HomefitnessExercise Induced Headaches & Migraines- Causes & Observations

Exercise Induced Headaches & Migraines- Causes & Observations

Exercise induced migraine headache

Exercise Induced Headaches & Migraines- Causes & Observations

Even after all these years, the pain is still easy to recall: I was finishing up my last set of bench presses- a skinny but enthusiastic teen who had just started weight training a mere three weeks before, when it hit. In the final throes of my last set, pushing as hard as I could to overcome the forces of gravity I felt a sudden pain on the right side of my head. I finished the set and the workout, but as I kept going I felt the pain growing and growing in intensity. With every repetition sending a searing pulse of what can only be described as bright white pain shooting through my temples. At the end of the workout, my coach asked me if I was alright. In typical male machismo fashion, I nodded that all was well and went my way. I was no stranger to pain. Some would even say that I courted it, given the extreme nature of my martial arts training and my newly found love of weight training. But this was something that I was not ready for, a pain that reached into the depths of my being, and it took everything I had to walk the ½ mile home from the gym under the hot tropical sun. These headaches persisted for what seemed to be an eternity- but lasted only about a month. In the midst of training, it would strike, narrowing my vision with a haze of pain that would descend upon me. A pain that could only be soothed by the darkness of my room and the blissful release that sleep would bring. I began to worry that there was something wrong with me, and that perhaps I couldn’t keep on training the way I did. My goal of transforming myself from a lanky 125lber into a statuesque natural bodybuilder seemed further and further away with every throb of my skull- and yet as suddenly as it started, the headaches just stopped. This phenomenon, which I would later learn was a classic case of exercise induced migraine wasn’t a curse that had befallen me for some unacknowledged transgression, but rather a bane that affects many who engage in intensive physical activity.

Exercise Induced Headaches & Migraines- What Are They?

exercise induced migraine headache
Exercise induced migraines can be extremely painful but seem to go away for most people over time

Exercise induced headaches and migraines have been diagnosed since the time of Hippocrates and yet we still know little about its causes. Often called ‘weightlifter’s headache’, it is associated with intense physical activity- especially unaccustomed levels of exertion. Clinically, these headaches fall into two major groups- exercise induced migraines or effort-exertion headaches.[2,3] Strict classification of headaches in one particular group presents significant diagnostic challenges as individuals can often have symptoms that can appear to fit several categories at the same time and many experts criticize the practice of strict categorization. Head trauma is a significant causative factor in sports related injuries and represent a very distinct group of sport related headaches. However, for the purpose of this article, we restrict our focus to the phenomenon of non-trauma related headaches.


Category 1- Exercise or Sports Induced Migraines


Exercise related migraine headaches usually have the following symptoms:

1. An aura, or visual or sensory warning before the onset of the headache
2. A pounding or throbbing headache of significant intensity lasting several hours.
3. A headache that is confined to one side of the head.
4. Nausea and or vomiting associated with the headache[3]

Exercise related migraines tend to happen more than once and in many cases is a family history of such headaches as well.


Woman suffering from exercise induced headache and migraine
More women than men suffer from exercise induced headaches and migraines



Exercise Induced Migraine Headaches – Apparent Causes

As common as exercise induced migraines may be, we still don’t have a concrete understanding of why and how it happens. Exercise induced migraines tend to be more common in women than in men[3] and the prevailing theory is that it may have some connection to low oxygen levels.[4,5] The low oxygen theory is commonly accepted as symptoms not only appear to be similar in nature to altitude sickness related migraines, but also due to the prevalence of exercise induced migraines among athletes during the 1968 Summer Olympics in Mexico City.[5] A location 7,000 feet above sea level. At sea level such headaches are rare among highly trained athletes which suggests low oxygen levels as a possible trigger.[3] While we are at this point unable to pinpoint the exact cause of exercise induced migraines, there are several factors that have been recognized as aggravating factors.


