Powerlifting

[Joe Rodgers]

I am 56 year old male and until recently competed in powerlifting on March 30 I squatted 450 lbs, benched 350 lbs and deadlifted 540 lbs. I wanted to start competing in strongman events again, so I requested a complete physical and echocardiogram. The echo took place on April 23rd and the Cardiologist said my heart was fine, BUT my aorta root was enlarged (4.6 cm). His instructions were to walk more and keep weights under 10 - 15 pounds another echo is scheduled for one year ... it was honestly one of the saddest days of my life. I still go to the gym and keep the weights under 155 pounds and reps in the 15 - 20 range. Are there any people still lifting heavy in this group? Is it possible to have surgery and return to heavy lifting? I am a large man that has lifted heavy my entire life, could a larger aorta root be normal for me? Sorry for the questions I was taken by complete surprise....

 

[Gordo60]

Welcome.

Try a search on TheGymGuy who’s a power lifter who had the surgery then returned to competitive lifting albeit younger. However I doubt that there would be too many cardiologists / surgeons keen on offering that advice.

https://www.valvereplacement.org/members/thegymguy.8754/#recent-content

 

[Gordo60]

I am a large man that has lifted heavy my entire life, could a larger aorta root be normal for me?

At 4.6 cm that’s generally considered beyond the outer limit even for very large men. From memory the upper bounds for large men particularly athletes / lifters range from 3.8 - 4.2 cm?

 

[Gordo60]

@TheGymGuy, you still around?

 

[vitdoc]

The big discussion in medicine is the idea that decisions in medicine should be EVIDENCE BASED.
Unfortunately in many (most) situations there is little evidence so statements are made based on Gut instinct or what seems OK. So unless there is some article that followed weight lifters with enlarged aortic roots that said that the weight lifting had something to do with enlargement then the statement you were given was PLUCKED FROM AIR.
I am a physician with three open hearts from bicuspid Aortic valve and subsequent aortic aneurysm (6.5 cm) with the last surgery in 2006.
Weight lifting probably is not the greatest activity for general health given the forces on the back , legs etc.. When you lift you increase your intra chest pressure (VALSALVA). This increases the pressure the venous return has to overcome to get blood back to the heart. Hence the bulging veins and reddening of the face. What that does to the aortic root is unclear. At the same time perhaps the blood pressure goes ski high. Perhaps the blood pressure issues might have some affect on the aorta. But probably unless there is some study, the cardiologist is just being conservative and careful but not scientific. If something does happen to you the cardiologist can say he did not have anything to do with it given his restrictions but they may not be necessary. Ask the next time you see him where these recommendations come from. Probably for your general health an exercise regimen that was more cardiovascular would be better for you.

 

[Agian]

Don't be sad Joe. You can still maintain your fitness without lifting big.

 

[AZ Don]

Welcome to the forum,
See towards the end of this paper http://content.onlinejacc.org/article.aspx?articleid=1140497
the section titled: The Date and Time that Aortic Dissection Occurs is Not Random
From a follow-up study done with patients and surviving family members of people that suffered an aortic dissection or rupture: "Specifically, we found that a majority of patients could recall a specific episode of severe emotional upset" ... " or extreme exertion at the time of their dissection." (in fact the accompanying chart shows 27% of dissections were preceded by physical exertion).

I think the restrictions on lifting a specific weight are ridiculous, as weights that I could not even lift would be easy for you. It's all about the stress and accompanying increase in blood pressure that creates additional risk for someone with an aortic aneurysm. My Dr's have been ok with my lifting a weight that I can lift 20 times - but that is after having my aortic aneurysm repaired. Years ago there was a good series of articles by Kevin Helliker in the WSJ about living with an aortic aneurysm - he was a runner and basically adapted to racing without competing. Here is a follow-up article: https://www.wsj.com/articles/SB10001424052970204047504574384973660445730

I think the outlook for lifting is better post surgery. Kevin Green returned to pro basketball following such surgery.
https://www.nba.com/magic/news/jeff-green/five-years-open-heart-surgery-thankful-20170109

I did a post 5 or 6 years ago on exercising after aortic aneurysm surgery. As I recall there was no clear guidance or evidence for limitations following surgery, though most Dr's will still advise some. The way one of my Dr's put it is that having an aortic aneurysm indicates that my aorta is weaker than normal, and so we have to assume that the rest of my aorta may be as well. Though I think the evidence shows that for those with BAV, the weakness is limited to the root and ascending aorta.

 

[Joe Rodgers]

Thank you all, I will read these articles and I have asked for a referral to a specialist. I am glad that I stumbled across this site.

