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Thread: Dr. Jonathon Sullivan: An Important article on the Valsalva

  1. #1
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    Default Dr. Jonathon Sullivan: An Important article on the Valsalva

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    http://startingstrength.com/index.ph...lva_and_stroke

    This is the type of article that we refer to as a genuine addition to The Literature. Read it, get familiar with its important points, and prepare to change the minds of those who keep to the conventional wisdom.

  2. #2
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    Fantastic article. It explained with medical terms, but let us everyday folk understand as well. For instance:
    Quote Originally Posted by Jonathon Sullivan
    saccular cerebral aneurysm... perimesencephalic cistern... subconjunctival hemorrhage
    I didn't know what any of these were, but thankfully you didn't make it necessary. And on the plus side, you explained the last one very well, and that explains what happened to me a few months ago while I was squatting. Nice to know.

    There's solid, practical advice as well:
    Quote Originally Posted by Jonathon Sullivan
    try not to drop the barbell on your head...
    You can go out and grab life. Or you can hide…but where?
    If you want to be strong, you have to lift heavy.
    Now for those of you lazy bastards (I know you're out there) who won't read eight pages of an excellent article, here's the tl:dr version.

    Quote Originally Posted by Jonathon Sullivan
    If the results of Haykowski’s direct measurements in living human beings are correct, then lifting weights with a Valsalva generates less stress across the vascular wall than lifting weights without a Valsalva.
    Quote Originally Posted by Jonathon Sullivan
    It is an everyday occurrence and is virtually unavoidable under heavy loading, even when the lifter is instructed not to do it
    Quote Originally Posted by Jonathon Sullivan
    In other words, if you don’t already have a time bomb in your head, it probably won’t go off, no matter how much you lift and grunt.
    Sully, regarding the last one, would you mind explaining the physiological aspects of grunting? I know Rip has explained it before, but I feel like a refresher/further explanation from you would help.

  3. #3
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    Wow - real bravura (and serious humor) on display in the service of an arcane, but important aspect of training. Here, here!

    And many thanks -- it's the sort of subject that would have remained one of those sources of frequent, but frustratingly incomplete debate without this very thorough and expert treatment to use as a reference.

  4. #4
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    Excellent. Really well done, Sully. Read it on the plane this morning. Also, very approachable from a non-medical, non-clinician perspective. Thanks for this contribution!

  5. #5
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    Outstanding. Dr Sullivan, you can flat-out write.

    I am always impressed by the standard of excellence set by Rip and the Starting Strength coaches. Absolutely extraordinary.

  6. #6
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    Really a great article. I never would have thought an analysis of holding your breath could be so entertaining! Thanks Sully.

  7. #7
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    After reading this article I'm wondering about something,

    I don't know if this applies as family history, but my dad had a thoracic aortic aneurysm and had it surgically repaired with a stent about 4-5 years ago, he is 67 now. He had uncontrolled hypertension for a long time I believe, I've seen him test in the 180 and up while just sitting down before. He is taking some blood pressure meds now and it is under control though.

    I am 27 and have been lifting since I was about 17, but only "training" in the last year or so. Been using valsalva for most of those 10 years though. I'm just wondering if its something I should get checked for, or maybe if its something I should get checked for down the line?

  8. #8
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    If you have a family history of aneurysm, you should get it checked, Valsalva or not.

  9. #9
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    ok thanks,

    the reason I didn't think to get checked before was because he has all the risk factors contributing to development and rupture of congenital CA include smoking, hypertension, heavy alcohol use, and increasing age.

    I mean he smoked since he was in his teens at least, and smoked a couple packs a day, had uncontrolled hypertension for a long time (didn't want to take his blood pressure meds, or change lifestyle until much later), had heavy alcohol use, and was 62-63.

    I was just thinking it was caused by his lifestyle and there was no way that I could have this? but I guess its better to be on the safe side.

  10. #10
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    starting strength coach development program
    Quote Originally Posted by Mark Rippetoe View Post
    If you have a family history of aneurysm, you should get it checked, Valsalva or not.
    And sometimes, even that may do nothing to prevent one from occurring. I had a patient the other day, who at 61, a model of health, knowing his family history of aneurysms had yearly check-ups for 30+ years, went to the doctors a three years ago with abdominal pain. Turned out it was a 7 cm aneurysm in his abdominal aorta. Surgery fixed the AAA and saved his life, but could not fix his spinal cord, that due to the lack of perfusion has rendered him a bed confined paraplegic, with a urinary catheter and a colostomy bag at 64. Such is life. Unpredictable, cruel and one where "shit happens".

    I don't want to give you the wrong impression; you should obviously still follow Rip's advice here.

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