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Exertion Headaches
By: Nick Ryan | June 23, 2011 263 Comments
UPDATE: This article was originally published by itself. As of May 5, 2015 we decided to include it as a part of our series "The A.P.E.X. Way".
Strenuous, intense physical training can result in what are known as EXERTION HEADACHES. This article describes exertion headaches, what causes an exertion headache, what to do to avoid exertion headaches, and how to properly transition back into training after suffering from an exertion headache. The majority of the article centers on exertion headaches that result from lifting weights; however, there is a CrossFit specific section towards the end of the article, updated March 2014. Endurance athletes that experience exertion headaches after high intensity cardio will find the CrossFit section most helpful. This article is not intended to replace a medical visit. In fact, if you are reading this because you recently experienced an exertion headache, take a moment and schedule a medical visit.
Exertion headaches are exercise-induced headaches that are correlated with training at a very high intensity. They most commonly occur after a set of a compound leg movement (i.e. leg press, squat, deadlift) performed to failure or close to failure. Right after the set, sometimes on the final rep, an intense headache occurs typically in the back of the head or in the temples. What scientifically occurs is a forced dilation (expansion) of the blood vessels in your brain beyond their normal thresholds. This puts pressure on the meninges, (small nerves that cover the brain) which causes the painful headache. Once the heart rate and blood pressure drop, the headache becomes less intense; however, the meninges remain extra sensitive, and are susceptible to future headaches if blood pressure or heart rate spike.
Exertion headaches occur when a combination of the following circumstances are true:
- DEHYDRATION: Dehydration thickens your blood
- VALSALVA MANEUVER (Holding Breath): This causes a dramatic spike in blood pressure
- POOR NECK POSITION: Anything other than a neutral spine causes constrictions on the carotid arteries, the main arteries that deliver blood to the brain.
- INCREASED HEART RATE: As a set progresses, your heart rate will steadily climb so that by the end of your set it can be close to (or above) your maximal heart rate.
- HEAVY WEIGHT: The more weight on your body, the more blood pressure will rise while lifting it. Because legs are the strongest muscle group in the body, more weight is needed to reach a level of fatigue or failure. The correlation between heavy weight and an increase in blood pressure makes compound leg movements more risky than other movements.
The combination of elevated blood pressure, heart rate, thickened blood and constricted arteries can result in a devastating surge of blood attempting to enter the brain, forcibly expanding the arteriole walls and putting pressure on the meninges.
Exertion headaches have three phases:
- INTENSE HEADACHE: The first phase is the intense, painful headache that occurs during or immediately after an intense workout. The pain is typically in the temples or back of head. The feeling can best be described as a grenade exploding in the head. The headache hits rapidly, and throbs painfully. This headache will not go away until there is a decrease in heart rate, blood pressure, and all activity has ceased.
- DULL HEADACHE: The second phase is a dull, fatiguing headache that can last for up to 2 weeks. It typically lingers wherever the initial phase of the headache was felt because that is the area that the meninges flared up.
- FULL RECOVERY: Full recovery depends on the severity of the initial headache and the quality of rest given to the body to recover. If the body is given the opportunity to heal, dull headaches are typically gone in 1 week. True full recovery, meaning the ability to perform at the same level as before the headache, will take approximately 2 months.
To prevent an exertion headache:
- HYDRATE: Drink enough water that you're urine is clear or faintly yellow (never dark golden) the day before your lift and the day of, and continue to drink water during your workout. This will ensure that your blood can flow freely and smoothly through your blood vessels.
- BREATHE: The valsalva maneuver is a valuable tool for creating stability in the thoracic cavity (torso area) that can help prevent lower back injuries during maximal lifts. It should not, however, be used during sets of multiple repetitions. When performing multiple repetitions, exhale during the positive phase and inhale during the negative phase. You can find more detailed information on breathing techniques here.
- NEUTRAL SPINE: Unless performing a neck exercise, there is no need for the neck to be bent. Maintaining a neutral spinal alignment allows for proper circulation through the arteries and veins responsible for moving blood in and out of the brain. While "looking up" may mentally help keep the back straight during a squat or a deadlift, it is not essential. Keep the head and neck in a neutral position.
- CONDITIONING: Developing a healthy heart and lungs that can handle high intensity training can be accomplished with regimented cardiovascular training. General conditioning along with interval training can help reduce the risk of exertion headaches by developing an efficient and healthy cardiovascular system that can handle the stress.
Training with a high level of intensity is part of improving the body's performance potential, increasing size and strength; however, it can also create an opportunity for an exertion headache. To avoid exertion headaches during high intensity training sessions, build a solid cardiovascular base, be hydrated, breathe correctly, and maintain a neutral spine. Also, consider performing the larger compound leg movements at the beginning of the workout. Leg movements are inherently heavy, taxing exercises. Performing them early in the workout is safer because fatigue, exercise-induced dehydration, and a peaking heart rate won't be part of the equation yet.
There are some simple guidelines that will help with full recovery and full pre-headache performance:
- STOP: Once an exertion headache occurs, STOP. Do not attempt to push through the rest of the training session, it will only worsen the headache and the duration of symptoms.
- MEDICAL VISIT: It is important to rule out any other underlying potential causes. Aneurysm's, thunderclap headaches, and slipped discs may be potential causes for similar symptoms and must be ruled out. If it is an exertion headache, physicians may recommend rest, plenty of fluids and ibuprofen taken every 4 – 6 hours daily to help with the swelling of the meninges. Or, they may recommend something else which is why it is important to consult the physician.
- REST 1 WEEK: The initial rest phase should be a complete week of total rest from all physical activity, including practices, strength training, cardio, as well as recreational and competitive activities.
If steps 1 – 3 are done without any interruptions, then the headache should subside and the head should feel normal after 1 week. However, the body is still not ready at this point for pre-headache performance. Here are some guidelines for building back up to pre-headache performance:
- PHASE 1 (2 WEEKS): Take two weeks off from any lower body exercises, performing only upper body exercises at 50 – 75% of your pre-headache weight. By the end of the two weeks, weight should be approaching pre-workout level. Introduce light cardio, no more than 70% of your Maximum Target Heart Rate (220-Age), for no more than 20 minutes.
- PHASE 2 (2 WEEKS): Introduce single-joint, isolateral leg exercises to the upper body strength program. This includes leg extensions, leg curls, hip adduction and abduction. This allows for strength maintenance without loading the frame. Attempting to do compound leg movements such as squats, leg press, or deadlifts prematurely can cause a flair-up of the meninges and another full-blown exertion headache. Begin increasing intensity of cardiovascular training slowly during this phase.
- PHASE 3 (4 WEEKS): Begin introducing compound leg movements at 50% OF PRE-HEADACHE WEIGHT. Slowly add back volume and weight each workout. Begin pushing the cardiovascular system.
If at any point during this recovery plan an exertion headache occurs, then go back to step one which was STOP. Repeat with physician visit, rest, and slow recovery. It is important to note that while 2 months of recovery does seem like a long time, these headaches can linger for over 6 months if the body is not allowed to heal. 2 months of strategic recovery is better than 6 months of bull-headed attempts to push through it.
Since the original post of this article in 2011, and my original post back in 2007, CrossFit has exploded in popularity and has become a huge part of the fitness culture. WOD's, CrossFit Games, and CrossFit Gyms have saturated the fitness world internationally. The reason I mention this because we have noticed a gradual climb in emails, hits, and posts related to exertion headaches coming from CrossFitters. None of our A.P.E.X. Coaches are CrossFit Certified, A.P.E.X. is not affiliated with CrossFit in any formal way at this point; however, we are all here to train at a high level and I have a tremendous respect for any athlete willing to push themselves hard enough to cause an exertion headache. Here are some things to consider as a CrossFitter as it relates to exertion headaches:
- OLYMPIC MOVEMENTS: CrossFit incorporates big, compound, technical movements such as snatches, power cleans, jerks, deadlifts and squats
- VALSALVA MANEUVER: Holding your breath can help protect your spine during Olympic movements by creating thoracic pressure, helping your abdominal wall create a stable core
- SUPER-SETS: CrossFit workouts, in general, combine big movements with cardio movements, or big movements with other big movements
- NO REST: CrossFit workouts tend to omit rest between exercises, thus heart rate and blood pressure steadily climb, also leaving no time for water consumption during the workout
- COMPETITION: Competition can help by tapping into adrenaline, resiliency, and a never-quit attitude that can mask pain
Big movements that put weight on your frame cause a spike in blood pressure. Holding your breath to improve posture during big movements also causes additional spike in blood pressure. Doing multiple exercises back-to-back without rest causes an additional spike in blood pressure, but mainly an increase in heart rate. An increase in both heart rate and blood pressure, in a competitive setting, while not being able to calm down or drink water, can lead to an exertion headache. It will not be early in the workout when you are calm, energetic, and focused, but towards the end when blood pressure and heart rate are peaking out, and your trying to overcompensate to finish the workout by holding your breath as your core fatigues.
CrossFit philosophy dictates that variables 1, 3, 4 and 5 are part of what makes CrossFit workouts intense, and that will not change. Many people have successfully completed WOD's without causing an exertion headache; therefore, CrossFit workouts do not inherently cause exertion headaches. The key to preventing an exertion headache during bouts of intense exercise is coming into the workout rested, hydrated, and mentally focused. During the workout, you must maintain a good breathing cadence, making sure to exhale during the positive phase, and inhale during the negative phase of the movement. Late in the workouts when your blood pressure and heart rate are climbing, you must remain calm and focused, regulate your breathing, and concentrating on good body mechanics. If you do these things, you will be able to perform CrossFit style training free from exertion headaches.
If you do experience an exertion headache during a CrossFit workout, here is the recommended recovery timeline to get back to performing WOD's at 100% pre-headache performance levels.
- STOP: Once an exertion headache occurs, STOP. Do not attempt to push through the rest of the training session, it will only worsen the headache and the duration of symptoms.
- MEDICAL VISIT: It is important to rule out any other underlying potential causes. Aneurysm's, thunderclap headaches, and slipped discs may be potential causes for similar symptoms and must be ruled out. If it is an exertion headache, physicians may recommend rest, plenty of fluids and ibuprofen taken every 4 – 6 hours daily to help with the swelling of the meninges. Or, they may recommend something else which is why it is important to consult the physician.
- REST 1 WEEK: The initial rest phase should be a complete week of total rest from all physical activity, including practices, strength training, cardio, as well as recreational and competitive activities.
