Primary Exercise Headaches: What You Need to Know

Cameron gets out of the pool and dries himself off … only to realize he has an intense headache. After a good workout, he realizes that it is probably not stress related. It doesn’t feel like the migraines he used to get in college. Yet, he can’t quite put his finger on what this headache might be about.

Primary Exercise Headaches

He may be experiencing what is commonly known as a primary exercise headache. The International Headache Society also calls them exertional headaches. These types of headaches still remain somewhat of a mystery to people who get them and even to their healthcare providers. Exercise headaches usually occur during or right after exercise.

These headaches are common. By the Mayo Clinic’s estimation, about one out of every 100 people will have at least one during their life. Even though many different studies have been done, no one has been able to identify exactly what causes them.

Primary exercise headaches, which are not linked to any other health problem, are distinct from secondary exercise headaches, which are connected to health problems and triggered by the exertion of a workout.

Primary headaches usually cause throbbing-type pain on both sides of the head and have a duration of five minutes and 48 hours. On the other hand, secondary headaches can last for several days and can include visual changes, stiffness of the neck, and vomiting.

Causes and Risk Factors

What we do know about primary exercise headaches is that they are brought on by some type of strenuous activity, be it working in your yard or cycling at you local gym.

Headaches, in general, are related to blood flow changes in the brain. Primary exercise headaches are believed to be caused by one or more of the following factors:

• Starting an intense training program, such as triathlon training, without working up to it.
• Beginning a workout without properly warming up.
• Low blood sugar, a sudden drop in blood sugar, or not eating properly prior to a workout.
• The increased oxygen demand on the brain, heart, and skeletal muscles.
• A family or personal history of migraine headaches.

During a workout, the blood vessels in the brain dilate, or widen, to accommodate greater blood flow and oxygen delivery. This blood flow change is theorized to be at least partially responsible for exercise-induced headaches. Working out in warm conditions, such as outdoors on a hot day or in a warm pool, can increase the risk of these headaches as the increased temperature aids in vasodilation.

Genetics and other environmental factors are also thought to be a potential factor in developing primary exercise headaches.

Generally, these types of headaches are more of an annoyance than anything and tend to dissipate quickly. But if they occur during exercise, they can prevent workouts from being completed or slow training for a triathlon or other competition. They also can cause people to stop their exercise routine due to the risk of post-workout pain.

Prevention and Treatment

If you experience such a headache for the first time, you should make an appointment with your doctor to rule out any other causes. The best way to treat an exercise-induced headache is to actually prevent it in the first place.

Successful prevention methods include the following:

• Warming up and cooling down properly prior to a workout.
• Cooling and ventilation in the exercise environment.
• Getting enough rest and sleep.
• Having a quarter cup of orange juice prior to your workout and a high-carbohydrate snack after.
• Drinking 16 to 24 ounces of water pre-workout and another 8 ounces for every 15 minutes of exercise when finished.
• Eating and hydrating properly in general.
• Gradually working towards more intense trainings.
• Focusing on proper breathing during anaerobic workouts.
• Decreasing the intensity of your workouts.

Head cooling has proven to be an effective treatment and prevention method for exertion headaches. Cooling helps the blood vessels constrict and reduces circulation in the brain. This can be done by immersing the head in ice water or by applying ice packs or even a cool towel to the head.

Some people may benefit from prescription medications to help prevent or shorten the duration of their exercise-induced headaches. For some athletes, caffeine has been found to be a successful treatment, as it causes blood vessel constriction.

When it comes to primary exercise headaches, the old adage is true: an ounce of prevention is worth a pound of cure. While not every prevention method will work for every athlete, a combination of a few of the prevention methods can, for most, minimize these painful headaches.