@@DrMattDrMike I have a few questions though: firstly, I thought the Valsalva was advocated (perhaps by lifters, if not doctors) for *all* squat weights really? I tend to do it automatically on all my squats, even when going for sets of 10-12, which is approx. 71-75% of 1RM. Secondly, you briefly mentioned some dangers there, but could you tell us more about any direct danger from passing-out through doing this (aside from the danger of serious embarassment or potentially banging your head on the gym floor). And lastly, if I were ever to witness someone going all wobbly and keeling-over due to this, and assuming there are no complications, would it help to raise the person's feet like you might when someone faints or is about to faint i.e. to restore blood flow to the torso/ brain more quickly? Anything else we fellow gym-goers should do (apart from try not to laugh?! 😄)
Thanks for providing one of the easiest and most understandable explanation of valsalva maneuver. Could you also explain its use and effect in change of ambient pressure like during flight descent, diving,etc?
Great video. Explains a lot. I notice that when lifting heavy, I'll get episodes of a really high heart rate. This triggering of the sympathetic system triggers a panic attack that makes things worse. I'll try this maneuver next time to lower my heart rate.
Learned this the hard way while deadlifting. Collapsed with the straps still in my hand. Just muscle strained back THANKFULLY but I lost all feeling in my legs before feeling a surge of heat returning to my legs (which was the blood). My immediate reaction was that I must’ve tore something but now I know better. I also learned just how important breathing out is during a lift. It’s not just for show. It’s to prevent injuries and sudden collapse. *Update* 2 months after initial post: actually herniated the L4-L5 and L5-S1. Have spinal stenosis where the nerve now compresses onto my sciatic nerve. Annnnnd the Doctors say once a disc is herniated it never replaces itself. The herniation may dissolve over time or can be removed surgically but the space where it used to be (the gap leftover from the disc pushing outwards) is said to remain that way for life. Thankfully it wasn’t an extreme herniation. It’s a moderate and mild one. Be safe fellow lifters! I’ve been advised not to Squat or Deadlift ever again but we’ll see how it goes. The biggest factor outside of the weight itself (515) was that I started another set while winded. And I was dehydrated that day. I contemplated getting a sip at the water fountain because I had dry mouth but decided to do it after my final set. Big mistake! Your spines discs are composed of fluid that needs water to retain its shape and structure. Lifting heavy while dehydrated isn’t only bad because you can pass it, it is also bad structurally for your spines strength!
Wow, I'm Sorry that that happened to you but Thanks for you going into great detail about it too show what can happen! Water & Oxygen are key! I always thought of the fact that Aerobic activity is with Breathing (filling the lungs-> Blood-> Muscles with Oxygen) that helps you get more from the lifting {Vs Anaerobic- not breathing}.
Did AAU powerlifting in high school 525 squat 550 deadlift, resulting in horrible back pain in adulthood at age 40. Saw excellent neurosurgeon Columbia U schooled, mri showed L3- L4, L4-L5 disc's herniated and ruptured and laminectomy surgery the only remedy ( tried PT, traction, muscle relaxing meds). Doctor explained that a disc is like the ture on your car, it can bulge ( herniate) or blowout the cords ( rupture), the disc tissue get little blood supply so healing takes much time bit his procedure was to remove the bits and pieces from the ruptured disc that were jamming lower joint causing nerve compression and drill out the ruptured cracked wall in ruptured disc and that a few months of restrictions ( lifting limit of a gallon of milk or less) the disc wall would fill with the jelly like disc fluid and basically repair itself as if it were " welded" rather than allow it to heal " as is". The laminectomy procedure re.oves the lamina ( the lamina vertebral bone surrounding the spinal nerve canal) to widen the nerve canal and relieve pressure on the spinal nerve and the bulging herniated disc. Immediate relief after surgery and have had virtually no pain for decades since.
Excellent explanation of the Valsalva maneuver! My cardio doc has advised against using it lifting heavy weights due to an aorta root dilatation. Evidently it can aggravate a stretched aortic root.