 

[hevishot]

Hi Joe,
I had my aortic valve replaced with a CE bovine valve in 05. I compete in the USAPL bench press competitions only. I don't squat or dead lift. I recently set a state record in the bench press M3 74 k class. Not giving any advice here. I was advised over and over again and again not to lift heavy. I didn't take it. I'm still here. I understand the risks. This was the right thing for ME. Nobody else. What organization do you lift with?

 

[Joe Rodgers]

Hello,
Thank you for the response, I agree everyone has to make the right choice for them. It is tough for me because I live to lift heavy (especially squats), however, that may not be the right choice. I have drastically reduced the weight I lift in the gym while determine which direction I want to go. Currently, I lift in USPA. Congratulations on the State record! Stay Strong!

 

[MethodAir]

Aortic root size and prevalence of aortic regurgitation in elite strength trained athletes

https://www.ncbi.nlm.nih.gov/pubmed/17659941

 

[Joe Rodgers]

Thank you for the reference, much appreciated. I need to locate the right specialist, I understand that most doctors will recommend against lifting heavy weights with an enlarged aorta. I am not asking them to make the final decision for me I am just looking for more information, so that I can make an informed decision.

 

[Protimenow]

This is almost entirely related to lifting heavy, but what I do, I do at a gym.

I'm 117 years old (not really, sometimes I wonder), and I have a St. Jude Aortic valve. I've been taking warfarin for the 27+ years since I had the valve implanted.

I keep my INR within range (usually 2.5 - 3.5). I returned to the gym a few months ago. The weights that I've been using haven't been very high - depending on the part of body, my max is around 80 pounds. But I take this 200+ pound body and do a lot of stuff on the floor, too.

Because I take warfarin, little rips and tears can become nice, fairly large bruises. Last week, I may have overdone it on a 'bicycle-' riding for considerably longer than I had in previous sessions. I have bad knees, but cycled anyway.

I developed pain on the inside of my right leg, just below the knee. Probably a slight rip of something. It hurt for a few days (still does) and developed a pair of nice sized bruises.

My point is this - on warfarin, there's a slightly increased possibility that certain activities may result in bleeding that may be quickly coagulated when the INR is normal, but can become bruising for those of us on warfarin. I'm not going to stop cycling in the gym, but will wait until the bruises ease up a bit. (And, for me, I'll be working on the upper half of my body while this thing heals).

My point here is that many people on coumadin (I use coumadin and warfarin interchangeably here) carry on full, active lives. The stuff doesn't hold us back. But these activities can occasionally come with a bit extra bleeding or bruising.

 

[user 16827]

Hi at @Protimenow

I cycle a lot and have been on warfarin 9 years, the knee pain and bruising may be a patella tracking issue
especially if you over did it.

I only mention this as i never bruise from pedalling......
The Quads can tighten and force the kneecap slightly off.

if you stretch out the quads and manually manipulate the patella it may help ?



Only a suggestion

Happy cycling

 

[TheGymGuy]

@TheGymGuy, you still around?

Hello folks, I forget to check here as often as I should. Miss you all immensely.
@Joe Rodgers, I am a competitive powerlifter (82.5kg bw 463/297/545 last year), and and dabble in some crossfit now. I am also getting into more Oly lifts. This being said, all results and experiences vary.

There is a lot of wonderful research out there and lots of different thoughts from old school cardiologists, but keep in mind that there is a huge population of competitive tri-athletes that have had various heart procedures (https://cardiacathletes.com/) who continue to compete. There are also those that say (fear monger) that anything over 10lbs will kill ya, etc., etc.

My understanding after choosing and conferring with my surgeon was that once the plumbing is fixed (aorta parts replaced, I aneurysmic ascending aorta which was replaced) and faulty parts are replaced completely (aortic valve in my case) and scar tissue has finished forming you should be able to continue same as before, though, by listening to your body and at times scaling down just a tad which your joints will likely thank you for.

I'd be happy to chat with you if you have any questions.

 

[Joe Rodgers]

Thanks Gym Guy, that helps! I am glad to hear that you returned to the platform and those are solid numbers. I greatly appreciate the response and may have more questions as I move forward.

