Training guide

How to do shrugs: form, how heavy to go, and your neck

A shrug is about the simplest lift in the gym: with a weight in each hand and your arms hanging straight, you lift your shoulders towards your ears, hold for a second and lower them all the way. It trains the upper part of your trapezius, the muscle across the tops of your shoulders, more directly than any exercise it has been compared with.

The details matter more than the weight. Lift straight up rather than rolling, and use a load you can lift to full height. No study has tested shrugs on their own for muscle growth, but in a trial in women with long-standing neck muscle pain, 10 weeks of dumbbell training that included shrugs cut their worst pain by about four-fifths and enlarged their trapezius muscle fibres.

This guide covers the shrug step by step on the 3D figure, what it works and what it misses, the versions, how heavy to go, sets and reps, and what to do if shrugs bring on neck pain or a headache.

The short version

The shrug

Stand tall with a dumbbell in each hand at your sides, palms facing your thighs and arms straight. Lift both shoulders straight up towards your ears, as high as they'll go, hold for about a second, then lower them slowly all the way. A barbell, a cable or a machine loads the same movement.

Source 1

It works the upper traps hardest

Of 10 exercises in 30 healthy adults, the one-arm shrug worked the upper trapezius hardest, and in 12 women with neck muscle pain the dumbbell shrug reached 102% of a maximal test contraction. The middle and lower parts of the muscle need rows and face-down raises.

Sources 2, 3

Straight up, no rolling

No study has tested rolling the shoulders during a shrug, for or against. The American Council on Exercise's (ACE's) coaching advice is to lift straight up "avoiding any shoulder rotation", and our move page says rolling adds nothing and irritates some necks.

Source 1

Full height beats heavy

In the women's study, they reached full trapezius activity with 20 to 30 kg, and across many trials light and heavy loads built similar muscle when sets were hard, while full range built more strength than partial range. Use a weight you can lift to full height and hold for a second: 2 to 3 sets of 8 to 12, stopping 2 or 3 reps short (our editorial starting point).

Sources 3, 4, 5

Do shrugs build the traps?

Probably, but that's our inference. In 18 women with trapezius muscle pain, 10 weeks of five dumbbell exercises, shrugs among them, enlarged their type II (faster) trapezius fibres by about 20%. No study has tested shrugs alone, or in people without neck pain.

Source 6

Your neck

In women with long-standing neck muscle pain, strength training that included shrugs cut their worst pain by about 79% in 10 weeks; for tension-type headache, strength training did no better than posture advice. If shrugging brings on a headache or tingling in your arm, go lighter, and get it checked if it persists, as our move page says.

Sources 7, 8

What a shrug is, and what it works

The move

Shrugging lifts your shoulder blades straight up with your arms hanging straight, then lowers them. Dumbbells hang at your sides with your palms facing in; a barbell sits in front of your thighs, or behind them in the behind-the-back shrug; cables, a Smith machine, a calf machine and lever machines load the same movement. ACE rates the standing shrug intermediate and allows a split stance for balance.

Source 1

The trapezius

The trapezius is a large muscle in upper, middle and lower parts that works with the serratus anterior to steady the shoulder blade. As our trapezius page describes, it runs from the base of your skull and your upper spine to your collarbone and shoulder blades; the upper part lifts your shoulders and helps turn the shoulder blade up as your arm rises, the middle draws your shoulder blades together and the lower draws them down.

Source 9

The helpers

The levator scapulae, at the side of your neck, also lifts the shoulder blade, and shrug studies measure it alongside the trapezius. Your grip and forearm muscles work to hold the weights.

Sources 10, 11

Kelso, clean and snatch shrugs

The Kelso shrug isn't really a shrug: lying face down on an incline bench, you squeeze your shoulder blades together, which works the middle traps. Clean and snatch shrugs are fast weightlifting shrugs from mid-thigh, part of the pull; in the second pull of the power clean, trapezius activity and the shrug's range fell as the load rose, in 20 trained men.

Source 12

A short lift for a big muscle

Your shoulder blades travel only a few centimetres, so the weight can climb fast, and piling it on mostly shortens the lift (our reading). Full range built more strength than partial range across 16 studies, and training through the stretched part of a movement tends to grow muscle best, though none of these studies used shrugs.