I'm convinced that the stress situation caused by chrinic sympathetic nervous system activation is behind a lot of men having erectile dysfunction. They spend ages doing kegals and squats etc but it doesn't work, wrong target. Do HIIT training and just walking, getting out in nature, be with an understanding woman and do anything you can to activate the parasympathetic nervous system, breathing is the number one best way to activate it, I'm a shallow breather, which is probably caused by trauma. So I do a lot of breathing exercises. One thing I do is breath in, hold it, push down, then release whilst humming....so it's doing 3 things at once to activate the vagus nerve.
Nice explanation of something I've had to use many time to reverse my PSVT. I've also found that if I drink something with carbon dioxide, sparkling water then slightly invert my body and burp that can convert my PSVT episode. I also massage my aorta in my neck to calm myself so I dont go into an episode. Most of my episodes happen when Im playing pickleball.
Hi, do you recommend valsalva maneuver exercise (Pinch your nose closed, close your mouth, and then try to exhale forcefully) to regulate heart rate when experiencing palpitation?
Isn't all of this controlled by the parasympathetic nervous system? Maybe my confusion just comes from the very basic points we were taught about the two nervous systems but I was told parasympathetic controls all subconscious, reactive actions and the sympathetic is when the body starts introducing the brain into the loop and we are able to start reacting with conscious intent. Again, I know I've got to be the wrong one here. I just want to figure out where I'm wrong and fix it.
Can we circumvent the valsalva manoeuvre by decreasing thoracic pressure during heavy lifting? Or does the nervous stimulation not respond, or metabolites override any mechanical circumvention to decrease thoracic pressure?
Thanks for the highly informational video. You mentioned passing out as a short term consequence from the valsalva maneuver. What about the consequence of blood pressure raising? If one does let's say 1h of repetitive valsalva maneuver 4-5 times a week. Does the higher blood pressure provoke health issues like a rupture of vessels and or other cardiovascular problems?
Is there something more effective for SVT? The Valsalva manoeuvre seems to only work for a few seconds as you mentioned, then the heart goes back into SVT from normal sinus rhythm?
Nowadays the ER gives 40meq potassium chloride by mouth when a cardiac patient whose potassium is NORMAL, but below 4.0. That is about 1500 mg, or 15 over the counter potassium pills.Many might not know taking a balance of minerals is going to keep you out of the ER because electrolyte abnormalities will cause SVT. (Potassium is not absorbed when magnesium is needed. And calcium is needed; also D3K2, and zinc. I truly believe vitamin C is needed as well.)
This happened to me when I was a kid, I was playing and getting my right neck vein to bulge, and I did it for so long that I passed out, I was standing up at the side of the road, fell face first in the cracked pavement.
Have you ever played a trumpet or trombone? Do you know what "breathe support" is? Have you ever watched a baby sleeping on it's back? Or watched it cry while on it's back? Breathe in, abdominal muscles out, then abdominal muscles tensed and cry. Same for play an instrument. Raising of the shoulders and consciously expanding the ribs outward only as a possible 2nd stage yoga type "topping off", which frankly, very few people do. In fact, we learn to NOT raise our shoulders and breathe from the abdomen. Breath in into the abdomen, which means the diaphragm pushed the intestine downwards and outwards with relaxed abdominal muscles, which then tighten and, tempered by the size of the mouth cavity controled through tongue position (forward towards the teeth and or arched towards the roof of the mouth). Speed of the air being expelled is also tempered by relative jaw position, meaning for slow air speed, the jaw is brought to the point where opne is blowing parallel to the floor, for fast speed, the jaw is retrcted and the air is blow downwards. Of course the lips and the tension in the lips also have to do with the speed of air being expelled and the abdominal muscles help (support) especially in extreme low registers (slow air but a lot) or extreme high registers (fast and little amount of air). The danger to us wind instrument players is the back pressure where not enough air can be expelled quickly enough. Also not supporting it combined with extreme register can cause us to black out. Never happened to me on my present instrument but did when I was playing extremely high trumpet parts and also when playing orchestral flute - not enough resistence can also lead to this happening. The other danger, more prevelant to instrument with high levels of resistence like high trumpets and oboe is the so-called "closed throat". An involuntary attempt to counter the resistence found in the instrument. While I suffereed from this on the trumpet, I never had it on trombone. I was instructed to do this type of breathing, but to hold my breathe in the middle and consciously constrict my abdominal muscles, feeling them also contract at my spine - this to build them up to support (that word again) my L5/S1 disks, ie to take the pressure off them to relieve back pain . this from a physical therapiest specialising in back problems. I noticed immediately that this was extremely similar to what I'd been doing for decades with my musical instruments and "breathe support".