If steps 1 – 3 are done without any interruptions, then the headache should subside and the head should feel normal after 1 week. However, the body is still not ready at this point for pre-headache performance. Here are some guidelines for building back up to pre-headache performance:
- PHASE 1 (2 WEEKS): Focus on cardiovascular conditioning, introduce light cardio, no more than 70% of your Maximum Target Heart Rate (220-Age), for no more than 20 minutes. Jogging, running, swimming, and hiking are the types of cardio to do during phase 1.
- PHASE 2 (2 WEEKS): Begin pushing your cardiovascular system to closer to 90% of your Maximum Target Heart Rate, introducing rowing and other body-weight exercises (burpees, air squats, vertical jumps, lunges, jumping jacks, etc.). There are "No Equipment" CrossFit workouts that you can test yourself on, seeing how well you can handle intensity before adding in weights.
- PHASE 3 (4 WEEKS): Week 1, do WOD's at 50% of pre-headache WEIGHT and TOTAL VOLUME. Week 2, do WOD's at 50% of pre-headache weight, but normal VOLUME. Week 3, up the weight to 75% of pre-headache weight. Week 4, attempt with caution, pre-headache weights.
During PHASE 1 and PHASE 2, focus on hydration, breathing, and sleep, and listen to your body. If you feel like a flair-up may happen, STOP. The key is getting through PHASE 1 and 2 without a headache while performing at a high level. Before moving into PHASE 3, you should be dominating body weight WOD's without any fear of a headache. For PHASE 3, use the following example for clarification.
EXAMPLE: WOD – 10 rounds, 10 snatches @ 100 kilos / 30 seconds of speed rope
- PHASE 3, WEEK 1: 5 rounds, 10 snatches @ 50 kilos / 30 seconds of speed rope (50% WEIGHT & VOLUME)
- PHASE 3, WEEK 2: 10 rounds, 10 snatches @ 50 kilos / 30 seconds of speed rope (50% WEIGHT)
- PHASE 3, WEEK 3: 10 rounds, 10 snatches @ 75 kilos / 30 seconds of speed rope (75% WEIGHT)
- PHASE 3, WEEK 4: 10 rounds, 10 snatches @ 100 kilos / 30 seconds of speed rope (100% WEIGHT)
The key is to slowly re-introduce weight while under stress. PHASES 1 and 2 should have prepared your blood vessels for the increase of heart rate, but the spike in blood pressure comes with additional weight on your frame. Remember, if at any point you experience an exertion headache, you are back to STOP, a MEDICAL VISIT, and 1 FULL WEEK OF REST, so don't try to skip ahead, it will only delay your full recovery.
FINAL thought
Those of us that have experienced exertion headaches are like pit bulls. We have a high pain tolerance, we push ourselves beyond normal limits, and we are stubborn as hell if we are told to take some time off for any injury, especially one that doesn't involve a torn muscle or a broken bone. We all believe we are the exception, and that we can heal like Wolverine. Remember, an EXERTION HEADACHE is an INJURY TO THE BRAIN. If not taken seriously, it won't go away and can become worse. Just like any other injury, certain steps must be taken to transition the body back to a high performance level again. So from one pit bull to another, please take the next 2 months to slowly recover and get back to pre-headache performance levels. If you think you are the exception, you're not. Hopefully you find this article to be helpful. If you have any questions, email me at email@example.com. You can also find other helpful articles on our website at www.apexllc.org. Thanks!
Nick Ryan, CSCS
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263 Comments
I wanted to thank you so much for this article. It has helped explain to my son and myself clearly what is going on with my son. My son got more information from this article than he did from the neurologist. My son started experiencing severe exertion headaches about 6 weeks ago. He took the supplement N-Zero before his workouts and that is when the severe headaches started. He stopped the supplement but the damage had been done. He had an MRI, CT scan and spinal tap which all came out good. The severe headaches lasted about a month. He also had severe side effects from the spinal tap.He has been trying to recover and keep his heart rate down by not working out, this has helped the headaches to go away. What he is experiencing now is what he calls a weird feeling in his head. He says he is constantly aware of his brain and blood flow in back of his head and then weird sensations around his skull. This started when the headaches left. Could this be because his nerves are still so sensitive? Does he need more recovery time? Thank you for your help. Barbara Treece
In awe of that anwser! Really cool!
Do you have any other suggestions for recovery? Sounds like this is what I have. I saw a Dr, had an MRI/MRA/labs and everything… and I can't get in to see a neurologist for 3 months. My doctor is hesitant to diagnose anything, but this sounds like exactly what I have and so I want to try to solve it myself – I can't go another three months with terrible, nauseating headaches all the time, and I also can't go three months without living the lifestyle I want.
Ice or heat? best medication – naproxen, ibuprofen, acetaminophen, aspirin? Anything else?
I had one of these on friday, but to be honest it went away after about 5-10 minutes, and after that I ran three miles and never had a problem. BUT yesterday I was doing curls and push ups, and I was trying to get that last push up and I held my breath, my form went out the window and I finished it, then i was slowly getting up and right when I was about to get up It felt like my head was swollen with blood and about to explode, it was there but going away. I had it for about 4-6 hours, and then I fell asleep. In the morning I had this very, very light headache on the back of my head, but It went away I still feel like it would happen again in the future if I do another full blown workout, this was minor, but to anyone who gets one, take an asprin and use heat, and breath because you want to lower your blood pressure.
I'm extremely inspired along with your writing skills and also with the format in your weblog. Is that this a paid theme or did you customize it your self? Anyway keep up the nice high quality writing, it's rare to look a great blog like this one nowadays..
this helped me alot. i started getting headaches whenever i squatted or dead lifted recently and cannot get them to stop. They start at the base of my skull and go up the left side of my head. They seem to pop up during sex as well.
I did just see a chiropractor who told me my neck is out of alignment and my left side muscles are very tight, which is the side the pain occurs. I have yet to be adjusted though.
The pain seems to flare when my heart rate comes up like the increase pressure triggers a nerve. I had my pressure checked and it was 124/82
I have been on natural mass building program for the last year and went from 189 to 221 in just under a year. I am 38 and i guess my body is probably telling me to take a break
Would it still be okay to train lightly?
Thank you for your positive feedback! We are glad that you found the article helpful and that you enjoyed your experience on our website. Here's a link to our webmaster's website. He does an excellent job and charges less than he probably should! http://www.crossdistinction.com/
It sounds like you have a classic exertion headache. It is not uncommon to feel headache symptoms when your heart rate increases, regardless of the stimulus. A blood pressure of 124/82 is well within the "health normal" for adults. Remember, the meninges will remain sensitive until full recovery, so any spike in blood pressure can cause a flair up. Can you train lightly? It depends. If "light" training triggers a headache, then no. If not, then gradually introduce activity as outlined in the article. Be patient, and remember that this is an injury to the brain and should be respected accordingly. Good luck and God bless!
I hope our email dialogue was helpful. Thank you for your positive feedback, and I am glad that we were able to help in your son's full recovery!
thank you so much for this information. I have been getting these headaches for the past week and a half. Last night was so terrible i bit the bullet, stopped working out and drove myself to the E.R. only to have a cat scan show normal results. I believe I had the headache occur from using Muscle Pharm Assault. I had never used a pre-workout shake before and now i know I never will again. I'm hoping to fully recover. I love training hard so this is a disappointment, but I'm glad i have a little direction as to what to do. Thank you for this post it took a huge weight off my shoulders
is doing squats 6 days ago. I start with light set the heavy and heavier then I dropped down to light and went all out for 16reps. The moment I racked it I experienced intense pain at the base of my skull. Now I'm still suffering 6 days later, headaches and a stiff weak neck. Can I do light cardio on a treadmill? Or will that be dangerous?
I have had 2 exertion headaches this week and one about six months ago. The way I dealth with it was by stopping to lift for about 15 minutes, wait until relaxed, then took 3 ibuprofen pills (600 ml), returned to the gym after about half hour and the pain was gone completelly, I started lifting again being cautious as if I start to feel the pain creeping again, but no pain at all, I continued very heavy weights all the way with no problems at all. It has been about 12 hours of that and I feel great. My advise. Is to stop or finish your set if you can, and then do what I did. Of course I am not a doctor and I don't want to be liable if you grow an eye on your forehead of you get sick so go talk with your doctor. It was just peer to peer advise take it or leave it.
Thanks for your comment Fred! It sounds like you were able to walk the fine line a little by continuing to train while nursing the headache. For those reading Fred's comment, depending on the severity of the headache, it is possible to continue to train through it cautiously. The recovery/prevention we have come up with works with both mild and severe exertion headaches, and is conservative in it's timeline. Our goal is to provide a reliable way to get back to training at 100%, but of course there are many variations and everyone's timeline can be slightly different.
Love the article! Very informative but not over the top so your average person can not understand. I'm suffering from an exertion headache as we speak – it sucks more than anything because all I want to do is train. I have had it before about 2 years ago and the best thing for it was rest… I didn't workout for about 2 weeks and when I started again it was light lifting.
My exertion headaches started again when i was doing leg press and wasn't focusing on my breathing and also just pushing myself to the limit…hate the feeling.
This is a follow up. The headaches continued until I felt them even taking ibuprofen, so because I am not crazy, I went to the doctor. I have an MRI, MRA scheduled for April 16th. Today is the 5th of April, so I can't just quit working out just like that. What Im going to do is I am going to lift light until I get the results. in 2 weeks. I know I will not have much gains not fat loss no nothing, I will just be maintaining the routine that's all.
Thanks for the clear article, it is really helpful.
I have been suffering with exertion headaches for about 4 weeks now! I was training 4 times a week with a PT and scared him to death when I would literally drop to the floor holding my head! I took a week off to rest, went for a couple of sports massages and started taking ibuprofen and a pre-workout drink prior to lifting. Over the last week we have also incorporated isolation movements to calfs or forearms prior to lifting to fill the muscles with blood and diverting away from my head. This seems to have stopped them altogether this week and if I feel the familiar pressure coming on we quickly stop and divert again. Thanks for the great article
I get these too and they are not as severe on the onset but linger in my head/neck/upper back for days afterwards. Do you have recommendations on some breathing techniques? Mine seem to trigger during long runs or heavy squats. I have also read that taking Ibuprofen after workouts is bad because it strips blood from muscles in need of repair. Is there another pain reliever that is not an anti-inflammatory that would work equally as well?
