Pros and Cons of the Valsalva Maneuver

Breathing is a crucial aspect of both resistance and cardiovascular training. There are many breathing patterns and techniques that we may engage in to maximize our performance. When running, some choose to inhale and exhale in a 3:2 pattern, which consist of inhaling for 3 steps and exhaling for two steps. Other runners may prefer the 2:2 patterns, but ultimately, your breathing rhythm is influenced by the intensity in which you are exercising. When it comes to resistance training, there are many beliefs as to what breathing techniques promote maximal force and this article will examine one technique in particular, The Valsalva Maneuver (VM).

What is the Valsalva maneuver (VM)?

So first things first, what exactly is the Valsalva maneuver? Believe it or not you may be doing it without even realizing you are. The VM occurs when we forcefully attempt exhalation against a closed airway. In other words, it is when we hold our breath and exhale force as if we are attempting to breathe. This can be done by closing your mouth or pinching your nose. You may have done this when traveling on an airplane and to make your ears pop, by “clearing sinuses.” The VM decreases pre-load to the heart. In strength training, many have stated that the VM is the optimal breathing pattern to increase force, but what are the actual benefits and risks of the VM? Are there any more efficient breathing patterns for exerting maximal force? Below I will analyze the pros and cons of “holding your breath” when exerting force.

Benefits of the Valsalva maneuver

The Valsalva maneuver is used often in power lifting to stabilize the trunk but there is limited research on this theory. Exercises such as bench press, squats, dead lifts and cleans are all routinely done with the VM. The VM results in a mild increase in stroke volume which facilitates maximal force output. The VM is more natural during exercises at maximal force because it increases your power output potential.

Dangers of the Valsalva maneuver

Generally speaking, the VM is not dangerous for a moderate blowing force. There are however some risks associate with repeated Valsalva maneuvers, during weightlifting. These risks include fainting, transient global amnesia, spontaneous cerebrospinal fluid leak, and heart attack for those with CVD. Blood pressure has been recorded as high as 480/350 mm Hg when performing the VM due to the increase pressure in the thoracic cavity. More common side effects include dizziness, vertigo, headaches, and hernias.

Forced Exhalation

It has been shown that voluntary breathing can influence maximal muscle force, similar to the VM. Voluntary breathing refers to the forced exhalation when producing force against an object. For example, instead of holding your breath, breathing out forcefully will aid in your potential power output. This can minimize the induced risks associated with the VM. Blood pressure was significantly lower with forced exhalation when compared to blood pressure when using the Valsalva maneuver. It is highly recommended that you use forced exertion as opposed to VM during exercises at maximal level, especially repetitive repetitions.


In conclusion, the VM is beneficial for those who use it correctly during single explosive movements. Due to the high risks associated with the VM, forced exhalation is what I would recommend during strength training. It provides similar results without the risks. Those with heart disease and older adults should avoid the VM and focus more on breathing deeply and more forcefully when resistance training. 


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