Sources 5, 13

Activity isn't growth

Most shrug research measures EMG (electromyography: electrodes measuring how hard a muscle works in a few reps). That shows effort, not what a muscle builds over months.

Source 14

What the evidence says

Shrugs top the upper trapeziusEmerging evidence

Of 10 exercises in 30 healthy adults, the one-arm shrug drew the most upper-trapezius activity, while face-down raises worked the middle and lower trapezius hardest. In 12 women with chronic neck muscle pain, the shrug drew 102% of a maximal test contraction (plus or minus 11%) with 20 to 30 kg, against 97% for lateral raises and 85% for upright rows with only 3 to 10 kg. These are small studies of effort in a few reps, not of growth.

Sources 2, 3

Arms a little out from your sidesEmerging evidence

With the arms held 30 degrees out to the sides, the upper and lower trapezius worked harder than in a standard shrug, in 23 healthy adults and 14 with loose shoulders. In people whose shoulder blades rest turned down, shrugs with the arms raised to 90 or 150 degrees worked them harder than at 30 degrees (20 people), and a shrug with the arms out to the sides raised upper-trapezius activity (17 people). These are one-session rehabilitation studies, not training trials.

Sources 15, 10, 11

Trap growth: our inference from one trialEmerging evidence

In 18 women with long-standing trapezius muscle pain, 10 weeks of five dumbbell exercises (lateral raises, shrugs, one-arm rows, reverse flys and upright rows; three of the five each session, 3 sets at 8 to 12 repetitions maximum, 3 times a week) enlarged their type II trapezius fibres from 3,439 to 4,133 square micrometres, about 20%, measured by biopsy, with a trend towards larger type I fibres. That's the best direct evidence that shrug-based training builds the trapezius, and it's our inference: no study has tested shrugs alone, or in people without neck pain.

Sources 6, 7

Rolling the shoulders: coaching advice, untestedEmerging evidence

We found no study of rolling the shoulders during a shrug. ACE's coaching advice is to lift straight up and down, "avoiding any shoulder rotation or elbow flexion".

Source 1

Light or heavy, through a full rangeStrong evidence

Across 28 studies of 747 adults, light, moderate and heavy loads built similar muscle when sets were taken to failure, and heavier loads built more strength. Full range built more strength than partial range across 16 studies (effect size 0.56). None of these studies used shrugs, so applying them to shrugs is our reading.

Sources 4, 5, 13

Bands work like weightsEmerging evidence

At each person's 3-rep maximum, elastic tubing and dumbbells drew similar muscle activity (64 to 86% against 59 to 87% of maximum) in 16 women with neck and shoulder pain, and across 8 studies band training built strength like machines and dumbbells.

Sources 16, 17

More weekly sets build more muscleStrong evidence

More weekly sets built more muscle, with returns shrinking as the sets go up, and the American College of Sports Medicine's (ACSM's) overview of 137 reviews found growth enhanced with 10 or more sets a week. Across 67 studies, counting indirect sets as half sets predicted growth best.

Sources 18, 19, 20

How to do a shrug, step by step

Steps from our move page and ACE's standing shrug; the stopping rule is our editorial suggestion.

  1. Stand tall with your feet about hip-width apart, or one foot slightly in front for balance, a dumbbell in each hand at your sides, palms facing your thighs and arms relaxed and straight.
  2. Brace your trunk and keep your head level, in line with your spine. Don't poke your chin forward.
  3. Breathe out and lift both shoulders straight up towards your ears, as high as they'll go, keeping your elbows straight. Don't roll them or bend your arms.
  4. Hold for about a second at the top.
  5. Breathe in and lower slowly all the way, until your shoulders are fully down and your arms hang long.
  6. Repeat. End the set when you can no longer lift to full height or hold the pause.

Loading the 3D figure…

Gets into position, then repeats the movement. Technical checks passed; qualified exercise review is pending.

The movement on the figure: Dumbbell shrug

Straight up, not rolled: getting the shrug right

Straight up and down

Lift and lower in a straight line. ACE's coaching advice is not to roll your shoulders or bend your elbows; no study has tested rolling either way.

Source 1

Arms long, like ropes

Your arms only hold the weight; your shoulders do the moving, as our move page cues. If your elbows bend, the weight is too heavy.

Head level

Keep your chin level and your eyes ahead. Craning your neck forward makes shrugs uncomfortable for many people (our view).