Exercise Induced Migraine: Aggravating Factors

1. Dehydration and inadequate water intake before strenuous physical activity
2. Hypoglycemia brought on from inadequate nutrition before intense exercise
3. Extreme exercise
4. Exertion at high altitudes
5. Exercise in high temperatures[6,7]


Exercise Induced Migraine: Treatments And Recommendations


Proper hydration can play a key role in avoiding exercise induced headaches
In my personal training practice, where high intensity training protocols call for training at near or beyond the point of momentary muscular failure, 1% of trainees (2 individuals over the course of three years) experienced migraine type headaches- usually within their first month of training. This data comes from a fairly large group of 296 people. Interestingly enough, and in line with my personal experience, symptoms subsided within a period of two months. Increased water intake before training as well and adequate pre-workout nutrition is recommended to avoid exercise induced migraines and may account for the cessation of symptoms among clients. Dietary and water intake are regulated among all who train within our system and improvements in adherence corresponded with the reduction of exercise induced migraines. All who suffered from exercise induced migraines self-reported that they did not drink anywhere near the amounts of water recommended on days that the headaches occurred and it is easy to hold these factors as being causative. However’they may simply be correlative as reduced incidence of migraines may also be a result of physiological adaptations to high intensity training as trainees increase their levels of fitness and tolerance to high levels of exertion. Thus, there is no real way to discern what factor actually caused the exercised induced migraines to stop and it bears noting that in only one case was exercise induced migraines clinically diagnosed by a physician. Longer warm up periods have also been recommended as a way of minimizing exercise induced migraines and is often effective as well.


Category II: Exercise Induced/Effort-Exertion Headaches

exertion type headache and migraine after weight training
Exertion type headaches and migraines can often come after intense weight training. Especially if it’s something you are just starting out with.

Effort-exertion headaches are the most common and most diverse of the subgroups of exercise related headaches, and like exercise induced migraines they tend to occur more among women than men.[3] Exertion type or exercise induced headaches appear to occur after strenuous lifting, bending over, running and physical jarring[8] but can also occur after sneezing, coughing and sexual intercourse.[3] Such headaches tend to have the following symptoms:


1. A sudden acute headache that lasts for several seconds to as long as several hours as a result of physical exertion, but without visual or sensory cues beforehand.
2. A gradual headache lasting an hour or longer [3]
3. Pain in the occipital and neck region lasting only a few minutes in duration [9,10]


Exercise Induced/Effort-Exertion Headaches- Possible Causes


Sudden exertion headaches are usually caused as a result of strenuous anaerobic activity like intense weight lifting or sprinting, whereas the gradually building headaches tend to come after more sustained aerobic effort and fatigue.[4] Like exercise induced migraines, the pathogenesis of exercise induced headaches remains unidentified but there are several theories that have been put forward. The possible causes include increased intrathoracic pressure[11,12], compression of blood vessels due to muscular tension[12,13], vasodilation of cerebral blood vessels as a response to stress[14], neck muscle tension and or strain[15], stimulation of nerve cells or fibers that transmit nerve impulses via monoamine neurotransmitters[16] or a combination of these factors.[17] While pathogenesis remains speculative there are some clearly defined factors that appear to trigger exercise induced headaches- factors that are listed below:


Exercise Induced Headache: Aggravating Factors

  1. Poor fitness levels
  2. Altitude
  3. Hot workout environments
  4. Extreme exercise or exertion
  5. Hypoglycemia due to inadequate pre-workout nutritional intake
  6. Alcohol and caffeine consumption [6,7,18]


Exercise Induced Headaches- Observations And Commonly Recommended Treatments
exercise induced headache and migraine- the importance of water
Adequate rest, proper hydration and regular meals can in some cases reduce the occurrence of exercise induced headaches.

