Squat headache

[Ershin]

Hey Rip, was wondering if I could get some advice;

My wife and I lift together - up until about 2 weeks ago, she would refuse to do the valsalva manouver, claiming it 'seemed unsafe' and she didnt like the sound of it.

Anyway, finally convinced her that it was the right thing to do. We also moved her to triples, on the advice of Andy Baker (if you read this, my internet went down for a couple of days and the thread closed before I could thank you, so - thanks!) which has her moving forward.

With the first set of her squat workset she gets a pain in the one side of her head at the back, in a line as opposed to radiating from a point, on the way up, since shes started the valsalva. It is apparently very painful, but not extreme. She thinks it might get worse throughout the first set.

It continues through the second set, and starts to fade between the second and third. From then on, it gradually fades, leaving a quite normal non-localised headache by the end of the fifth set, which lasts at worst for the rest of the day.

The headache is not aggravated by the other lifts, nor has she ever had a similar thing with the other lifts, despite using the valsalva. I can get her to just reproduce the valsalva without lifting anything and, again, no pain.

I have tried to get her to let some of the valsalva out during the concentric part of the squat, but if she tries she just completely lets the breath out, so no luck there.

Due to the fact that it actually gets better during repeated bouts of the same intensity squat, and deadlifts dont make it worse, I am not immediatly concerned about stroke, or anything like that.

However, I am not a doctor, and would appreciate the advice of someone more experienced with these things. So my main question is, is she ok to carry on for now, or do you should we stop her training and see a doctor?

If its nothing to worry about, do you have any idea what might be causing it and how we could stop it? she does arch her neck back a tiny bit, but not really badly, could that be causing it?

Thanks,

- Simon

[Mark Rippetoe]

Sounds like she hurt her neck squatting. Video?

[spacediver]

I'm no physician/expert, but I'll share a personal anecdote:

When I first started squatting, I got a similar thing but on both sides of my head. The headache was severe and didn't go away for about 12 hours. Absolutely debilitating. It sounds similar to what you describe your wife experiencing - it started at the upper part of my neck and there was a very powerful throb of pain that made its way up across my head in a line. It happened the first two times I was in the gym. Was told it was probably an exertion headache - something to do with the increased blood pressure resulting in a release of inflammatory substances.

Anyway, whatever the cause, I decided to take a couple ibuprofen before my third session as a preemptive measure. Not a single iota of pain after that - I continued taking ibuprofen before my sessions for the next couple months, just in case, and the pain never returned. It could have been the ibuprofen, or it could have been that by the third session my body had adapted. I'll never know.

[Ershin]

Sounds like she hurt her neck squatting. Video?

She's due to squat next on tuesday, I'll try to get a video up tuesday/wednesday - though advance warning, we workout in a very small room, so the angle will be pretty terrible

I should probably point out that it hasnt been getting worse, or anything, same level of pain everytime

Oh, and since I'm actually talking to you, and I'm sure you get this a lot - your books are absolutely fantastic, and have genuinely had a profound impact on both myself and my wife's lives, so thanks


spacediver;

Yeah, I have read some stuff about exertion headaches when I was looking it up - all the accounts, including yours make it sound much more painful and longer lasting than whats happening, so I'm not so sure - that said, if it turns out to not be the neck thing, not having adapted to increased blood pressure would be my bet too, given the recent introduction of the valsalva. Only its confusing it doesent happen when she deadlifts, but a lot of the exertion headache accounts seem to only happen with squats as well, so who knows

[Dave_G]

On a similar note, I've gotten more than few spontaneous nose bleeds while squatting, especially in the winter when the air is dry. I'm sure it is related to the valsalva, but I'm not worried about it. Should I be? I just put some tissue up there and continue.

[Mark Rippetoe]

They are seldom serious, especially if they only occur when you train and if they stop quickly. Use some saline nasal spray before you train and see if that helps. If not, oxymetazoline will stop it.

[sbhikes]

I got headaches a lot at first. This was because I held my breath throughout the entire squat. Someone said to let it out on the way up, at least past the sticking point. I have not had any headaches again since I began doing that, unless I've done stupid stuff like 20 rep squats.

[Joe Jaloszynski]

I got headaches a lot at first. This was because I held my breath throughout the entire squat. Someone said to let it out on the way up, at least past the sticking point. I have not had any headaches again since I began doing that, unless I've done stupid stuff like 20 rep squats.

Who told you to do that? Doesn't sound like a very smart move.

[Carlos Daniel]

A fair amount of weird head shit happening during squats are caused by people that do the Valsalva wrong.

A Valsalva is a forced expiration against a closed glottis. Some peole however do it against their closed mouth, which leads to all sorts of weird shit by mechanisms which are misterious to me.

[sbhikes]

Who told you to do that? Doesn't sound like a very smart move.

People around here told me. I only let out my breath when I'm through the hard part. I was holding it for too long, giving myself a headache.