How to avoid Valsalva during exercise.


By Gus Diamantopoulos, Director, THE STRENGTH ROOM


-What is Valsalva?-


Although proper breathing during exercise is one of the most important aspects of a safe and effective workout, correct breathing is not intuitive for most of us.  Instead of breathing freely and openly during exercise, most people actually do the opposite.


When it comes to weight-training, most of us hold (or force) our breath as a means of handling intensity.  Unfortunately, breath-holding obviates our ability to produce high intensity muscular contractions, and it can actually be dangerous.  Breath-holding during exercise increases blood pressure rapidly and this can lead to fainting, painful Exercise-Induced-Headaches, or even stroke.


The fancy term for breath-holding is Valsalva.  Taking its name from 17th Century Italian Anatomist, Anton Maria Valsalva, the Valsalva Maneuver (or simply, Valsalva) occurs when we attempt to forcibly exhale while keeping the mouth and nose closed. 


To concisely experience Valsalva, try the following:


Stand up. Curl your fingers, and link both hands together in front of your chest (left hand palm towards you, right hand palm away and thumb down). Take a deep breath and try to pull your hands apart as hard as you can without letting go. Pull hard. While pulling, notice how the muscles in your chest and abdomen tighten up. Notice also that your throat (glottis) closes up. Try it again and pull really hard. The harder you pull, the more tightly your throat closes and the more likely you are to grunt or stain as you bear down.




The purpose of Valsalva is to increase air pressure in the thorax and lungs to help with physical exertion or to help force things out of the body. The Valsalva Mechanism is coordinated by many muscles neurologically programmed to contract at the same time during a Valsalva Maneuver.


The abdominal muscles tighten up, which then squeezes the intestines and organs in the abdominal cavity so that they press upward against the diaphragm.  The diaphragm then bulges upward, compressing the chest cavity.  Certain chest muscles also tighten to bring the rib cage down, which compresses the chest cavity even more.  Concurrently, the larynx closes tightly around the upper airway to keep the air in the lungs from escaping. The more the abdominal muscles squeeze, the greater the air pressure becomes in the lungs, the tighter the larynx closes, magnifying the Valsalva effect (see diagram below).


This air pressure helps stabilize the diaphragm so that the abdominal muscles can help squeeze things Diagram of a Valsalva Maneuverout of the body, as in defecation, urination, and childbirth.  In activities requiring physical effort, the increased lung pressure created by Valsalva, helps us exert.    


Realize, however, that the performance of Valsalva is merely the common, instinctive reaction to the aforementioned activities. Despite its anthropological ubiquity, Valsalva is not necessarily good practice for either physical exertion or evacuation. In the case of expelling things from the body, Ken Hutchins, inventor of the Superslow® Philosophy, often indicates that elderly people are commonly found dead of a stroke on the commode because of increased blood pressure from Valsalva, while straining.  And when it comes to physical exertion, the dangers of Valsalva are no less concerning.      


Many of us have seen Olympic weight-lifters hold their breath as they strain to lift a weight.  The air pressure they build in the lungs keeps the chest and shoulders firm and rigid, giving greater support to the arms.  Such lifters may also violently expel their breath at peak effort. However, while Valsalva might assist a maximum lift, it also increases the risk of the associated concerns of rapidly spiked blood pressure.   Risk increases to very dangerous limits when the duration of the exertion (and Valsalva) increases, as can occur in a high intensity workout.


When the objective is to LIFT, you might believe that Valsalva can be of value. But when the objective is to EXERCISE, that is, to load the muscular structures and keep them loaded, then Valsalva serves no useful purpose.


-Valsalva & Exercise-


According to Hutchins, “When an exercise movement becomes difficult, our natural instinct is to back off or hold and then jab or heave at the movement arm of the machine (called Offing and Oning). This is often synced to breathing and Valsalva (called Valsalva Sync). Naturally we simultaneously Valsalva and heave at the resistance for a brief distance and time. Then we simultaneously ventilate and hold, or back off from the resistance. After a few huffs and puffs, we simultaneously Valsalva and heave at the resistance again.”


