner’s clinginess can also help the avoidant partner feel better about themself (bearing in mind, the avoidant partner almost certainly grew up feeling deeply unwanted).
    • Anxious-anxious pairings happen less because anxiously attached people don’t tend to be attracted to people who are in the same boat.
    • Avoidant-avoidant pairings happen least of all, because avoidantly attached people having nothing to bind them together. Iff they even get together in the first place, then later when trouble hits, one will propose breaking up, and the other will say “ok, bye”.

    This is fascinating, but is there a practical use for this knowledge?

    Yes! Understanding our own attachment styles, and those around us, helps us understand why we/they act a certain way, and realize what relational need is or isn’t being met, and react accordingly.

    That sometimes, an anxiously attached person just needs some reassurance:

    • “I love you”
    • “I miss you”
    • “I look forward to seeing you later”

    That sometimes, an avoidantly attached person needs exactly the right amount of space:

    • Give them too little space, and they will feel their independence slipping, and yearn to break free
    • Give them too much space, and oops, they’re gone now

    Maybe you’re reading that and thinking “won’t that make their anxious partner anxious?” and yes, yes it will. That’s why the avoidant partner needs to skip back up and remember to do the reassurance.

    It helps also when either partner is going to be away (physically or emotionally! This counts the same for if a partner will just be preoccupied for a while), that they parameter that, for example:

    • Not: “Don’t worry, I just need some space for now, that’s all” (à la “I am just going outside and may be some time“)
    • But: “I need to be undisturbed for a bit, but let’s schedule some me-and-you-time for [specific scheduled time]”.

    Want to learn more about addressing attachment issues?

    Psychology Today: Ten Ways to Heal Your Attachment Issues

    You also might enjoy such articles such as:

    Lastly, to end on a light note…

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    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

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    So, no question/request too big or small

    “It was superb !! Just loved that healthy recipe !!! I would love to see one of those every day, if possible !! Keep up the fabulous work !!! ”

    We’re glad you enjoyed! We can’t promise a recipe every day, but here’s one just for you:

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  • How the stress of playing chess can be fatal

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    The death of a chess player in the middle of a match at the world’s most prestigious competition may have shocked those who view the game as a relaxing pastime. Kurt Meier, 67, collapsed during his final match in the tournament and died in hospital later that day. But chess, like any other game or sport, can lead to an immense amount of stress, which can be bad for a competitor’s physical health too.

    We tend to associate playing sport or games with good health and well-being. And there are a countless number of studies showing playing games has an association with feeling happier. While this argument is true for recreational players, the story can be different for the elite, where success and failure are won and lost by the finest margins and where winning can mean funding and a future, and losing can mean poverty and unemployment. If this is the case, can being successful at a sport or game actually be bad for you?

    Competitive anxiety

    Elite competition can be stressful because the outcome is so important to the competitors. We can measure stress using a whole range of physiological indicators such as heart rate and temperature, and responses such as changes in the intensity of our emotions.

    Emotions provide a warning of threat. So if you feel that achieving your goal is going to be difficult, then expect to feel intense emotions. The leading candidate that signals we are experiencing stress is anxiety, characterised by thoughts of worry, fears of dread about performance, along with accompanying physiological responses such as increased heart rate and sweaty palms. If these symptoms are experienced regularly or chronically, then this is clearly detrimental to health.

    This stress response is probably not restricted to elite athletes. Intense emotions are linked to trying to achieve important goals and while it isn’t the only situation where it occurs, it is just very noticeable in sport.

    The causes of stress

    It makes more sense to focus on what the causes of stress are rather than where we experience it. The principle is that the more important the goal is to achieve, then the greater the propensity for the situation to intensify emotions.

    Emotions intensify also by the degree of uncertainty and competing, at whatever level of a sport, is uncertain when the opposition is trying its hardest to win the contest and also has a motivation to succeed. The key point is that almost all athletes at any level can suffer bouts of stress, partly due to high levels of motivation.

    A stress response is also linked to how performance is judged and reported. Potentially stressful tasks tend to be ones where performance is public and feedback is immediate. In chess – as with most sporting contests – we see who the winner is and can start celebrating success or commiserating failure as soon as the game is over.

