Aortic aneurysm (watchful waiting) weight / resistance training

[Gordo60]

Hello and again being a new member thanks to all those here who have contributed to this incredible resource of information.

Like most with an aortic aneurysm who potentially can spend years of watchful waiting until meeting the criteria for surgery the conflicting information on exercise and resistance training in particular is incredibly frustrating. After having searched this forum quite a bit I know this subject gets raised periodically. However I thought I’d create this thread specifically for those of us in “watchful waiting” mode.

Apologies if any of the links and information mentioned has been discussed before. I have tried my best to search the site.

Personally I’m 59, very tall (6’ 7” / 200 cm) and thin having tested negative for Marfan etc with TAV appearing to be working well but with a thoracic aortic Aneurysm of the root at 4.8 cm. Blood pressure with a small 25mg dose of Losartan (existing blood pressure was normal) is around 110 / 75.

My current weight training (not heavy lifting) strategy to minimise raising blood pressure / stress on the aneurysm is:

1. Dumbbells only
2. Most exercises are “one arm” at a time to halve the weight load on the body
3. Mostly isolation exercises
4. Repetitions no less than 15 - 20
5. No breath holding, breathe smoothly during reps
6. Stop short of any straining, don’t try to force out any final reps

Current upper body exercises for example are:

1. Shoulders - One arm seated DB overhead press
2. Chest - Flat bench DB flys
3. Back - One arm DB row
4. Triceps - One arm seated DB triceps extension
5. Biceps - Standing one arm DB bicep curl

Some articles I found useful most having been reviewed by medical aneurysm specialists are linked below. I’d love to hear other’s views, experience and links to further articles:

https://scarysymptoms.com/2014/09/aortic-aneurysm-safe-weight-lifting/
https://scarysymptoms.com/2014/09/aortic-aneurysm-lifting-weights-wha/
https://scarysymptoms.com/2014/09/aortic-aneurysm-lifting-weights_16/
https://scarysymptoms.com/2012/11/thoracic-aortic-aneurysm-weightlifting/
https://scarysymptoms.com/2017/01/fat-heavy-make-lifting-safer-aortic-aneurysm/
https://scarysymptoms.com/2014/09/aortic-aneurysm-are-barbell-squats-safe/
https://scarysymptoms.com/2014/09/aortic-aneurysm-are-deadlifts-safe-to-do/
https://scarysymptoms.com/2015/07/bench-pressing-with-thoracic-aortic/
https://scarysymptoms.com/2014/09/aortic-aneurysm-are-pull-ups-safe-to-do/
https://scarysymptoms.com/2014/09/aortic-aneurysm-biceps-curl-safety/
https://scarysymptoms.com/2014/09/aortic-aneurysm-safely-build-muscle/
https://scarysymptoms.com/2014/09/aortic-aneurysm-resistance-band/
https://scarysymptoms.com/2014/09/aortic-aneurysm-is-high-intensity/
https://scarysymptoms.com/2014/09/aortic-aneurysm-are-heavy-bag-workouts/
https://scarysymptoms.com/2014/09/aortic-aneurysm-lift-weights-safely/
https://scarysymptoms.com/2014/09/aortic-aneurysm-lifting-weights/
Hope others find this useful.

Gordon

 

[user 16827]

Some great links there Gordo, very useful information

My wife was terrified that i still went to the gym while i was in waiting the room ( 4 years )
Post opp i couldn't find any good advice, well i couldn't get a cardio to tell me what i wanted to hear.

i still lift and enjoy it

 

[user 16827]

To add ; Reading the articles i would class my efforts pre surgery as 'challenging'

my aneurysm went from 4.8 to 5.2 in 4 years
There is no way of knowing if the weights sped up the process

my opinion was i had to have surgery anyway so i decided to be as strong and
lean as possible to help my recovery.

it seems to have worked for me, and i enjoyed and still enjoy the gym which
is important to do the things we like

 

[Gordo60]

@leadville would you kindly be able to expand on your workout routine or direct me to a suitable post if you’ve already covered this in the past?

It drives me insane my cardiologist’s view of lifting no more than 10 - 15 kg. If one stops lifting anything much strength deteriorates to the point where even lifting a well stocked shopping bag requires progressively more effort to lift. In effect an increasing risk.

I found by weight training with dumbbells using higher reps and gradually increasing the weights a little at a time lifting say bags of garden fertiliser in the 20 - 25 kg range requires no effort at all. Last annual checkup when I told the cardiologist I’d been lifting 25 kg bags he reprimanded me for doing so. Worse still my wife insists on being present so now anytime she sees me lifting anything over 15 kgs she gets stuck into me as well.

