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General Resistance Training and Glaucoma: Building Strength While Managing IOP Spikes · Glaucoma, Vision & Longevity: Supplements & Science

• 0:00
  SPEAKER_00: General Resistance Training in Glaucoma Building Strength while managing IOP spikes.
• 0:05
  SPEAKER_00: Introduction.
• 0:06
  SPEAKER_00: Strength training is a proven way to boost fitness, control weight, improve blood sugar and blood pressure, and build muscle and bone.
• 0:14
  SPEAKER_00: Benefits that reduce risk of diabetes, heart disease, and falls in older adults.
• 0:20
  SPEAKER_00: However, for people with glaucoma, a disease caused by damage to the optic nerve, often from high eye pressure, heavy lifting can briefly spike intraocular pressure inside the eye.
• 0:31
  SPEAKER_00: Since high IOP is the main modifiable risk factor for glaucoma progression, we must find a balance.
• 0:37
  SPEAKER_00: Enjoy the health perks of resistance exercise while keeping IOP under control.
• 0:43
  SPEAKER_00: Why strength training matters?
• 0:45
  SPEAKER_00: Resistance exercises, like lifting weights or using bands, help maintain metabolic health and strength as we age.
• 0:52
  SPEAKER_00: Regular strength training lowers body fat and abdominal obesity, improves insulin sensitivity and blood sugar control, and even modestly reduces blood pressure.
• 1:01
  SPEAKER_00: This combats features of metabolic syndrome, which raises diabetes and heart disease risk.
• 1:06
  SPEAKER_00: Strength workouts also fight sarcopenia, age-related muscle loss, and osteoporosis, bone thinning, keeping older adults stronger and more independent.
• 1:17
  SPEAKER_00: Importantly, studies show that stronger muscles and better balance from resistance training dramatically reduce fall risk in seniors.
• 1:25
  SPEAKER_00: In short, smart strength training can improve overall health, mood, and quality of life while helping prevent fractures.
• 1:32
  SPEAKER_00: How lifting affects eye pressure.
• 1:35
  SPEAKER_00: Although exercise often lowers IOP after a workout, heavy or strained lifting can acutely raise IOP.
• 1:42
  SPEAKER_00: We briefly review key findings.
• 1:44
  SPEAKER_00: Dynamic versus isometric, static hold, lifts, load intensity, breath holding, and head position.
• 1:50
  SPEAKER_00: Heavy versus moderate loads, multiple studies find that heavier weights cause bigger IOP spikes.
• 1:56
  SPEAKER_00: For example, one review noted that lifting heavy loads and using multi-joint exercises like squats or bench press produce the greatest IOP increases.
• 2:05
  SPEAKER_00: In a leg press study, lifting 95 Bronz max 1RM caused IOP jumps of 27 millimeter on average, reaching 40 millimeters absolute, well above normal, often 12 to 15 millimeter hergrams.
• 2:17
  SPEAKER_00: Even moderate heavy sets, six reps at 75% 1RM, raised IOP by 24 millimeter hergrangs.
• 2:24
  SPEAKER_00: By contrast, lighter weights cause smaller spikes.
• 2:28
  SPEAKER_00: One analysis suggests that using only 20 to 30% of 1RM, often combined with blood flow restriction, can still build muscle, but with much lower pressure changes.
• 2:37
  SPEAKER_00: In practice, choosing moderate weights, e.g., starting around half to two-thirds of your 1RM, and doing more repetitions tends to produce smaller IOP rises than max effort lifts.
• 2:48
  SPEAKER_00: Dynamic versus isometric lifting.
• 2:50
  SPEAKER_00: Both moving exercises and static holds can raise IOP, but their effects may differ.
• 2:55
  SPEAKER_00: A study comparing three types of leg exercises found that maximal lifts, one rep at 95% 1RM, and a static isometric push against an immovable load both caused similar large IOP spikes, 27-29 mH increase, whereas multiple reps at 75%, 6RM, caused slightly smaller spike, 24 mmhergrams.
• 3:16
  SPEAKER_00: In other words, holding a heavy weight still causes dramatic pressure jumps comparable to lifting heavy.
• 3:22
  SPEAKER_00: Earlier work with bench press showed the same.
• 3:25
  SPEAKER_00: Just lifting a heavy weight caused IOP to rise by a few millimeterhergrams, but if the trainee held their breath, turning it into a quasi-isometric effort, the increase was even larger.
• 3:36
  SPEAKER_00: In summary, static straining, isometric effort tends to raise IOP very sharply, often as much or more than dynamic lifts.
• 3:45
  SPEAKER_00: The Valsalva maneuver, breath holding, holding your breath while straining the valsalva maneuver hugely increases IOP.
• 3:52
  SPEAKER_00: Studies show that any effort involving a closed glottis strain drives up chest and abdominal pressure, which transmits to the eye.
• 3:59
  SPEAKER_00: In some reported cases, brief valsalva maneuvers shot IOP over 40 to 50 millimeter her grams.
