“What does the Valsalva maneuver have to do with periodization?” you may rightfully ask. In a classical understanding of periodization, the Valsalva maneuver has nothing to do with periodization. Periodization is mainly about set and rep schemes.

The notion that in a classical understanding of periodization, the Valsalva maneuver has nothing to do with periodization illustrates one of the biggest challenges in the world of training. On one hand, the teachings of different topics are fragmented, which means that many of us can have a hard time making sense of different topics and seeing their correlation. On the other hand, if all aspects of training were taught as one big topic, that would be confusing as well. Thus, the balanced approach would be to learn about a given topic and then correctly place this knowledge in context.

In this particular context, the challenge is to create the best possible periodized training program. At the same time, we want to remember that it is probably better to have a not so good program that is properly instructed and perfectly executed than to have a “perfect” program that is poorly instructed and poorly executed. Thus, within the context of the flexible periodization method, there is complete awareness that a great program isn't enough. When the program is made, it must be properly instructed (and then executed, supervised, and refined).

Effective exercise instruction is a science as well as an art form. I consider exercise instruction so important that I have developed an entire one-day workshop on the topic titled "The Art of Exercise Instruction." Intimately linked with exercise instruction is, of course, optimal exercise technique. An absolute key aspect of exercise technique is an optimal breathing pattern, a potentially controversial topic. Some authorities are of the opinion that breathing shouldn't be taught, that optimal breathing will take care of itself. I agree that some athletes breathe optimally without ever being taught a single word about breathing, but they are the rare exception, not the rule.

When I discuss the issue of the necessity of teaching breathing with strength coaches and personal trainers, I state that if they know how to teach proper breathing, they can choose to teach it to athletes who need to be taught how to breathe optimally and can keep their mouths shut when they work with athletes who already breathe optimally. On the other hand, if you have adopted the mindset that “breathing takes care of itself,” you won’t be able to help those athletes who need to be taught optimal breathing.

One of the most important lessons about optimal breathing is that there are different breathing techniques for different purposes or outcomes (1). The type of breathing that I will cover in the next two columns is breathing to enhance maximal strength. I recognize the need for belts in certain situations, but I have never recommended belts to any athlete who I have worked with except for powerlifters.

My first introduction to forced exhalation techniques was through Pavel Tsatsouline. Today, I teach a method of forced inhalation/forced exhalation that I have dubbed “French press diaphragmatic breathing” (FPDB). I will share the physiology behind the method as well as the progression used to teach it, including the specific cues used and taught during my workshops and work with individual athletes.

Roland Ens, certified personal trainer and competitive bodybuilder, provided the testimonial regarding the FPDB method: "One seminar in particular that I really enjoyed was ‘A Course in Breathing.’ My favorite technique that I was taught was the French press diaphragmatic breathing technique. This technique alone has helped my clients increase their core strength and lifts. I have two partial hernias that haven't gotten any worse and, in fact, have healed due to being taught this technique. Clients of mine who have suffered hernias have also had great success in lifting and core training due to this technique. With the education offered in this seminar, I have had clients do hands-on tests on themselves by placing fingers in specific areas of their core, which allows them to feel the techniques working."

Breathing to enhance maximal strength

When breathing to enhance maximal strength, a key purpose is to increase intra-abdominal pressure and stabilize the spine during heavy lifts (2). Pressure is a measure of force per unit of area. The abdominal cavity contains mainly fluid and very little gas and is therefore virtually incompressible. During inhalation, the diaphragm sinks into the abdominal cavity. If, during inhalation, the abdominal muscles are engaged to prevent an expansion of the abdominal wall, the result is an increase in pressure, manifested as force vectors directed up, out, and down and sometimes described as a fluid ball. This fluid ball may create a "lift force," thus supporting the erector spinae muscles in their efforts to maintain a neutral spine during various lifts (3).

French press diaphragmatic breathing (FPDB)

The FPDB involves a combination of forced inhalation and forced exhalation with the diaphragm acting as a “piston” that moves downward into the abdominal cavity much like the press in a French press bottle. The French press bottle doesn't expand when the piston is pressed down. Likewise, the abdominal wall shouldn't expand as you inhale (for maximal strength). Hence, the French press breathing analogy.

