Does Inversion Therapy Help Decompression?

You may have read about or witnessed some of the hype surrounding David Blaine’s most recent stunt which involved him “hanging upside down” for 60 hours, including some of the health concerns expressed by his medical advisors. Do the risks of performing a stunt like this apply also to the practice of inversion as a health and fitness activity? We’ll attempt to answer some of your questions.

The effects of long-term inversion, where an individual is suspended for hours on end without movement or changing body position, are generally speculated. What is generally accepted principal is that any posture, held without movement for excessive periods of time, can generate negative side effects, most notably to the circulatory system. Similar concerns regarding stress on internal organs and circulation exist whether someone remains sitting in one position for 60 hours as would if they were inverted for 60 hours. The body simply requires movement and changing postures to function most efficiently. That is the reality of life on this planet and the effects of gravity on the human body. Even Blaine himself rested for several minutes every hour and was able to maneuver his head and legs to relieve the stress of remaining in one position for so long.

When you consider the risks of hanging upside down for 60 hours versus inversion for fitness, you’re not comparing apples to apples. Most people who invert for fitness (whether they do so on an inversion table, in a yoga stance or through some other means) do so to relieve stress and stretch out – and this can be accomplished in as little as a few minutes a day. Some people invert for 5 minutes up to 20 – the length of time is really determined by the person’s own experience and comfort level. The most effective inversion sessions incorporate some kind of movement to help mobilize the joints. Many people enjoy the sensation of oscillation, a rhythmic rocking up and down using an inversion table, which helps them experience many of the benefits of inversion without the pressure in the head that they may experience from “static” inversion (inversion without movement).

Can inversion cause a stroke?
A medical study published in 1983 by Dr. Goldman and colleagues showed that inverted patients experienced a temporary increase in blood and intraoccular pressure. They concluded that “there is concern with full static inversion in individuals with a history of hypertension, cardiovascular disease and stroke,” and recommended that “general caution” be observed. Media outlets misinterpreted the findings of the study, warning that stroke was a potential result of inversion. However…

Two years after, Dr. Goldman and colleagues published results of a follow up study and noted that 15 minutes of inverted oscillation resulted in progressive decrease in both blood and intraocular pressure. Goldman reversed his original position, asserting the opinion that you are at no more of a stroke risk hanging upside down than if you are exercising right side up.

" The risk of stroke expressed in previous studies appears to be exaggerated. CSF [cerebral spinal fluid] pressure increased as well, therefore supporting and protecting the vessels from hemorrhage. There have been no reports of stroke, cerebrovascular accident, or any serious injury with properly functioning gravity inversion equipment.”

(This statement, to the best of our knowledge, is as true today as when Dr. Goldman made it over twenty years ago). Other universities, including Marquette, Iowa, and Portland studied inversion during this time, with results that also helped to vindicate Inversion as a healthy physical activity.

Goldman's research indicated that the body actually has mechanisms that adjust to the changes in pressure and prevent damage - the increase in cerebral spinal fluid supports and protects the vessels. Another study by Wilkins evaluated the effects of the head-down position in a simulated “negative G” experience (as a pilot would experience), finding that venous and arterial hypertension in the head changed with inversion and that the increase in cerebral venous pressure is less than might otherwise be expected.

Will inversion cause blood to “pool” in your head?
The body accommodates for the changing blood pressure by dilating the vessels and capillaries and increasing the cerebral spinal fluid to support the vessels. Will you feel increased pressure and will your face turn red? Probably. The redness is a result of the increased blood flow and dilation of the capillaries, which actually brings more oxygen to the brain, eyes, skin and hair. That feeling of pressure (caused by a reversal of the hydrostatic column) is actually occurs outside of the skull in the face and eyes. Inside the skull, there are compensating pressures, as discussed above. Any discomfort caused by the superficial pressure changes usually lessens over time as you become accustomed to inverting.

TIP: The best way to acclimate to inversion is to start slowly. Begin at an angle of 20-30 degrees and work up to greater angles over time. This will help to train the autonomic nervous system to being upside down and the body will adjust to inversion quicker so that you’re able to relax and feel the benefits without discomfort.

Can inversion cause blindness?
The effects of excessive inversion (as performed by Blaine in his recent stunt) are not widely known or studied. As reported by the BBC News (September 24, 2008):

On the plus side for Blaine, while the US media have reported that blindness could be one of the dangers he faces, they appear to be wrong. Rob Scott, of the Royal College of Ophthalmologists, an expert in aviation medicine, says there should be no long-term damage to his eyesight from the stunt.

As for short term inversion, or inversion for fitness, it is important to note that inversion does cause some pressure changes within the eye. We generally recommend that anyone with an eye condition speak with a doctor prior to inverting.

Is the human body meant to be upside down?
Inversion is an activity that comes naturally to us in all stages of life:

As fetuses, we all develop in the near-weightless environment of our mothers' wombs. During the last trimester, we actually turn upside-down to assist with brain development.
As infants, we often slept bottoms-up! Keeping our heads lower than our hearts, we encouraged an adequate supply of blood and oxygen to our brain for development.
As children, we love to "escape from gravity" by riding the swings or hanging upside down on the monkey bars.
As adults, we prop our legs and feet on desks or stools to compensate for gravity's constant presence.

Inversion is NOT a “no pain, no gain” activity. Inversion therapy is a gentle activity that can bring immediate as well as subtle benefits to your body. Your body is your own expert in telling you what is good for it. If your body experiences discomfort after a period of time while inverted, you should rest. The benefits of inversion are best achieved with relaxation and in moderation. Equipment like inversion tables are a great way for people to ease into the practice by beginning at slight angles and working up over time. Most beginners won’t feel comfortable inverting fully upside down right away, but many do over time (over 50% of our own customers, by survey).

IN THE NEWS: Is hanging upside down dangerous? September 2008

IN THE NEWS:
Is hanging upside down dangerous?
September 2008