• 4:05
  SPEAKER_00: One bench press study found that breath holding during the lift raised mean IOP by 4.3 millimeters range range up to plus 17.7 mm versus only plus 2, 2 mmHH when breathing normally.
• 4:17
  SPEAKER_00: In practical terms, never hold your breath or strain forcefully while lifting.
• 4:21
  SPEAKER_00: Exhale on the exertion.
• 4:23
  SPEAKER_00: Even gentle valsalva, like a deep breath, can add several moment grounds of pressure, so staying relaxed and breathing steadily is critical.
• 4:30
  SPEAKER_00: Body position, head-down lifts.
• 4:33
  SPEAKER_00: Inverted or head-down positions greatly elevate IOP.
• 4:36
  SPEAKER_00: Yoga studies show that poses like downward dog or plow increase eye pressure substantially.
• 4:42
  SPEAKER_00: One analysis noted that even a modest head-down tilt rapidly elevates IOP and keeps it high for minutes.
• 4:49
  SPEAKER_00: In practice, exercises that put your head below your heart, bending far forward, inverted lifts, or lying flat on back, should be minimized.
• 4:58
  SPEAKER_00: For example, when performing lower body lifts like leg presses, keep an upright neck and avoid deep forward bends.
• 5:04
  SPEAKER_00: In yoga and other routines, avoid prolonged inverted poses, e.g.
• 5:09
  SPEAKER_00: downward facing dog, seated forward fold, headstands.
• 5:12
  SPEAKER_00: In summary, strenuous lifting, heavy loads plus valsalva plus poor head position causes large IOP spikes.
• 5:19
  SPEAKER_00: But controlled, moderate intensity training, no breath holds, upright posture limits those spikes.
• 5:25
  SPEAKER_00: Safe strength training guidelines.
• 5:27
  SPEAKER_00: The good news you can still lift weights safely with glaucoma by following a careful protocol.
• 5:32
  SPEAKER_00: Moderate loads and higher reps.
• 5:35
  SPEAKER_00: Use sub-maximal weights.
• 5:37
  SPEAKER_00: For example, weights you can lift 10 to 15 times instead of 1 to 5 times.
• 5:41
  SPEAKER_00: A sensible target is 5 to 8 exercises for major muscle groups, performing 10 to 15 repetitions per set at roughly 50 to 70% of your 1RM.
• 5:51
  SPEAKER_00: In contrast, avoid very heavy singles or low rep sets at 80 to 90% loads.
• 5:58
  SPEAKER_00: Moderate weight means the effort feels challenging but not maximal.
• 6:02
  SPEAKER_00: For example, leg pressing or squatting with half your maximum weight will cause far smaller pressure rises than straining with near maximal loads.
• 6:10
  SPEAKER_00: Breathing, no valsalva.
• 6:12
  SPEAKER_00: Exhale steadily during the lifting strain phase and inhale on the return.
• 6:17
  SPEAKER_00: Never hold your breath.
• 6:18
  SPEAKER_00: A telling study found bench press IOP increases went from 2 mm to 4 mm g simply by breath holding.
• 6:26
  SPEAKER_00: Good rhythm.
• 6:27
  SPEAKER_00: Exhale when pushing, pulling prevents the big pressure surges of breath holding.
• 6:31
  SPEAKER_00: Avoid straining or max effort.
• 6:33
  SPEAKER_00: Stop each set well before failure.
• 6:36
  SPEAKER_00: Do not push the last rep if it forces you to gasp or hold breath.
• 6:39
  SPEAKER_00: Avoid maximal static holds entirely.
• 6:42
  SPEAKER_00: Even a 10-second all-out leg push spiked IOP 28mm hergrams in one study.
• 6:48
  SPEAKER_00: In practice, choose weights that allow comfortable breathing and form throughout each set.
• 6:53
  SPEAKER_00: If you find yourself gripping near max and feeling pressure buildup, lighten the load or skip that set.
• 6:59
  SPEAKER_00: Proper positioning.
• 7:00
  SPEAKER_00: Keep your head level or higher than your heart.
• 7:02
  SPEAKER_00: Perform exercises standing, seated, or lying face up, not prone or inverted.
• 7:08
  SPEAKER_00: Avoid exercises that tuck your chin to chest or tilt head down, e.g.
• 7:12
  SPEAKER_00: deep forward barbell bends or certain plank variations.
• 7:16
  SPEAKER_00: If using machines like a leg press or seated row, ensure you aren't arching or bending low in a way that lowers the head too much.
• 7:24
  SPEAKER_00: Rest between sets.
• 7:25
  SPEAKER_00: Allow at least one to two minutes of rest between sets.
• 7:29
  SPEAKER_00: Research has shown that IOP spikes during a lift normalize within seconds after stopping, giving brief rest and breathing calmly.
• 7:37
  SPEAKER_00: Let's your eye pressure return to baseline before the next set.
• 7:42
  SPEAKER_00: Monitor effects.
• 7:43
  SPEAKER_00: Pay attention to any symptoms like eye pain, blurred vision, or halos during or after exercise.
• 7:50
  SPEAKER_00: These could signal unsafe pressure spikes.