Arms a little out, if you like

Holding your arms slightly out from your sides, as the snatch-grip shrug does, made the upper and lower trapezius work harder in a one-session study. Using it in the gym is our reading, not a tested programme.

Source 15

Straps

If your grip gives out before your traps, use lifting straps, as our barbell shrug page suggests.

Common mistakes and how to fix them

Rolling the shoulders

Lift straight up and lower straight down, as ACE coaches it.

Source 1

Bending the elbows or pulling with the arms

Your arms hang like ropes; only your shoulders move. Go lighter if your elbows bend.

Craning your neck

Keep your head level and your eyes ahead.

Too heavy, so the lift is an inch or two

Use a weight you can lift to full height and hold for a second; full range built more strength than partial range in trials.

Source 5

Dropping the weight on the way down

Lower slowly, all the way, until your arms hang long.

Leaning back, or the bar dragging up your thighs

Stand tall. Dumbbells at your sides or the behind-the-back shrug keep the weight out of the way.

Dumbbell, barbell, cable, machine and weightlifting shrugs

Each gives 2 to 3 sets of 8 to 12, stopping 2 or 3 reps short, on its move page; the clean and snatch shrugs give 3 sets of 3 to 5 fast reps. Learn the barbell shrug in front before the behind-the-back versions. There's no trap bar shrug in our catalog: hold the handles at your sides, as for dumbbell shrugs.

How heavy, how many and how often

Sets and reps

2 to 3 sets of 8 to 12, stopping 2 or 3 reps short of failure, with a one-second pause at the top (our move page's editorial starting point); the last set can go to 0 to 2 reps short, as our plans allow for small moves. The trapezius trial used 3 sets at 8 to 12 repetitions maximum, and our back workouts use 2 sets of 8 to 12 or of 12.

Source 6

Rest

60 to 90 seconds between sets, our plans' rest for small moves.

How often

Twice a week suits most people (our suggestion). The trapezius trial trained 3 times a week, doing three of its five exercises each session.

Source 6

Weekly sets for bigger traps

Build towards about 10 hard sets a week, counting shrugs in full and other trap work (carries, rows, deadlifts and upright rows) as half sets at most, since no study has measured how much they load the upper traps (our editorial counting). For health alone, shrugs are optional: the guidelines ask for strength work for all the major muscle groups on at least 2 days a week.

Sources 19, 20, 37

How heavy

There's no useful ratio to any other lift. The women in the activity study used 20 to 30 kg, which is an observation, not a target. Start with a weight you could lift about 10 to 12 times, as our plans suggest, and add reps before weight.

Source 3

Warm-up

A few slow shoulder circles and band pull-aparts, then one light set of shrugs, as our back workouts do.

Shrugs, neck pain and headaches

Strength training helped neck muscle painEmerging evidence

In a trial of 48 women with chronic trapezius muscle pain, 10 weeks of specific strength training (five dumbbell exercises, shrugs among them) cut their worst pain by 35 mm on a 100 mm scale, about 79%, while leg cycling gave only a small, short-lived drop. In 198 workers with frequent neck and shoulder pain, 2 or 12 minutes a day of band training, 5 days a week for 10 weeks, cut pain by 1.4 and 1.9 points out of 10 against health information.

Sources 7, 21

Shrugs aren't essentialEmerging evidence

Training the lower trapezius and serratus while keeping the upper trapezius quiet cut neck and shoulder pain by 2.0 points against a control group, in 47 office workers.

Source 22

Tension-type headacheEmerging evidence

In 60 patients, 10 weeks of shoulder and neck strength training with bands did no better than ergonomic and posture correction (44 finished the trial), and neither group's improvement reached clinical significance.

Source 8

If shrugs bring on symptoms

If shrugs bring on a headache, or pins and needles, numbness or pain down your arm, lighten them or leave them out, and get it checked if it persists, as our move page says. Arm symptoms that spread further or last more than an hour afterwards mean make the exercise smaller or leave it out, as our neck pain guide says.

The neck pain rule

During exercise, neck pain of 0 to 3 out of 10 is minimal and 4 to 5 acceptable; 6 or more is too much, and your neck should be no worse the next morning, as our neck pain guide sets out from NHS inform.