I suffered severe exertion headaches as a result of swimming in the morning .Morning=thicker blood
.a bit dehydrated from previous night drinking =thicker blood
.Poor breathing technique (holding breath)=increased intracranial pressure
.Going for it= Bad idea!
This article is spot on and the best recovery advice I've seen on the net. Frustrating, however, good advice to take it easy and get through it allowing yourself to heal. As others have said once you've had an exertion headache you can feel the pressure build so when that warning bell sounds. STOP!!!
Thanks for the article.
Thank You APEX!
I researched my issue over and over and could not find a discussion on the same symptoms…and then I landed here on your page; I was getting worried, because the only other research/webpages were leading up to an "un-ruptured aneurysm" as the cause. Here is my issue – I do strength training twice a week and I try to cardio everyday, I eat very healthy and drink a half gallon of water a day. I think my issue started, because I/We were bombarded with multiple life-changing events (all bad)and the stress pushed me to start drinking more alcohol than usual and I started eating wrong as well. Combination of the sudden change in diet with alcohol and stress…bam – I had the headache for about 15 days. It was intense the first week and it would gradually build throughout the day, I had to take BC powder & Excedrin two/three times a day. That's when I found your article and I stopped everything! The second week was more like a dull headache…but was there none-the-less and I had to continue taking BC powder everyday. Its now the 3rd week and I'm not really feeling the headache…although I feel that it could start again at anytime. I am contemplating on whether I should hit the Gym tomorrow for some strength training. Either way…I am very grateful for this article and your advice, it gives me direction. Thanks again…
Doctor.. I think you saved my life! Ur information was like none other that i could find. Im 16 and a trainer forced me to do an extra set of leg press with over double the weight i was previously using i repeatedly told him that i was done and cant do it and he just kept saying "yes you can" and then bam! Massive pain on my right temple now whenever i do any exersize or have sex it just pops up… I take comfort in the fact that i knew what my limit was but i just got forced. Anyway thankyou for this article i will try my hardest to not workout but i know it wont stop me from having sex
Helpful article..
I got this a week ago..
Been resting for the whole week..
Worst headache ever..
A question, how do I know if the headache already gone?
Coz it's really painful and I don't want to just back to gym and suddenly struck end again on my head.
Thanks APEX!
This is exactly the article I needed. THANKS! I was actually having these due to very intense abdominal workouts. I would get a slight headache during the workout, but it would really show up during sex. Which was DEVESTATING to me AND my wife. It was like a bomb going off in my head. It would start where my neck meets my head and would explode into the sides of my head and behind my eyes. I followed this advice, and it got me back on track. I got a $1,200 MRI done and the neurologist shrugged his shoulders and said, "I don't know, man." Thanks again!
Any update on your conditions Mike or Fred? I've had the dull headache for about a week (it doesn't seem to be dying down) and while I've had a CAT scan (clean), I'm getting my MRI results on Monday. As you can probably tell, I'm very nervous (I have a history of strokes in my family, and I've had quite a lot of stress recently).
Got results back and nothing wrong with my brain Scary injury but true to form my headaches started to peter out about a week since I suffered the initial exertion headaches. I haven't been back to the gym yet but I'll certainly follow this guide when I get back on the horse after New years. Thanks for compiling this information APEX! Very helpful!
Spoke a bit too soon about recovery, as a couple days ago–a week and a few days out from the initial pain–I got a pretty severe headache again (without too much exertion either) that warranted another ER visit. They gave me another CAT scan–but with dye this time–to see if it could be blood vessel damage. Clean again. I've done some more research and exertion headaches can sometimes be a sign of a pheochromocytoma: a rare and usually benign tumor in the adrenal gland. My symptoms fit perfectly. I'm quite upset that this avenue hasn't been explored in two ER visits and countless doctors appointments, so I've got an appointment for tomorrow and I'll request a referral to get the required tests done. Either way I'm going to take it very easy over the next week or so. I've dropped nearly 10kg (82kg to 72kg) in the last week and a half, so this has already been the most detrimental injury I've had yet. Word to the wise: take these injuries seriously as they can be very dangerous. With any luck mine is just a primary (benign) exertion headache with particularly long-lasting and painful symptoms, but there's always a chance it's something worse. I'll check back and update with news on my particular case for public knowledge.
99% sure it's nerve damage in my upper back. hopefully not permanent, got a bit of pain today when moving stuff around the house. The lesson: form is infinitely important. No more ego lifting for me.
I would like to thank you very much Apex, for this first rate article. Yesterday I experienced my first exertion headache, frightened the life out of me!! Going to doctors in an hour. I feel much calmer now as your article fully describes all the symptoms i have been experiencing.As you can imagine, you start to think all sorts could be happening, i will ensure that i rest now for at least a week and then start to re train with reduced weights gradually providing my GP approves.
Yesterday while doing my leg workout and in my drop set i felt an intense headache in my left side of the head. I felt the same about 2 years ago. This time i knew that i wasn't breathe correctly while doing squats. I stopped for 5 minutes and then continued my workout doing legs extensions and leg curls. I stayed at the gym for about one more hour. My headache has receded a little bit since then but is still there and pulsating in moderate manner.Does this symptoms match the symptoms with the exertional headache symptoms? I feel a lttle bit dizzzy and when i walk and put my head down the pain increases. Do i have to worry more than usual?? Someone said earlier that the meninges maybe are swollen and this require time to heal, am i correct?? Thank you for the information.
It sounds like a classic exertion headache. The fact that you were able to continue the workout means that it was likely a moderate injury. Severe exertion headaches bring you to your knees they can be so painful. The meninges are going to remain sensitive and will likely flair up another headache if you do not give them a month or so to recover.
I've been doing double under jump rope for a couple months now. I taught myself to concentrate by looking up while jumping. Little did I know I was probably wreaking havoc on my neck. Last week all the sudden I felt like someone was drilling into my temples and punching the back of my head. Once I read the Internet I realized my head position caused this. A few days later I tried them again looking forward and no pain. I thought I was cured but the following day the headache came back during jump rope amd then again today! The headache does not come on during squats or any other exercise…only the jump rope even though I look straight ahead now. Any advice would be greatly appreciated I'm very frustrated
This happened to me 2 years ago. Had every test on my brain all negative. Now I started doing a crossfitbtupe gym n during a hard work out. Bam!! Throbbing pain in my temples. Had to leave. I go back to neuro dr next week to rule out once again underlying conditions. But sure it's an exhertion headache. It's 3 days. Now still exercising lightly but headache is still there but mild
This is a great article. No other article offers any other explanation of recovery time. They all just lecture me about how it could be something serious and that I should go to a doctor (which I've done). One concern of mine is that you mention 'Aneurysm's, thunderclap headaches' as if they are each known to be a part of a more serious condition. I've experienced thunderclap during ejaculation and have even gotten the same sensation before ejaculation. Also, I have a herniated disc in my lower back, which I injured about eight months ago (this is probably irrelevant but I don't know about a nerve issue since I have terrible medical knowledge). Should I be more concerned than usual about my headaches because of either of those two issues? Does thunderclap mean start from day 0 because it has the same negative effect on the arteries and nerves? Also, after seven days of rest can I do light cardio, even if I am not use to cardio but just want to begin strengthening my cardiovascular system? And, I'm curious, are you quite sure that there is potential for full recover because the meninges return to normal? Thanks for any help you can offer.
Christian, thanks for your comment. I'm going to take my time on this answer because it's a common fear and misconception.
Thunderclap headaches are a more severe headache that share all the same initial symptoms of an exertion headache. You feel a sudden intense headache in your temples, it pounds like a grenade went off in your head, and for about an hour it is very intense, but then becomes a dull headache for about a week. While the following distinction is not fully supported in the medical field, it helps me if I draw a line here between exertion and thunderclap. Exertion headaches are caused by a forced dilation of the arteries which then puts pressure on the meninges of the brain, resulting in the intense headache followed by a dull headache for a week. Thunderclap headaches share all that, but an artery actually ruptures or tears. It is impossible to know the difference without a brain scan. Brain scanning will either reveal inter-cranial bleeding, or it won't. If it does, it's thunderclap. If it doesn't it's an exertion headache. The frustrating part for us is that the doctor will either shrug his/her shoulders, and say, "everything looks normal, let's do some more tests, but for now just rest and take ibuprofen," or they may call it thunderclap regardless of brain bleed or not. So from here forward for the purpose of this response: thunderclap = rupture, exertion headache = no rupture.
Thunderclap headaches can happen to people with high blood pressure, and an artery finally bursts in their brain suddenly. For young and healthy people, it is possible during strenuous exercise, or sex, if blood pressure is peaking out and the blood vessel is weak. Thunderclap headaches are also common in car accidents, where the car hits something, your face hits the air bag, and your brain hits the inside of your skull. CAT scans reveal if there is an inter-cranial bleed, which can be fatal. Thunderclap headaches symptoms include syncope (blacking out), nausea and vomiting. As I write that, I realize that rigorous exercise can make you nauseous, feel light headed, and then puke. In a workout that is intense enough to cause an exertion headache, there is a high probability that you may want to puke afterwards. Bottom line, if you get an intense headache after or during a workout, go to a doctor. If brain scanning reveals that nothing is abnormal, you had an exertion headache and the article lays out your recovery timeline. Because thunderclap headaches can involve tearing or busting of blood vessels, the timeline for recovery is going to be much longer than an exertion headache before you feel back to normal. That is beyond my scope. I'd say be more conservative, maybe extending the timeline over 6 months rather than 2.
Next, regarding herniated discs and thunderclap before/during ejaculation. I have had people email me saying that herniated discs did contribute to having headaches, which is due to the impingement on nerves. Meninges are part of the central nervous system, and an impingement in the lower back could affect pain in the head. Those that have emailed me about disc issues have all said that the chiropractor did wonders for them, in conjunction with the timeline laid out in this article. I have had people comment and email me about flair-ups of headaches, after the initial headache in the gym, during sex. After an exertion headache, your meninges are extra sensitive, so the rise in blood pressure and heart rate during sex can trigger the headache, unfortunately… As far as thunderclap before/during ejaculation, as I mentioned above, unless there is bursting or tearing, it's hard to call that thunderclap for me. Bottom line is that your meninges are sensitive, and once you get an exertion headache, they are on red alert. The slightest spike in blood pressure or heart rate can cause your meninges to signal for another headache, which is your bodies way of protecting itself from further harm. You have to let that red alert phase pass. That's where easing back into both heart rate first, then blood pressure, can make or break your recovery. Too much too soon? BAM, headache. Start all over.