The purpose of FPDB is to increase intra-abdominal pressure by virtue of the pneumo-muscular reflex (increased motor drive to non-respiratory muscles modulated by voluntary breathing) and mechanical artifacts (the direct effect of inhalation and exhalation on the position of the bones that are involved with the specific muscles) and increase the peak force generated (4).FPDB involves the intent to “breathe down the back of the ribcage” (10) (see step four of the technique exercises). No controlled scientific study seems to support the notion that it is possible to “breathe down the back of the ribcage” or, if desired, ”breathe down the front of the body.” However, the diaphragm is a three-part muscle with sternal, costal, and lumbar origins and an insertion in a central tendon. The diaphragm is also supplied by three different nerves (from C3, C4, and C5) (11). It can be speculated that consciously trying to breathe “down the back of the body” may emphasize activation of the lumbar portion of the diaphragm, potentially facilitating the previously discussed lift force. I'm confident that you will feel the difference if you try the exercises.

The Valsalva maneuver is an expiratory effort against a closed epiglottis and can—like FPDB—increase intra-abdominal pressure as well as momentarily triple the blood pressure (5).If the athlete/client isn't trained in forced exhalation techniques, the Valsalva maneuver is unavoidable when the desired force production exceeds 80 percent maximal voluntary contraction (MVC), the “isometric 1RM” (6).It is hypothesized that forced exhalation results in increases in blood pressure but not to the same degree as the Valsalva maneuver. One study showed no increase in peak force from the Valsalva maneuver compared to forced exhalation during multi-joint lifts and the authors recommended forced exhalation during lifting (4).

Eighty percent of MVC might be reached at even lower percentages of one repetition maximum during dynamic contractions due to the effect of acceleration and deceleration during dynamic movements. To be more on “the safe side,” keep the intensity for any hypertensive athletes below 75 percent of 1RM (or lower).

Some believe that many recreationally active fitness enthusiasts don’t perform a full Valsalva maneuver (“bearing down”) but are simply holding their breath. This study showed that ten repetitions at 60 percent of the 1RM, tempo equals three seconds per repetition, performed with a breath holding technique (inhaling on the lowering phase and simply holding the breath on the exertion) that resulted in only moderate and safe increases in systolic blood pressure (7).

When to use FPDB exercise

FPDB can be used in any kind of strength and power training, thus FPDB is used in all blocks of the flexible periodization method except for the restoration and active rest block. FPDB must be used with intensities above 75 percent of 1RM, as a Valsalva maneuver is otherwise unavoidable at that level of intensity (75 percent of a 1RM corresponds roughly to a 10RM load).

Muscle tone is defined as “the resting tautness or laxity of a muscle, ideally somewhere in the middle of the range between total contraction and total relaxation. Tone is important for good function of the body” (8). Lack of tone of the muscles that control the abdominal wall becomes very apparent as the abdominal wall will be “hanging out.” Early on, I made an empirically-based decision to make sure that the tone of the abdominal wall is optimal before engaging in exercises that require the abdominal wall to stay flat.

The young athlete is built up to FPDB through eight steps:

Step 1: Explain the anatomy of the diaphragm to the athlete.

Step 2: Explain the French press coffee analogy to the athlete.

This column discussed the rationale for systematically teaching breathing techniques and the physiology behind so called “French press diaphragmatic breathing” as well as the first two steps of an seven-step progression used to build up a young athlete to this style of breathing. Watch out for part two of this series where you'll learn steps three through seven.


  1. Jensen K. A Course In Breathing, 8-hour workshop. www.yestostrength.com.
  2. Siff M (2000) "Factors Influencing Strength Production." In: Supertraining. Denver: Supertraining Institute, pg. 171.
  3. Harmann E (2008) Biomechanics of Resistance Exercise: Essentials of Strength Training and Conditioning. 3rd Ed. Human Kinetics, pg. 85.
  4. Ikeda ER, Borg A, Brown D, Malouf J, Showers KM, Li S (2009) The Valsalva Maneouver Revisited: The Influence of Voluntary Breathing on Isometric Muscle Strength. J Strength Cond Res 23(1):127–32.
  5. Narloch NA, Brandstater ME (1995) Influence on breathing technique on arterial blood pressure during heavy weight lifting. Arch Phys Med Rehabil 76(5):457–62.
  6. MacDougall JD, McKelvie RS, Moroz DE, Sale DG, McCartney N, Buick F (1992) Factors affecting blood pressure during heavy weight lifting and static contractions. J Appl Phys 73(4):1590–7.
  7. LepLey AS, Hatzel BM (2010) Effects of Weightlifting and Breathing Technique on Blood Pressure and Heart Rate. J Strength Cond Res 24(8):2179–83.
  8. Chek P. The Inner Unit.
  9. Pilsborg T. Personal communication. http://pilsborgholm.dk/tomas.
  10. Kendall FP, McCreary EK, Provance PG (1993) "Facial, Eye and Neck Muscles: Muscles of Deglutition and Respiratory Muscles." In: Muscles Testing and Function, 4th Ed. Williams and Wilkins, pgs. 323–30.