For the rest of your traps, and your neck

For the middle and lower traps: Y-T-W raises at 5 to 8 of each shape for 2 rounds, face pulls at 3 sets of 12 to 20, and reverse flys and one-arm rows, as our workouts use them. Farmer's carries load your traps and grip. The upper trap release takes 2 slow holds of 30 seconds each side (its move page), and chin tucks suit a stiff neck.

Shrugs vs upright rows, carries and face pulls

Shrugs or upright rows

Both work the upper traps hard: in the women's activity study the upright row reached 85% of maximal trapezius activity with 3 to 10 kg, and the shrug 102% with 20 to 30 kg. Upright rows also work the side of the shoulder; shrugs keep your arms by your sides, which suits a shoulder that complains when you raise your arm (our view). Our upright row guide has the details.

Source 3

Shrugs or farmer's carries

Carries hold your shoulders up while you walk and train your grip, but no study has measured how hard they work the traps. Many programmes use both; our farmer's carry guide covers carries.

Shrugs or face pulls

They train different parts: shrugs the upper traps; face pulls and face-down raises the middle and lower traps and the back of the shoulder.

Source 2

Who should change it

With neck pain

Start with our neck pain guide's plan and the neck and shoulder strength routine, and add loaded shrugs within its pain rule.

High blood pressure, heart disease or glaucoma

Breathe out as you lift rather than holding your breath, keep the effort moderate, and get advice before maximal lifts, as our breathing guide sets out. The American Heart Association says people with controlled high blood pressure can do low- to moderate-intensity strength training with proper breathing.

Source 23

Pregnancy

The NHS says you can keep up strength training if you already do it, and stop if you feel uncomfortable, too hot or unwell. Tommy's says not to hold your breath, and that pregnancy isn't the time to try your heaviest weights.

Sources 24, 25

A hernia

See a GP if you think you have a hernia, and get advice before heavy lifting, as our breathing guide suggests.

Source 26

Workouts to follow

Our traps workout is built on the five dumbbell exercises of the trapezius trials, with shrugs first and carries to finish. The back workouts end with shrugs at 2 sets of 8 to 12 or of 12, and the neck routines use them, or band work, for sore necks.

Plans that use it

The bro split's back day ends with shrugs.

Warning signs

Stop and get medical help

If you get chest pain or pressure, feel faint or dizzy, are unusually breathless, or your heart races or beats irregularly during exercise, as our plans advise. The American Heart Association says these need immediate medical evaluation.

Source 23

Call 999 (911 in the US) or go to A&E

For a headache that started suddenly and is extremely painful, for example while straining under a heavy lift: a bleed on the brain may be more likely when lifting something heavy, the NHS says. For numbness or weakness in your face or body, a drooping face, being unable to lift both arms and keep them up, or difficulty speaking, swallowing, balancing or walking, as our neck pain guide lists. For sudden chest pain that doesn't go away, spreads to your arms, neck, jaw, stomach or back, or comes with sweating, feeling sick, light-headedness or breathlessness. For palpitations that don't stop, or come with chest pain, breathlessness or feeling faint. If someone faints while exercising. For back pain with numbness, tingling or weakness in both legs, loss of feeling around your genitals or bottom, or changes in your bladder or bowels. If glaucoma symptoms come on suddenly, such as intense eye pain or a red eye. Don't drive yourself.

Sources 27, 28, 29, 30, 31, 32, 33, 34

The same day: an urgent GP appointment or NHS 111

For severe neck pain that starts suddenly or gets worse quickly, heaviness or weakness in your arms or legs, or pins and needles in an arm along with neck or arm pain, as our neck pain guide lists. For a headache brought on or made worse by exercising, coughing, sneezing or bending down: stop heavy lifting until it's been checked. In the US, contact your doctor or urgent care.

Source 27

See a GP

If neck pain or stiffness hasn't gone after a few weeks, painkillers haven't helped, or you have pins and needles or a cold arm. In many areas you can refer yourself to NHS physiotherapy.

Source 35

Light-headed after a set

Stop, sit or lie down until it passes, and get up slowly. See a GP if it keeps happening.

Sources 32, 36

Stop the set

If a pain is sharp, builds during the set or lingers into the next day, go lighter or leave shrugs out, and see a clinician if it persists.