Your last question was in regards to full recovery. I gave myself 3 exertion headaches on 3 separate occasions, once at 16, once at 19, and again at 20. I have always been nerdy about the science behind strength training, so I paid close attention to my recovery timeline and listened to my body for things that caused the flair-ups. I became my own test subject, and learned first hand how to recover and avoid them. One of my clients at the time was an ER doctor, so I talked about my theories and got his feedback, he actually spent a lot of time with me explaining the science, and what other bigger problems could be involved. I experienced the flair-ups, the frustration, the fear having an aneurism, and losing all my hard-earned progress. Each headache I got, the more I learned about the recovery timeline. By the third headache, I was a recovery pro. During all that, I was also a personal trainer, and had 2 clients as crazy as I was that got exertion headaches during our workouts. Between the 5 headaches, I learned what caused them and how to prevent them. I learned it the hard way, but this article stems from my bull-headed struggle with exertion headaches and my first-hand experience getting back to training. I have been pushing my body hard for the last 10 years free from exertion headaches. I am stronger and bigger than I have ever been. I won't start a workout unless my urine is crystal clear, I have perfected a breathing cadence that helps me maintain proper time under tension while also preventing headaches, I keep my neck neutral, and I try to stay calm as I break my body down. You can get back to a high level of training. Get headache free with however much rest you need, ease back into it, and do all the little things to prevent one in the future. I hope this helps!
Thanks for the article. I suffered an exertion headache while doing a crossfit amrap of dead lifts and box jumps. The dead lifts started light and then increased in weight and reps. At the end of 8 minutes and dead lifting 275 till failure my form and breathing we're not correct resulting in a pounding headache. The headache subsided after about 45 minutes. I felt fine the next day until I had sex and it returned so severe I almost passed out. I am having a hard time staying out of the gym for a week but I am going to follow your great recovery plan. I have one question will icing the back of the neck at the base of the head or putting ice on the head speed up recovery? Thanks again and I will be looking for a reply
I just finished my free trial of crossfit and I too got the throbbing,brain exploding sharp headache pain like never before. I'm a 44 year old and only slightly over weight as I have been fairly sedentary for some time. I was dehydrated, doing push-ups at the time of the headache. I also looked up at the instructor who was telling me to improve my form so my neck was not aligned when the headache occurred. The headache did subside after about 2 minutes and I went home. I know do not have a headache at all. The on ramp program starts in 10 days and I would really like to take it. I was thinking I could try some strenuous activity in about a week to see if my headache comes back and if not then I thought it would be okay to start the on ramp classes. Does that sound like a bad idea..am I pushing it??
Kelby, thanks for your comment. Ice will feel good, but I'm not confident it will speed up recovery. I know you are frustrated and want to get back to training. Rest, re-post some updates as you recover to help others, and hang in there.
Jennifer, it's possible that you had a mild headache more related to being dehydrated and new to exercise. Hopefully you did not get a full-blown exertion headache, because they take much longer to recover from. Consider doing some mild/moderate cardio before attempting more intense work and see how your body responds in a week.
Two years ago I was in the gym doing dumbbell press laying flat on a bench. I felt like I was breathing fine. I got up and felt my head pounding so hard I had to sit back down. Perhaps the blood pressure increase of both lifting and then standing was too much for me. Anyway since then its been a pretty dull headache exacerbated by any type of straining. Either lifting or sexual activity does the trick to make it worse. However, cardio can make it better. It hurts primarily in the temple region, back of my head, and behind my eyes. It's painful to move my eyes peripherally, and my entire head/face is tender to the touch. When I look in the mirror I can see the blood vessels in my temples twitching, which I'm guessing is a sign of high bp. It's been 2 years since the first headache, but it has never gone away. Lack of sleep, alcohol, and caffeine all make it worse. I went to the neurologist, had an MRI and MRA done to rule out anything serious and my blood tests checked out ok. In my latest blood test I have an elevated rbc count, but its still within the range. Doc said it could be caused sleep apnea, but that wouldn't make any sense since I'm 22 y/o male 155 lbs 6′ tall. There is no pressure on my neck and I sleep through the night just fine. I have a feeling that there is a connection though with sleep apnea causing a lack of oxygen and the fact that these exertion headaches can be a result of not breathing properly. Anyway I'm really struggling to get rid of these things. Should I refrain from elevating my blood pressure at all? I play video games that can get very stressful at times between yelling and trying to win. Please help! I need to get my life back. I need a routine I can follow to get better. I'm guessing I should stop lifting, sexing, playing video games for a month straight and ease back into things once I'm feeling better, but I could use the input. Any response is deeply appreciated.
Joe, thanks for your comment. It sounds like the initial incident doing heavy dumbbell presses at 20 years old was a classic exertion headache. The location of temples and back of head is also a classic exertion headache pain location. It is possible to drag out the lingering dull headache for 2 years IF you don't allow the meninges to properly calm down. Lack of sleep, not drinking enough water, continuing to lift weights and have sex and push yourself without letting it rest can absolutely drag out the dull headache symptoms. My first exertion headache had the dull lingering headache for 6 months before I finally forced myself to SLOW DOWN and recover.
Since you have already done the MRI/MRA and medical visit to rule out anything major, I would recommend 2 weeks of easy going. Keep your heart rate and blood pressure down (no cardio, no lifting, no sex, no intense gaming). Additionally, gradually decrease your caffeine intake to 1 mug of coffee in the morning, and gradually reduce alcohol consumption until you're not drinking any alcohol. Instead of caffeinated beverages (coffee, Monster, Redbull, Mt Dew, etc.), drink 2 gallons of water a day, spread out across meals and throughout the day. Take ibuprofen every 4-6 hours like the bottle says, and aim to get 8 hours of sleep every night, with naps in the day if you can make that happen. If you don't let the meninges in your brain calm down, they will remain on red alert and this lingering headache will last. Do this until the dull headache is 100% gone. Once the dull headache is 100% gone, begin easy cardio 2x/week for 2 weeks. If you don't have a flair up, then begin the 2 month recovery plan exactly as laid out in the article. As far as sleep apnea goes, it makes sense to look into that for that as an issue in and of itself, but like you said, that is probably not the #1 cause of the headaches, but a contributor.
Keep us posted on your recovery Joe. Thanks for sharing your story, others are reading this and it is a reminder that if these headaches are not dealt with appropriately, they can linger for a long time… For Joe, it's been 2 years. Much like the rest of us that give ourselves these headaches, it has been hard for Joe to slow down and let his meninges calm down. People that push themselves hard enough to get these headaches are the kind of people that will refuse to rest. A torn ACL, a dislocated shoulder, a back injury, all these are examples of injuries that mandate recovery timelines. For these headaches, there is no broken bone or torn muscle that prevents us from training. Mental toughness and adrenaline can allow you to push through and train regardless of the dull headache. However, what's better, 2 months of tactical recovery, or 2 years of minor gains due to a lingering headache that you're trying to push through? Approach your recovery with the same dedication and determination that you apply in other areas of your life and you will back to training at a high level in a couple months.
Great article! As a fan of workouts (not professional insanes) I had one time experience of this bad experience. I had just done my squats and tummy muscles work out. Sweating and in high heart rate, I lifted up some 80kg mass, not as part of the work-out, though. What I felt after a good strain and breath holding, was the experience that made me feel regrets for having not written my will yet!
That headache was too severe, throbbing, feeling as exerting pressure from central of my brain. Like somebody drumming my head from inside it with a blunt bow-shaped hard material. I thought it was temporary, I tried to hold on to what I was holding few more meters. Then I realize this could kill me (being aware of cardiovascular accidents (CVAs). I sought to lie down, but my partner thought I should jump into the shower.
Cold shower it was…but didnt help as much. Slowly, but while feeling it, it started cooling off. Right now, when I re-do the workouts, they kind of recur but not as severe. Now 3 days old, I can still feel it, but subtly.
Your article explained it all. Thanks. Interestingly, no any other feelings like vertigo…blurred vision….vomiting….loss of function of limbs…Not at all, since then up to now, but I was so keen to observe these signs. Thanks once again.
Hey all. You can read lots of good stuff here (and elsewhere), but I wanted to throw out some ideas that I've come across while looking into this with some doctor friends of mine. Quick background: I've been an avid crossfitter for 3-4 years now and got my first exertion headache about 2 years ago. It was of the "Yeah, grenade, I'm done for a month" variety. I took an entire month off (unheard of for me) while going to a chiro 2x weekly and doing some physical therapy. Eased back into things and after a few months got back to full intensity mode. BUT, in the last 4 months or so I've been experiencing the "lite version" (as I've come to call it) where I can feel it creeping into my neck and jaw gradually. The after-headache (because I don't push it when it starts a'creepin') is less as well.
So here are a few crossfit-specific tips for those of you still wanting to work-through this (hopefully as you get it treated). First, stop when you first feel it! Forget your time on WODs and anytime you begin to feel the pain start, step away from whatever you're doing for 20-30 seconds and breathe. Second, neck position and tension are triggers so be extra cautious in certain movements (for me: wall balls, DUs, and snatch especially). Third, for scaling, even though in general you should take it down a little bit intensity-wise, for some workouts it's better to go heavier weight and more breaks rather than lighter weights with more reps before setting the bar down. Example: heavy Fran is actually better than a light Fran for this condition. If you don't believe me, do a heavy set of snatch one day, and Crossfit Open WOD 12.2 another day. (12.2 is what triggered my first EH).
There are also some possible indications that this can be related to a GABA and Glutamine imbalance. Increased Glutamine = decreased GABA; and when you have increased Glutamine you can also have increased anxiety and tremors. This is me exactly, which is why I've been exploring this avenue. I have essential tremors and I came across this theory while exploring what factors made my tremors better or worse. In fact, my nerdiest doctor friend is convinced this is what's going one—not that she's offered up a specific therapy or cure yet. For now, I'm sticking with my lite-WOD philosophy and working with masseurs and chiros to keep things managed. Good luck to any who have this—it's a pain in the…well, you know.
