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Headaches can arise from a variety of causes: insufficient hydration, eye fatigue, overconsumption of alcohol the night before, and physical exertion. Surprisingly, exercise can also trigger headaches, which are just as bothersome as other types. This article explores the distinction between exercise-related headaches and typical headaches, along with effective ways to manage or prevent them.
Exercise-induced headaches are quite common and particularly frustrating because they can occur even after mild physical activity. They are significant enough to be recognized by the International Headache Society (IHS) in their classification of headache disorders. Previously known as exertional headaches, this category includes headaches triggered by activities like coughing, sneezing, and even sexual activity.
As per the IHS classification, exercise headaches specifically occur during or after intense physical activity. These headaches usually persist for five minutes to 48 hours and can be quite intense. The pain is often pulsating and may resemble a migraine, especially for those prone to migraines.
Not everyone experiences exercise headaches, and their frequency varies among individuals. The exact cause remains unclear, largely because headaches are complex and can result from numerous factors. Some experts believe exercise headaches may be linked to changes in brain blood flow and blood vessel dilation during intense activity. Factors like exercising in hot weather, at high altitudes, or wearing tight gear, such as swim goggles, can increase the likelihood of these headaches.
A two-part study in the British Journal of Sports Medicine revealed that exercise headaches occur equally in men and women, but their frequency varies depending on the type of sport. These headaches are most often linked to activities like running, cycling, weightlifting (commonly called “weightlifter’s headache”), swimming, rowing, tennis, and various contact sports.
Ensure It’s Not a Sign of a Serious Condition
Determining whether an exercise headache indicates a serious issue can be challenging. The IHS categorizes these and other exertion-related headaches into primary and secondary types. Primary headaches typically lack a clear medical cause and are usually harmless, often resulting from environmental factors, genetics, or a mix of complex variables.
For example, exercise headaches might stem from a combination of dehydration, exposure to bright lights, strong odors, humid conditions, the specific demands of the sport, or a general predisposition to headaches.
On the other hand, secondary headaches may signal underlying serious health issues, with the headache serving as a symptom. While less common than primary headaches, they are a genuine concern. There are no definitive tests to confirm a headache is harmless; instead, tests are used to exclude more severe potential causes.
Certain red flags for secondary headaches include the sudden onset of a new and unusually severe headache, a headache that worsens over several days, vomiting, confusion, and drowsiness. These symptoms could point to a serious issue such as a concussion. If you experience your first exercise-related headache while engaging in sports with potential head trauma (like frequently heading a soccer ball), it’s wise to consult a doctor, ideally a neurologist specializing in sports injuries.
Since headache triggers can be elusive and easily overlooked, maintaining a headache diary can help you and your doctor identify patterns. Consistently record when and why you believe your headaches occur to narrow down potential causes.
Strategies to Prevent Exercise Headaches
The positive aspect is that exercise headaches typically subside once you reduce the intensity of your workout. However, for athletes, fitness enthusiasts, or anyone committed to improving their health, this advice can feel as impractical as being told to stop breathing.
If you prefer not to quit exercising entirely, consider lowering the intensity and impact of your routine (avoiding activities like jumping or explosive movements) to see if the headaches persist. In severe cases, collaborating with a certified trainer to identify exercises or positions that trigger or worsen your headaches can help design a modified workout plan that still keeps you active.
Additionally, research published in the Current Sports Medicine Reports indicates that a thorough warm-up and maintaining key aspects of your health—such as diet, recovery, and stress management—can be beneficial. Chronic sleep deprivation, poor nutrition, or undiagnosed food sensitivities may all contribute to triggering severe migraines and headaches.
If your headaches are not linked to a serious condition, here are some strategies to manage them:
Medication: While based on anecdotal evidence, the IHS recommends prescription NSAIDs like indomethacin and ergotamine tartrate, taken before exercise. Ibuprofen may also help but isn’t advised for regular use. Consult your doctor to determine if these are safe for preventive use.
Improve Breathing: Headaches can sometimes result from increased blood pressure during intense weightlifting or unintentional breath-holding. Avoid full Valsalva maneuvers and focus on exhaling forcefully during exertion.
Pre-Workout Nutrition: For some, headaches stem from inadequate hydration or insufficient food intake before exercising. Ensure you drink plenty of water throughout the day, particularly before and during prolonged workouts.
Many active individuals experience exercise headaches at some point. According to a study in the journal Sports Medicine, these headaches often recur over weeks or months before subsiding, though in rare cases, they may persist indefinitely.
While primary exercise headaches are not inherently dangerous, it’s crucial to have your symptoms properly evaluated by a doctor. This allows you to develop a tailored plan to manage your headaches effectively if necessary.
Illustration by Sam Woolley.
