"I spent almost 20 years trying to become smaller. I starved myself. I made myself sick. And then one day, I decided to get stronger, and my life changed forever."
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I am a 20 year old male who started Starting Strength in January and have gained about 20 pounds of muscle since. I have gone from looking like I came from a concentration camp at 120 pounds, to a reasonably healthy looking 140 pounds (5'8). However, I was recently diagnosed with a Bicuspid Aortic Valve, a disease in which the aorta only has two flaps instead of three like a normal person. This means I am at risk for aortic dissection which is potentially fatal.
I went to see a geneticist regarding this condition and she said I couldn't do any lifting at all and that it was "very dangerous" to lift weights. The only thing she said I can do is dumb cardio things like swimming that would really only cause me to lose weight. Needless to say I am very disappointed. I really, really enjoyed lifting and I was totally committed to working out three days a week, and only missed 3 workouts since January. The worst part about this advice is that it means this is literally the best shape my body will be for the rest of my life and the most I'll ever weigh unless I get fat.
What is your advice or understanding regarding BAV? I know that Arnold Schwarzenegger has a BAV and he obviously hasn't died after 50+ years of weight lifting, so I don't understand why I can't lift anything. I feel as though this geneticist just told me not to lift anything because she didn't know any better. I am still going to see another doctor who is supposed to be a world expert cardiologist regarding BAV, and hopefully he can give me a more definitive answer.
The geneticist confirmed that so far I can lift up to 50 pounds. This makes me feel slightly better. My empty barbell is only 45 pounds, so at least I can get under that again. Does anyone know of a good program that involves a high amount of reps? So far I'm just lifting the empty bar with 3 sets of 15 or so reps. Better than nothing I guess.
Looks like we may be on our own here. Have your doctor explain why 55 pounds will kill you.
I'm not a cardiologist. I am a doctor, but the following is not medical advice:
I don't see why a bicuspid aortic valve would prevent you from lifting more than 50#. That seems extreme and ridiculous, unless there are some more severe deformities involved. The problem with bicuspid aortic valves is that they tend to calcify more quickly than the tricuspid variety. Because of this, you are going to need to have regular checkups and echocardiography with a cardiologist your whole life so they can monitor it. Eventually, you are going to need a valve replacement, there is probably no avoiding it. But we're talking when you’re in your late 40s or 50s, depending on how quickly it calcifies and how much it is impairing your life (average age for replacement is 43). Other than that, you should be able to live a normal life, and train with barbells if you want to. If I were you, I'd find someone who follows lots people with this problem for their whole lives and has experience with the limitations that it imposes. There are probably more athletes with this genetic problem than this geneticist is aware of, since this is the most common genetic cardiac anomaly (affecting 1 in 50 people, not really that uncommon). You may be at increased risk for things like aortic root dilation and rupture because of increased pressure at the valve, and this risk increases as the valve calcifies and the opening gets smaller (increasing pressure on the left heart). But for the life of me, I can't see why you should restrict yourself to lifting 50#. When you're 20, this risk, while increased, is still likely fairly small. Informing you of the risks of your condition is one thing, but telling you that you now have to live your whole life as an invalid!?...you need to fire this person.
If you tool around pub med or even google and find anything that says that a 20 year old with asymptomatic BAV can only lift 50# -- and it's printed in a reputable journal -- I'd be very interested to see it. I'll go ahead and go on record saying that I suspect that such a statement doesn't exist in the literature, and this doctor just pulled it right out of his ass.
I've scanned many patients with bicuspid AV (I'm a cardiac sonographer). If it were me and the valve area was normal with no aortic dilatation I would continue lifting. You'll need periodic imaging to monitor the valve.
I've seen people in their 20s that needed a valve replacement and I've seen people in their 40s with little effects from it.
I'd find a respected cardiologist that appreciates athletic endeavors and have a conversation with them.
After seeing many pictures of the classic deadlifters with closed stances (feet ~6 in apart), I decided to try it today and it made the lift much easier. I was able to accelerate with the weight and my lockout felt stronger.
Closing up my stance and slightly pointing my toes out was the best thing I have done with my deads in a long time...after years of a medium stance with toes straight ahead. The extra quad and adductor activity was sufficient for a 25 lb PR without any other technique or programming changes.
No doubt. And closing up my stance a bit makes deadlifting in lifting shoes a reality, whereas before I was getting nothing out of them.
After reading this thread, I tried doing a set of cleans with a narrower stance earlier today. WOW - more power and a smoother lift overall, right through the rack. Previously I had kept my heels about 12-14 inches apart, but moving them to about 8 inches apart made a very noticeable difference. I'll have to try the closer stance on Monday when I deadlift.
Just wondering, Rip, do you recommend a closer stance long-term? I see videos of powerlifters pulling with heels about shoulder width and with the closer stance (like Konstantinov).
The effectiveness of the closer stance is predicated on the knees-out position. It works well for all anthropometries, and is essential for longer-legged people using a conventional style.
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