Caleb, awesome insight. While weight on the frame causes an increase in blood pressure, you are absolutely right that sometimes heavier weight with more rest may be a better option depending on the movement than a lighter weight for more reps. When it comes to the Olympic movements in particular, the most adaptation actually occurs in the neuro-muscular junctions (your brain and muscles get more efficient and precise in their communication), not in cross-fiber hypertrophy (muscles getting bigger). While their are some crazy physiological adaptations that occur when incorporating Olympic lifts with a variety of conditioning movements for a true CrossFit workout, there is something to still be said of isolating the Olympic movement with adequate rest to ensure that you are moving as much weight as possible as fast as possible, not being held back by fatigue.
As far as glutamine goes, for those that are not familiar, glutamine is a non-essential amino acid that has been studied extensively and has been found to help in cell repair. In the medical field, it is sometimes used for trauma, burn, or cancer patients. For fitness enthusiasts, it is a logical supplement to help with cell repair after intense training (I'm not going to poke the bear on the pre vs. post debate). I'm not 100% sure of the link between increased glutamine intake on exertion headaches, but you make a good point. When it comes to training and nutrition, everything is interwoven and no stone should be left unturned. Keep us posted on this theory, I'm interested in learning more.
Thanks again Caleb for your insight. I know this will help CrossFit Athletes looking to get back to peak performance on WOD's.
I am just posting an update on my recovery from an exertion headache. I took 10 days off from any exercise and sex. (Ps. During sex the headaches were severe.) I have since started my crossfit training again. The first week was just body weight exercises and running. The next week I added some light weight to my workouts. I have felt a little pain from some workouts but as soon as I feel the pain I slow down and rest. This seems to be working for me. I have also made a special effort to breathe properly and stay hydrated with plenty of water.
Hey guys I have recently just had this same Experience. for me it was a simple as just doing some push-ups, I always make sure to breath and have good form when I work out, so when this happened I was really confused, I have been really into fitness and exercising for a while now so I was worried when this happened.
I have done some Research and have found this: L-Arginine and L-Citrulline which suggest to help with the relieving of the pressure in ones veins, they ar Amino acids that are sold a supplements, it is something that my doctor mentioned and suggested to me, might be something worth researching, i am going to try it to see if it works and helps. they do have some side affects, and like everything it is not intended for all, different bodies have different reactions. also check out Nitric Oxide, it seems to help with this Exertion headache problem as well. hope this helps anyone.
Thanks man i think I have this and I've gotten them during leg presses and today on my last set on the bench, and during sex. I'm going to the doctor tomorrow, the pain justs stops my workout completely. I hate to think I have to take time off because I am a football player
Hi, first may I say it was an excellent article, I've been an age trolling through the net looking for non complicated information. I first got the headaches while having sex in my early 20's I would have been unfit at this stage and couldn't explain them, the pain was mainly on the right side of the forehead, the the next time they occurred was when bench pressing in my mid twenties, my solution to this was to take ibuprofen and do a 20 time fast cardio work out usually running at a quick pace on a threadmill. They soon ceased after this, now I'm in my mid thirties and would consider myself to be the fittest I've been, up to now I mostly ran and cycled. But recently I've started crossfit too, although I haven't yet had an extreme headache I have felt the warning signs on a couple of occasions. I wonder is it that I go straight into squats dead lifts etc., without having my heart rate already raised from a cardio workout ? I don't really want to start taking ibuprofen again, but may have to as it was the only solution before. I would always be well hydrated too. Any advice would be appreciated. Thanks Paul
Firstly, great article!
I think I had this problem last Friday during a leg workout. Did around 5/6 sets of incline leg presses and had the familiar slight headache at the end. Re-racked the weights, took on some fluids and moved on to seated leg presses. Second set, around 6 of 8 reps while pushing to finish (and I think holding my breath), I felt this ripping in my head, front to back on the right hand side, followed by a throbbing headache and slight dizziness. I lay down, sure I was having a stroke until the pulsing stopped and I was left with a dull ache on the right hand side of my head.
I rested that night and went back to train back and bi's the next day. I had the same pain again mid-set doing lat pull downs, albeit, not as bad.
Sufficiently concerned, I went to the GP. They did a full neuro exam but would not offer a scan, no matter how worried I was about the ripping sensation (I'm in the UK; NHS don't like spending money!).
Something I never do is Google symptoms but this then led me to your website and exertion headaches. The spike in blood pressure could I suppose have caused the surge of blood through the vessels and the sensation I felt. Might be worth mentioning, I'd had a pre-workout prior to the first session.
4 days since the last headache and I still don't feel quite right. A little fuzzy headed on the right with a dull ache at the front and back of my head. I also get the odd pain over the area where I had the ripping feeling (over sensitive meninges?). Exertion during other activities has caused a slightly more severer headache in the same area since.
I'd be interested in your thoughts.
Hi, first mini exertion headache in years just happened. 20 rep sets of front squats. Breathing was perfect but just realized how dehydrated I was. Classic mistake. Luckily I didn't get to bad a headache. The first time I did it I thought I was a goner.
I feel fine now. Hydration imagine missing that. Also think the high reps do damage too.
Guess it's back to the machines for legs for a while.
Great site thanks
Hi, first mini exertion headache in years just happened. 20 rep sets of front squats. Breathing was perfect but just realized how dehydrated I was. Classic mistake. Luckily I didn't get to bad a headache. The first time I did it I thought I was a goner.
I feel fine now. Hydration,imagine missing that. Also think the high reps do damage too.
Guess it's back to the machines for legs for a while.
Great site thanks
Gym this morning, felt great. Until inclines. Headache back. Looks like a week off.
Thank you so much for such valuable information! Got the first big one 2 weeks ago while lifting weights. Same thing next day, so went to doctor. A million blood tests later, all clear. MRI scheduled but still getting little bursts, bout 20 times a day.
Do you think taking the ibuprofen daily will actually HELP with recovery? Always been hesitant to just pop pills but if it'll actually help me get back to the gym (all my hard earned muscles are disappearing!) then awesome
Thanks again!
Before I go into what I experienced I want to thank you Nick for this insightful article.
I was struck with exertion headache/migraine (starting from the back of my neck reaching to my forehead) in the middle of my wod while back-squatting (3 rounds, 21/16/9 reps, back squat @ 50Kg + box jump, for time). Tracing back my moves I believe my neck was in a bad position while squatting (upper cervical extension), resulting in crushing the soft tissue and blood supply there – I say this bc I still feel some soreness on my neck. I did soldier on till the end of the exercise and now I know I shouldn't have. The guys at the box put some ice on my neck which I'm not sure if that was a good move either. The next few days I had to take some strong pain killers and felt super dizzy (although no blood pressure fluctuations) to the point where I almost fainted while walking. After consulting to my friend who's an orthopedist, he strongly suggested that I see a neurologist. So I did take his advise, went through a physical check-up and MRI scan and thankfully came out clean, but the dr told me to rest for a week (no negotiations here!). I was prescribed a muscle relaxant, a specific headache pill for future general headaches and a medicine called 'Indocin' (indomethacin) (ENDOL where I live) to be taken 30 mins before workouts. Having experienced (still) this I strongly recommend sufferers or victims of exertional headache to see a doctor in order to seek the right cure and rule out other life threatening medical causes. I hope this helps..
Ibuprofen will help the first few weeks, after that, it doesn't help as much with the lingering headache. Thanks for your input!
Sounds like you are doing the right thing and have an attack plan for getting back to high level training by tactically easing back into legs. Strong work.
This sounds almost exactly like how I got my first exertion headache. Everything you described sounds like a classic exertion headache. That being said, I'd recommend following the recovery plan of the article before I'd offer any custom-tailored advice. Keep me posted.
I also stumbled across your article. I recently joined crossfit, I have worked out a total of 4 times. I started getting these headaches after the 2nd workout. However, I did not associate the headaches with my workouts. No medication worked and made a trip to the ER ( act of god for me). Test all within normal. Menengitis suspected due to the pain described but refused the lumbar puncture.
After the 3rd flare i finally connected it with my workouts. I am not sure what exercise I am doing to cause this because I am so new to the program and working out in general. It is obvious to me now that the recurrences are due to the menengines sensitivity and not enough down time.
I am relived that there is an answer now. Thanks!!
Thanks for this write up. I had a scare last week, 2 headaches, one day apart. They have put me on a beta blocker to take daily and indomethacin to take 45 minutes before exertion. My headaches were extremely painful, as in screaming in agony, went to the ER. They ruled out the dangerous stuff.
They did a spinal tap, which in hindsight I think I would have skipped. The hole didn't heal and I needed to go back in for a blood patch. was miserable all week and still have a sore back after being up for a couple hours.
Great site, great idea. The comments by others, as well as your dedication to answering them, are particularly helpful as they help us relate to our own version of the exertion headache.
I had my exertion headache nearly three weeks ago from dehydration, improper breathing, and lifting too heavy of a load. It was intense but faded away quickly. What I've been suffering from since is a dull headache that refuses to go away. Light cardio makes me feel dizzy and even prolonged walks cause thumping in the back of my head and bring up dull headache symptoms. I've stopped all serious cardio activity and working out but am discouraged at the progress I have made thus far. I still drink a couple of cups of coffee and have several alcoholic drinks in the evening. I will eliminate caffeine intake but the alcohol is difficult to get rid off as it helps me sleep now since I have practically no physical activity.
Please advise on how I can speed up the recovery process and if my current routine will eventually eliminate the dull headache symptoms. I'm committed to not working out or partaking in strenuous cardio, but do I have to stop walking and drink water only? This would be a serious challenge.
Thanks a lot! This article was really helpful! I experienced one of these when I hit about 120kgs on the Squat and 140kg on the Deadlifts for my 5×5 workouts. Went back to sleep it off and all was good and well the next day.
One week later I tried the same thing while dehydrated, with poor next position while holding breath and I get a massive headache after my workout.
The headaches got better day by day, but today is day 5 and its still there so I expect that I'll probably take two months to recover too.
Thanks so much for the useful advice, it was really informative, well written, and solved all the queries I had when I visited my doctor today.
Thank you APEX!
Unfortunately, there is nothing you can really do to "speed things up" other than resting and allowing the meninges to calm completely down. The initial exertion headache you experienced was interpreted by your brain as an attack, and now all the sensors around your brain are on Red Alert, so walking, running, and of course heavy intense lifting, will cause the dull headache to become severe again, which sets you back even further.
It sounds like you got a classic exertion headache, and from your personality, it sounds like you are a prototypical pit-bull-headed person. High pain tolerance, push yourself very far, and reluctant to slow down to heal. The kind of people that push themselves hard enough to give themselves this headache are typically, like you, looking for shortcuts to get back at it and refuse to slow down.
