Have You Implemented the Valsalva Manoeuvre in Your Lifts?

ave you ever suffered from the worst back pain of your life from just one gym session? Trust me when I say, that just a slight shift in your form can set you back weeks or even months! Alas, here I am with an answer. What I am about to discuss is a technique that I have implemented for over a decade when weight-lifting.

The name of this underrated technique is the Valsalva Manoeuvre. You may or may not have already heard of this or you might be utilising it subconsciously. Regardless, I’m sure this article will help you improve or gain the confidence to implement it into your routine

What is the Valsalva Maneuver?

Valsalva refers to a dead Italian dude from seventeenth-century named Antonio Maria Valsalva. He was a brilliant physician and anatomist, who gave “breath” to this breathing technique. In its essence, the Valsalva manoeuvre is performed by “forcefully exhaling against a closed airway’”. Believe it or not, but we utilise this manoeuvre in many of our daily activities. For example, straining during defecation or playing a wind instrument. Besides the main focus of this article, the Valsalva manoeuvre has other application including:

  1. Medical examination of cardiac function
  2. Clinical diagnosis of nerves of the cervical spine
  3. Equalising pressure in ears (think, diving or flying in a plane)

Typically, weightlifters implement this technique to keep their spine from bending during exercises like squat, deadlift, and bench press

How to perform the Valsalva Maneuver

Before we discuss how this breathing technique can benefit your lifts, lets first discuss how you should be performing it.

Here are the 3 simple steps to this maneuver:

  1. Breath into your belly — Inhale a large amount of air through your mouth. You should notice your belly expanding rather than your chest.
  2. Close your glottis and exhale against it — wind travels in and out through your glottis when breathing. When the glottis is closed and exhaled against, the pressure inside your abdomen is elevated providing stability for heavy lifting.
  3. Perform your lift — Do not let any of the air out throughout the entirety of your lift. Only exhale after completing one rep.

Pro tip: many people confuse closing the glottis to closing your mouth. Try performing the Valsalva manoeuvre with an open mouth. If you can feel a flow of air coming out, you’re not closing your damn glottis. SHUT IT!

Benefits of the Valsalva Maneuver in Lifting

Performing the Valsalva manoeuvre produces a large amount of pressure on your torso. As the lungs expand, they put pressure on the back, chest, and internal organs. The pressure helps your torso resist being bent or shifted out of position when picking up heavy-ass weights.

Let’s imagine your upper body is like a soda can. When the can is empty (no air in your lungs), it’s relatively easy to bend. However, when the can is full (air in your lungs), it’s more difficult to bend.

Weightlifting belts help to intensify this intra-abdominal pressure. Many people believe that a belt often supports your back while lifting; however, a weightlifting belt merely sends a proprioceptive cue to your torso. This initiates a squeeze in your torso and tightens your core muscles when lifting those heavy-ass weights. Therefore, utilising the weightlifting belt with this breathing technique could keep your back safe whilst allowing you to transfer more force to the bar.

TL;DR — It helps you lift more weight.

Can the Valsalva Maneuver Kill You?

Many “well educated” doctors and trainers instruct to avoid using the Valsalva maneuver because its dangerous. Heck, even the American Heart Association had a Scientific Statement on Resistance Excercise discouraging lifting under Valsalva. It has been said to increase pressure in the brain, heart and blood vessels, resulting in a stroke, ruptured aneurysm or high blood pressure.

Dr Jonathan Sullivan — a physician and Starting Strength coach compiled a robust analysis on the dangers of performing the Valsalva manoeuvre. In short, Dr Sullivan’s research found no evidence that the Valsalva manoeuvre may increase chances of having a stroke, aneurysm or high blood pressure. Furthermore, he emphasised that there are a plethora of misguided, misleading and dangerous opinions on barbell training. These ideas find its way into peer-reviewed literature, courthouses and ultimately legislature. It is up to us, as a community, to shift through all the crap and shine a light on the truth.

However — there is always a however. If you have an intracranial aneurysm (and you probably won’t know until it bursts), the Valsalva manoeuvre may burst a cerebral artery. In saying that, an aneurysm is more likely to occur from having sex or blowing your nose. In other words, performing the Valsalva manoeuvre on the toilet seat could be more deadly than lifting weights.

Everyone, Take a Deep Breath

Is the Valsalva unsafe?

Are you going to die?

The answer to the last question is definitely yes…although probably not today. Our poor chap, Antonio Valsalva reportedly died of Stroke in Bologna at the age of 57. It is not clear whether Valsalva had a stroke under Valsalva, although there’s a good chance he was not standing under a barbell while it happened.

There is not enough hard evidence to show a cause-effect relationship between performing the Valsalva Manoeuvre and its proclaimed side effects. Yet, if you do have a family history of aneurysms or you suspect you may have an intracranial aneurysm you should not be lifting at all unless cleared by your doctor.

So go ahead and the next time you’re at the gym, try the Valsalva manoeuvre. This may save you from a burst capillary the next time you’re trying to impress someone with your lift.

Part-time food scientist and full-time foodie — Piecing together the disconnect of food, health and well-being.

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