It's hard to keep our eyes away from his chest 😂 I mean I respect him so much but can't keep my eyes away 😂 he should wear something that doesn't show his body 😂
@jamrock8877 I feel you sis😂. I’d let this honky ragdoll me proper and stupid. Youd think you watching the exorcism of emily rose when he is popping me off
Pretty pathetic...you see this guys motive very easy! So every human being who has a hard push when going to the washroom has died or is going to die? Unreal...get educated.
This explains what happened to me recently. Used a cough for the maneuver and noticed I had no corotid pulse. Then my head started feeling like I was being choked out for a couple of seconds. Then the blood started pumping real hard back into my head. Scared the crap out of me. I was just sitting down at my desk at the time.
All the way from India here. Thank you Dr. Mike for being the best teacher ❤️
Thank you for sharing this knowledge. This works to manage my SVT episodes until I can get ablation surgery. Works like a charm.
We are in the same position. Good luck.
The best explanation I've watched! Thank you so much Dr.!!!!
Such a great explanation! Thanks for making it so simple to understand!
You're very welcome!
@@DrMattDrMike I have a few questions though: firstly, I thought the Valsalva was advocated (perhaps by lifters, if not doctors) for *all* squat weights really? I tend to do it automatically on all my squats, even when going for sets of 10-12, which is approx. 71-75% of 1RM. Secondly, you briefly mentioned some dangers there, but could you tell us more about any direct danger from passing-out through doing this (aside from the danger of serious embarassment or potentially banging your head on the gym floor). And lastly, if I were ever to witness someone going all wobbly and keeling-over due to this, and assuming there are no complications, would it help to raise the person's feet like you might when someone faints or is about to faint i.e. to restore blood flow to the torso/ brain more quickly? Anything else we fellow gym-goers should do (apart from try not to laugh?! 😄)
Always making things simple. Thanks Dr Mike
Bullcrap
??? @@PatrickGoBrrrr
Thank you for this man, love your enthusiasm and knowledge. RN's like me need videos like this. THANKS!
Thanks for providing one of the easiest and most understandable explanation of valsalva maneuver. Could you also explain its use and effect in change of ambient pressure like during flight descent, diving,etc?
Great video. Explains a lot. I notice that when lifting heavy, I'll get episodes of a really high heart rate. This triggering of the sympathetic system triggers a panic attack that makes things worse. I'll try this maneuver next time to lower my heart rate.
I literally gave a presentation on SVT and the VSM this morning and now this pops up! 😅
That's the law of attraction!!
My young daughter has SVT. How can I get your presentation? Pretty please?
the best explanation I've ever had
the best explanation online for that maneuver
Thank you Sir for explaining that in detail. I have tachycardia and every kind of defense I can use is a blessing
I loved and am retired from teaching. You are an excellent teacher!! Thank you for your clear and descriptive explanation of the Valsalva maneuver!! 👍
Learned this the hard way while deadlifting. Collapsed with the straps still in my hand. Just muscle strained back THANKFULLY but I lost all feeling in my legs before feeling a surge of heat returning to my legs (which was the blood). My immediate reaction was that I must’ve tore something but now I know better. I also learned just how important breathing out is during a lift. It’s not just for show. It’s to prevent injuries and sudden collapse.