In my personal training practice, occurrence of acute exercise induced headaches was slightly higher than that of exercise induced migraines- 1.7% as opposed to 1% (a total of 2 trainees self reporting exercise induced migraines and 5 self reporting exercise induced exertion headaches). However, caution must be exercised when comparing these numbers since they are merely casual observations as no formal clinical diagnoses were made in each case. The symptoms of exercise induced headaches mimic that of many other potentially serious neurological disorders and self diagnosis should never be relied upon. That being said, about those who did experience exercise induced headaches at one point or another usually did so early on in their training as well. Self-reported among those who experienced the headaches was consumption off caffeinated drinks pre-workout, inadequate water intake, skipping breakfast and lack of sleep. Like exercise induced migraines, the headaches never persisted among 4 out of 5 who suffered from the headaches. The 5th trainee has only experienced self reported exercise induced headaches for just about a month, however those headaches appear to be decreasing intensity in keeping with the pattern experienced by other trainees whose headaches tended to go away gradually. For those who continued to exercise the headaches usually subsided no longer than one to two months after they began- becoming less and less intense with every occurrence. It is again hard to say what causes the improvement and without clinical verification all observations are speculative at best. However, all who experienced the headaches either stopped drinking coffee, increased their water intake and or made sure that they did not skip breakfast and ate adequate amounts of carbohydrates and fats to fuel their high intensity workouts. Again, these factors may be simply correlative as the increased fitness levels and adaptations to exercise that occur over time may be ultimately responsible or perhaps a combination of all of the aforementioned factors.


A Clinically Viable Method To Stop Exercise Induced Headaches & Migraines

Caffeine is widely consumed around the world in both food and beverages, and it has been shown to have some considerable effect on stopping migraines. As a personal trainer, it is not my place nor practice to recommend the use of any type of drug, however I did come across the use of a particular protocol for the treatment of exercise induced migraines. The book, Where There Is No Doctor has always been a constant companion of mine, and it is a has been a standard among health care workers across the globe for decades. The protocol described to stop a migraine is as follows:

  • Take 2 aspirin with a cup of strong coffee or strong black tea
  • Lie down in a dark quiet place, relax [20]

That said, I did have an online client who complained of headaches immediately after his high intensity weight training sessions and he asked if there was anything I could recommend. I suggested that he consult his physician about the use of caffeine and aspirin as a possible aid and he brought it to his doctor’s attention. She agreed that there was no evidence of any harm coming from it and that it did show some efficacy in several studies [21] and so the next time he had a headache coming on after a workout, he had some coffee with 2 aspirin and retired to a dark place. Miraculously, the headache went away and did so on two more occasions when he did the same thing upon the first onset of symptoms. This was not known in my time, but research now shows that combining caffeine with over the counter analgesic medications, such as acetaminophen, aspirin, and ibuprofen, significantly improves relief of migraine headaches and more so than the use of an over the counter painkiller on its own.[21,22,23,24,25,26] however it would appear that the treatment works best when it is used immediately as symptoms begin to present themselves.


Aside from increasing fitness levels over time, the best treatments for exercise related headaches and migraines are proper sleep to minimize fatigue, good nutrition, adequate hydration and an extended warm up period.[19] Other suggested treatments include keeping a journal of headaches as a way to pinpoint the causative factors- a method I undertook myself but thankfully my migraines stopped before I had a chance to record much of anything. Pharmacological solutions are often suggested as well, however it is recognized in the medical community that there is a need for more large scale studies of athletes who suffer from these headaches. Not only to identify the mechanisms of pathogenesis but also for the creation of standardized treatment protocols. [19] Either way, given the substantial benefits of physical exercise and activity, unless you are advised otherwise by a physician, it is important that you do your best to keep exercising whenever possible . Be sure to always consult your physician about any recurring headaches you may experience even if you believe that they may simply be exercise induced. There is no such thing as being too safe.

5th Avenue Gym circa 2009- 5 years out from my last show.

As you can see, trophies and competitions were NEVER the driving force behind why I train the way I train and why I eat the way I eat.

It's always been my passion to see how far I could go as a natural athlete and perhaps even more so, to show what can be accomplished without using drugs.

And 5th Avenue Gym was the perfect place to do it.

I really miss that gym.

It was a place where legends came to train and while it wasn't pretty, it had everything we needed to do the work we needed to do.

And boy did we work!!!

5th Avenue for life as they say!!!

Hope you are still training hard and as always, Excelsior!!! #naturallyintense

And thanks @pit_bulls_67 for snapping the shot!!!!

