Mini Pause #16: Smart Changes to Increase Your Muscle Mass

Try Long-Length Partial Repetitions for Muscle Gains

TL,DR (too long, didn’t read)

Long-length partials are a great addition to your already established weightlifting routine. The literature seems to agree that long-length partials–when the goal is muscle hypertrophy (increase in muscle mass)–seem to be at least equivalent to a full range of motion.

They are great to use if you are injured (and cannot perform full range of motion exercises), or as a finisher to a set, or for variety to combat boredom.

Oh, and I have never been so sore. It hurts so good!


Recently at the gym, as I was peeling myself off of a leg machine, my husband was looking at me, somewhat amused, and I knew what he was thinking so I answered the question before he asked it.

“I’d rather endure the pain of this exercise than the pain of staying the same.”

It was one of those “damn I need to remember that line and tell more people” moments.

There are many reasons why I like to push beyond my comfort zone in the gym. To the point where I am riding the line of pain and excruciating pain. If we ever get to train together, you will find me often shaking my head no as I descend into yet another squat, mentally overriding my desire to stop.

Because staying the same, never growing, and never challenging myself feels like death to me.
Maybe I was a huntress in a previous life, but I find extreme satisfaction in the hunt. In this case, the hunt for hypertrophy.

So on a recent Friday night, I was nose deep down a muscle hypertrophy rabbit hole on PubMed (as one does on a Friday) and came across some interesting meta-analysis on long-length partials compared to full range of motion and their effect on muscle hypertrophy. I was so excited I started rabidly consuming several studies, and have now incorporated them into my training routine and have noticed some exciting preliminary changes in my strength.


Long-length partials are essentially a half rep focusing on the lengthened portion of the movement.

For an easy visual, think of a bicep curl. Where the bicep muscle is most lengthened is when the elbow is straight. A half rep would be bending the elbow to about 90 degrees of flexion, rather than bringing the weight to your shoulder.

  • For a pull-up: It would be when the arms are straight, and you pull up halfway.
  • For a squat: It would be at the bottom of the squat and lifting up halfway before going right back down again.
  • For a chest press: It would be when the bar or weight is closest to your chest, with the pec muscles stretched out.

The literature agrees that long-length partials, when the goal is muscle hypertrophy, seem to be at least equivalent to a full range of motion (ROM).

This study [*] looked at women performing knee extension exercises at various ranges of motion varying from full ROM to long-length partial extension to shortened-length partial extensions. They found partial ROM training in the lengthened phase of the knee extension promoted greater relative hypertrophy in certain muscle regions than training in other ROM configurations.

It holds true for the entire body. This study [*] looked at muscle hypertrophy in the bicep muscle, again in women, and found an identical result.
This meta-analysis [*] concluded full range of motion or long ROM enhanced results for most outcomes (strength, speed, power, muscle size, and body composition).


So, should you swap out all your full ROMs for partials? No! They’re a useful tool in the proverbial tool belt but by no means a total replacement for full ROM.

Where you can, proper form and full range of motion should be performed. This preserves muscle movement at all angles and is conducive to range of motion and proprioception at the level of the joint as well.

Where I think long-length partials (LLPs) may be handy:

  • When you are injured and cannot perform a full ROM. This can be useful as a rehab tool for getting back to full ROM and preserving muscle tissue.
  • When you have a condition like rheumatoid arthritis, adhesive capsulitis/ frozen shoulder, or bursitis and cannot perform full ROM without pain. Again, LLPs can preserve tissue, and act as a stepping stone to full ROM.
  • When you are close to completing a set but can no longer move the weight through the full range of motion, you can begin using long-length partials. I have found I can punch out five or six more reps this way.
  • When you want variety and are combating boredom. I have been playing with alternating a full ROM repetition with a LLPl rep in many of my leg and upper body days.


For your next workout, choose to incorporate LLPs in one of the following:

  • All sets and all reps are LLPs
  • Full ROM reps until you cannot anymore, then switch to LLPs to really finish the muscle you are working
  • Alternating between a full ROM and a LLP

Which one are you going to try?

Also a word of warning–it might be the novelty, but I have never had such an amazing pump and ensuing soreness the next day! Have your favorite recovery tool at the ready.

A few of my go-to recovery tools include: Coldture cold plunge, Sunlighten sauna, Bon Charge sauna blanket, and Bon Charge massage gun. (Curious? You can use code DRSTEPHANIE to get special discounts.)

Question of the Week

Q: I’ve noticed on Dr. Stephanie’s IG that she tends to use machines rather than free weights/barbells during her strength workouts. I’m very interested to learn her recommendations for women around this—the difference between using free weights vs. machines.

Thank you to April who sent in this question that I get asked a lot! I use a combination of all of the above.

