Headaches happen for myriad reasons: dehydration, eyestrain, drinking a wee bit much the previous night and exercising. Yes, exercise too, and they're just as annoying as any other headache. Here's the difference between exercise headaches and regular head pains, and how you can best treat or avoid them. Illustration by Sam Woolley.
Exercise headaches are actually pretty common, and they're especially sucky since you don't even have to do anything particularly rough to get them. In fact, they're enough of an issue to be included as a headache trigger in International Headache Society's (IHS) classification of headache disorders. Previously they were referred to as exertional headaches, a broad and varied category of headaches that were also associated with coughing, sneezing and intercourse.
According to the IHS classification, exercise headaches are headaches that occur specifically during or after any form of strenuous exercise. They typically last between five minutes and less than 48 hours and can get pretty severe. You'll often feel a throbbing-like pain, which could feel like a migraine if you're sensitive to migraines.
Not everyone gets exercise headaches though, and some people get them more than others. We're still not clear on why they happen, mainly because headaches in general are so complex and can stem from any number of factors. Some researchers surmise the origin of exercise headaches may have to do with how hard exercise impacts blood flow to your brain and dilates the blood vessels there. We do know that they're more likely to happen if you exercise in hot temperatures or at higher elevations, or even when you wear special gear, like swim goggles, on too tight of a setting.
A two-part study in the British Journal of Sports Medicine explained that there are no differences in the prevalence of exercise headaches between men and women, just that their occurrence seems to be more sport specific. Exercise headaches are more commonly associated with running, cycling, weightlifting (AKA "weightlifter's" headache), swimming, rowing, tennis and many contact sports.
Make Sure It's Not Something More Serious
Here's the tricky thing about figuring out if your exercise headache points to something worrisome. The IHS lumps these and the other exertional-type headaches into categories of primary and secondary headaches. In general, primary headaches happen spontaneously for no obvious medical reason and are mostly benign. More likely, they're the result of your environment, genetics and a combination of other complex variables.
With exercise headaches, for instance, they could be a combination of dehydration, bright lights, strong smells, humid weather, the nature of the sport and simply that you're more prone to headaches in general.
A secondary headache, on the other hand, could be related to other hidden, more serious diseases and conditions, and the headache is just a symptom. They're less common than primary headaches, but are still a real possibility. There are no specific tests to say your headache is "just a headache", only tests to rule out other more troubling causes.
There are, however, certain warning signs for secondary headaches: Suddenly getting a new and unaccustomed (severe) headache, a worsening headache that lasts days, vomiting, confusion and drowsiness could indicate a serious condition like a concussion. If this is your first time getting a headache from exercise and you play sports where there's a bit of head trauma involved (constantly headbutting a soccer ball, for example), play it safe and get it checked out by a doctor, preferably a neurologist who specialises in sports-related injuries.
Since headache triggers are often mysterious and certain things can be unintentionally overlooked, you can help yourself and your doctor narrow down the causes by keeping a headache diary, where you consistently note when and why you think your headaches are happening.
Tips to Keep Exercise Headaches From Bothering You
The good news is that exercise headaches stop... once you stop exercising so hard. But for some of us athletes, fitness enthusiasts and anyone on the path to better health, that's the same as telling us to stop breathing.
So, if you'd rather not stop exercising altogether, you can lessen the intensity of your exercise program and make it lower impact (less jumping and explosive type activities) to see if the headaches still come on strongly. In really bad cases, it'd help to work together with a certified trainer on figuring out the types of exercises and positions that provoke or exacerbate your headache, and creating a program to work around them that still gives you a workout.
In addition, the findings from this study in the Current Sports Medicine Reports suggest a proper warm-up and making sure you've got the other "big rocks" of your general health in order, like your diet, recovery time and overall stress levels could help. After all, a chronic lack of sleep, a crappy diet or even previously undetected food allergies can all play a role in triggering nasty migraines and headaches.
Assuming your headaches aren't more serious in nature, here are some other ways to address them:
- Medication: Although the evidence they use is anecdotal, the IHS suggests trying prescription NSAIDs from your doctor, such as indomethacin, and taking them before exercise. Ibuprofen could work, but it's not recommended for use on a regular basis. Check with your doctor to see if it's safe for you to take these as a preventative measure.
- Breathing more: In some cases, your headache could be from a rise in blood pressure during heavy weightlifting and generally holding your breath more than you could manage, intentionally or not. Avoid doing full Valsalva breathing techniques and try to remember to breathe out forcefully during exertion.
- Eating and drinking before a workout: For some people, headaches can be a result of not being hydrated and/or eating enough before exercise. Be sure to drink enough water throughout the day, especially before and during your workout if you're going to be exercising for longer periods of time.
Most active people have had to deal with exercise headaches in one form or another. For many, these headaches tend to recur over weeks to months and eventually go away, but in rarer cases these headaches may never resolve, the authors of a paper in the journal Sports Medicine noted.
Primary exercise headaches are not dangerous in and of themselves, but it's important to get your head pain properly diagnosed by your doctor. Then, you can work with your doctor to come up with a firmer action plan to manage your headaches if needed.