#naturalbodybuilder #naturalbodybuilding #throwback #fifthavenuegym #5thavenuegym #drugfreebodybuilding #naturalbodybuildinglifestyle #gym #gymlife #gymmotivation #naturalbodybuildingmotivation #bodybuilding #bodybuildinggym

116 21

Why Are Pull Ups So Hard For Some But Not For Others?

Pull ups are an exercise people love to hate!

They love to hate it because in my experience, most untrained men or women can't do one pull up and those who train can often struggle to do 6 or 10.


Because pull ups are hard!

And yet people like myself can easily do as many as 20-25!

So what's the reason for this discrepancy?

Is there some secret that allows me and others to do pullups so easily?

There isn't, and in this video I go over exactly why I can do as many as I can and why it can be so much harder for others.

I also go over my #1 pull up variant that ANYONE can do, even if you can't do one pull up.

And yet it can build strength and muscle size in some cases even more so than regular pull ups!

So click the link in my bio to see the full video on YouTube or go to my channel by looking up naturallyintense!

Thanks in advance for watching and as always, Excelsior!!! #naturallyintense

#pullups #highintensitytraining #naturalbodybuilder #naturalbodybuilding #fitover40 #naturalbodybuildingvideos #backworkout #pullupworkout #naturalbodybuildingtips #backtraining #highintensitytrainingtips #hometraining #trainingtips #bodybuildingtips

77 13

Maximize Biceps Growth With High Intensity Arm Blaster Hammer Curls!

50lb Dumbbells For 20 reps!

The Arm Blaster is a fantastic piece of equipment for a home gym or any gym!

It doesn't take up much space and allows you to add variety to your biceps training.

It locks your elbows in place, thus increasing training intensity, and by doing a hammer curl, you can use more weight (thus increasing intensity even more) and target your brachialis muscles which help add density to your biceps!

This was my last set and I couldn't go any heavier as I am still nursing a wrist injury, but the 50lbers were more than enough to do the job!

Try them out next time you train arms and let me know how it goes!!!

Still training, hope you are too and as always, Excelsior!!! #naturallyintense

#hometraining #homeworkout #homeworkout #nuobell #highintensitytraining #naturalbodybuilder #naturalbodybuilding #fitover40 #naturalbodybuildingvideos #armworkout #bicepsworkout #naturalbodybuildingtips #biceps #armtraining #bicepsworkout #highintensitytrainingtips #drugfreebodybuilding#powertec #armblaster #hammercurls

101 12

Injury-Proof Your Training: The Power of Workout Variation!

One of the main reasons why I can still train heavy and intensely at 49 after 35 years of nonstop training without any training related overuse injuries is the fact that I vary EVERY workout!

Overuse injuries come from doing the same movements over and over and by always changing your routine, you radically lessen the likelihood of chronic injury.

Squats, deadlifts, barbell curls and bench presses are great exercises, but if you do them all the time, you do increase the odds of getting injured.

And as a natural athlete, it bears mentioning that it takes years to realize your full potential, and so it's crucial to have a training program that is sustainable, and one that will allow you to train injury free for as long as I have or longer!

Thanks so much for tuning in and as always, Excelsior!!! #naturallyintense

#naturalbodybuilding #naturalbodybuildingtips #naturalbodybuilder #naturalbodybuildingvideos #injuryprevention #fitover40 #workout #gymlife #workouttips #trainingmotivation #naturalbodybuildingmotivation #drugfreebodybuilding #highintensitytraining #injuryfreetraining #longevity

84 19

High Intensity Training Leg Extensions To Failure!
And as always, Excelsior!!! #naturallyintense

#naturalbodybuilding #naturalbodybuilder #highintensitytraining #highintensitytrainingtips #hometraining #homeworkout #fitover40 #naturalbodybuildingvideos #naturalbodybuildingtraining #naturalbodybuildingtips #naturalbodybuildingmotivation #legextensions #legday #legworkout #powertec #legdayworkout

117 16

This Is What 35 Years of Natural Bodybuilding Looks Like!

So as you know, As you may know I recently turned 49 and every year I do a photoshoot to show my progression.