For legs, I often use a Smith machine (which is a barbell with a fixed range of motion), a barbell for deadlifts or squats, walking lunges with dumbbells, Bulgarian split squats, and then machines like abduction and hamstring curls or leg extension.

Same goes for back days and shoulder days–it’s usually a combination of free weights, some type of axial loading with a barbell, and machines.

There is no right way or wrong way to train.

Machines have a predetermined line of drive, so in a sense, they are more stable because you do not need to create the stability yourself. There is an inherent trade-off to this. We want stability when we’re focusing on strength because the less stable the surface, the less strength you generate. But we also want to endogenously generate stability with accessory muscles and joints. So, I often use certain machines for six to eight weeks and then switch it up.

As long as you are going close to failure (making ugly faces, grunting noises, and getting to a place where you can no longer perform a full range of motion rep and drop down to long-length partials)–truthfully do whatever you love to do.


I’ll be answering your questions every week right here in the Mini Pause! Let me know what’s on your mind. I’ll be checking for both questions and feedback at

WHAT I RECOMMEND: Tips for nutrition, hydration, sleep & stress

I love hearing from my Bettys! When you write in, DM me, or comment on my socials, consistent themes emerge, like: Ways to keep your nutrition on point, how to stay hydrated, what to do to get good sleep, and how to handle stress. Here are some simple choices I make that you may find useful.

GREENSAG1 is convenient, comprehensive, foundational nutrition. Use this link to order and receive a FREE One Year Supply of Vitamin D3+K2 and 5 Travel Packs!

ELECTROLYTESLMNT prevents muscle cramps, headaches, and energy dips. Visit to receive a free LMNT Sample Pack with any order.


  • Hello NED: A unique combination of CBN plus full-spectrum hemp and botanicals (non-addictive). Check out the Sleep Blends. On April 29 & 30, all Sleep Blend tincture + capsules will be buy one, get one free with code DRSTEPHANIEBOGO.
  • Qualia Night. Help your nervous system naturally wind down, starting after dinner. Learn more about how this supplement works differently here. If you try it, use code ESTIMA15 to save 15%.

STRESS: The Apollo wearable uses the gentle vibrations of touch therapy to promote stress resilience. (My kids use it, too.) Explore its features and use code DRSTEPHANIE to save $50.


Disclaimer: The information included in a newsletter, email, or on is intended solely for educational purposes. It does not replace a direct relationship with your licensed medical provider and is not intended to diagnose, treat, cure, or prevent any disease.

Affiliate Disclosure: Products mentioned in a newsletter, email, or on, may be part of an affiliate agreement in which Dr. Stephanie Estima receives a small commission on the sale of an item you purchase.

Mini Pause #15: Creatine Essentials for Women

Why You Need Creatine, Especially in Perimenopause & Menopause

TL,DR (too long, didn’t read)

Creatine is one of my absolute favorite supplements for women over 40. It helps with brain fog, cognition, and performance in the gym and makes your muscles look full and beautiful.


Creatine can offer several benefits like augmenting performance, slowing down your fatigue in the gym, and amping up muscle mass and recovery. It has also been shown to help with cognitive capacity. Yet, perhaps perplexingly, myths around creatine persist. I want to address some of these in kind, with some actionable items for you to try in your own life.


Myth 1: Creatine Causes Water Retention

Of all the myths surrounding creatine, this is the most common one I encounter from women. Most of us have likely already experienced the annoyance and inevitability of water retention in the luteal phase of the cycle, with rings not fitting, and our pants feeling just a little too snug for our liking.

So it comes as no surprise that if a woman is presented with the slightest inkling of water retention, she will avoid it.

The only issue is… creatine does not cause water retention in the extracellular matrix, but it does so in the intracellular one. There’s debate in the literature as to whether that is short-lived.

Creatine is an osmotically active substance and is taken up into muscle from circulation by a sodium-dependent creatine transporter. [*] Since the transport involves sodium, water also will be taken up into muscle to help maintain intracellular osmolality.

What does that actually mean? The water retention is not outside the muscle, which would lead to more puffiness and inflammation. The water retention is inside the muscle, which only makes the muscle look fuller and more defined.

And even if that is not your jam (full defined muscles), there are several studies that suggest long-term supplementation of creatine does not affect increases in either total body water volume, extracellular water volume, or even intracellular water volume! [*][*]

Although there is some disagreement about this in the literature, [*][*][*] the take-home point is that creatine is not going to make you puffy.

At worst, there is no change in water volume after long-term supplementation, and at best, you increase the water and sodium in the muscle cell which is important for muscle transcription and hypertrophy.

