Abstract
It is observed that people hold their breath while heavy weight lifting to get extra strength. Holding the breath during weight lifting can lead to abnormal increase in middle ear pressure which can lead to several hearing/auditory complications. The objective of the study was to investigate the impact of heavy weightlifting on various parameters related to ears like blocking sensation, tinnitus, vertigo, headache and temporary threshold shift across light and heavy weightlifters, as amateur weightlifting among youth is rapidly increasing. A cross-sectional survey design was used in this study. Based on the random sampling strategy, 40 participants in the age range of were selected across various gyms in Gurgaon India. The participants were equally divided into two categories; light weigh-lifters (LWL) who lifted half of the body weight and heavy weightlifters (HWL) who lifted equal or more than the body weight. A questionnaire was developed, validated and administered which consists of 23 questions targeting blocking sensation, tinnitus, vertigo, temporary threshold shift and headache. Chi-square analysis revealed that higher proportion of HWL group experienced blocking sensation (65% vs 25%), tinnitus (70% vs 35%), vertigo (75% vs 40%), headache (80% vs 35%), and temporary threshold shift (60% vs 35%) then the LWL group. Strenuous exercises like heavy weight lifting can lead to various ear problems such as blocking sensation, temporary threshold shift, tinnitus, and vertigo, which, may lead to hearing loss.
Keywords: Blocking sensation, Temporary threshold shift, Tinnitus, Vertigo, Weight lifting
Introduction
Exercises such as squats and dead-lifts, are elemental full body exercises. The squat is a well‒known exercise to strengthen the muscles of the lower limb. The squat is a closed‒chain movement, requiring simultaneous extension patterns of the ankle, knee and hip joints. The deadlift is a simple and functional exercise that requires force application and transfer through the entire kinetic chain. Deadlift involves the simultaneous activation of multiple muscle groups throughout the entire body; this coordinated effort results in a significant amount of stress on the musculoskeletal system including ears. The Deadlift involves many of the large muscle groups in both lower and upper body. The deadlift is commonly performed by power lifters and weightlifters [1]. It is observed that people hold their breath while lifting to get extra strength. During the Valsalva maneuver which is the exhalation against a closed glottis, intrathoracic pressure increases and it leads to increased arterial pressure as a result of increased afterload. This increased pressure is transferred to the peripheral vascular system. Breath control during heavy exercise significantly increases intra-abdominal pressure and helps to stabilize the spine while performing the exercises [2]. Intra-abdominal pressure has been shown to increase consistently during static and dynamic lifting tasks [3]. During weight lifting, the tendency of breath holding increases as the participant lifts heavier weight. However, holding the breath during weight lifting can lead to menacing increase in blood pressure, which can lead to injury to internal organs including cochlea.
This research was executed to know the effect of heavy weight lifting on various attributes of ear. In this study we determined the damage on hearing functioning because of heavy weight lifting. The outcome of the study will be used to create the awareness about the negative impact of holding breath during heavy weight lifting task.
The primary aim of the study was to investigate the impact of heavy weightlifting on various parameters related to ears like blocking sensation, tinnitus, vertigo, headache and temporary threshold shift on light weight lifters (LWL) and heavy weight lifters (HWL).
Method
A total of 40 participants aged 18 to 30 years were involved. The participants who use any types of steroids were excluded from the study. This study was conducted using survey design method.
Participants
A systematic random sampling strategy was used to select participants from various gyms in Gurgaon. These participants were actively involved in weight lifting task for minimum one months. Participants were only included if written consent was provided. A total of 40 individuals (20 LWL and 20 HWL) were included in the study. The average age of the LWL was 22.8 years (range: 19–28; ± 2.5) and the majority (65%; n = 13) were males. On an average, they lift 0.41 times their body weight as shown in Table 1. The average age of the HWL was 23.95 years (range: 21–28; ± 1.96) and the majority (70%; n = 14) were males. On an average they lift 1.13 times their body weight as shown in Table 2. LWL includes participants who lift half or less than half the body weight. HWL includes participants who lift more than the body weight.
Table 1.
