Dr. Andy Galpin

The valsalva maneuver is that intra-abdominal pressure that you create when you're doing things like lifting weights or having a bowel movement. This is exactly how you use it. Again, we're still talking about chronic or acute rather. This is something you're going to do right now.

It's not going to fix your long-term stuff, but it'll give you that change when you're feeling like you need it right now. So you're going to hold your breath. You can do an inhale and hold, or you can do an exhale and hold. It doesn't really matter, but you're going to hold and then create a bunch of intra-abdominal pressure.

It's not going to fix your long-term stuff, but it'll give you that change when you're feeling like you need it right now. So you're going to hold your breath. You can do an inhale and hold, or you can do an exhale and hold. It doesn't really matter, but you're going to hold and then create a bunch of intra-abdominal pressure.

And what's really key about this is the pressure needs to be in a true 360 degree range. Here's the analogy I like in this one. Imagine you are a can of soda. So you're a barrel, if you will. And the bottom of the barrel that's sitting flat on the ground is your pelvic floor. And the top is your diaphragm. So these are running parallel to each other.

And what's really key about this is the pressure needs to be in a true 360 degree range. Here's the analogy I like in this one. Imagine you are a can of soda. So you're a barrel, if you will. And the bottom of the barrel that's sitting flat on the ground is your pelvic floor. And the top is your diaphragm. So these are running parallel to each other.

And then the barrel, or the can of soda, however you like to think about it, is everything from the front of your stomach to the side of your stomach all the way to your back. You want to create pressure against all of those surfaces. So imagine you're trying to explode that barrel. Every way. You're trying to blow the bottom out. So blow the bottom into the ground.

And then the barrel, or the can of soda, however you like to think about it, is everything from the front of your stomach to the side of your stomach all the way to your back. You want to create pressure against all of those surfaces. So imagine you're trying to explode that barrel. Every way. You're trying to blow the bottom out. So blow the bottom into the ground.

You're trying to blow the top up in the air and you're trying to blow every side out each individual way, right? That's how we do it. It's not just a crunch. It's not a back extension. It's not anything else. It is a all quadrants, vertical and horizontal. And you're going to do that and you're going to hold it for 10 seconds.

You're trying to blow the top up in the air and you're trying to blow every side out each individual way, right? That's how we do it. It's not just a crunch. It's not a back extension. It's not anything else. It is a all quadrants, vertical and horizontal. And you're going to do that and you're going to hold it for 10 seconds.

In doing that, you're going to see your heart rate jump from 60, 70 beats per minute to 120. It'll shoot way, way, way up in the air. But then at the end of those 10 seconds, you exhale. And actually the literature suggests that it doesn't really matter how you exhale. Go slowly, go through your mouth, go through your nose, kind of let it all dump out quickly.

In doing that, you're going to see your heart rate jump from 60, 70 beats per minute to 120. It'll shoot way, way, way up in the air. But then at the end of those 10 seconds, you exhale. And actually the literature suggests that it doesn't really matter how you exhale. Go slowly, go through your mouth, go through your nose, kind of let it all dump out quickly.

It doesn't actually matter that much. In doing that, that heart rate will go from 110 or 120 all the way now down to like 40 or 50. So before you started the drill, you were at 60 or 70, and now your new baseline is significantly lower. Really effective. You can do it anywhere. It takes just a few seconds to do. It doesn't cost you any money at all.

It doesn't actually matter that much. In doing that, that heart rate will go from 110 or 120 all the way now down to like 40 or 50. So before you started the drill, you were at 60 or 70, and now your new baseline is significantly lower. Really effective. You can do it anywhere. It takes just a few seconds to do. It doesn't cost you any money at all.

And it is particularly good at altering what are called baroreceptors that have specific action on that vagus nerve. And so you can do this. The magnitude of effect is actually really, really high. You'll hear in a second, but there's different technology you can use to directly stimulate your vagus nerve. But the magnitude of effect is much lower than something like this Valsalva.

And it is particularly good at altering what are called baroreceptors that have specific action on that vagus nerve. And so you can do this. The magnitude of effect is actually really, really high. You'll hear in a second, but there's different technology you can use to directly stimulate your vagus nerve. But the magnitude of effect is much lower than something like this Valsalva.

So it's free, it's cheap, it's easy. You can do it a bunch and it has a big magnitude of effect. Couple of caveats here with this modified Valsalva though. If you are prone to orthostatic issues, you pass out a lot, you have low blood pressure, don't do this. Don't do this if you're by water or in a pool or in the ocean. Don't do this a whole bunch of times.

So it's free, it's cheap, it's easy. You can do it a bunch and it has a big magnitude of effect. Couple of caveats here with this modified Valsalva though. If you are prone to orthostatic issues, you pass out a lot, you have low blood pressure, don't do this. Don't do this if you're by water or in a pool or in the ocean. Don't do this a whole bunch of times.

Probably don't do this immediately during your workout. All the caveats aside, right? You're going to create a bunch of intra-abdominal pressure. You're going to block a lot of blood flow, if not occluded entirely. Don't pass out. Don't fall into water. Don't drown. Don't do all that stuff. Another option, like I just mentioned, are what are called those vagal nerve stimulators.

Probably don't do this immediately during your workout. All the caveats aside, right? You're going to create a bunch of intra-abdominal pressure. You're going to block a lot of blood flow, if not occluded entirely. Don't pass out. Don't fall into water. Don't drown. Don't do all that stuff. Another option, like I just mentioned, are what are called those vagal nerve stimulators.

These are somewhat new. There are a handful of FDA approved devices that you can use. You generally have to have a prescription to get them though. You can buy a ton of these as normal consumers. And I have not been impressed with any of them. The data are, I would say, weak at best on them. I have personally used many of them and found like I got nothing out of it.