Brain Aneurysm Risks, Exercises and Therapy

[Guest guest]

Wilbanks wrote:

<On another board, someone proposed that doing weight training exercises with

the head below the heart may increase one's risk of having a brain aneurysm

or other CVI. It was discussed in the context of Decline Bench Presses, but

since I do handstand push ups - which would presumably be even worse - I am

concerned about this aneurysm question.

On the one hand, there are plenty of gymnasts and acrobats out there who do

strenuous feats upside down, and I've never heard of them dropping dead in

droves from brain bleeds. On the other hand, if there are some medical facts

about increased risk, it would be good to know them. I have emailed a few

neurosurgeons with the question. Does anyone here have any information? >

*** One need worry about this problem only if there is a pre-existing

weakness in the relevant blood vessels, especially if one forcibly holds the

breath in that upside-down position. The risks are increased further in the

yoga " candlestick " and " shoulder stand " asanas or poses, as well as by

hanging upside down on that inversion

tables. In the decline bench press, the difference in height between head and

heart is not very large, so that the risk of aneurysm is not greatly

increased. If one is really concerned, then avoid forcibly holding the

breath while lifting heavy weights in that exercise.

Anyway, I trust that the same person who wrote that article also pointed out

that lying with head slightly below the feet is not the only way to increase

cerebral blood pressure. In fact, strongly invoking the breath-holding

Valsalva manoeuvre during actions as simple as straining bowel movements or

heavy lifting can also dramatically increase blood pressure, intra-abdominal

and intra-thoracic pressure. In the person with healthy arteries, these

transient pressure increases do not seem to pose any great risk. Naturally,

the risks increase with ageing, as the blood vessels tend to lose some of

their elasticity and diameter. If these pressure increases concern you, keep

the mouth slightly open while you are doing your exercises and even very

gradually exhale through the nostrils during the latter stages of the action

(but don't exhale suddenly because this reduces overall stability and drops

blood pressure precipitously).

Manipulation of the neck by oneself, physical therapists or chiropractors,

especially if done regularly, also is known to pose a risk for arteries and

nerves running to the head, so anyone with any family history of

cardiovascular disease or injury to the nerves of the neck and head would be

well advised to avoid passively twisting the relaxed neck to " readjust " or

" release tension " . In the neurosurgical department where my late father

worked and where I carried out some of my earlier brain research, there were

several cases of patients who experienced vascular or neural damage during

manipulative therapy. Most therapists do not carry out expensive MRI or

other scans to assess the circulatory or neural status of patients, so it is

probably advisable not to subject oneself to forceful cervical manipulation

with relaxed neck muscles (as opposed to gentle mobilisation) as means of

therapy, during poor execution of wrestlers' bridge exercises or in a

collapsing rugby scrum.

Just remember that you will not die, have an aneurysm or become quadriplegic

if you do NOT intentionally or unintentionally subject your relaxed neck to

forceful manipulation. However, if you do, the risks do increase and even a 1

percent increase can mean the difference between living normally and living

in a wheelchair. That is certainly not a risk that I am willing to take,

even if manipulation may be applied 99 times out of 100 without incident -

the next time might be my last.

Dr Mel C Siff

Denver, USA

Supertraining/