Demographic and weight lifting details of Light Weight Lifters
| S.No | Participants | Gender | Age (years) | Weight of participant (KG) | Weight lifting (KG) | Weight lifted to Body weight percentage |
|---|---|---|---|---|---|---|
| 1 | P 1 | M | 19 | 60 | 25 | 41.67% |
| 2 | P 2 | M | 22 | 58 | 25 | 43.10% |
| 3 | P 3 | F | 22 | 55 | 20 | 36.36% |
| 4 | P 4 | F | 21 | 53 | 25 | 47.17% |
| 5 | P 5 | M | 25 | 62 | 25 | 40.32% |
| 6 | P 6 | M | 23 | 65 | 25 | 38.46% |
| 7 | P 7 | M | 20 | 59 | 25 | 42.37% |
| 8 | P 8 | M | 28 | 63 | 25 | 39.68% |
| 9 | P 9 | M | 26 | 57 | 25 | 43.86% |
| 10 | P 10 | F | 22 | 53 | 25 | 47.17% |
| 11 | P 11 | M | 22 | 55 | 20 | 36.36% |
| 12 | P 12 | F | 25 | 57 | 20 | 35.09% |
| 13 | P 13 | F | 19 | 52 | 20 | 38.46% |
| 14 | P 14 | M | 23 | 58 | 25 | 43.10% |
| 15 | P 15 | F | 27 | 63 | 25 | 39.68% |
| 16 | P 16 | M | 21 | 54 | 25 | 46.30% |
| 17 | P 17 | F | 25 | 60 | 25 | 41.67% |
| 18 | P 18 | M | 23 | 58 | 25 | 43.10% |
| 19 | P 19 | M | 22 | 55 | 20 | 36.36% |
| 20 | P 20 | M | 21 | 60 | 25 | 41.67% |
| Average | 22.8 | 57.85 | 23.75 | 41.10% |
Table 2.
Demographic and weight lifting details of Heavy Weight Lifters
| S.No | Participants | Gender | Age (years) | Weight of participant (KG) | Weight lifting (KG) | Weight lifted to Body weight percentage |
|---|---|---|---|---|---|---|
| 1 | P 1 | M | 25 | 70 | 75 | 107.14% |
| 2 | P 2 | M | 27 | 68 | 75 | 110.29% |
| 3 | P 3 | M | 22 | 66 | 75 | 113.64% |
| 4 | P 4 | M | 26 | 60 | 70 | 116.67% |
| 5 | P 5 | F | 22 | 59 | 70 | 118.64% |
| 6 | P 6 | F | 21 | 63 | 70 | 111.11% |
| 7 | P 7 | M | 24 | 63 | 70 | 111.11% |
| 8 | P 8 | M | 23 | 71 | 75 | 105.63% |
| 9 | P 9 | M | 22 | 65 | 75 | 115.38% |
| 10 | P 10 | F | 22 | 60 | 70 | 116.67% |
| 11 | P 11 | M | 27 | 63 | 70 | 111.11% |
| 12 | P 12 | F | 23 | 59 | 70 | 118.64% |
| 13 | P 13 | M | 28 | 70 | 75 | 107.14% |
| 14 | P 14 | M | 24 | 67 | 75 | 111.94% |
| 15 | P 15 | M | 25 | 68 | 70 | 102.94% |
| 16 | P 16 | F | 24 | 61 | 70 | 114.75% |
| 17 | P 17 | M | 22 | 62 | 75 | 120.97% |
| 18 | P 18 | M | 25 | 64 | 70 | 109.38% |
| 19 | P 19 | M | 24 | 66 | 75 | 113.64% |
| 20 | P 20 | F | 23 | 62 | 70 | 112.90% |
| Average | 23.95 | 64.35 | 72.25 | 112.49% |
Measure
A self-developed questionnaire was used to collect data. The questionnaire consisted of five sections and a total of 23 open- and/or closed-ended questions. The five sections of the questionnaire were demographic information, Questions addressing blocking sensation, tinnitus, vertigo, headache and temporary threshold shift. The survey questionnaires were administered by trained research assistants fluent in Hindi and English. A pilot study was conducted prior to data collection. The research team comprised an audiologist and two research assistants (BASLP student trained for the purpose of the study). Each research assistant was required to administer the questionnaire on five participants who met the same inclusion criteria as for the main study. The objectives of the pilot study were to ensure the face and content validity of the questionnaire as well as to ensure that there were no discrepancies with regard to the documentation of participant responses.