    There are many tasks which have similar features. Giving a speech in public, taking an academic examination, or taking your driving test are all examples of tasks that can illicit stress. Stress is not restricted to formal tasks but can also include social tasks. Asking a potential partner for a date, hand in marriage, and meeting the in-laws for the first time can be equally stressful.

    Winning a contest or going on a date relate to higher-order goals about how we see ourselves. If we define ourselves as “being a good player” or “being attractive or likeable” then contrasting information is likely to associate with unpleasant emotions. You will feel devastated if you are turned down when asking someone out on a date, for instance, and if this was repeated, it could lead to reduced self-esteem and depression.

    The key message here is to recognise what your goals are and think about how important they are. If you want to achieve them with a passion and if the act of achieving them leads to intense and sometimes unwanted emotions, then it’s worth thinking about doing some work to manage these emotions.

    Andrew Lane, Professor in Sport and Learning, University of Wolverhampton

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    The Conversation

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  • Palliative care as a true art form

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    How do you ease the pain from an ailment amidst lost words? How can you serve the afflicted when lines start to blur? When the foundation of communication begins to crumble, what will be the pillar health-care professionals can lean on to support patients afflicted with dementia during their final days?

    The practice of medicine is both highly analytical and evidence based in nature. However, it is considered a “practice” because at the highest level, it resembles a musician navigating an instrument. It resembles art. Between lab values, imaging techniques and treatment options, the nuances for individualized patient care so often become threatened.

    Dementia, a non-malignant terminal illness, involves the progressive cognitive and social decline in those afflicted. Though there is no cure, dementia is commonly met in the setting of end-of-life care. During this final stage of life, the importance of comfort via symptomatic management and communication usually is a priority in patient care. But what about the care of a patient suffering from dementia? While communication serves as the vehicle to deliver care at a high level, medical professionals are suddenly met with a roadblock. And there … behind the pieces of shattered communication and a dampened map of ethical guidelines, health-care providers are at a standstill.

    It’s 4:37 a.m. You receive a text message from the overnight nurse at a care facility regarding a current seizure. After lorazepam is ordered and administered, Mr. H, a quick-witted 76-year-old, stabilizes. Phenobarbital 15mg SC qhs was also added to prevent future similar events. You exhale a sigh of relief.

    Mr. H. has been admitted to the floor 36 hours earlier after having a seizure while playing poker with colleagues. Since he became your patient, he’s shared many stories from professional and family life with you, along with as many jokes as he could fit in between. However, over the course of the next seven days, Mr. H. would develop aspiration pneumonia, progressing to ventilator dependency and, ultimately, multi-organ failure with rapid cognitive decline.

    What strategies and tools would you use to maximize the well-being of your patient during his decline? How would you bridge the gap of understanding between the patient’s family and health-care team to provide the standard of care that all patients are owed?

    To give Mr. H. the type of care he would have wanted, upon his hospital admission, he should have been questioned about his understanding of illness along with the goals of care of the medical team. The patient should have been informed that it is imperative to adhere to the medical regimen implemented by his team along with the risks of not doing so. In the event disease-related complications arose, advanced directives should have been documented to avoid any unnecessary measures.

    It is important to note, that with each change in status of the patient’s health status, the goal of treatment must be reassessed. The patient or surrogate decision-maker’s understanding of these goals is paramount in maintaining the patient’s autonomy. It is often said that effective communication is the bedrock of a healthy relationship. This is true regardless of type of relationship.

    This is why I and Megan Vierhout wrote Integrated End of Life Care in Dementia: A Comprehensive Guide, a book targeted at providing a much-needed road map to navigate the many challenges involved in end-of-life care for individuals with dementia. Ultimately, our aim is to provide a compass for both health-care professionals and the families of those affected by the progressive effects of dementia. We provide practical advice on optimizing communication with individuals with dementia while taking their cognitive limitations, preferences and needs into account.

    I invite you to explore the unpredictable terrain of end-of-life care for patients with dementia. Together, we can pave a smoother, sturdier path toward the practice of medicine as a true art form.

    This article is republished from healthydebate under a Creative Commons license. Read the original article.

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