So again, from one pit-bull-headed guy to another, take some time and let your meninges calm down. Follow the recommended recovery timeline in the article, and keep us all posted. Thanks brother!
I recently suffered from this on Monday after starting as an intern at a new no frills gym. I pushed through training all week, every session resulting in a headache right from the beginning. Nevertheless i bull-headed through every session until the friday (very intense training culture – and i was the new guy!). I suffered a headache over night and the pulsating is still going now. I went to the physio who has experienced this with a few clients. Only now have I realised i must stop completely. The physio said he had one client who bulldosed through for over a month and had the symptoms last for over 7 months, also decreasing his cognitive function. So i've now learned that i need to stop and rest, much to the disappointment of both of my new employer and myself. Hopefully it doesn't affect my internship and career as a result… Good article!
It sounds like you've found a pretty intense company to work for. Congrats! Every fitness company looking to walk the fine line between insanity and maximal human performance need to become familiar with exertion headaches. Even as the "FNG," you can help your new employer learn more about these headaches and perhaps enhance the program design to prevent them. Proper breathing, hydration, remaining calm during the workout, and proper form all play a huge role in preventing these headaches, and as a fitness company the challenge is pushing people as far as they can go without hurting them. I encourage you to sit down with the masterminds of the program design at your new job and just have an open discussion about exertion headaches. Feel free to contact me with more questions, I'm happy to help!
Great article APEX. I am in my first month of crossfit and during a dead-lift WOD I experienced a medium throbbing headache and pain behind my right eye. The pain comes and goes usually when I bend over it becomes more severe. It has been 48 hours now and the those two symptoms persist. I have researched exertion headaches and like I said the severe pain only comes when I bent over every once in a while. I have worked out intensely the past couple of days with no issues. Based on your article I will head to the doctor tomorrow for tests. Does this sounds like a excretion headache? Thanks.
Thanks for the great article apex:) I believe I may be suffering from a exertion headache but not 100% convinced if that makes sence.
I was doing leg press 4 sets of. 8 reps, however on the last set I thought I would push to failure. I got 20 , on about rep 16 I got a tensing feeling in my right temple area. Since this has happened It seems to come and go throughout the day every day. I can describe it as not a painful headache but a weird pulling sort of sensation on the right side of my head. When it flares up it feels like my gums on the right side of my mouth are rubbing my back teeth??? Sounds unusual but is really getting on my nerves and am wondering if this is a exertion headache sympton. I notice if I lean down , bend over it feels like blood filling my temple on the right side and then the dull funny head kicks in. Could this be a pulled temporal muscle instead? Found this article in google, it has been a good read, thanks Steve
Thanks for your comment. It sounds like you did experience an exertion headache based on the mechanism of injury (deadlift) and the location of the headache being behind the eye (temporal region). The fact that you only feel the flair up of a headache coming when you bend over may mean that fluctuations in blood pressure play more of a factor for you than heart rate. I would recommend taking some time off because if those symptoms persist, you are still in that window of time where you are highly susceptible to getting another full blown exertion headache. Keep me posted.
The fact that you experienced the initial headache on the 16th rep of the 4th set of leg press leads me to believe it is an exertion headache. I have had people email me about the same sensation in the past, and after visiting a doctor, what they passed on to me was that as the blood vessels were impinging on the nerves responsible for signaling the temporal muscles to contract, not a damages temporal muscle. Unless you were grinding your teeth to the point of snapping your jaw, it seems unlikely that you tore or damaged any muscles in your head. What actually happens during an exertion headache is a forced dilation of the blood vessels in the head, which then press on the meninges covering the brain. The blood vessel remains swollen for about a week, and the meninges remain sensitive to being pushed on for about a month. Any changes in blood pressure or heart rate can cause the blood vessel to dilate and press on the meninges again, causing another full blown exertion headache. Now, to explain the contraction of your temporal muscles, what could be happening is as the swollen blood vessel may not only be pressing on the meninges covering the brain, but it could also be impinging on the nerves that tell your temporal muscle to contract. To help understand this, relax your left hand and then squeeze your left wrist with your right hand. Did your left hand clench into a fist? It's not a perfect example because you are also squeezing the muscles themselves, but the concept is applicable. With swollen blood vessels in your head, you have less room than normal, so other areas are going to be getting pushed on, which can cause things like weird muscle contractions. That being said, I would recommend a medical visit where further testing can be done to rule out anything more serious.
Thanks apex for your comments. it is really nice to get a good reply. I have laid off training for a bit, so hopefully this will help. the headache does not seem as bad right now but I still have the weird pressure feeling in my temple area. when I get up in the morning I,m pretty much ok, as soon as I come down stairs and I start cooking some eggs for breakfast I feel the same temple pressure kicking in and then it lingers about for hours at a time.
something telling me I have tight neck muscles that are pulling on my head lol.i don't know
but I must add I was out in the sun working on the 11th june (forgot to add in previous comment) and later that day I had a heat type of headache, the pounding type that really hurts until you go to bed. I,m am not sure if this had something to do with starting the exertion headache off? maybe swelling the meninges ? and then when I did the heavy weights it triggered the exertion headache off?
on a scale of 1-10 what would you say the pain is of a exertion headache?
I,m on about a 3 out of 10, just enough to let me know I don't feel right.
thanks for your imput again, I will keep a eye on it and update here on what I do to relieve it. thanks again steve
Thank you for the information! It seems like everyone is a little different which is strange because most of it is caused by the same thing. I like a few others got my first one by very heavy dumbell presses. I was probably dehydrated and held my breath too much. The pain was very intense but would subside a little after some heavy breathing. I eventually could not even continue the workout (very scary for me). The residual effects lasted a day or so and was not very noticeable and felt fine until today when I tried to work out again… Like others have said I did notice my neck is really tight and some neck rotations did seem to help so I might get that checked out. I'm really convinced it's not something serious. My case is different from other people as I am fine doing cardio and when I say cardio I mean a 20 minute 5k and intense basketball. I did not feel a thing from that, but today just doing 2 pullups brought it right back… I will take it easy for a month… or maybe get bullheaded enough to do very light weights after a couple weeks. lol I noticed I could control it by doing light weights and focusing on my breathing and. It was kind of comforting to see others who have been dealing with this as well. I had never heard of this before and knew right away it was because I was doing heavy weights. Wonder why I can do intense cardio and have sex with no symptoms, but 2 pullups will do it? Any Ideas?
On a scale of 1-10, the INITIAL exertion headache for most people is a 10, and has been described as, "a grenade exploding" in either the temporal region or the back of head. After the initial headache, that usually only lasts 24 hours if you rest, there is typically a lingering dull headache that is maybe a 2 or 3. That dull headache can revert back to an intense level 10 headache with either an increase in heart rate, blood pressure, or both.
The yard work in the sun probably contributed to dehydration more so than swelling the meninges. Heat related headaches are typically correlated to dehydration more than anything else. Going into a strength workout with a mild dehydration headache is a risk factor for an exertion headache though.
As for the tense neck muscles causing the weird pulling sensation, that is possible. You are going to need a medical visit, since only an MRI can tell you for sure what muscles are doing beneath the skin. Have you tried any relaxants, a massage, or anything else to relax the muscles in your neck? I have had maybe 5 out of 500 people say that acupuncture helped their headaches. It could be related, or could have been a coincidence. Keep me posted Steve, thanks brother!
Thanks for your comment. The reason you can do cardio and have sex and be fine, but 2 pull-ups causes a full-blown exertion headache is because for you, blood pressure is the primary trigger, not heart rate. Weight lifting adds pressure to your frame externally, and the way your body combats that external load is by matching it with internal pressure of its own. Part of that is done by tensing muscles, part of that comes from an acute increase in blood pressure. It was a forced dilation of blood vessels that caused your initial exertion headache, and spikes in blood pressure will cause flair ups. For others, their heart rate also plays a factor in the flair ups, so cardio and sex are risky for them.
Blood pressure is a trigger for everyone, which is the main reason why the recovery timeline keeps you away from heavy movements with legs like dead lifts and squats, but allows for some mild cardio and upper body lifting first, followed by isolateral leg exercises and finally light weight compound leg movements. I have never heard of someone that can do 1RM dead lifts, but a light jog causes a flair up.
I have had a history of these headaches starting when I was around 17-18, (I'm 23 now). I would get them, it would suck, I would take 2 weeks off that usually did the trick. I got one of these about 2 weeks ago. Did the same process, too 2 weeks off. Then started working out again lightly and was feeling fine. I worked out for a week with no issues, although I took it light. Just yesterday (now 3 weeks since first headache) I had sex with this chic after a few drinks and I felt a minor one come on and then pass. Then today at work I got a dull headache that got like 30% worse throughout the day without doing anything physical. I just joined the work force out of college at a desk job, ergo I drink about 1-2 cups of coffee per day. I would prefer to give us working out over sex. Do you think I need to take the full 2 month recovery process and do I have to give up sex? Also does creatine have an effect on this? I've heard mixed reviews on that. Thank you
Following up to my previous post, it has now been 16 days since my initial headache and 12 days since my last one (4 training sessions in a row). I'm now only just able to do some light upper body training, but can still feel a slight increase in the dull background headache when doing this. I will still continue to train lightly, increasing the loads when I feel ready. I also wonder why some people seem a lot more susceptible to this than others. I have a feeling stress played a part in mine, which often causes neck pain/aggravation/tightness and may have left me more susceptible to the headaches. I also have a comparatively long neck and lack a big yoke (traps and neck). I wonder if building up a strong and powerful yoke would help? Improving blood flow/or blood vessel distribution…What do you think? Really appreciate you taking the time to get back to everyone.
Awesome artical! Covered all of my many questions plus some! Ty!
I've been getting these headaches for about 3 months now, only recently managed to get a Dr's app't..he's told me to stop working out altogether as I might get a hemorrhage….can this be right??
I am now on my 3rd week of rest, not working out at all. Even now I can 'feel' the area where the last headache was. I love weight lifting and training in Karate and am feeling so down about not being able to do either of these. I don't know how long to rest for as I'm so nervous of getting another of these crippling headaches. Was thinking of going back to karate as I don't recall getting these headaches when doing that.
The dull headache you are still feeling is an indicator that you are not ready to lift again yet. As far as the karate goes, I would imagine that forms and mild workouts would be fine, but competitive workouts may not be wise. Once the dull headache is 100% gone, start easing back into harder karate workouts followed by easy lifting ones.