Ethical Considerations
Participants were fully informed about the nature of the study and assured of confidentiality and their rights to withdraw from the study at any time without negative consequences. Ethical guidelines as per the Helsinki declaration (1964) were followed during this study. Only participants who gave written consent were included in the study. Institutional ethical approval was obtained for the study (AUH/ASLP/2022/7). All completed questionnaires were verified for completeness by the audiologist and data were captured on an Excel spreadsheet.
Statistics
Each question consists of two responses i.e., “yes” & “no”. The participants were requested to fill all the questions of the questionnaire. The questionnaire was validated by ten audiologists. This survey was done via Google form and direct face to face interview method. Shapiro–Wilk test was administered, and it was observed that the responses for all the parameters were normally distributed. Pearson chi-square test of independence was administered to compare the responses of each parameter between LWL and HWL.
Results
The results were analyzed across following domains of weight lifting task: (1) blocking sensation, (2) tinnitus, (3) vertigo (4) temporary threshold shift and (5) headache. The combined result has been shown in Fig. 1.
Fig. 1.
Percentage of response for blocking sensation, tinnitus, vertigo, headache and temporary threshold shift across heavy weight lifters and light weight lifters
For blocking sensation, there is a significant difference between HWL and LWL. HWL are more likely to have blocking sensation than LWL, X2 (1, 40) = 6.46, p = 0.011. 65% from HWL and 25% from LWL experienced blocking sensation. For heavy weight lifting, the athlete might do Valsalva maneuver, due to which the positive pressure shifted to middle ear via Eustachian tube and results into blocking sensation.
For tinnitus, there is a significant difference between HWL and LWL. HWL are more likely to have tinnitus than LWL, X2 (1, 40) = 4.912, p = 0.027. 70% from HWL and 35% from LWL experienced tinnitus. During heavy weight lifting, the athletes experienced beating, pulsing or pumping sound, this is because of increase arterial hypertension.
For vertigo, there is a significant difference between HWL and LWL. HWL are more likely to have vertigo than LWL, X2 (1, 40) = 5.013, p = 0.025. 75% from HWL and 40% from LWL experienced vertigo. As systemic arterial hypertension increases after heavy weight lifting, which may result in vertigo.
For headache, there is a significant difference between HWL and LWL. HWL are more likely to have headache than LWL, X2 (1, 40) = 8.286, p = 0.004. 80% from HWL and 35% from LWL experienced headache. Increased arterial hypertension may affects blood–brain barrier which might lead to headache.
For temporary threshold shift, no significant difference between HWL and LWL for temporary threshold shift, X2 (1, 40) = 2.506, p = 0.113. 60% from HWL and 35% from LWL experienced temporary threshold shift. HWL experienced more temporary threshold shift because of blocking sensation in middle ear along with this, increased arterial blood pressure might affects the micro-capillaries of cochlea.
Discussion
These findings suggest the hypothesis of the study that holding the breath during heavy weight lifting creates the negative impact on ears. The parameters like blocking sensation, tinnitus, vertigo, headache and temporary threshold shift were observed more in HWL as compared to LWL, as HWLs hold their breath during lifting task. Breathing ensures that the blood circulating to working muscles is oxygenated and that waste products are removed. Holding the breath during weight lifting can lead to increases in blood pressure, which can lead to internal injury. High blood pressure can affect blood vessels throughout body, including ears. Arterial hypertension occurring during heavy exercises may be a risk factor for stroke in healthy young adults [4].
Reasons for Blocking Sensation, Tinnitus and Temporary Threshold Shift
Individuals engaging in weight training may be dangerously increasing their blood pressure (BP) during exercise. With the load of weight, one will use a Valsalva technique, resulting in an increase in intrathecal pressure raising BP to extreme levels [5]. Research has linked increased rates of hearing loss in individuals with hypertension [6–8]. Holding breath during exercise has a negative impact on overall health including ears. A brief Valsalva maneuver, which exaggerates the increase in blood pressure, is unavoidable when desired force production exceeds approximately 80% maximum voluntary contraction [9]. Because of this Valsalva maneuver, the positive pressure shifted to middle ear via Eustachian tube, which leads to a sensation of blocking in the ear, tinnitus and temporary threshold shift.