*Update* 2 months after initial post:
actually herniated the L4-L5 and L5-S1. Have spinal stenosis where the nerve now compresses onto my sciatic nerve. Annnnnd the Doctors say once a disc is herniated it never replaces itself. The herniation may dissolve over time or can be removed surgically but the space where it used to be (the gap leftover from the disc pushing outwards) is said to remain that way for life. Thankfully it wasn’t an extreme herniation. It’s a moderate and mild one. Be safe fellow lifters! I’ve been advised not to Squat or Deadlift ever again but we’ll see how it goes.
The biggest factor outside of the weight itself (515) was that I started another set while winded. And I was dehydrated that day. I contemplated getting a sip at the water fountain because I had dry mouth but decided to do it after my final set. Big mistake! Your spines discs are composed of fluid that needs water to retain its shape and structure. Lifting heavy while dehydrated isn’t only bad because you can pass it, it is also bad structurally for your spines strength!
The body can be extremely scary to someone who is scared of it or extremely beneficial to someone that benefits it all about that input output
any new updates?
Wow, I'm Sorry that that happened to you but Thanks for you going into great detail about it too show what can happen!
Water & Oxygen are key!
I always thought of the fact that Aerobic activity is with Breathing (filling the lungs-> Blood-> Muscles with Oxygen) that helps you get more from the lifting {Vs Anaerobic- not breathing}.
Did AAU powerlifting in high school 525 squat 550 deadlift, resulting in horrible back pain in adulthood at age 40. Saw excellent neurosurgeon Columbia U schooled, mri showed L3- L4, L4-L5 disc's herniated and ruptured and laminectomy surgery the only remedy ( tried PT, traction, muscle relaxing meds). Doctor explained that a disc is like the ture on your car, it can bulge ( herniate) or blowout the cords ( rupture), the disc tissue get little blood supply so healing takes much time bit his procedure was to remove the bits and pieces from the ruptured disc that were jamming lower joint causing nerve compression and drill out the ruptured cracked wall in ruptured disc and that a few months of restrictions ( lifting limit of a gallon of milk or less) the disc wall would fill with the jelly like disc fluid and basically repair itself as if it were " welded" rather than allow it to heal " as is". The laminectomy procedure re.oves the lamina ( the lamina vertebral bone surrounding the spinal nerve canal) to widen the nerve canal and relieve pressure on the spinal nerve and the bulging herniated disc. Immediate relief after surgery and have had virtually no pain for decades since.
Thank u for saving me before exam
Best video on Valsalva manuveur
Excellent explanation of the Valsalva maneuver! My cardio doc has advised against using it lifting heavy weights due to an aorta root dilatation. Evidently it can aggravate a stretched aortic root.
YOU ARE AMAZING AT EXPLAINING THESE CONCEPTS! THANK YOU
I'm convinced that the stress situation caused by chrinic sympathetic nervous system activation is behind a lot of men having erectile dysfunction. They spend ages doing kegals and squats etc but it doesn't work, wrong target. Do HIIT training and just walking, getting out in nature, be with an understanding woman and do anything you can to activate the parasympathetic nervous system, breathing is the number one best way to activate it, I'm a shallow breather, which is probably caused by trauma. So I do a lot of breathing exercises. One thing I do is breath in, hold it, push down, then release whilst humming....so it's doing 3 things at once to activate the vagus nerve.
Thanks doc you've made it much easier than our lecture note wish you the best 👌 🔥
Great first 2 minutes of this video.
Great explanation! Just what I needed. Please do more!
Thanks, will do!
Wonderful teaching
Nice explanation of something I've had to use many time to reverse my PSVT. I've also found that if I drink something with carbon dioxide, sparkling water then slightly invert my body and burp that can convert my PSVT episode. I also massage my aorta in my neck to calm myself so I dont go into an episode. Most of my episodes happen when Im playing pickleball.
Superb presentation...quite a bit of scientific contents...thanks so much
God bless you for the wonderfully clear and cohesive explanation
Glad it was helpful! 😊
Great way to learn Physiology.
