Category Archives: Anatomy & Physiology

Black Out

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Blacking out is kind of a problem when lifting weights. The blacking out itself isn’t harmful, but falling and smashing your face on some dumbbells is.

In most cases passing out can be prevented. Passing out is a little different than just feeling light headed. When an unadapted person does an intense conditioning workout, they may feel light headed since their body isn’t accustomed to using and being depleted of substrates and oxygen. This is analogous to when a person is deadlifting or lifting heavy without being adapted to it. When you contract near maximally, vessels will be constricted and this increases blood pressure. If this isn’t gradually introduced in a training program, there can be some residual dizziness or a “light headed” feeling. I’ve never had anyone pass out from this feeling and if you have as a coach or a lifter, then you probably aren’t going about it the right way. “The right way” would be to increase the weight gradually, even if a person is capable of lifting heavier weight. There are plenty of people who because of prior training or admirable genetics can deadlift significant weight their first workout, but that doesn’t mean they should (observe the video above as a case in point). There are other peripheral adaptations (in this case the blood vessels) that need to occur aside from the muscles themselves being or getting strong.

I notice that when I come back from a break in lifting that my limiting factor isn’t how the weight feels on my muscles, but on how my cardiovascular system must re-adapt to heavy weights. Not in the sense that my heart beats fast, but when the vessels are constricted because of the strain of squatting with heavy weight on my back, my head feels like it’s going to explode. My face will turn the color of this ’67 Chevelle, and I’ll even rupture tiny blood vessels and this produces little red dots on my shoulders, neck, and face (areas where the skin is thin). I’m experienced with lifting, so I know what my limit, but I wouldn’t advise any of my trainees or most of you to do the same. If you have taken a break from lifting and you are still new to it, relatively speaking, then take a few workouts to ease back into whatever your program is. It’s the smart thing to do.

You can prevent blacking out as a result of strain and not being adapted in lifts like the squat, press, deadlift, press, and bench, but what about the clean? The clean and it’s derivatives have the propensity to cause blackouts because of the rack position. Assuming you have a good rack position (bar is sitting on top of the deltoids, upper arm is parallel with the floor, no pain in the wrists/elbows, etc.), you can still have problems with the bar either sitting on or rolling back into your carotid arteries (this happens to me frequently when I pull the bar higher than I need to).

The carotid is that big red one



This occludes blood flow to the brain and can quickly cause loss of vision and consciousness. In either case, it isn’t harmful since when either of these happen the bar is usually dropped, therefore the lack of blood flow doesn’t persist to cause damage. Again, the main harm is hitting your head, so having an open lifting area is important. Even if someone is adapted to lifting heavy weights, the carotids are still susceptible to being occluded, even if it is only partially. Compound that limited blood flow with intense strain that can occur in heavy cleans, and you have a recipe for a blackout.

Grinding through heavy cleans and deadlifts are not only tough, they are sometimes necessary to do in order to win an Olympic or powerlifting meet. At the end of a meet or training session, your body is tired, and having to grind through reps is common. You’ll remember Chris’ third attempt deadlift at 650 that ended in a mid-thigh stalemate. He may have been able to lock that lift out if he had known what to do.



The way that you can stave off the strain-induced blackout is by exhaling a bit of air as you grind through the rep. This is completely different than exhaling as you go up on a rep, fitness style. Instead, you will hiss air out from between your teeth or produce a guttural sound from your throat (grunting/yelling, but not singing). This is like putting your thumb over the end of the house; a little bit comes out, but the pressure stays high inside. Letting some air out relieves some of the pressure overall while the teeth/glottis help keep the pressure up enough so that your trunk is still stabilized as you finish the lift. Completely exhaling would let out too much air and not keep the trunk stabilized. There was a sweet guy at USAPL Raw Nationals who yelled stuff like, “Yeah c’mon babyyyyy” as he deadlifted over 600 pounds at 50 years old to A) avoid passing out by releasing some pressure and B) look and sound awesome doing it.