In essence, as the set progresses, we tend to revert to that Olympic weight-lifter mentality. But the correct approach is the opposite. As per Hutchins, “We want a continuous contraction force combined with continuous and relaxed ventilation.” This keeps our effort on the resistance and allows meaningful loading of the muscle.


Text Box: “The bottom line in exercise is efficient mechanical loading of the muscle. All direct benefits of exercise – known, suspected, and unsuspected – follow from this fundamental principle.” (-Hutchins)Valsalva actually prevents continuous and efficient loading of the intended musculature. It reduces your strength to fulfill the primary objective of exercise.


r    Straining, groaning, grunting, and even speaking during your set means that you are performing Valsalva and not breathing correctly.


r    It is also incorrect to BLOW air by pursing the lips and puffing out the cheeks, to HISS air through a grimaced mouth, or to BURST air after holding it. Louder air does not mean FLOWING AIR.


r    Breathe through the mouth primarily. Try to keep the jaw loose (unclenched), the mouth open, the lips un-pursed, and the teeth parted. If you’re breathing properly, your breathing sounds will be lighter – whisper-like – and you will take in more air with less work.


‘Power of 10’ author, Adam Zickerman, recommends mouthing/whispering “HA-A” as you breathe to help you from tightening up your face, gritting your teeth, or generally tensing your body as you go. (That is, “HA” during the exhalation, and “A” on the inhalation – like a panting dog.)


r    To break the ‘Valsalva Sync/Push Hard’ association, breathe faster as you near muscle failure. Breathing faster, however, should NOT mean MOVING faster. Your breathing rate should be independent of your movement speed. Breathing should be a counterpart to effort: The higher your output, the more you should breathe.


Chad Morris, owner/operator of Myogenics Fitness in California, uses the example of his hike up The Santa Monica Mountains to demonstrate the separation between breathing rate and movement speed.


Upon commencement of his hike, (along a relatively low-grade incline) his hiking pace is quick and his breathing is normal. But as he approaches the hill’s peak, the steeper incline forces him to exert more effort. Now his pace is slower but his breathing is much, much heavier. More effort, more breathing, but slower speed.


Don’t be afraid of the idea of breathing faster. The only real consequence of such rapid breathing is perhaps slight dizziness or light-headedness, which will not harm you, and you will eventually become accustomed to it. In the final analysis, it is far preferable to be a little light-headed than to experience the deleterious effects of Valsalva.


Some people feel self-conscious the first few times they try to breathe in this manner—it can sound like a Lamaze class when you’re breathing so much.   But you will be in complete privacy at The Strength Room, training under direct supervision with an instructor who is skilled in teaching proper breathing.  With patience and understanding, you will come to appreciate the technique of continuous breathing and its benefits.


Read this document often so that you can truly master the art of breathing and the avoidance of Valsalva. Don’t be discouraged by the initial difficulties. It may take as many as 10 workouts to really understand the concept, but in time you will be able to avoid Valsalva and make your workouts much more intense.


Make a habit of being aware of your breathing in other arenas of life where stress or tension (physical or otherwise) occurs. And seek to summon all of your attention and enthusiasm to each and every workout so that you can enjoy all the benefits of a stronger, healthier body.


An effective weight training workout is an amazing event. There is no other human experience quite like it. And the ideal workout requires the mind to help you perform such feats as slow, controlled movements and proper breathing.


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The demonstration exercise earlier in this article is an effective way to illustrate the nature of Valsalva because it calls for the use of physical effort to engage the Valsalva Mechanism.


Try the exercise again, only this time apply the tenets of proper breathing during exercise and see how the effect in your body is different.

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Explanation of Valsalva Mechanism and diagram from William D. Perry’s (Esq.) book, Understanding and Controlling Stuttering, A  comprehensive new approach based on the Valsalva Hypothesis, 2d edition, 2000


Copyright 2005