Jordan & Max,
Things like coffee (caffeine) and Creatine can affect fluid balance in the body, and while recovering from an exertion headache, it makes sense to back off on both to maximize your hydration. As far as building up your trapezius, that does absolutely help with preventing exertion headaches during heavy squats, the number one culprit for the headache, because you essentially build some padding (muscle) between the bar and your blood vessels.
As far as sex and time off goes, would you rather take an easy two months off, or would you prefer to have these headaches affect your sex life and workout program for the next year?
Thank you so much for this article, I had the same exertion headache you have highlighted above when doing leg press. It felt like my brain had exploded, my partner took me to the emergency unit and a CT scan was done and the results were normal. The consultant advised that was no need to do a lumbar puncture since I didnt have any blurred/double vision or stiff neck or any of the common symptoms with a patient that has suffered from a brain aneurysm as that was my fear. I will take some time of the gym to recover as i find that even when having sex the headache returns but the pain is not as bad as the initial pain when the incident happened. I am now less worried, so once again thnak you for this detailed article.
Hi Guys,
I had one of these at Crossfit training on Training on MOnday Evening , Wednesday was fine , but got another one while training last night. I noticed two things in common here , firstly I am also using a Pre Work out supplement , and I also tend to hold my breath. I think I need to go into rehab.
Very excellent information. I will follow exactly after my first exertion headache today and hopefully recover very quickly. thank you very much
I can't thank you enough for this thread. It's been a valuable resource in my recent joyful discovery of exertion headaches. I'm 42, and have been cross fitting for three years. I'm not a games competitor but am in very good condition. I'm including my story here to reinforce that YOU CAN'T SPEED UP RECOVERY.
My story is that I came in a little tired, probably dehydrated and did a three-round WOD that included 15x overhead squats per round. Despite the light weight (95 lbs), I was gassed and locked into a valsalva breathing pattern in the third set and near the end, WHAM, the pressure went off between my temples. I dropped the weight, knelt down, and it was gone in less than a minute. I finished the rest of the workout at half pace. I actually felt fine the rest of the day, but waking the next morning, I knew something was wrong. The dull, tingly headache left me feeling foggy for days as it SLOWLY got better. But I had discovered another site that said to take some time off, so I wasn't working out.
By day five, I felt vaguely human and started incorporating some biking back into the routine, and did a few intense cross-country rides. Everything went so well, that by day ten I was back at the xfit gym doing non-weight classes. Again, they went great and I started feeling strong again for three classes. On the fourth, the class incorporated some dumbbell thrusters (front squat with shoulder press at the top), so I thought I'd go light with just enough weight to challenge me a bit. All was good until the last set of thrusters when the headache crept in at the edges. Though I stopped quickly, it left me with a prickly, hot feeling around my skull. That too passed in a few minutes, but the dull residual headache went to a whole new level.
Eight days later, the dull headache and temporal pressure are healing, but MUCH SLOWER THAN BEFORE. To say that this has been life-altering is putting it mildly. The headache leaves me feeling tired and foggy. Not good when you're a working writer.
So the long and the short of it is that the advice here is dead on. Don't push it, or you'll only be that much further behind the ball when you do heal.
I've put the xfit on hold for at least a month and am about to introduce swimming and light cardio. In the above posts, I've wanted to see some successful recovery stories (timelines, etc), so I'll do my best to report back.
Good luck everyone.
(For the record, I did see my doctor after each round of headaches)
Bit of an update:
Nearly 15 weeks since the initial flair up and I'm back in to pretty strenuous cardio again.
Recovery took at least 8 weeks until I could begin to push myself slightly. Ibuprofen certainly helped with the dull ache and exercise began to help keep the headache away until a few hours after and it would come back. Also found the biggest help being massage and acupunture of the neck muscles.
I'm still not lifting heavy and I don't plan to for a little while yet as the whole experience is one I'd very much like to avoid! Back at the gym though but weight is down with an increase in reps. Still found that lat pull downs give me a slight headache; thinking this has to be body position/neck related and will work on it.
Otherwise, all's well (went for an MRI and that was all clear too)! Thank you for again for a great article, it really helped with the worry of a problem with my head and then the recovery.
I will echo the sentiment that many have shared on this thread as I am very appreciative for the information as well.
I have been doing crossfit for almost three years now and a few weeks ago I started to feel a pain when I bent over to pick up the bar during heavy lifts. It would occur near the end of my met-con when I was near the ceiling of my conditioning. The pain was not a '10' but it was noticeable. It went away within 6 hours. This week again I felt this sensation and it lasted a little longer. I have severe, and I mean severe, allergies that have similar symptoms (dull or cloudy type headache).
Within the last two weeks I have completed very strenuous hikes will no issues of headaches.
From following this thread it appears that I have greater impact from high blood pressure than a high heart rate. From your experience do allergies play a role in building up to an exertion headache? Any advice will be greatly appreciated. I will post an update as I consult my physician in the near future.
Thank you for this information. I believe I got an exertion headache about a week and half ago. I drank plenty of fluids and took ibuprofen but had a neurologist tell me I should take two days off ibuprofen so that my body didn't get accustom to taking meds. I was doing great and thought it was slowly going away until last night when the excruciating pain came right back at the back of the head and temples. Is it still ok to keep taking ibuprofen? I am considering getting an MRI/ct scan but I'm so scared of the costs without insurance and reading everyone's comments make me think I only had an exertion headache.
I apologize for the late response. Your comment was pinned between a few spammers and slipped through the cracks as I approved comments. Thank you for your feedback. Any updates?
The fact that strenuous hiking did not trigger a headache for you is either a sign that your initial headache was not a severe exertion headache, which your other comments support (you did not describe it as a 10/10 or "grenade exploding in your temples"); or, that heart rate has less impact on you as you mentioned. It is hard to tell.
I used to suffer from allergies and I believe with 100% confidence that they compound the risk factors. Many of the medications used to counter allergies can leave you slightly dehydrated and may serve as a stimulant, increasing base heart rate. Allergies will also create additional sinus pressure, and any additional pressure while dealing with an exertion headache can be very painful.
Rico, I would encourage you to drink extra water during allergy seasons to ensure that you are adequately hydrated, and pay close attention to your blood pressure and heart rate while taking medications. It sounds like your initial headache was moderate, but still apply due diligence on recovery. An exertion headache is no different from a broken bone or a torn ligament. Take the time to heal correctly.
On a side note, have you considered getting allergy shots? I just finished the process and am in a maintenance phase now and it absolutely worked for me. Basically, they test you for everything you might be allergic to, then create a custom serum of everything you are allergic to, and then inject you with it on a weekly basis with a progressively stronger concentration which builds up tolerance until you reach the max dose. About half way through the process it was the middle of Spring and I was out doing yard work, hiking, and backcountry camping, all symptom free. I may have sneezed twice all Spring… Look into it at least.
Thanks for bringing up Ibuprofen. I have gotten a few personal emails outside of this thread about it, and I will touch on it here.
Ibuprofen is a handy tool for helping with exertion headaches, but can be addictive and must be respected as a drug. As it relates to exertion headaches, typically Ibuprofen is MOST helpful after the initial headache during the 2-weeks-off phase, as it can help with the initial pain and swelling associated with the forced-dilation of the blood vessels in your head. Drinking plenty of water during those 2 weeks is also paramount, as it will keep your body hydrated which will allow your blood to flow smoothly and effortlessly through the tender blood vessels. For most people, the severe headache only lasts a few hours with a "lingering dull headache" that lasts for those first 2 weeks. After the first 2 weeks, most people feel report that the dull headache subsides, but they still feel slightly foggy and can tell they are not 100%. To account for the pain/swelling relief, as well as considerations for addiction, a healthy balance that works for most people is the following:
1. Take the maximum recommended dose for the first 3-5 days following an exertion headache, along with tons of water and no activity
2. Continue taking slightly less than the maximum recommended dose of Ibuprofen the rest of the first week
3. Begin tapering off Ibuprofen during week 2, so that at the beginning of week 3 your are no longer taking any
This should give you the relief you need without causing dependence. Keep me posted.
My girl friend I believe has this problem but I'm not sure if I should give her aspirin or ibprophin
Thank you for the thread, Nick, and keeping it updated!
Have you heard of anyone getting "delayed exertion headaches". I call it that because I get a headache a couple hours _after_ the completion of a strenuous cardio workout. It is usually modest (not sharp) and responds well to Excedrin (acetaminophen/caffeine/aspirin) but still, I'd like to not get them. (And the caffeine in the Excedrin conflicts with sleep if it is an evening workout.) I've experimented with lots or no hydration and/or eating post workout and haven't seen a correlation. Any suggestions?
If your girlfriend has an exertion headache, ibuprofen will be more useful than aspirin. Ibuprofen helps with swelling, which is the cause of the headache. While aspirin or medications with aspirin can help normal headaches, an exertion headache is different and aspirin will not help the root of the problem, the swelling. Aspirin may help some because it will thin the blood and allow for the blood flowing through the veins and arteries in the head to flow more smoothly, but the swelling will only go away with time, drinking lots of water, and no more than the daily recommended dose of ibuprofen.
Check out my reply to Mina on 8/22/2014 at 5:47AM for more info on ibuprofen. Also, make sure your girlfriend gets checked out by her primary doctor just to make sure the headache isn't something other than an exertion headache. Always feel free to reach out again if you have more questions, and keep us posted on her recovery. Thanks Nate.
Thanks for your comment. To answer the question, no, I have never heard of a delayed exertion headache. Furthermore, it seems unlikely from a scientific standpoint because of how one gets an exertion headache.
Exertion headaches are a forced dilation of the arterioles in the head. Those blood vessels then press on the meninges surrounding the brain, which results in a, "rush," of a headache in the temples or back of head that feels similar to a "grenade exploding" in your head (you described yours as "modest" and "not sharp"). It typically occurs during or immediately following a heavy set of strength training, but it is possible during or immediately after a very strenuous cardio bout (CrossFit incorporates both simultaneously). It is not likely to occur several hours after a cardio bout, even a very strenuous one. My guess would be that it is a normal headache that has something to do with hydration and/or nutrition, and that the Excedrin (caffeine) just fixes it because Excedrin is awesome for normal headaches and migraines.