Joe

 

[Joe Rodgers]

Update... I had my appointment with the Aortic Surgeon/Specialist today after a Gated CT Scan. The aorta looked good, the scan showed the ascending was 4.2 cm (Echo measured 4.6 cm) the heart and valves are in good shape, very minor regurgitation. Factoring in my size and the results of the scan the doctor approved me to return to the gym with no restrictions and said to let him know the results of my next competition... his colleague agreed. I am typically not very emotional, but I almost jumped up and gave them a hug.... I will have a follow up Echo in one year. I want to thank everyone that took time to reply and I also learned a lot about aortic issues by reading the posts on this site. Thank you and all the best to each and everyone of you! Joe

 

[user 16827]

Great news Joe

Go get um champ

Enjoy your training , best wishes

 

[ddwheeler]

I don't power-lift, but I do like to work out. I am not a big guy, at all... 5'11" ~165/170 lbs. For a number of years I have been using just a set of 25 lb. dumbbells and a Total Gym machine to do all of my exercises. When I was diagnosed with a leaky aortic valve, and an aneurysm at the root of my aorta, about 5 years ago, my cardiologist initially had me stop all exercise while they went through my test results. I was told that my aneurysm measured at 4.5 cm. My cardiologist, and a heart surgeon, both not only told me it was OK to continue exercising/working out, but greatly encouraged me to do so. But they did stress to me to not lift heavy, due to the stress it would place on my heart.

I've continued with my "normal" workout regimen, still using the 25 lb dumbbells for a few different sets of exercises, and using the Total Gym for others.

I'm somewhat sensitive to the threat of an aneurysm. In the past few years I know of two people who died due to their having had an aneurysm to rupture. In fact, one lady I know died of that, this week. So, this is quite fresh on my mind and in my thinking. In all honesty, I am not aware of whether or not they had even been diagnosed and were under any form of monitoring or treatment. But, my having been diagnosed does keep me aware of the various activities that could potentially stress it and cause a rupture. A rupture is pretty much certain death. So, it isn't a matter to take lightly, at all.

I have wondered, though, many times, just how abnormal is the measurement at the root of my aorta which is determined to be an "aneurysm". I have a very serious mistrust of doctors these days, due to many things I've seen them do which can't be anything but their ringing up the cash register and bombing my insurance (and my pocket with the deductibles and financial obligation I must pay) with a boatload of tests and procedures.

 

[David Robbins]

I am 56 year old male and until recently competed in powerlifting on March 30 I squatted 450 lbs, benched 350 lbs and deadlifted 540 lbs. I wanted to start competing in strongman events again, so I requested a complete physical and echocardiogram. The echo took place on April 23rd and the Cardiologist said my heart was fine, BUT my aorta root was enlarged (4.6 cm). His instructions were to walk more and keep weights under 10 - 15 pounds another echo is scheduled for one year ... it was honestly one of the saddest days of my life. I still go to the gym and keep the weights under 155 pounds and reps in the 15 - 20 range. Are there any people still lifting heavy in this group? Is it possible to have surgery and return to heavy lifting? I am a large man that has lifted heavy my entire life, could a larger aorta root be normal for me? Sorry for the questions I was taken by complete surprise....

Joe-
Thos reponse is well past your posting. Anyways, I have been a lifelong weightlifter and competed in power lifting and bodybuilding in my 20's. I am 69. I had endocarditis in 2008 and had an aortic valve replacement and a redo the same year. I also had a stroke due to the blood bacteria and had brain surgery within 30 days of teh first aortic valve replacement. After 114 days impatient care(hospital and cognitive rehab), I returned home and did cardio rehab on my own, primarily walking but light weights. Used Hammer Strength machines to avoid sternum contact. I wasnt at the level you were, except in my 20's. I went back to heavy lifting with my doctors blessing 5 months after cardio rehab and post hospital discharge. I was benching 300 lbs, squatting 275lbs and deadlifting 325lbs. Nothing like your totals, but I wanted to maintain the bodybuilding appearance. Now that I'm 69, I no longer free bar squat, but use the power squat, the hips sled and hack machine. I also don't deadlift, except the Romanian deadlift for my hamstrings. Since the Pandemic ended, I'm benching 275lbs flat bench and incline press 275lbs and decline press 250lbs. I also hike between 5-15 miles on weekends and 4-5 on a weekday. I am finding it difficult to sustain the high intensity on uphill hikes. It is not uncommon to endure a sustained heart rate of over 100bpm for 2 hours. I wear an Apple Watch, so my tracking of heart rate is very detailed. Since I was an intense miler before I was ill, my heart rate can spike to 170-180 occasionally. I was previously running the mile at 6 minutes average at 190lbs. These are my stats:

Age: 69
WEIGHT: 185lbs
Biceps 17"
Chest 46"
Waist 33"
Hips 39"
Quads 24"
Height 5'9"
BF: 10-12%
Bench:
Flat 275lbs
Incline 275lbs
Decline 250lbs

David Robbins