- Some people
develop headaches during or immediately after strenuous exercise and it is
called exercise induced headache.
- The causes for
the headache could be due to certain foods consumed, dehydration, poor
neck position and improper breathing technique.
- Prevention is
associated with adopting healthier exercise pattern.
that occur after a strenuous activity
could be an indication that the patient may find it difficult to exercise for
longer duration or at high intensity. Such headaches are termed primary
headaches and can affect people during exercise or immediately following it.
the exact mechanism of why the headaches occur is not well understood, there
have been two hypotheses which could explain their occurrence. An understanding
of why this occurs will aid in providing the necessary intervention strategies
which could prevent these headaches.
‘Good exercise practices like warm up and drinking plenty of water could limit exercise induced headaches.’
Classification of Headache Disorders
definition of primary exercise headache as provided by The International Classification of Headache Disorders
is that form
of headache which is caused by any form of exercise and which does not occur
due to any intracranial disorder.
- Diagnostic Criteria: When two or more headaches occur after or when
exercises are carried out and which last longer than 48 hours. These
headaches should not be due an underlying neurologic problem.
- Primary exercise
- primary cough
- headache linked
to sexual activity.
have shown that 1.5% of all headache consultations were due to exertional
headache occurs during a combination of the following situations
- Bad Position of the Neck:
A position other than the neutral spine position results in a constriction
of the carotid arteries.
- Excess Weight:
The more amount of additional weight, the higher the blood pressure would
- Practice of Holding the Breath: Holding the breath can lead to a spike in blood pressure.
- Lack of Sufficient Water:
Dehydration can result in the thickening of blood.
- Increase in Heart Rate:
Exercise increases the heart rate with every set, resulting in increase
above maximal heart rate.
mix of all these factors affects the blood entering the brain, forcefully
expanding the walls of the arteries and adding pressure to the meninges.
Phases in Exertional
induced headaches pass through 3 phases:
- Intense Headache Phase:
This is the first phase which is severe and painful, occurring during or
soon after a workout. The headache is felt at the back of the head or in
the temples with searing pain which is rapid. The headache remains even
after the workout till there is a decrease in heart rate.
- Dull Headache Phase:
The next phase is dull and lasts up to 2 weeks. This type of headache is
felt in the areas where the initial intense headache was felt.
- Recovery Phase:
Complete recovery from the headache depends on how severe the initial
headache was and the extent of rest that was provided to the body.
exercise is beneficial to the body, people who experience exertional headaches
should stop or lower the intensity of their exercise. It is very important for
athletes to find out the various mechanisms of prevention.
Warm up Before Exercise
- Food intake
varies with each individual and certain foods like cured meat, beans,
nuts, fruits or cheese could cause headache.
- Eating small,
well-balanced meals spaced throughout the day for three to six times along
with drinking plenty of water could be helpful in lowering primary
- Adequate sleep is
another important preventive measure. People should sleep for at least 8
hours. Sleep disruptions like an uncomfortable sleep environment, excess
noise and lights should be avoided.
a good warm up schedule will aid in preventing exercise mediated headaches
according to a study by scientist Varkey and colleagues. They examined the
effect of an exercise program among migraine patients to increase oxygen uptake
without making the migraine worse. In this study, the participants were asked
to carry out a 15minutes warm up before they carried out 45 minutes of intense
physical activity. The findings of the study show that
- The migraine did
not become worse even though the exercise was intense.
appropriate warm-up has been shown to prevent headaches induced as a result of
Supplements to Reduce Exercise Induced
- People to develop
a tolerance towards headaches induced by strenuous exercise
- Lowered the
monthly number of migraines
- Magnesium: Studies
have shown that magnesium could lower exercise induced headaches.
- Low levels of
magnesium or Hypomagnesemia in the cerebrospinal fluid are associated with
- Nearly 30% of
people with migraines have reduced magnesium levels.
supplementation with 400mg of magnesium was found to reduce the frequency
- Riboflavin and
CoQ10: Riboflavin and ubiquinone affect mitochondrial
energy. When these are present in low amounts, it could affect the
mitochondrial energy production and lead to the development of migraines.
Feverfew aids in reduction in aggregation of platelets along with the
prevention of serotonin release. A daily supplementation of 300 mg reduces
the frequency of migraines.
study shows that carrying out warm-up exercises as well as non-pharmacologic
measures could prevent exercise-induced headaches among patients. Among
patients for whom warm up exercises are not very effective, Preventive
supplementation like magnesium and riboflavin should be considered, for those
who feel that warm up has very less effect in preventing heaches. They must
also ensure adequate rehydration during exercise.
- Exertion Headaches - (http://www.apexllc.org/articles/exertion-headaches/)