8 tips for managing “exertional headaches” after a tough workout

Niggling pain derailing your workouts? It’s not all in your head. We asked the experts how to get rid of post-exercise headaches once and for all.     

There’s nothing quite like the satisfying ache of an overworked muscle after a gym session to make you feel like you smashed it. While a little soreness is to be expected post-training, an exertional headache is certainly not. And yet research has revealed that up to 26% of us suffer from headaches caused by physical activity that can last up to 48 hours after working up a sweat. 

As someone who has experienced exertional headaches on multiple occasions, I can tell you that symptoms akin to a migraine are enough to quickly derail your workout regime. It starts with a tightness around the neck, which then leads to a pull in the back of the head and around the ear. Before long, I can start to feel it behind my eyes and across the tops of my shoulders until the unmistakable throbbing appears and my bed is calling. I stretch, massage, knead and stroke, but no amount of hot baths or muscle rubs can ease that feeling of my muscles about to ‘ping’ at any moment.  

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Sound familiar? What was once a relatively rare side effect of exercise (the prevalence of exertional headaches was estimated to be 0.2 and 1% in 1988) has now become a more common occurrence among runners, swimmers and weight lifters alike. So, what can we do about it?

What exactly are exertional headaches?

The clue may be in the name, but osteopath Anisha Joshi warns that exertional headaches are not to be underestimated. “An exertional headache is a pain that occurs during or immediately following exercise or physical activity,” she begins. “They can come on quickly, sometimes during exercise or in the hours afterwards, and usually last anywhere between five minutes and 48 hours. 

“The main symptom experienced is moderate-to-severe pain that is often described as throbbing or pulsating on one or both sides of the head. However, they have also been known to mimic migraines with symptoms that involve effects on vision, nausea, vomiting and sensitivity to light.” 

What causes an exertional headache?

While it’s easy to see how loading up the barbell could cause undue muscle strain on the head and neck area, the high impact of running can also take its toll. Exertional headaches occur when an activity causes veins and arteries to dilate to allow more blood flow, causing pressure in the skull and pain.

“We have a lot of postural muscles and nerves in the occipital area (the rear of the brain) that the large trapezius muscles and cervical extensor muscles are linked to. So, any additional tension in these areas will result in an exertional headache,” Joshi tells Stylist. 

Unfortunately, if you’re physically active and like a good workout then you could be at risk, as anything from the swing of an arm while running to an overhead shoulder press could trigger a chain reaction that ends with a throbbing head. But it’s important to stress that you can avoid them if you know how.

Running in hot temperatures can put you at risk of an exertion headache.

“Not everyone is prone to exertional headaches,” Joshi reassures. “Posture and form can certainly play their part in exacerbating the problem and provide additional tension in those shoulder and neck muscles that will pull on the cranium. Although the headaches tend to repeat every so often, they usually resolve within three to six months or sooner if you amend your activity.” 

In other words, start testing your trigger points to see where you need to amend your workouts.  

How to soothe an exertional headache

As miserable as they are, the good news is that exertional headaches don’t need to derail your workouts. Although you may want to rest up until the pain subsides, there’s no reason why you can’t pick up where you left off. 

Researchers found that neck and shoulder muscles were 26% weaker in people with regular tension headaches, so creating a stronger physique can help alleviate the problem over time. “If you notice you’re getting exertional headaches, the best thing to do is to try to gradually build up your exercise and see if that makes a difference,” Joshi says. 

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“For example, some people might experience pain after running for 15 minutes, so it’s OK to just run for 15 minutes and build up from there. Another example is that if you are exercising in hot, humid conditions that your body isn’t acclimated to yet, this can bring on exertional headaches. In this scenario, the exertional headache you are experiencing is your body’s way of telling you to start slowly and gradually build up speed.”

By taking things slowly, Joshi says you’ll gradually increase your heart rate to get your blood flowing, which will prepare your body for physical activity. “In short, a warm-up before starting the exercise can help prevent exertional headaches.” Granted, it’s a bit of a chicken and egg situation, but by testing your limits and executing the process of elimination, you can start to see a clearer pain pattern.  

How can I prevent an exertional headache? 

They say prevention is better than cure and thankfully, there are plenty of things you can do to stave off a pounding head. Personal trainer Aimee Victoria Long suggests going back to basics for a full-on form MOT. “If you’re struggling with exertional headaches while lifting weights, you may have some mobility issues in your thoracic spine, shoulders and neck,” she says. 

“I’d suggest getting a personal trainer to check your form and posture before using some mobility drills before every workout to help release any tension prior to training. Exercises such as threading the needle, cat/cow stretches, thoracic openers on a foam roller and some neck rolls can loosen any tension in these areas and are great for mobility. For runners, I’d recommend having your gait checked and supplement runs with some yoga or pilates to keep muscles loose.”

Both Joshi and Long agree that rehydration, prioritising rest days, daily stretching, soaking in a warm bath with magnesium salts and a heat pad to the head and neck are all great ways to keep tension from building up in the head and neck area. 

“Lastly, if you’re still unable to shake the headaches, then I’d suggest switching up your workout routine a little,” says Long. “Look to do something that requires less strain from your body but that will still strengthen and elongate the muscles, such as yoga or pilates.” If there’s ever an excuse to dust off the mat and get stretching, we think it’s worth a shot.

Images: Getty

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