Myths

"Roll your shoulders when you shrug"Emerging evidence

No study has tested rolling, for or against. ACE's coaching advice is straight up and down without rotation; rolling adds nothing we know of, and some necks dislike it, as our move page says.

Source 1

"Go as heavy as you can on shrugs"Emerging evidence

Women with neck pain reached full trapezius activity with 20 to 30 kg, light and heavy loads built similar muscle when sets were hard, and full range built more strength than partial range. A weight too heavy to lift far only shortens the lift: go to full height and hold for a second.

Sources 3, 4, 5

"Shrugs work your whole trapezius"Emerging evidence

The shrug topped the upper trapezius, but face-down raises worked the middle and lower trapezius hardest.

Source 2

"You can't build your traps without shrugs"Emerging evidence

Lateral raises and upright rows reached 97% and 85% of maximal trapezius activity with only 3 to 10 kg in women with neck pain. No growth trial compares shrugs with anything else, so shrugs are the most direct option, not the only one.

Source 3

"Shrugs fix rounded shoulders"Mixed evidence

We found no trial of shrugs for posture. The neck pain trials measured pain and strength, not posture; our posture guides cover what does change it.

Sources 7, 21

"Shrugs are bad for your neck"Emerging evidence

Strength training that included shrugs eased long-standing neck muscle pain in women, and short daily band training helped workers with frequent neck and shoulder pain. Some people do get headaches or arm symptoms when shrugging: lighten the load or leave them out.

Sources 7, 21

Questions people ask

How do you do shrugs properly?

Stand tall with a dumbbell in each hand at your sides, palms facing in. Lift your shoulders straight up towards your ears as high as they'll go, hold for a second, then lower them slowly all the way. Keep your arms straight and your head level.

What muscles do shrugs work?

Mainly the upper trapezius, the muscle across the tops of your shoulders, helped by the levator scapulae at the side of your neck, while your grip holds the weights. The middle and lower trapezius do much less: face-down raises and rows work them hardest.

Are shrugs a back or shoulder exercise?

The trapezius is a back muscle that moves your shoulder blades, so shrugs fit on a back day or a shoulder day, and in a push and pull split they count as a pull. What matters is doing enough hard sets in the week, not which day they're on.

How heavy should I go on shrugs?

Heavy enough that 8 to 12 reps are hard, light enough that you can lift to full height and hold for a second. Women in one study reached full trapezius activity with 20 to 30 kg, and light and heavy loads build similar muscle when sets are hard. Add reps before weight.

How many sets and reps of shrugs should I do?

Start with 2 to 3 sets of 8 to 12, stopping 2 or 3 reps short, with 60 to 90 seconds' rest. A trial that enlarged trapezius muscle fibres used 3 sets at 8 to 12 repetitions maximum, 3 times a week. For bigger traps, build towards about 10 hard sets a week.

Should you roll your shoulders when you shrug?

No. No study has tested rolling either way, and the American Council on Exercise's coaching advice is to lift straight up and down without rotation. Rolling adds nothing we know of, and some necks dislike it.

Dumbbell, barbell or trap bar shrugs: which is best?

They all train the same movement. Dumbbells hang at your sides; a barbell in front can bump your thighs, which the behind-the-back version avoids; a cable adds weight in small steps. We found no study comparing them, and with a trap bar you hold the handles at your sides, as with dumbbells.

Can shrugs cause neck pain or headaches?

They can for some people, often from going too heavy or craning the neck. If shrugs bring on a headache or tingling in your arm, go lighter or leave them out, and get it checked if it persists. A sudden, extremely painful headache while lifting is a 999 call.

Do shrugs help neck pain?

They can be part of it. In women with long-standing trapezius pain, 10 weeks of strength training that included shrugs cut their worst pain by about 79%, but training the lower traps instead also helped, so shrugs aren't essential. Our neck pain guide has the plan.

Can I do shrugs at home without weights?

Without any weight, shrugs are too easy to build much strength. Filled water bottles, a loaded backpack or a band under your feet all add load, and band training built strength like weights in trials.

Do shrugs build bigger traps?

Probably, but no study has tested shrugs on their own. In a trial in women with neck muscle pain, 10 weeks of five exercises, shrugs among them, enlarged their trapezius muscle fibres by about a fifth. That's our inference, not a tested promise.

What is a Kelso shrug?