I think my cardiologist has concerns given my height of 6’ 7” which is much taller than my parents / great parents. Even though I tested negative for Marfan syndrome he has concerns there might be some other genetic factor involved. I know of no history of aneurysms in our family line. Then again from what I understand the cardiologist gives all patients the limit of lifting around 10 kgs.

I figure given I’m nearly 60 with a normal apparently healthy valve but a TAA of 4.8 cm if there was any significant genetic issue it would have impacted me earlier on. Especially given that up till about 5 years ago when the aneurysm was discovered I regularly lifted heavy weights and pushed my heart rate way up there doing interval aerobic exercise.

All very frustrating.

 

[user 16827]

remember that i'm post opp.....

my regime beforehand at the gym was very similar though.

the absolute weight imo is a non starter it's the perceived effort i work with.

if i can lift the weight for 20 max reps i will stop at around 15
if my max rep is 6 ill just do 2 or 3.

I train like a bodybuilder more than a powerlifter, the weight is never the limiting factor it's
always the lactic build up that stops the set once the pain is enough.

I always super or triple set Gordo to keep the muscles moving and always use great form, 2 sec up 3 seconds down, never breath hold ( valsalva )

i generally do a full body workout 3 days a week

i never : Deadlift & back squat with weights , i do however free squat a lot

i do bench press & use other compound movements too.

Usually in and out the gym in an hour

Back..

lat pulldowns
low pulley rows
bent over barbell rows

Chest..

bench press
dumbell press
assisted dips machine

Shoulders..

Military barbell press
uprights rows

Legs..

free squats
free lunges


Arms..

Biceps barbell curls
Triceps rope pushdowns


Its continuous involving super sets with very little rest, i would say i do
3 to 4 sets per exercise rep range 6 to 30 depending on the exercise .

i go more for feel rather than a strict programme

This is only my opinion but as we age our testosterone drops and i think lifting
heavy ( ish ) objects is good for us as humans.

For testosterone, HGH and Bone density

 

[user 16827]

Iv'e spotted a typo but i'm too scared to EDIT

 

[Gordo60]

Thanks @leadville, wonderful info thanks. Most of what you posted is what my research suggests is a safer approach to weight training for those with aneurysms until time for surgery.

Sorry I meant to specify that it’s your pre-surgery workout routine I was interested in. Although you said it was very similar did you use less weight / higher reps or say for example avoided bench press etc prior to surgery?

In my early days when I did body building routines (I’ve never powerlifted) there was a well known bodybuilding trainer / author called Vince Gironda. He had a couple of routines such as 8 x 8 / 10 x 10 reps per exercise. However you were only allowed a few breaths break between sets / exercises. This greatly reduced the weights able to be used and failure is due to as you say lactic acid build up rather than mechanical strength failure.

 

[Gordo60]

Iv'e spotted a typo but i'm too scared to EDIT

EDIT has worked very well for me. To be on the safe side simple select ALL then copy text so if anything goes wrong during edit (unlikely) you just paste the text back again.

 

[OldManEmu]

I had a 4.7cm aortic aneurysm at the time of my first surgery that couldn't be addressed then because of my poor state, only the AVR was done. It remained stable for close to 6 years with yearly CT scans until it went to 5.2cm triggering a 6 month follow up in which it had slightly increased again triggering surgery. In the 6 years I was only warned by the cardio and surgeon to avoid breath hold ( valsalva ) weight lifting. I continued to work out at the gym and do my 3 spin classes a week. I was never given a weight limit.

 

[user 16827]

Vince gironda eh ? showing your age

Before surgery i still bench pressed yes, the routine was very similar to what i do now
if you pre exhaust your pecs with say flys / Pec deck, then the amount of weight bench pressed is not a lot

the main changes were i just avoided weighted squats and deadlifting because it's just too easy to get sucked into holding your breath.


post surgery my surgeon said that where the graft on my arch is sewn into my natural aorta
then that stitch site is susceptible to BP spiking.

that's the reason that i now avoid weighted squats & Deadlifts
before surgery you risk dissecting with BP spikes


A bit of common sense & a conservative approach to lifting seems to be acceptable to
the cardios iv'e spoken to both pre & post opp.

You are never going to get a free pass from the medics i'm afraid

 

[Gordo60]

if you pre exhaust your pecs with say flys / Pec deck, then the amount of weight bench pressed is not a lot

Popularised by Mike Mentzer early on. However for anerysm resistance training obviously minus the forced reps, negatives etc to total failure. Used that approach also many years ago, quite enjoyed it.

