When Exercise is a Headache

I’d like to begin this post with this understatement: physical activity has a number of health benefits. I’m not sure I could find someone to sincerely counter this statement. Physical activity has so many health benefits that we often forget that the road to physical fitness, improved body composition, athletic skill and the like also has some particularly unsavory things in store. These dangers include joint and muscle aches, stress fractures, and… headaches?

When I was in high school, I experienced a headache at the end of a morning swim practice. Towards the end of practice, I began to feel light headed, but assumed I was just dehydrated and would be fine after I ate and drank. On the way home and upon arrival, my headache had not only gotten worse, but the pain moved behind one eye and I began to have “mercury vision”—dark blotches that would dart in and out of my peripheral vision. At that point, I didn’t want to even look at food, let alone eat or drink anything—I just wanted to lie down in a dark room and hope that the pain would subside. It was what seemed to be a typical migraine in every sense, complete with nausea and the inability to tolerate light or noise. I considered it such, slept it off that day and didn’t really think of it as a problem.

Until it happened again.

I estimate I had these headaches about twice a month in high school, during the height of in-season training, and about the same frequency in college during the winter when rowing on open water was off-limits and the team was relegated to ergometer workouts. Sometimes the headaches would strike and fade as quickly as they came. Other times they would be gruesome ordeals that would force me to hole up in my room for an entire day, afraid to look at my phone and irritated by the white noise of the urban campus around me. It wasn’t until well into college that I began to directly correlate my headaches with the level of physical activity in which I was engaged every day. Some mornings, my coach would announce the workout and I would know immediately that a headache would occur—and I was always right.

Intense activity like a race can be a migraine trigger for some

Apparently, there’s a name for these experiences. The term Primary Exertional Headache describes headaches that are precipitated by physical activity, stress, and exertion.

Primary Exertional Headaches:

-typically occur either during or shortly after physical activity-last between 5 minutes and 48 hours
-can cause the person with the headache to suffer from photophobia (inability to tolerate light) and phonophobia (inability to tolerate sounds and noise)-can induce nausea or vomiting
-ARE NOT attributed to another disease or disorder

So, now that we know it has a name, what can we do to prevent them from happening— and lessen the anguish if they do happen?

First off, warming up for your workout is always a good idea, as it provides you with the opportunity to do a body scan and set the tone for your workout. If your headache tends to come on as a workout gets more intense, it may be a good idea to allow your workout to build its intensity gradually, within a session and within the number of sessions you do in a week, to a month, and so on. If workout intensity becomes too much, too fast, it can create a stressful environment for the body, which may be a headache trigger for some people. This is not to say that you should not be working out with intensity, but that intensity should be monitored by you (or you and your personal trainer), and if you begin to experience the symptoms of a headache, either back the intensity off or STOP the activity before the headache gets worse.

Hydration can also be a factor in many of these headaches. Even slight dehydration causes your blood to thicken, which means your heart has to work that much harder to circulate your blood. Do yourself a favor and make sure that you’re hydrated for workouts, races, and the like. It may not be the only factor that goes into headache prevention, but the benefits of being fully hydrated can only help your performance.

In one of my earlier blogs, I talked about the importance of breathing, especially where it’s related to workout performance—it can also be a key player in keeping an exertional headache at bay. Say you’re running/biking/lifting weights/doing a physical activity that you enjoy, and you up the intensity—awesome. But say that this bump in intensity also causes you to hold your breath just for a couple seconds at a time, like to push through a stretch on a run or get one last rep while weight lifting. By holding your breath, you can cause a spike in blood pressure, which can stress your body—again, by making your heart work harder than it needs to in order to oxygenate your blood. Remember—oxygen gets you high… and can help save you from having to hide out in a dark room, writhing in pain.

So, you’ve employed all these great strategies that I’ve mentioned, but you’re still worried that after (insert athletic event here), you may get one of these dreaded headaches. After all, I couldn’t very well tell my coach I wasn’t going to do whatever the day’s practice was because I’d get a headache later. What do you do when you’re about to do something you’re either fairly certain will give you a headache after, or when you’ve just completed an event and the first symptoms are just surfacing? If absolutely nothing is helping, talk to your doctor about specific strategies and/or medications that can help you be migraine free.

Until I began doing some research on this subject for this post, I was fairly unaware that exertion headaches were so common. Evidently, exertion headaches are something that plagues anyone from endurance athletes to powerlifters, regardless of ethnicity, age, or gender. Hopefully, this post has given you some ideas about how to deal with these headaches should you get one, and a proper course of action to take if they’re a chronic occurrence.