Is the Valsalva Maneuver Safe and Effective?
Using a Valsalva maneuver (VM) is a pretty standard practice in weightlifting. Even if you don’t know what it is, you probably still perform it regularly at the gym. The VM is the forced exhalation against a closed glottis (the part of your throat that can close and, among other things, prevent exhalation).
Most people reading will have probably tried to do a VM by now, but it’s safety and effectiveness have actually been a point of discussion for some time. In a recent review in the Journal of Strength and Conditioning, researchers were looking for the answer to address those two concerns.
If you’re wondering why I say that most of you probably do a VM at the gym regularly, it's because it’s natural to do so. Even if you don’t do it on purpose, when you lift heavy weights it’s a part of your unconscious process. Of course, if it's instinctual to us, this leads to the inevitable thought that the VM must have an important natural purpose.
Indeed, the VM has a few proposed benefits. It increases blood pressure, so perhaps it assists in the movement of nutrients into cells. One of the most well-known uses of a VM is to increase intra-abdominal pressure. The idea is that with greater pressure in the abdomen, the lower spine receives more support and protection from injury.
The researchers looked at a selection of studies screened for quality and healthy subjects. They found that the VM in fact did increase intra-abdominal pressure. Interestingly, it actually increased the pressure more when performed all by itself and not during exercise. This may sound odd, but the researchers speculated that the postures involved and the reduced volume of air in the lungs during exercise led to lower pressure.
There is, however, good reason why the safety and effectiveness of the VM were being questioned. As a natural mechanism that seemingly helps protect our spines, it wouldn’t be worth much talk if there weren’t a downside. Specifically, a sharp spike in blood pressure isn’t so great for everyone, and may be associated with cardiovascular problems, stroke, aneurysm, blindness, and other concerns.
The researchers were interested to see if a VM could cause a blood pressure increase significant enough to lead to one of these events. While the VM seemed more or less safe, fourteen case studies did report problems that the subjects eventually recovered from, but nothing you want to experience. No advanced lifters were associated with the injurious events, but that might be because advanced lifters adapt changes that make the VM safer.
Overall, it seems that using the VM is probably pretty safe. The pressures it generates are lower during exercise, making a VM during weight lifting probably even safer than one performed without exercise. Plus, it’s a natural, unconscious thing for us to do.
As far as effectiveness goes, more research is needed. Yes, a VM fairly safely improves intra-abdominal pressure, and this probably protects the spine, but that’s a big probably. There may well be an unknown point of diminishing returns and rising safety concerns. Ultimately, the researchers suggested novices use light weights until more research is done.
1. Hackett, DA, et. al., “The Valsalva Maneuver: Its Effect on Intra-abdominal Pressure and Safety Issues During Resistance Exercise,” Journal of Strength and Conditioning Research, 27(8), 2013.
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