Reasons for Tinnitus
There is an association between tinnitus and arterial hypertension. Arterial hypertension may affect the inner ear microcirculation [10]. The connection between sudden increase in blood pressure and tinnitus relates to the delicate network of vessels in the auditory system. When pressure builds in this system, it can result in symptoms of tinnitus. If the tinnitus symptoms include a beating, pulsing or pumping sound, it could be related to the blood pressure. After Valsalva maneuver, positive pressure is created inside the middle ear, which may lead to tinnitus. Most patients with tinnitus complain about a sensation of fullness or blockage in the middle ear, suggesting a problem with middle ear pressure [11].
Reasons for Vertigo
There is an association between vertigo and arterial hypertension. Dizziness was significantly associated with hypertension. According to studies, the 62.5% clients with increased arterial systemic hypertension reported dizziness. Dizziness was significantly associated with hypertension [12]. Abnormal blood pressures (hypertension, hypotension and orthostatic hypotension) were found in 18.67% clients who reported vertigo [13].
Reasons for Headache
Researchers reported the incidence of sport-related headache to be around 35%. Individuals participating in weight training were the second most common group of headache sufferers behind runners [14]. Sport-related headaches have been reported in relation to many activities, including weight lifting [15]. In weight lifting, the brief intense activity is believed to trigger specific headache types. During heavy weight lifting, holding a breath increases blood pressure, which may result in tinnitus, vertigo, headache, and temporary or permanent threshold shift.
Clinical Application
Clinically this study may help in development of a comprehensive test which can investigate the multidimensional impact of amateur as well as professional weight lifting on ear and its attributes. Real time assessment of hearing and its attributes along with an awareness drive among the weight lifters and other related professional athletes can ensure and preserve healthy hearing.
Future Direction
The outcome of the study also advocates the periodic screening assessment of hearing and its attributes among weight lifters. Those suspected positively can be recommended for comprehensive audiological assessment and based on this, suitable intervention program shall be provided.
Summary and Conclusion
Strenuous exercises like heavy weight lifting can lead to various ear problems such as blocking sensation, temporary threshold shift, tinnitus, and vertigo (as shown in Fig. 2). This might lead to permanent hearing loss. Good breathing technique can help you control feelings of lightheadedness. If you lift heavy weights that cause you to strain, force yourself to breathe uninterruptedly throughout the movement. Exhale through to the top of the movement, and then inhale as you return to the starting position. Holding your breath while lifting weights is not recommended, due to the strain it places on the heart and the spike it causes in blood pressure. Exercises which do not require breath holding will be a better option. Hence, one should do exercises that are ear friendly by keeping these health parameters in mind. One should not ignore any symptoms like blocking sensation, tinnitus, vertigo, headache, temporary threshold shift, and go for hearing evaluation promptly if experiencing any change in these parameters during or after a workout. Remember to reduce the amount of weight in lifting exercise to prevent excessive straining.
Fig. 2.
Summary of effect of Valsalva maneuver on attributes of ear
Acknowledgements
The support provided by Amity University Haryana is acknowledged.
Abbreviations
- HWL
Heavy weight lifters
- LWL
Light weight lifters
Author Contribution
NB, VK, MS and BG conceptualized the hypothesis of this manuscript. BG and MS collected data. Manuscript was written by NB, VK, MS and BG. The critical review and editing were conducted by NB, VK, MS and BG. All authors read and approved the final manuscript.
Funding
This study was not funded by any agency.
Declarations
Conflict of interest
Authors have no conflict of interest.
Ethical Approval
Institutional ethical approval has been obtained.
Informed Consent
Informed consent form has been signed by every participant.
Footnotes
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Contributor Information
Neelesh Benet, Email: nbenet@ggn.amity.edu.
Vijay Kumar, Email: vkumar@ggn.amity.edu.
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