If you feel yourself starting to black out, then expel some air as I described. I like to push it out of my teeth (makes a loud hissing noise, “ssssssssss”), and this saves me from toppling over like a Gordon. You’ll notice good weightlifters doing it routinely, usually in the form of yelling. It took me falling over twice while cleaning 160+kg to completely learn this lesson. Luckily I didn’t get hurt, but hopefully you can be prepared for when it happens to you.

Q&A – Hamstring Inflexibility

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Hey Justin,

Basically, I have poor hamstring extensibility.
The test I have used for this is to put my feet together lock my back in lumbar extension and bow forward with my knees locked. I get to just above 45 degree from the horizontal.

I am concerned that this may be causing problems with my DL and Squat. I was missing a few DLs, usually with my back losing extension in later reps. Also on squats I buttwink, but also I really don’t feel the bounce at all, which could be another problem all together.

The short run would be: is poor hamstring extensibility a big deal? Do you find it inhibits your trainees DL & squats? Are things like barbell assistance (RDL, SLDL) exercises better than good ol’ stretching?

I appreciate any words you can muster.

Regards

Cormac

Hamstring extensibility is the same thing as flexibility. A good definition of flexibility is
having sufficient range of motion (ROM) around major joints to meet the demands of every day activities as well as any other activities that are participated in. This means that flexibility is relative to the individual and what they do. For example, I like to strength train and compete in Olympic weightlifting, therefore I should be sufficiently flexible for both. I am not, however, a gymnast/dancer/ninja, and therefore do not need the flexibility to do a split for any reason.

The hamstrings are a group of muscles on the back of the thigh that always get a bad rap of “being tight”. While it’s true that it is farily common to have inflexible hamstrings, it isn’t as big a problem as it has been made out to be. The squat (AKA low bar back squat to those of you who aren’t familiar with Starting Strength) is a wonderful exercise to stretch the hamstrings.

The hamstrings attach at the ischial tuberosity (on the bottom of the pelvis) and wrap around the knee (condyles of the tibia, head of the fibula, etc.). When you squat properly (reference the squat chapter of Starting Strength), you set your knees by pushing them out, which angles the femurs parallel with the feet, and then you sit back with your hips so that the hamstrings (and adductors) are stretched out. These are requirements for the “bounce” to occur out of the bottom of the squat. Each time you do a full ROM squat, it is like a PNF (proprioceptive neuromuscular facilitation) stretch. A PNF stretch is essentially placing a muscle in a position in which it will elongate while intermittently contracting the muscle to improve flexibility (for more).

The problem is that you must do the squat correctly and through a full range of motion, and not everyone is capable of teaching themselves this complex movement (it is one of the hardest lifts to master). If you consider yourself to have poor hamstring flexibility, then you need to first think about shoving your knees OUT and then sitting BACK. If it feels normal, then you’re doing it incorrectly. If you have never felt a full stretch on your adductors and hamstrings, you should know the first time you do.

Another factor with squatting/deadlifting and hamstring flexibility is that it may take you a few sets to get the muscles warm enough to go through the correct ROM. In such a case, you should make sure to incorporate a general warm-up and extra warm-up sets into your training session.

I’ve never had a problem with getting anyone to do a full ROM squat the first time that I teach them, and Rip has always said it is never a problem at all of the seminars he has done over the past few years. The best solution is to find someone that can coach you whether it be at a gym locally or at a seminar (the Starting Strength Seminars are utilized for reasons like this all the time).

Until you have squatted correctly, it is a waste of time to try anything else to loosen up your hamstrings. The squat will not only improve hamstring flexibility, but it will also (re)teach the hamstrings how to undergo a stretch reflex and also strengthen the muscles throughout the full ROM.

As for Cormac’s lack of extension in his back on his deadlifts, I don’t have enough information to have an opinion. He could be using bad form, is really skinny, attempting too much weight, or is doing everything correctly and having the natural curvature of the back on a heavy set of five. However, judging from his seeming hamstring inflexibility, I place the fault on the form on both his squat and deadlift.

