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Thread: Spontaneous Bilateral Vertebral Dissection and Training

  1. #1
    Join Date
    Dec 2020
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    Default Spontaneous Bilateral Vertebral Dissection and Training

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    A friend of mine was recently diagnosed with a spontaneous bilateral vertebral dissection, and she has been told that she will never be able to pick up her large dog again, much less a barbell.

    Basically, she was at the gym training and started experience stroke-like symptoms. Not recognizing the symptoms, she went home. Started experiencing numbness and cognitive issues before heading to the ER. Was released two days later. No stints, no surgery at this point.

    She is a very active, healthy, mid-20 year old that trains regularly and works as a personal trainer, so this is obviously devastating.

    I spoke with a couple of SSCs and a few others regarding there thoughts on it, but was wondering if anyone had experienced something similar and been able to lift again? I don't see it likely that she will ever go super heavy again, but surely a sedentary lifestyle would be far more detrimental than moderate training?

    Any insight at all would be great.

  2. #2
    Join Date
    Nov 2012
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    Long Island, NY
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    This is out of my league to comment on. Maybe other members of the board will have experience with this issue. If you want to look into the literature on this I'm linking two articles you can use as starting points. Unfortunately, the quick search I did really only yielded a bunch of case reports. The good news is they are open source.

    Spontaneous Bilateral Vertebral Artery Dissection During a Basketball Game

    Bilateral Vertebral Artery Dissection: A Case Report with Literature Review

    Pay attention to the second to last line in the second article.

  3. #3
    Join Date
    Feb 2018
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    599

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    Quote Originally Posted by dksmith View Post
    A friend of mine was recently diagnosed with a spontaneous bilateral vertebral dissection, and she has been told that she will never be able to pick up her large dog again, much less a barbell.

    Basically, she was at the gym training and started experience stroke-like symptoms. Not recognizing the symptoms, she went home. Started experiencing numbness and cognitive issues before heading to the ER. Was released two days later. No stints, no surgery at this point.

    She is a very active, healthy, mid-20 year old that trains regularly and works as a personal trainer, so this is obviously devastating.

    I spoke with a couple of SSCs and a few others regarding there thoughts on it, but was wondering if anyone had experienced something similar and been able to lift again? I don't see it likely that she will ever go super heavy again, but surely a sedentary lifestyle would be far more detrimental than moderate training?

    Any insight at all would be great.
    It’s going to be difficult to make a recommendation here, as this is potentially a life-threatening condition or perhaps worse. Dissections of the vertebral arteries can lead to basilar artery, or posterior circulation strokes, which are quite serious.

    Once she has been worked up for possible interventions, and the circulation is thought to be stable, she will have to decide how to proceed with training and exercise. As Dr. Sullivan (the other guy, the author) has written, it is not possible to go through life without some exertion or valsalva. I think you are right that becoming sedentary is not the best choice, but whether and how to return to lifting heavy is going to be up to her to work out and decide the risks and benefits for herself. I doubt her neurologist or vascular surgeon will ever fully OK a heavy deadlift: not because they know it to be dangerous, but because they don’t know it to be safe.

    This is a very scary diagnosis to get, especially when young and healthy, but I do think that if she escaped a stroke at the time of the dissections, she has dodged the bullet and should be able to return to training in some fashion.

    On the other hand, the other major factor here is why did this happen in the first place: she should be evaluated for connective tissue disorder and other conditions that predispose to dissection. This will help her figure out what the risks are.

  4. #4
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    Dec 2020
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    Thank you both for your replies and for the information!

  5. #5
    Join Date
    Feb 2018
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    599

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    I’ve been thinking about this case a lot since it was posted. I hope your friend is OK. The other recommendation I would have is that she should stay away from the chiropractor, or at least keep the chiropractor away from her neck. This is from both my personal observed experience and the recommendation from the paper posted by Nick above.

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