• 7:53
  SPEAKER_00: It's wise to get a baseline IOP check and then discuss your exercise plan with your eye doctor.
• 7:58
  SPEAKER_00: Portable home tonometers are uncommon, but be vigilant about eye symptoms and follow your doctor's advice on regular pressure checks.
• 8:05
  SPEAKER_00: Always stop the exercise if you feel strained and see a sudden change in vision.
• 8:10
  SPEAKER_00: Weighing benefits versus risks.
• 8:12
  SPEAKER_00: While heavy lifting can raise concern, remember the overall benefits of being active.
• 8:17
  SPEAKER_00: Moderate strength training can lower IOP over time and help your general health.
• 8:22
  SPEAKER_00: Some studies show that after completing an exercise session, even resistance, IOP often drops below baseline and stays lower for a while.
• 8:31
  SPEAKER_00: Plus, fitter individuals tend to have smaller pressure spikes.
• 8:35
  SPEAKER_00: Nonetheless, nobody suggests weightlifting is completely risk-free for glaucoma.
• 8:40
  SPEAKER_00: In fact, several reviews caution that abrupt IOP surges could contribute to glaucoma progression.
• 8:46
  SPEAKER_00: Therefore, glaucoma patients are encouraged to exercise with care.
• 8:51
  SPEAKER_00: Regular cardiorespiratory exercise, walking, cycling, swimming, is clearly safe and beneficial, and strength training can be included if done wisely.
• 9:00
  SPEAKER_00: Post-surgery and monitoring advice.
• 9:03
  SPEAKER_00: After any eye surgery, glaucoma surgery, cataract removal, retinal surgery, etc., special care is needed.
• 9:09
  SPEAKER_00: Follow your surgeon's rules.
• 9:11
  SPEAKER_00: Doctors vary by procedure, but common advice is to pause strenuous exercise for a period.
• 9:16
  SPEAKER_00: For example, after refractive surgeries like LASIK, most surgeons recommend no heavy workouts for about two weeks.
• 9:23
  SPEAKER_00: After cataract surgery, patients are advised to avoid heavy lifting or head below waist activities for at least several days to a week.
• 9:32
  SPEAKER_00: After a trabeculectomy or glaucoma shunt, you might be told to avoid bending, straining, or lifting any weight for several weeks.
• 9:40
  SPEAKER_00: These limits protect the healing eye from pressure spikes or strain that could disrupt surgical outcomes.
• 9:47
  SPEAKER_00: Gradual return to training.
• 9:49
  SPEAKER_00: Once cleared by your eye doctor, often after four to six weeks, resume exercise very gradually.
• 9:55
  SPEAKER_00: Start with light movements like walking or gentle cycling.
• 9:59
  SPEAKER_00: You can then reintroduce very lightweight resistance sessions, e.g., bodyweight exercises or very light bands, after a month or so, checking in that you have no pain or visual issues.
• 10:10
  SPEAKER_00: Only after about six to eight weeks, or longer, depending on advice, should you attempt moderate weights and only if your doctor confirms your eye is stable.
• 10:19
  SPEAKER_00: When you restart lifting, follow all the above safety guidelines, moderate load, careful breathing, etc.
• 10:26
  SPEAKER_00: Ongoing monitoring.
• 10:28
  SPEAKER_00: Have your IOP and eye exams monitored regularly.
• 10:31
  SPEAKER_00: It's wise to discuss weight training with your ophthalmologist.
• 10:35
  SPEAKER_00: They may advise more frequent pressure checks or pauses in training if your glaucoma is not fully controlled.
• 10:41
  SPEAKER_00: Also, keep an eye out for warning signals.
• 10:44
  SPEAKER_00: New blotches of vision, floaters, or flashes, increasing blurriness or eye pain mean you should stop exercise and seek care.
• 10:52
  SPEAKER_00: Conclusion: resistance training can and should be part of a healthy lifestyle, even in glaucoma, because of its proven benefits for metabolism, strength, and fall prevention.
• 11:02
  SPEAKER_00: The key is how you train.
• 11:04
  SPEAKER_00: Avoid heavy, maximal lifts, breath holding, and inverted positions, which cause IOP spikes.
• 11:10
  SPEAKER_00: Instead, use moderate weights with more reps, breathe properly during each rep, rest adequately between sets, and steer clear of pushing to failure.
• 11:19
  SPEAKER_00: By following a careful protocol, many people with glaucoma can safely build strength without unduly raising their eye pressure.
• 11:28
  SPEAKER_00: Always communicate with your eye doctor about your workout routine, especially after any eye surgery, and watch your eyes for any changes.
• 11:36
  SPEAKER_00: With smart training and monitoring, you can preserve both your vision and your health.
• 11:41
  SPEAKER_00: All links to sources are available in the text version of this article.
• 11:45
  SPEAKER_00: You can find the full article at VisualFieldTest.com.
• 11:49
  SPEAKER_00: Thanks for listening.
• 11:51
  SPEAKER_00: To check your visual field, click the link at the bottom of this article or visit visualfieldtest.com.