The butt wink he references is over-hyped, and this is probably due to the CrossFit community branding it in their “air squat”. A butt wink is not that big of a deal assuming the squat is otherwise done correctly. It may even be anthropometry that looks like a butt wink — people that have a long pelvis and short torso will appear to be rounding their low back when it is actually the iliac crests of their pelvis. Besides, if the butt wink exists because of inflexibility, proper squatting will make it subside and disappear over time.

Again, a proper warm-up and squatting can cure common hamstring inflexibility and trying anything else is a waste of time until these are addressed. Barring any limiting pathology, the inflexible will become flexible.

The Bee’s Knees

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“Damn it man, I’m trying to save an innocent life!”
“I love ya, always have.”

Dude – killer website. I enjoy all the humor and content…great for motivation on slow days.

I do have a question though: I’ve always had really bad knees. My father and grandfather have both had knee surgery to repair bad knees. After trying crossfit and barely being able to walk after some wods (double unders, box jumps, etc really kill the knees), I went to the doc to get x-rays, and I pretty much have no cartilage in my knee joints and have bad tendinitis of the patellae tendon. I don’t want to give up though as I think building more strength in the hamstrings and quads will really help my knee stability and keep my knees from hurting so bad.

Have you had any clients with issues like this? What type of stretching or exercises would you have them do before or after a squat day to help the knee rehab a bit more and keep them lifting without having to take days off for the knee to recover?

–Joey

I’ve responded to Joey, but I thought the topic was worthy of discussion. Here are a few points.

  • The fact that Joey’s father and grandfather have bad knees is irrelevant. The development of the skeletal anatomy is primarily dependent on its mechanical environment. This means that it is an individualized thing, and thus the familial problems are coincidental.
  • Doing a bunch of ridiculous things in a conditioning workout when unadapted can yield some problematic consequences. Be aware of this if you are training/coaching others, or if you are trying stuff out on your own.
  • A lack of cartilage is not something I would classify in the category “awesome”.
  • If Joey learns how to squat with the method that we teach, then his pain may go away entirely. The squat, when done correctly, is a knee neutral exercise; the net anterior/posterior force acting on the knee is equal because the hamstrings pull back on the tibia (when hip driving) while the quadriceps pull anteriorly via the patellar tendon, patella, and patellar ligament to extend the knee. All of these structures are strengthened accordingly.
  • As far as the patellar tendonitis is concerned, it depends on where the tendonitis is. Stretching the quadriceps can help decrease any potential tendonitis above the patella, which is typically a symptom of letting the knees slide forward at the bottom of the squat.
  • There is a limited amount of information on Joey, but his pain will probably go away if the structures adapt to the strength training. Assuming he has problems six weeks from now, many people have found that heating their knees prior to squatting helps warm them up for the ensuing activity. Many have also found that icing their knees after squatting does not really help much. This is probably due to tendons having poor vascularization, thus their lack of response to ice. But this all depends on what problem a particular person is experiencing.
  • The best stretches for the quadriceps are any that have the knee in complete flexion while the hip is in extension. Remember, the rectus femoris (one of the quadriceps) crosses both the knee joint and the hip joint. It extends the knee and flexes the hip, so reversing those movements will elongate the muscle belly. You can help extend your hip whether you are standing or kneeling by flexing the gluteals (or ass cheek) on the same side as the quadriceps you are trying to stretch.

While this summary is not comprehensive, hopefully it has helped Joey a little bit, helped anybody else that may have experienced a similar issue, or helped all you healthy people think about the complicated shit that goes on when you train.

———-

Jim wants to know what you think about his breakfast. So much that he made a video.

BREAKFAST! from Jim G-ville on Vimeo.

I’d probably have some more eggnog and less milk, since it will have some more calories (albeit more filling). It depends on what your body can handle though. Send pictures or videos here. I can’t guarantee they will go up, but I’ll make an effort. The more creative you are, the better the chances.