We agree!
this is the explanation I was looking for, I appreciate you ❤️💙👍✌🤘
Hi, do you recommend valsalva maneuver exercise (Pinch your nose closed, close your mouth, and then try to exhale forcefully) to regulate heart rate when experiencing palpitation?
Amazing Explanation Dr Mike..Loved it❤
Thanks for excellent explanation.
Thanks a lot for such an amazing explanation! Hope i remember it for the maximum time.
Wow, thanks for explaining the whole chain. I find it helpful.
I severe have mitral valve leak and now with moderate aorta problem , I dont want surgery is there any option?
Thank you. An excellent explanation.
Excellent explanation 😍
Thank you sir.❤
Very informative ❤
Now it all makes sense. Great explanation
Amazing, just the explanation I was looking for. Thank you!
This is one fine doctor. Great explanation too
13:30 said stimulates the sympathetic nerve system (vagus nerve) and not the parasympathetic (the right answer)
you've earned a subscriber. 🙏🏻 love your lectures.
Thank you so much Dr Mike!!
Brilliant explanation👍
Thank you so much for such a clear explanation !!
Isn't the transient pressure increase also potentially dangerous to someone who already has high blood pressure, or an aneurysm?
Thanks, that was a very clear explanation.
I didn't understand one thing
Why the increase of the vassels resistance => increase the blood return (it's the opposite no ?)
Isn't all of this controlled by the parasympathetic nervous system? Maybe my confusion just comes from the very basic points we were taught about the two nervous systems but I was told parasympathetic controls all subconscious, reactive actions and the sympathetic is when the body starts introducing the brain into the loop and we are able to start reacting with conscious intent.
Again, I know I've got to be the wrong one here. I just want to figure out where I'm wrong and fix it.
amazing explanation
Glad you think so!
Great explanation
Can we circumvent the valsalva manoeuvre by decreasing thoracic pressure during heavy lifting? Or does the nervous stimulation not respond, or metabolites override any mechanical circumvention to decrease thoracic pressure?
Well explained. Thanks
Very well explained, 👍
Just Excellent !! Thank you.
Hi Dr.,
does modified with legs up help with that fluctuation between parasympathetic and sympathetic? Thank you!
Excellent ❤️ lecture 👌 😊❤🙏
Thanks a lot!
Great lecture 🎉
Thanks for the highly informational video. You mentioned passing out as a short term consequence from the valsalva maneuver. What about the consequence of blood pressure raising? If one does let's say 1h of repetitive valsalva maneuver 4-5 times a week. Does the higher blood pressure provoke health issues like a rupture of vessels and or other cardiovascular problems?
Very much helpful
I live with heart disease right now I have svt and didn't know this could be dangerous for my heart
i love AI captioning.. "... and hopefully.. a rigid spawn" (16:28) heheh..
So we need to rest after each valsava manuver right? Any suggestions on how long should we take a rest
I’ve been getting really bad heart palpitations from this how do I get back to normal
Hello Doctor Matt,the Trendelenburg position also pruduces bradycardia,is the physiological process behind the same as the valsalva?
Ok so in weightlifting is good or bad to do it and does it have any effect on back or disc injuries
Ameizing, greetings from Mexico!!!!!!
we want a video about valsalva maneuver and its effect on murmurs
Does it lower high BP?
A masterclass!!!
I got this... Thank you so much..
You make it easy to understand thank you doctor .
does an increase in vasoconstriction result in an increase or decrease in blood flow ?
I asked typically the same question
Is there something more effective for SVT? The Valsalva manoeuvre seems to only work for a few seconds as you mentioned, then the heart goes back into SVT from normal sinus rhythm?
Nowadays the ER gives 40meq potassium chloride by mouth when a cardiac patient whose potassium is NORMAL, but below 4.0. That is about 1500 mg, or 15 over the counter potassium pills.Many might not know taking a balance of minerals is going to keep you out of the ER because electrolyte abnormalities will cause SVT.
