Do you experience headaches during or after intense exercise? You’re not alone. A sizeable number of people have so-called exertional headaches brought on by cardiovascular exercise like running or cycling, usually when they work out at a higher intensity.
Some people also experience a throbbing headache during or after resistance training. Should you be concerned if you have this symptom? Just as importantly, what causes it?
In my experience as a physician, this is a fairly common complaint. Some people have them almost every time they work out, most commonly when lifting weights or doing strenuous aerobic exercise. As if exercise isn’t hard enough!
Most Exercise-Induced Headaches Are Benign
Most, but not all, headaches triggered by exercise are benign, although a very small number are due to blood vessel abnormalities in the brain or tumors or heart disease.Sinus infections are another cause of exercise-induced headache. A sinus-related headache typically gets worse when you bend over to pick up a weight or change positions quickly.
The majority of people who get headaches during or after a workout have a condition called primary exertional headaches. This means they have headaches brought on by exercise, but they have no underlying structural problems in their brain or blood vessels to account for the pain. Some people with exertional headaches also experience headaches when they strain, sneeze, cough or have sex.
Still, headaches are inconvenient, especially when they last for hours and interfere with your workout.
Why Some People Get Exertional Headaches
Why do some people get exercise-induced headaches and others don’t? They’re more common in people who have migraine headaches. In this situation, they seem to be triggered by blood vessels in the brain dilating during strenuous exercise.
Exercise headaches that are benign typically affect both side of the head and last several minutes up to a day. They usually don’t cause visual changes, dizziness, vomiting, numbness, tingling or balance problems. If you have these symptoms, it should be a warning sign that you need to be evaluated by a doctor.
Can You Prevent Them?
There’s no sure-fire way to prevent an exertional headache, but there are some things you can do to decrease your chances of being sidelined by head pain:
Hydrate Well Before Working Out
Dehydration can trigger headaches, especially if you work out in a hot or humid environment. Exercising in heat and humidity increases the loss of electrolytes like sodium and potassium. This can bring on a headache.
If you’re susceptible to headaches, drink an electrolyte-rich beverage when working out instead of water. If possible, avoid working out in a hot or humid environment.
Use Proper Form When Exercising
If you get headaches when weight training, look closely at your form and how you’re breathing. Holding your breath when lifting causes sudden increases in blood pressure that can trigger headaches. Using improper form when lifting can cause neck and upper back strain that makes you more susceptible to headaches.
Don’t Work Out in a Fasted State.
Eat a protein and carb snack an hour before a strenuous workout to stabilize your blood sugar since blood sugar drops can trigger headaches. If you have migraines, avoid eating foods that have the amino acid tyramine since it can bring on headaches in migraine sufferers.
Don’t Do Too Much Too Quickly
Sudden increases in training intensity can trigger headaches. Gradually work up to a higher intensity level instead of “overdoing it” when you start a new routine. Likewise, allow plenty of time to warm up before doing a high-intensity workout to gradually elevate your heart rate. This gives your blood vessels time to “adapt.”
The Bottom Line?
Most exercise-induced headaches aren’t serious, but it’s a good idea to check with your doctor if they’re a new symptom, especially if you have high blood pressure, a history of heart disease or are over the age of 50.
You should have a neurological exam and, depending upon your history and exam, an MRI or MRA of your head to be on the safe side. Exercise headaches of a benign nature are most common in younger people. Also, if you have sudden onset of severe head pain, get evaluated immediately.
The good news? For some people with chronic migraine headaches, exercise makes them better as long as they don’t overtrain.
Mayo Clinic. “Exercise Headaches”
Medscape Family Medicine News. “Migraine in the Athlete: Sports-Related Headache”
National Headache Foundation. “Exertional Headaches”