Lying face down on an incline bench with dumbbells, you squeeze your shoulder blades together instead of lifting them. It works the middle traps, which standing shrugs don't, and our 3D demo shows it as the prone shoulder-blade squeeze.

Sources

  1. ACE · Standing shrug (exercise library, American Council on Exercise)
  2. Ekstrom 2003 · Trapezius and serratus anterior activity in 10 exercises in 30 healthy adults (muscle activity study, JOSPT)
  3. Andersen 2008 · Trapezius activity in shrugs, lateral raises, upright rows, rows and reverse flys in 12 women with neck muscle pain (muscle activity study, Phys Ther)
  4. Lopez 2021 · Light, moderate and heavy loads for muscle growth and strength: 28 studies, 747 adults (network meta-analysis, MSSE)
  5. Pallarés 2021 · Full against partial range of motion in resistance training: 16 studies (systematic review and meta-analysis, Scand J Med Sci Sports)
  6. Andersen 2014 · Strength training, muscle function and fibre size in women with trapezius muscle pain (case-control study and randomised trial, Biomed Res Int)
  7. Andersen 2008 · Specific strength training against leg cycling for chronic neck muscle pain in 48 women (randomised trial, Arthritis Rheum)
  8. Madsen 2018 · Strength training against posture and ergonomic advice for tension-type headache in 60 patients (randomised trial, Cephalalgia)
  9. Camargo 2019 · The trapezius: its parts, what they do and the exercises that target them (review, Braz J Phys Ther)
  10. Choi 2015 · Shrugs with the arms raised to 30, 90 and 150 degrees in 20 people (muscle activity study, J Electromyogr Kinesiol)
  11. Lee 2016 · Three shrug variations in 17 people whose shoulder blades rest turned down (muscle activity study, Hum Mov Sci)
  12. Nagao 2021 · The shrug and trapezius activity in the power clean in 20 trained men (lab study, JSCR)
  13. Kassiano 2023 · Range of motion and muscle growth: 11 studies (systematic review, JSCR)
  14. Vigotsky 2022 · Muscle activity measured in one session isn't a validated predictor of muscle growth (review, Sports Med)
  15. Pizzari 2014 · A shrug with the arms 30 degrees out, in 23 healthy adults and 14 with loose shoulders (muscle activity study, Clin Biomech)
  16. Andersen 2010 · Dumbbells against elastic tubing at matched effort in 16 women (muscle activity study, Phys Ther)
  17. Lopes 2019 · Elastic bands against weights and machines for strength: 8 studies (systematic review and meta-analysis, SAGE Open Med)
  18. Schoenfeld 2017 · Dose-response relationship between weekly resistance training volume and muscle growth (meta-analysis, J Sports Sci)
  19. Currier 2026 · Resistance training for muscle function, size and performance in healthy adults: 137 reviews (ACSM position stand, MSSE)
  20. Pelland 2026 · Weekly sets and training frequency against muscle growth and strength: 67 studies, 2,058 people (meta-regression, Sports Med)
  21. Andersen 2011 · 2 or 12 minutes a day of band training for neck and shoulder pain in 198 workers (randomised trial, Pain)
  22. Andersen 2014 · Lower trapezius and serratus training for neck and shoulder pain in 47 office workers (randomised trial, J Occup Rehabil)
  23. Paluch 2024 · Resistance exercise training with and without cardiovascular disease: 2023 update (American Heart Association scientific statement, Circulation)
  24. NHS · Exercise in pregnancy
  25. Tommy's · Strength training in pregnancy (pregnancy charity)
  26. NHS · Hernia
  27. NHS · Headaches
  28. NHS · Subarachnoid haemorrhage
  29. NHS · Chest pain (past its review date: reviewed August 2023, review due August 2026)
  30. NHS · Heart attack
  31. NHS · Heart palpitations
  32. NHS · Fainting
  33. NHS · Back pain
  34. NHS · Glaucoma
  35. NHS · Neck pain (past its review date: reviewed April 2023, review due April 2026)
  36. NHS · Dizziness (past its review date: reviewed April 2023, review due April 2026)
  37. NHS · Physical activity guidelines for adults aged 19 to 64

Exercise education, not a personal prescription, and clinical review of these guides is pending. Check with a GP before starting hard training if you have a heart condition, chest pain, dizziness or breathlessness when active, and stop for sharp or increasing pain. Health disclaimer.