Why Some Lifters Bleed During Max Lifts (How Common Is It?)

Many strength athletes have either bled or at least seen another lifter bleed during a maximal lift in their career. It’s not very common, and tends to happen most when lifters perform supra-maximal loads, or an amount of work that taxes the body to an extreme. A few areas you might see a lifter bleed from are the nose, ears (not common), and scalp (least common).

To the non-lifter, this act looks like something other-worldly and leaves them with a dropped jaw saying, “Oh my gosh,” or even, “And that’s why I don’t lift.” A weathered strength athlete understands there’s always a risk going into any heavy lift, so it’s often less shocking to those lifting than those witnessing.

Larry “Wheels” Williams recently posted a video of himself deadlifting 826×3, which left him with blood dripping from his head down his chest. When I was doing my daily dose of Instagram scrolling in the comments, I was surprised at how many people (usually non-elite lifters) were saying, “Why the hell is that happening?”

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All of the confused questions got me to thinking – Do strength athletes really know why some lifters bleed during supra-maximal lifts?

I reached out to strength coach John Gaglione, Owner of Gaglione Strength, for insights on this topic. The first point he stressed was for those who cringe at seeing bloody videos to understand the difference in lifting recreationally and being a competitive elite strength athlete.

Reasons Lifters Might Bleed During Maximal Loads

1. Blood Pressure

Heavy lifting increases blood pressure in the moment. Yes, lifting helps maintain a healthy blood pressure over time, but in the moment as you’re performing maximal lifts, pressure will be higher. This is due to increased heart rate, pressure on the body (abdominal/thoracic cavity), and amount of blood flow needed to produce the work.

Keep in mind, it’s not as simple as blood pressure alone. Gaglione talked about how you’ll see a lot of elite powerlifters (often in the heavier divisions) carrying extra weight, which can inherently contribute to higher blood pressure. When you factor in things like an elite athlete’s weight, lifestyle, and maximal loads (intensity of lifts), then you’ll see a lifter be more prone to bleeding.

Another point Gaglione mentioned, is that the recreational lifter who has a normal weight and lives a healthy lifestyle (outside of the gym) will be much less likely to bleed during maximal loads. Those worrisome of bleeding during heavy lifts shouldn’t worry, as it’s unlikely for those who aren’t at an elite strength level or in a peaking phase.

2. Valsalva Maneuver

The Valsalva maneuver is the voluntary manipulation of air in the body to create increased tension and pressure during lifts. When a coach instructs you to breathe in and hold your air throughout a lift, then you’re performing the Valsalva maneuver. This style of breathing increases blood pressure and tension on the body by preventing oxygen to flow as freely.

3. Powerlifting Gear

Powerlifting gear is another contributor to the build up of pressure during max lifts. Gaglione discussed how knee wraps, deadlift suits, ammonia, and belts all increase tension and pressure on the body. When you wear powerlifting equipment, the reasoning is to increase your body’s tension and pressure. Gaglione pointed out that sometimes the extra gear can push someone over their natural threshold.

4. Type of Exercise

Compound movements that require a heavy demand on the body to maintain tension and pressure can also contribute to bleeding. A study performed on blood pressure and heavy-resistance training found that squats and deadlifts put the most strain on blood pressure. This is due to their demand on thoracic and abdominal pressure.

5. Environment

This is a lesser point, but environment can also play a role in the likeliness of a lifter bleeding. For example, training in dry and cold areas, or even at high altitudes can cause lifters to be more susceptible to springing a leak.

6. Nutrition

Another unlikely, but plausible factor, that can cause a lifter to bleed is their diet. For example, if a lifter is low in vitamin C, K, B-9/12, and iron (to list a few), then they can be more likely bleed. This point, like environment is unlikely, but it’s a point to consider if you find yourself experiencing things like nosebleeds frequently.

Factors to Consider and How to Manage

To conclude our talk, Gaglione wanted to stress the reality of bleeding from maximal lifts. Also, the difference in bleeding’s prevalence between elite athletes and recreational lifters.

1. It Doesn’t Happen Often

Gaglione wanted to stress that the recreational lifter, or even novice powerlifter shouldn’t worry about bleeding during heavy lifting. Videos that become popularized where a lifter is bleeding are few and far between, and that shouldn’t be a determinate when considering working out or getting into powerlifting. Like mentioned above, the normal powerlifter or recreational lifter will be far less likely to experience any form of bleeding during lifts.

2. Inherent Risks and Times of Risk

Much like any sport, working out and powerlifting come with inherent risks. A powerlifter’s sport revolves around moving maximal loads and preparing for competitions. This being said, Gaglione pointed out that as a powerlifter progresses in training there will always be somewhat of a risk for bleeding during max attempts. A strong point he made was that if done properly it can be minimized.

A powerlifter following a well-made program will often experience limited occasions where they might bleed during a max attempt. These occasions often occur during peaking phases of training cycles and are constructed to last for a short amount of time as you prep for competition, Gaglione said. The important thing to know is that there is a risk, but if strategized properly, then it’s only for a short duration and can be limited.

All In All

Much like any sport, powerlifting and lifting maximal weight comes with some inherent risks. In terms of frequency with normal lifting they’re minimal, but always possible.

If you experience exceptional amounts of bleeding often while lifting, then you should seek medical attention to assess and identify an underlying issue.

Feature image screenshot from KigerStrength YouTube channel.