Vasovagal Syncope During the Press Vasovagal Syncope During the Press

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Thread: Vasovagal Syncope During the Press

  1. #1
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    Default Vasovagal Syncope During the Press

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    For almost a year, I've been making decent progress on the press with Nick D's advice to "get 15 reps any way I can get them." I'm currently at 195 pounds for (mostly) singles and the only thing slowing me down is that I am on the cusp of blacking out on almost every lift. This is not an issue if I do some sort of volume day (165 5x5, for example), and I am well aware of how to hold a deep belly breath and take a proper Valsalva against a closed glottis. This issue appeared somewhere around 180 pounds and has progressively gotten worse as the weight has increased. There have been a handful of experiences where I cannot remember the lift and all I am aware of is that the bar is on the rack and I am on one knee feeling like I've just been choked out.

    The blue book states there are three reasons for this: 1) Pressure on the neck from the bar, 2) the shrugged lockout position, and/or 3) the general effects of the anterior bar position's load on the vascular structure in the neck that is known as the carotid sinus.

    I do not notice any problems unracking the bar and/or holding it in the bottom position. The issue begins roughly as the bar passes my forehead. I will experience tingling in my arms and some lightheadedness. As the weight continues to get lifted overhead, the tingling in my arms gets so severe that I can no longer feel the weight. It feels as though I am pressing nothing. My vision will become very focused and I almost lose consciousness. Once back in the rack, the after effects are so severe that I feel like someone has beaten the shit out of me. Grinding through reps this way fucking sucks.

    Assuming the effects on my carotid sinus are from conditions 2 and/or 3 listed above, how the hell do I get past this and keep getting stronger?

  2. #2
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    How wide is your grip? Post a photo.

  3. #3
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    Can the neck muscles perform a blood-choke on self?

  4. #4
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    I've gone lights out several times pressing. I would go from an inch away from lockout to the bar and me being on the floor. I started paying closer attention to hydration and food on press days. I also cut caffeine back on press days. Lastly, I took my rest between sets walking rather than sitting (just for press). I haven't passed out in months and I'm hitting PRs again. Sometimes it gets blurry but one or all of those adjustments seem to have helped prevent the full blackout.

  5. #5
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    Dang man, passing out with a bar overhead like that could have been really ugly. Glad you came out of it ok.

  6. #6
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    Thanks dalan. I had one on video and between the layback and vertical path deteriorating right before it happened the bar went down a couple feet in front of me. Glad I've solved it for myself though rather than rolling the dice in perpetuity.

  7. #7
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    I attached a picture of me taking my grip while the bar is racked and also of me in the bottom position with the bar unracked. This is a pretty standard grip for me, with the inner part of my palm lining up on the transitions between the smooth bar and knurling. I've tinkered around by going 1/8"-1/4" in from this as well as about 1/8"-1/4" out from this grip with no real changes.

    Racked.jpg

    Unracked.jpg

  8. #8
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    Looks a little wide. Narrow it one finger, but this may not correct the problem.

  9. #9
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    What would the difference between 165 and 195 lbs be that would be different? Are you changing where you are holding your breath on the heavy sets when you valsalva?

  10. #10
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    Quote Originally Posted by GioFerrante View Post
    What would the difference between 165 and 195 lbs be that would be different? Are you changing where you are holding your breath on the heavy sets when you valsalva?
    No. I take my breath before the unrack the same way whether it's 165 or 195. The only difference at 165 is that I'll breath quickly at the top of the rep to prepare for the next rep. With ~195, I'm not getting multiple reps, and when the bar is at lockout, I'm just trying not to blackout. Letting the air out when I'm in this state with the weight over my head makes it even worse, so I don't do that. In fact, there almost seems to be something instinctive warning me not to let the air out.

    With the heavy lift, I've tried taking a valsalva before the unrack, letting some of the air out after I get set, and then breathing and bracing once more before the lift but it's too much time wasted with the weight in my arms and I fail the lift.

    Per Rip's suggestion, I did move my grip in a finger width during my volume day yesterday. It's narrower than I'm used to but I really liked how it felt in the bottom as well as how the weight felt as it passed my forehead. I felt a little stronger too, but that could also have been the massive amount of beef and potatoes I ate the day prior.

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