Myth 2: Creatine Is Just For Gym Bros

Much like lifting weights and eating meat has often been ascribed as phenotypical male behavior, creatine is not just for guys. There is ample evidence to suggest creatine supplementation is incredibly useful for women.

Hormone-driven fluctuations can alter your ability to synthesize and transport creatine effectively because creatine synthesis is affected by both estrogen and progesterone levels [*]. And so your ability to make and use creatine will be particularly affected during bleed week, perimenopause, and menopause [*] where we see drastic changes in concentrations of these hormones.

Creatine in the female frontal lobe has also been shown to be lower [*] than our male counterparts. So supplementing with creatine, particularly for women [*], can also help to reduce depression and anxiety.

And ladies in perimenopause and menopause, creatine has been shown to help with almost all measures of improving muscle mass and bone density [*] and reducing inflammation. Inflammaging, as the cool cats call it, is the epicenter of all chronic disease and accelerated aging.


Grab yourself a bag of creatine monohydrate. It MUST say creatine monohydrate in the ingredient list. No proprietary blend BS. I am asked all the time for recommendations and I absolutely love the Creatine with Taurine from mindbodygreen. (Visit mbg and use code DRSTEPHANIE for 15% off.)

The simplest way to start on creatine is to add 3-5g to your morning smoothie, your water for your workout, or even your coffee. It is flavorless so it will dissolve in just about any liquid and you won’t notice it.

Do this daily and just make it a part of your habit stack. No need to cycle on and off it, just take it consistently. Forever.

Although I find many things wrong with the fitness industry (unrealistic beauty standards, women getting so lean they don’t menstruate, filtered photos, etc.) one thing we can learn from them is their behaviors and habits toward tissue preservation. When fitness competitors are getting stage lean they undergo extreme caloric deficits, but their main goal is to preserve as much muscle as they can. So their protein intake never changes and they never stop taking creatine.

I think that’s more than telling in terms of the value creatine plays in muscle appearance and function.


  • Order your first bag of Creatine with Taurine here. (Use code DRSTEPHANIE to save 15%.)
  • Add one scoop to your morning smoothie, workout water, or cup of coffee daily
  • After a few weeks, ask yourself if you are noticing changes in your endurance and performance at the gym. Can you go harder for longer? What about your mood? Sleep? Recovery? If this is the only change you make over the next few weeks, you will likely notice several of these markers improving for the better.

Q: Do I take creatine before or after working out? Or does it even really matter when you take it?

Ahhhh, this is SUCH a good question with the possibility of going down several rabbit holes of nerdom. Thank you bltaillon who sent this in via IG. Let’s tuck into this without going TOO overboard, and give you a tangible answer.

So the TL;DR version of this answer is, based on the literature, it doesn’t seem to matter whether you take it before or after exercise. It seems strength gains and hypertrophy gains are all comparable.

For my medium- and dark-roast Bettys who want a little more detail, the largest study to date [*] on the topic of creatine timing involved a 32-week resistance exercise training program. They also had a placebo group so they could monitor the effects of strength training alone.

Thirty-nine healthy, older adults completed the double-blind placebo-controlled design, and were randomized into three groups: “Cr-Before”, “Cr-After”; or placebo (corn starch maltodextrin immediately before and immediately after resistance training).

Following the 32-week intervention, both creatine groups exhibited similar strength gains, with changes greater than the placebo control group.

The best answer here is: just take it when you can easily do it consistently!

I typically take it before training, but that’s because I make my proats (protein powder + oatmeal) and the creatine bag is right beside my protein powder. So they are stacked together for me. I scoop out of one and then just scoop out of the other.

Suggested for You: Another creatine option comes from Equip Foods. Take a look here at the PureWOD Pre-Workout. It includes creatine monohydrate.


I’ll be answering your questions every week right here in the Mini Pause! Let me know what’s on your mind. I’ll be checking for both questions and feedback at


In these newsletters, I often share the products, devices, and equipment that I use in my own life regularly. I ONLY mention items I feel are worth highlighting and that I believe may provide health and wellness benefits to my Bettys. I encourage you – pressure-free! – to explore and then determine if any of the items fit YOUR health needs, fitness goals, lifestyle, or budget.

You’ll find more resources in my online HEALTH TOOLKIT. I’ve compiled these for my Bettys who are still cycling, experiencing symptoms of perimenopause, or managing the transition to the other side of menopause. Take a look!


Disclaimer: The information included in a newsletter, email, or on is intended solely for educational purposes. It does not replace a direct relationship with your licensed medical provider and is not intended to diagnose, treat, cure, or prevent any disease.

Affiliate Disclosure: Products mentioned in a newsletter, email, or on, may be part of an affiliate agreement in which Dr. Stephanie Estima receives a small commission on the sale of an item you purchase.