Vasovegal Syncope Immediately Post-Power Clean

Medical Q&A [Moderated]
1

Hello Drs.

I had an incident yesterday at the end of during Day 1 of Week 1 of the Hypertrophy I template. I had finished doing Hip thrusts as my 3rd movement and set the bar on the pins at slightly lower than hips to let myself rest for a minute before going to lunges for the final movement. After waiting, I picked the bar back up and power cleaned it to my shoulders (weight was 125lbs which doesn’t seem like it is too crazy considering I have deadlifted 315 for a single @8 and I rowed 170 for 6 @8 just last week but I don’t really power clean in a structured manner to know for sure) then immediately set it down on the pins I had set at squat height. I was thinking about how I was going to set the weight on my back for the lunges when stuff got weird. I never fully lost consciousness but everything seemed scrambled as I fell to the ground and I didn’t really have enough control to stop the fall even though I was trying. My wife stopped her workout on our stationary bike to come over and said that I had some jerking movements as I fell to the ground which matches what I read from the lovely people at the Mayo Clinic. I decided to not to the final movement and recover instead.

Additional background, I am at the end of a 5 month cut and have lost about 30lbs down to 170lbs from 200lbs probably in the high teens for BF% so I am in an energy deficit on a daily basis but I sip Gatorade during my workouts that probably adds up to 12-16 ounces during a workout sessions. Maternal family has a history of hypotension and I had a resting BP of 108/69 when I went to Urgent care for a facial laceration in the last month for reference. I do often have times when I gray out slightly during the first rep of overhead press which may be why I was not as prepared for this because I thought it would just be a gray out like that.

So with the background hopefully sufficient: is this related to the calorie deficit at all, can I do anything to prevent this, and are there any safety precautions I should take if not?

Thank you so much for your time and knowledge as always!

2

This all sounds fairly typical for a vagal-type episode.

It’s probably not related to the calorie deficit, though no one will be able to tell you with 100% confidence. Hydration status, as you suspected, can often play a role here, as can prolonged Valsalva maneuvers in some individuals. I experience those sorts of “gray-out” episodes when doing overhead presses and have passed out a couple times, though it doesn’t happen on any other lift for me. If you feel the symptoms start to come on, performing a quick isometric-type muscle contraction (e.g. handgrip, crossing/squeezing your legs, or other such “counter-pressure” maneuvers) can sometimes help bring blood pressure back up quickly and avert syncope. Otherwise not much else to do unless there’s a secondary cause for all this like neurological disease or certain medications.

3

cj gotcher’s episode was classic - always loved the smile and thumbs up from the prone position

thanks for tips on averting a “nap”

4

Doctors -

Do genetics play a role in your tendency to have vasovagal episodes? I’ve had them all my life, usually for reasons other than weightlifting.

To the OP: this may be bad advice (perhaps someone more knowledgeable can weight in), but I like to drop slowly to my knees immediately after I complete a movement that might cause a vasovagal episode. For me it’s just deadlifting, but it may work for other movements as well. If you’re going to pass out it’s better to already be on the ground to minimize the risk of head trauma.