Did exactly as per your pecs example. For lats it was straight arm pulldowns / nautalus pullovers to pre exhaust then say lat pull downs / chin ups. Shoulders - side lateral then overhead press etc etc.

Thanks for reminding me of this. It provides another way for those with aneurysm to still get an effective muscle building workout whilst reducing the amount of weight on the compound exercise through pre exhaustion with the isolation exercise before hand.

As for squats / deadlifts I have no intention / interest in them anyhow as I gave them up many years ago due to back issues. My best mate (same age of 59) who I started training with in my late teens has always trained hard with squats / deadlifts but is beginning to experience all sorts of hip / back / knee problems.

For thighs lunges with or without dumbbells or single leg squats with foot of other leg on bench do the job. Single leg calf raises do well enough for calves. I also use my mountain bike on a resistance trainer to help work the legs a bit also but mostly for endurance. Wife won’t let me ride the bike on the road / trails anymore as she worries I might fall off or get hit by car causing dissection etc. Such is life. Not worth upsetting the other half. So bike mounted on the resistance trainer under the house it is.

 

[Paul1972]

Hi Gordo60 , I had a 8.2 cm anurysam that was found by chance which is now repaired . I had two ohs surgeries in the space of two years and now see a aorta specialist who says I’m fine to do my heavy construction job which I have been doing for the last two years.All the best Paul

 

[Gordo60]

Hi Gordo60 , I had a 8.2 cm anurysam that was found by chance which is now repaired . I had two ohs surgeries in the space of two years and now see a aorta specialist who says I’m fine to do my heavy construction job which I have been doing for the last two years.All the best Paul

8.2 cm, wow. Fantastic to hear you’re doing well and able to perform heavy work.

 

[user 16827]

Wow indeed, 8.2 incidental find ? you're a very lucky fella Paul

 

[Paul1972]

I know I am Leadville thats exactly what my surgeon said to me.Good to hear from you hope you are keeping well

 

[AZ Don]

Welcome to the forum Gordo60. A lot of good information in the links that you posted above and in your exercise routine. I especially appreciated the links to the articles talking about the hundreds routine and the guidance to warm up slowly for 10-15min prior to intense cardio. The 1st sounds like an interesting (but probably painful) routine and the second sounds like good advice.

I know how frustrating it can be to get clear guidance. 6 years ago I was diagnosed with a BAV and aortic aneurysm 5.1cm, ascending and root. Before I found out I was already a candidate for surgery I started researching exercising with an aortic aneurysm and posted a summary of what I found here, with links:
https://www.valvereplacement.org/threads/exercise-and-stress-with-aortic-aneurysm.42576/

Exercise guidance post-surgery (and recovery) is quite different from pre-surgery. As I understand it the risks are generally related to the size of the aneurysm and any co-morbid conditions (eg. marfans). As my BAV was spared along with part of my aortic root, I am still careful, especially with weight lifting. I have told my Dr's that I won't lift a weight that I can't lift at least 20 times and they are ok with this, and for Cardio I have been given no limits (given that I am not a competitive athlete) - but my aortic root has been stable since my surgery so I am looked as a post surgery patient.

 

[Gordo60]

Before I found out I was already a candidate for surgery I started researching exercising with an aortic aneurysm and posted a summary of what I found here, with links:
https://www.valvereplacement.org/threads/exercise-and-stress-with-aortic-aneurysm.42576/

Hi @AZ Don, thanks for the welcome.

I did read your post / links thanks but thought it might be worth starting a thread specific to resistance training for those of us in the waiting room.

It’s frustrating as a tall, thin person especially as age progresses and muscle / strength is harder to build / maintain even for those in normal health. I’m 6’ 7” (200 cm) and around 220 lbs (100 kg).

My damn cardiologist is still in the don’t lift more than 10 - 20 pounds camp or maybe a little more. Tried that and kept getting progressively weaker to the point where previously items that were not a strain at all were starting to be so. So I decided to research more on this myself. Sensible higher rep training (eg around 20 reps) with small but gradual increases in weight and stopping short of straining seemed like a sensible approach. Strength is returning and the range of items I can lift now without straining has increased noticeably.

I also felt that weight training in a controlled environment allows me to safely build strength so that if some unplanned / accidental lifting event happens in everyday life then one might come to less harm. For example the wife had purchased 25 kg bags of fertiliser recently which were in the rear area of our vehicle. When I opened the tail door one fell out with me automatically reacting to catch it, auto reflex action. Because of my training I didn’t feel the tiniest bit of strain when catching the falling bag. If I had kept following the don’t lift more than 10 - 20 lbs advice this event could have been considered high risk.