Headache, Exercise-Induced

Causes

There are several theories but very little compelling medical evidence regarding the cause of exercise-related headaches. Exercise causes an increase in the flow of blood throughout the body, as well as a rise in blood pressure. One theory says that some of that blood reaches the arteries in the scalp and the accompanying dilation of the vessels causes pain.

A second theory suggests that these headaches may be triggered by a previous injury or condition, such as a concussion or chronic migraine headaches. Individuals may not exhibit symptoms at rest but may develop painful headaches with vigorous physical activity.

A third possibility is that air is forced out of the body through airways that are partially closed, which may happen when a weight lifter completes a heavy lift. In this situation, blood flows from the arteries to the head at a normal rate, but the strain caused by lifting increases intracranial pressure while reducing the flow of blood out of the brain through the veins.

There is anecdotal evidence to show that the exercise environment could be a contributing factor. People who live at an altitude below 1,000 feet (304.8 meters) and exercise at altitudes higher than 1 mile (1.6 kilometers) may experience headaches because not enough oxygen-rich blood [Page 637]reaches the brain. Exercising in hot, humid weather is more likely to cause a headache than training or competing in less extreme temperatures.

Headaches can also be sport specific. “Swimmer's headache” affects some people who jump into cold water. “Swim-goggle headaches” are caused, not surprisingly, by goggles that fit too tightly. “Footballer's headache” is a European expression used to describe headaches caused by frequently heading a soccer ball.

Symptoms

Exertional headaches occur during or immediately after strenuous exercise, but at times they can be associated with sneezing, straining, or even sexual intercourse. They have been described as throbbing headaches (as opposed to dull) that affect the whole head, and most of them subside within a few minutes or a few hours after stopping activity. Some athletes report a feeling of nausea but not vomiting. Harmless exercise-related headaches do not get worse over a period of time, they are not usually described as “explosive,” and they are seldom, if ever, accompanied by other physical symptoms. When they are, it is important to see a physician.

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