In the hopes of showing that you can not only maintain a level of excellence as the years go by, but that you can do it without steroids, TRT, drugs or even pre-workouts and protein shakes!

(I’ve never had a pre-workout or energy drink and haven’t had a protein shake in decades!)

You don't need it as all it does make you forget tht excellence doesn’t require anything outside of yourself.

You already have all the tools you need!

Not a huge fan of taking photos of myself, (I much prefer being behind the camera) but I humbly try to be one example of just how much you can achieve with proper training and an uncompromisingly proper diet!

So here I am again at 49 and I am looking forward to seeing what you accomplish over the years as well!!! Thanks so much for tuning in and as always, Excelsior!!! #naturallyintense

#naturalbodybuilding #naturalbodybuilder #naturalbodybuildingvideo #naturalbodybuildingmotivation #naturalbodybuildingtips #highintensitytraining #drugfreebodybuilding #nodrugs #fitover40 #fitoverforty

365 36

High Intensity Arm Training- 50lb Concentration Curls!

There are two basic types of exercises, compound movements like barbell curls and isolation movements like concentration curls.

If you want above average arm development, you have to go hard on all exercises.

Isolation movements included, especially if you are drug free as we don't have the privilege of maximum growth from anything less than putting in some seriously hard work!

You have to go to that dark place where you can barely get the weight to move and do whatever it takes to get it up!

And then somehow find it in you to do it again!!!

You can't intellectualize it, you just have to do it and believe!!!

This was my third and last set and so I went all out!

My wrist is still a bit off so not going ultra heavy (by my standards) but
this was a hard set!

I haven't done concentration curls in a while, so I am really sore right now as I type this out two days after the workout!

Bear in mind that I always try to change it up and no one exercise is done every time I train.

Never training to maintain, always working hard to gain!!!

Still training and I hope you are too!!!

Thanks for tuning in and as always, Excelsior!!! #naturallyintense

#hometraining #homeworkout #homeworkout #roguerack #nuobell #highintensitytraining #naturalbodybuilder #naturalbodybuilding #fitover40 #naturalbodybuildingvideos #armworkout #bicepsworkout #naturalbodybuildingtips #biceps #armtraining #bicepsworkout #highintensitytrainingtips #drugfreebodybuilding

156 16

Unlock Your Natural Potential By Varying Your Workouts!
For the past 32 years I have always done a different workout every time I trained.

I have never followed a set program of exercises and the only unifying aspect of my workouts is the blistering intensity!

I train three times a week with a protocol I call Naturally Intense High Intensity Training, and what distinguishes it from other forms of high intensity training is the constant variety.

Muscles grow in response to overload and UNACCUSTOMED stimulation.

Remember when you first started training how effective everything seemed to be, but over time that progress slowly ground to a halt.

You change your routine and see some progress, but the gains in size and strength inevitably fall off over time if you don't make a change.

Now what if you never left that "beginner gains" stage and were always training with different exercises and radically different ways of doing the exercises every single time?

You would be where I am, not having experienced a plateau over the past 32 years and be able to really start unlocking your natural potential!

How does it all work, and how would you measure progression? Watch the full video on YouTube by clicking on my bio link, or going to my YouTube channel (Naturally Intense) and see for yourself!

I really think it can help make a difference in your overall progress, and best of all, it helps you avoid injuries so you can keep training hard for years on end! Thanks in advance for watching and as always, Excelsior!!! #naturallyintense

#naturalbodybuilding #naturalbodybuildingtips #naturalbodybuilder #naturalbodybuildingvideos #workout #workouttips #fitover40 #gymlife #workoutmotivation #trainingmotivation #naturalbodybuildingmotivation #drugfreebodybuilding #highintensitytraining #highintensitytrainingtips #HIT

142 21

Please note that all material is copyrighted and DMCA Protected and can be reprinted only with the expressed authorization of the author.

Click for a free copy!

No Time To Train? Click Get Celebrity Trainer Kevin Richardson’s Ebook On Why 10 Minutes Is All You Need!

