Dizziness and Weakness Under Load During Squats

Hi, I’m a 30-year-old male. About three years ago, I followed the Starting Strength program for around six months and had amazing results given my previous activity and pre-existing issues. I have Scheuermann’s disease, along with mild scoliosis, but kinda significant kyphosis and lordosis. Despite these, I was able to perform the movements with good enough form, and my posture and physique improved drastically.

I had a pre-existing lumbar hernia, and eventually, it resurfaced while warming up for deadlifts. Afterward, I stopped training for three years. Last year, I decided to get back into it, but on my second day of squats, I experienced severe dizziness, i felt lightheaded and numbness in my left-hand fingers, forcing me to stop. Thinking it might be related to bar position, I switched to belt squats, but the same thing happened during the second set. I then tried a pull-up/push-up routine but experienced dizziness again just six minutes in.

For a while, it happened during almost every physical activity, even walking in cold weather. My doctor suspected blood pressure issues, so I wore a 24-hour blood pressure monitor(dont know the name of the device, but nothing significant came up. A heart ultrasound showed no problems either. Also blood tests didnt show any sign of diabetes. I stopped working out for a while, but after a year, I started again with resistance bands with no problem. But ehen i started to train w barbells again the first session of ss went fine, but during the second session, I felt dizzy again at the second squat set.

Doctors have considered reactive hypoglycemia, blood pressure issues, or panic attacks. Last year when the symptoms first appeared during a difficult emotional period when I was heavy drinking, smoking, and consuming caffeine heavily. Now, I’ve reduced caffeine and alcohol, but the symptoms still appear when I push myself hard on squats. Interestingly, I haven’t experienced these issues during deadlifts, overhead presses, or bench presses and when iam trying to get back training and start working out with resistance bands but now they always happen when there’s a heavy load in a vertical position. I also suspect that maybe I’m trying to extend my spine too much to maintain posture or holding my breath too intensely during the Valsalva maneuver.

I’m not expecting a definitive diagnosis here, but in Germany, if you go to a doctor and mention having any problems while lifting weights in the gym, they immediately recommend stopping resistance training and switching to light aerobic exercises. It was already difficult enough to get the tests I’ve done so far. I’m just curious about what this issue might be related to and would like to find a safe point where I can return to weight training. Do you have any suggestions?

Sorry to hear about this issue. It sounds like you have had a reasonably thorough evaluation for the “dangerous” causes here (mostly cardiovascular issues), which is the most important thing.

I don’t have a great explanation for why these symptoms would only manifest while you are handling load in a squat, but are seemingly unaffected with deadlifting or overhead pressing (which would also seem to be loaded “vertically” / axially).

I would consider training this similar to how we might “rehab” a pain issue; namely, continuing to train those main lifts where you are unaffected, and temporarily substituting squats with other leg-focused activities to see what you can tolerate, for example leg pressing, leg extensions, hack squats, dumbbell split squats/step-ups, etc., and if that goes well you can consider re-introducing something like a dumbbell goblet squat down the road to see if you’re able to tolerate that before progressing further.