(Potassium is not absorbed when magnesium is needed. And calcium is needed; also D3K2, and zinc. I truly believe vitamin C is needed as well.)
Tried several times. Didn't work even though I feel more relaxed. Pulse went up then stayed the same around 90+.
Love this, thank you!
You're so welcome! 😊
As per @drkaran It's Resetting the Body during Svt
Todorović? Are you from 🇷🇸? ❤️
Nice💯
Thank you doc !
why does venoconstriction increase preload
Is this good for people with BAVD?
This happened to me when I was a kid, I was playing and getting my right neck vein to bulge, and I did it for so long that I passed out, I was standing up at the side of the road, fell face first in the cracked pavement.
What happens during breath work like that of "Wim Hoff"
My thoughts: Dangerous for people with concerns about blood pressure...
Great Ninja Technique
thank u soo much
Have you ever played a trumpet or trombone? Do you know what "breathe support" is? Have you ever watched a baby sleeping on it's back? Or watched it cry while on it's back? Breathe in, abdominal muscles out, then abdominal muscles tensed and cry. Same for play an instrument. Raising of the shoulders and consciously expanding the ribs outward only as a possible 2nd stage yoga type "topping off", which frankly, very few people do. In fact, we learn to NOT raise our shoulders and breathe from the abdomen. Breath in into the abdomen, which means the diaphragm pushed the intestine downwards and outwards with relaxed abdominal muscles, which then tighten and, tempered by the size of the mouth cavity controled through tongue position (forward towards the teeth and or arched towards the roof of the mouth). Speed of the air being expelled is also tempered by relative jaw position, meaning for slow air speed, the jaw is brought to the point where opne is blowing parallel to the floor, for fast speed, the jaw is retrcted and the air is blow downwards. Of course the lips and the tension in the lips also have to do with the speed of air being expelled and the abdominal muscles help (support) especially in extreme low registers (slow air but a lot) or extreme high registers (fast and little amount of air).
The danger to us wind instrument players is the back pressure where not enough air can be expelled quickly enough. Also not supporting it combined with extreme register can cause us to black out. Never happened to me on my present instrument but did when I was playing extremely high trumpet parts and also when playing orchestral flute - not enough resistence can also lead to this happening. The other danger, more prevelant to instrument with high levels of resistence like high trumpets and oboe is the so-called "closed throat". An involuntary attempt to counter the resistence found in the instrument. While I suffereed from this on the trumpet, I never had it on trombone.
I was instructed to do this type of breathing, but to hold my breathe in the middle and consciously constrict my abdominal muscles, feeling them also contract at my spine - this to build them up to support (that word again) my L5/S1 disks, ie to take the pressure off them to relieve back pain . this from a physical therapiest specialising in back problems. I noticed immediately that this was extremely similar to what I'd been doing for decades with my musical instruments and "breathe support".
I accidentally did this and looked it up
If only you were teaching me in med school
Preshah
Dude you explain everything 3-4 times, get to the point man! Video could be at least half as long.
...... you are so handsome!!!! Hard to concentrate 😘☺
U have an exam to worry about. 😂
@@stevebradford3939 lol 😆.. facts! I needed that reminder 🤓 back on tract!
Good luck on your studies!!!
Cum
It's hard to keep our eyes away from his chest 😂 I mean I respect him so much but can't keep my eyes away 😂 he should wear something that doesn't show his body 😂
@jamrock8877 I feel you sis😂. I’d let this honky ragdoll me proper and stupid. Youd think you watching the exorcism of emily rose when he is popping me off
Pretty pathetic...you see this guys motive very easy! So every human being who has a hard push when going to the washroom has died or is going to die? Unreal...get educated.
This explains what happened to me recently. Used a cough for the maneuver and noticed I had no corotid pulse. Then my head started feeling like I was being choked out for a couple of seconds. Then the blood started pumping real hard back into my head. Scared the crap out of me. I was just sitting down at my desk at the time.