Featured everywhere from the Wall Street Journal to CBS News, Kevin Richardson’s Naturally Intense High Intensity Training have helped hundreds lose weight and transform their bodies with his 10 Minute Workouts. One of the top natural bodybuilders of his time, Kevin is also the international fitness consultant for UNICEF and one of the top personal trainers in New York City.


Exercise Induced Headaches Causes & Recommendations References:

1. Ad Hoc Committee on Classification of Headache. Classification of Headache. JAMA 1962
2. Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988
3. Williams SJ, Nukada H. Sport and exercise headache: Diagnosis and classification. Br. J. Sp Med 1994
4. Atkinson R, Appenzellar 0. Headache in sport. Seminars in Neurology 1981
5. Jokl E. Olympic medicine/sports cardiology. Ann Sports Med 1984
6. Dalessio DJ. Effort migraine. Headache 1974
7. Massey EW. Effort headache in runners. Headache 1982.
8. Moskowitz MA. Neurogenic versus vascular mechanisms of sumatriptan and ergot alkaloids in migraine. Trends Pharmacol Sci 1992
9. Rooke ED. Benign exertional headache. Med Clin North Am 1968
10. Perry WJ. Exertional headache. Physician and Sportsmedicine 1985
11. Lambert RW Jr, Burnet DL. Prevention of exercise induced migraine by quantitative warm-up. Headache 1985
12. McCarthy P. Athletes’ headaches: not necessarily ‘little’ problems. Physician and Sportsmedicine 1988
13. Cleveland H. Headaches: a weighty problem for lifters? Physician and Sportsmedicine 1984
14. Rose CF. Headache: definitions and classification. In: Vinken PJ, Bruyn GW, eds. Handbook of Clinical Neurology Vol 48, Amsterdam, Netherlands: Elsevier, 1986
15. Paulson GW. Weightlifters headache. Headache 1983
16.Roos R. Luge participation is hard on the head. Physician and Sportsmedicine 1986
17.Jordan BD, Tsairis P. Warren RF eds. Sports Neurology. Rockville, Maryland, USA: Aspen, 1989
18. Thompson JK. Exercise-induced migraine prodrome symptoms.Headache 1987
19. Nadelson C. sports and exercise induced migraines. Curr Sports Med Rep 2006

20. Werener D, Thuman C, Maxwell J. Where There Is No Doctor: A Village Health Care Handbook, Hesperian Health Guides 1992

21. Prior MJ, Codispoti JR, Fu M. A randomized, placebo-controlled trial of acetaminophen for treatment of migraine headache. Headache. 2010
22. Lipton RB, et al. Aspirin is efficacious for the treatment of acute migraine. Headache. 2005
23. G, H., et al., Self-medication in migraines and tension headache: evidence-based recommendations of German Migraine and Headache Association (DMKG), German Neurological Society (DGN), the Autrian Headache Association (OKSG) and the Swiss Headache Association (SKG). Nervenheilkunde, 2009
24. Sawynok J. Caffeine and pain. Pain. 2011
25. Zhang WY, Po AL. Do codeine and caffeine enhance the analgesic effect of aspirin?–a systematic overview. J Clin Pharm Ther. 1997
26. Lipton RB, Diener H-C, Robbins MS, Garas SY, Patel K. Caffeine in the management of patients with headache. The Journal of Headache and Pain. 2017

Kevin Richardson
Kevin Richardsonhttps://www.naturallyintense.net
Featured everywhere from the Wall Street Journal to CBS News, celebrity Personal Trainer NYC and with over 2.6 million readers of his blog, Kevin Richardson is the creator of Naturally Intense High Intensity Training, one of the top lifetime drug free bodybuilders of his time, the first International Fitness & Nutrition Consultant for UNICEF, 2020 and 8 Time Winner of the Best of Manhattan Awards for Personal Training and a world recognized authority on high intensity training. Kevin has helped thousands, from celebrities to CEO's over the past 30 years achieve their fitness goals with his 10 minute high-intensity workouts done just three times a week in conjunction with his holistic nutrition approach. You can learn more about about his diet and training services at www.naturallyintense.net

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