I would approach this as a normal headache caused by a strenuous cardio workout, not an exertion headache as outlined in this article. For a normal headache caused by a hard workout, the main culprits are usually dehydration, not enough food, or either more/less caffeine than you normally consume. You mentioned that you have experimented with lots of hydration and your diet "post workout"and haven't had any success yet. Drinking water is always a good idea before, during and after a hard workout, but entering the workout dehydrated will set you up for headaches and poor performance. Food is the same. Many will eat light before a workout so they don't upset their stomach. Everyone is different.
My advice to you is to allow yourself to eat a little more both before and after the workout, and be mindful of drinking enough water that your piss is crystal clear the day before your strenuous cardio bout, and then re-hydrate after the workout. Also, pay attention to your caffeine intake. Coffee/Tea, pre-workout supplements like Jak3d/C-4/NOExplode/Monsters/Red Bulls, and sodas, particularly Mt. Dew (my favorite…) all have high caffeine content. If you fluctuate on your caffeine consumption, either consuming more or less than normal, you may get headaches.
Keep me posted Aaron, and if this advice isn't helpful, give me more information and I will try and do a better job.
Thanks, Nick! I'll try the things you suggested.
Thanks for your article. I now understand what happened to me. I lifting heavy at the gym and on my last rep I got stuck and decided to muscle through it by holding my breath. At that point I immediately felt blood rushing under pressure, starting at the base of my head (left side) and rushing to the top left of my head. I felt like my head was pounding and could not continue training. I returned to the gym every day that week and had to quit on the first set due to onset of a headache. On days that I did not attempt to lift I ran two miles at a slow pace and did not get a headache. Now that I have read your article I will rest the two months; however, does this mean I cannot have se for two months Oris that just for the first week?
4 to 5 weeks ago I experienced a sharp shooting pain right at the base of my skull when finishing up my CrossFit workout and straining to get my last couple push-ups. I felt fine the rest of that week and the following Monday had the same pain when I was straining to get my last couple pull-ups at the end of the workout. I went to a chiropractor and had him evaluate my spine and he found three spots along the left side of my neck that needed adjusting. He told me that I strained the sub-occipital muscles at the base of my skull and that combined with the misalignments in my neck were giving me the headaches that I was dealing with. I now have had dull headaches for the last four weeks and have been nervous about what the cause may be. Along with the dull headaches the last week I have gotten a little relief yet I have little shooting pains in the back of my head and temple area that just flare up periodically. I am not sure if that is the nerves and meninges just healing since some of the dullness has went away and they are still sensitive and just reacting or what? After reading your article it sounds exactly like what I have been dealing with, except that I was not doing a heavy leg lift when they occurred. Also I have had lot of tightness in my neck muscles that is only relieved by massaging them along with the headaches. I don't know if I could have had a combination of strained muscles like my doctor told me along with an exertion headache or what. I just know that it has been going on for over a month and I am very frustrated with it and it is causing a lot of stress in my life. I thoroughly appreciate the detailed post that Nick Ryan wrote on this topic and would love to talk with him a little bit about my situation if at all possible. I also sent a message to Apex through the contact tab on your website which has my email and phone number in it. Thanks again for your help and please contact me as soon as you get a chance.
Thanks for your comment. It sounds like a classic exertion headache, all the key variables were present (last rep, fatigue, holding breath). The fact that you felt the headache creep in on the first set all week yet were able to run at a slow pace without any symptoms makes it sound like a moderate initial headache. The 2 month recovery plan should work perfectly for you, keep us all updated with your timeline for everyone's benefit.
You are not the first person to ask about sex, so I will take a moment to share my thoughts on it. My advice would be to give yourself a full week off from EVERYTHING that is going to cause a surge in blood pressure and/or heart rate. That would include sex, masturbation, running, hiking, biking, swimming, its all the same. I've even had a few hardcore gamers tell me that the increase in heart rate felt during playing competitive online video games was enough to cause that lingering headache to flair up a little more. The first week is crucial. Unfortunately, most people that read this article have already attempted to train after the first headache and are looking into causes only after having no success. Side note, if you know anyone that trains at high level, they need to be educated on how to prevent these headaches, so spread the word.
To answer your question though, the first week I'd recommend refraining from EVERYTHING that will cause and increase in heart rate and/or blood pressure. After that, mild things can be introduced. I would be honest with your girlfriend/wife Isaac, and let them know that you pushed yourself a little too hard training and need a week fully off of EVERYTHING that causes a spike in blood pressure and/or heart rate, including sex. Most lovers will appreciate that you are training hard in the gym and will be understanding that you need to heal after a crippling headache. After that initial week, tread lightly. That being said, sex is a significant release for stress. After the build up in heart rate and blood pressure, the post-sex relaxation may be helpful. Again, I do not intend for this to be taken as medical advice here, just speaking from personal experience. Be honest and open with your significant other, keep them informed on how you're doing, and if they love you like I imagine they do, they will be supportive of easing back into the routine.
I hope this helps, keep us posted Isaac!
Thanks for your post. I do not have the current statistic accurate for you, but a ball park is that somewhere between 10-20% of people come back saying that a chiropractor helped in relieving the headaches, and that spinal alignment issues were a contributing factor. The 3 discs on your cervical spine that needed alignment, the tightness in your neck, the "shooting pain" you felt initially, and the fact that you "felt fine the rest of the week" make me think that this has a lot to do with what your chiropractor suspects. Massages helping with the headaches is more evidence.
That being said, just because you got the headache during push-ups does not mean that you did not get an exertion headache. Often times it is the snowball effect of many variables, not just a compound leg movement that triggers the exertion headache. I mentioned 5 risk factors in the article, and added a twist for CrossFit specifically for another 5 risk factors. CrossFitters can get these late in workouts doing almost anything. Hold your breath when you're dehydrated, fatigued, and pushing hard, and you can get an exertion headache swinging a kettle bell. It doesn't matter at that point, something will put you over the edge. For you, it may have been push-ups.
I've re-read your comment 5 times now Steve, and I have some questions.
1. When you experienced the first headache during push-ups… Were you peeing crystal clear all day before the workout? What else had you done during the workout leading up to that set of push-ups? How much sleep did you get the night before? Were you holding your breath at all?
2. You mentioned the headache being "shooting pain", which is very consistent with the nervous system, not so much with a forced dilation of arterioles that then press on the meninges. At any time, did you feel a sudden rush of localized pain in either the temples or back of your head that could be described as a grenade exploding that made you curl up in the fetal position, or was it exclusively "shooting pain" that surged through the neck and into the head?
3. You mentioned that you were "fine the rest of the week". What physical activity were you able to do that week, if any? Did you have any headache symptoms that week, or did it take a full week after that before the "lingering headache that's lasted 5 weeks" kicked in?
I think that's good for now. Keep me posted and I will keep trying to help. In case you don't feel comfortable replying, my gut is telling me that this was a CNS issue that time with the chiropractor will greatly help; however, as time has gone on, the meninges have flaired up to a point where you are experiencing exertion headache symptoms even though you did not start off with a classic exertion headache. Classic exertion headaches are high BP/HR, dehydrated, hold breath, last set of legs, then BOOM, rush of pain that feels like a grenade and drops you to the ground from the pain in your temples/back of head. That is not what you had from what I am reading. Shooting pains, a chiropractor diagnosis of c-spine alignment concerns, early-on pain-free training, and relief during neck massages are all red flags for spinal/chiropractor concerns, not exertion headache. Other than the dull lingering headaches that flair up occassionally (classic mid-game exertion headache symptoms), everything you have described sound like nervous system to me.
At this point, I realize you just want to get back to training again. Regardless of the cause, the proposed outline for recovery should still be spot-on for you, but you will need to add chiropractor visits. The good news is that once everything in the neck/back is aligned correctly, the shooting pains should go away. Then you need to baby your head with easy training until your head proves to you that it can handle higher intensities.
I wanted to post my experience with these headaches here because it's been difficult locating information for anyone who is not weight lifting or doing crossfit. In June I had a root canal, the dentist drilled into my sinuses so when I got home I felt the urge to blow my nose and all that kept coming out was black mucous. That led to a very serious sinus infection. Think intense pressure on cheeks, roof of mouth, eyes, temples, double vision, pus draining from sinuses induced vomiting… Ent suggested taking out the tooth to make sure it wasn't source of infection, got that tooth taken out as well as an adjacent wisdom tooth because they were digging around in there anyway. I spent 6 weeks on the couch recovering from the sinus infection, then antibiotics induced diarrhea and tooth removal. Finished antibiotics and decided to take a short trip to stay with my mother in law who's paralyzed from a stroke. I spent the week helping her get dressed, with chores around the house, shopping cooking baking, you name it. I pushed myself because I knew she didn't have anyone else to do any of it for her and I needed to get it done before I left. I was unloading the dishwasher and in general squatting instead of bending over because that caused sinus pain so I'm unloading the dishwasher and all of a sudden I feel like someone stuck a vice on my temples. I push through it because it's probably just another one of the many side effects I had been experiencing from sinusitis… this lasted for over a week. I'd run up the stairs and it would get worse. Any sexual activity was practically unbearable and prescription pain killers did not alleviate the pain. Here I am three weeks later with the same headache after a long walk through the grocery store… Just had another wisdom tooth removed a week ago which makes this all the more unpleasant. I drink plenty of water but since tooth removal have been dehydrated for sure which has made this time around more painful. Going to see a neurologist soon and am worried that they'll tell me that it's impossible I'm having exertion headaches because I'm not lifting weights or pushing my body to it's limit but going from weeks on the couch to being on the go go go from 7am to 1or2am for a week will definitely do this to you.
First off, thanks for sharing all this. It sounds like you have a handle on the sinus infection side of this which sounds like it has been an awful experience. As far as your headache goes, everything you describes sounds like a classic exertion headache (squatting down, all of a sudden, vice-like pain on temples, activity makes it worse, headache lingers). Since your experience was not vigorous exercise related, I can understand why you may think that it is not an exertion headache; however, your symptoms tell otherwise and you may have an exertion headache regardless of the cause.
Every spring and fall I get a flurry of comments and emails about these headaches. Many mention having allergies, some do not, but I wouldn't be surprised if those that do not mention it still are dealing with some level of sinus pressure due to allergies. It sounds to me Kitti like there was additional pressure in your head from the sinus infection (increased inner-cranial pressure), your immune system and body were worn out from fighting everything (increase in base metabolic heart rate), you had additional stress on you from caring for your mother-in-law (increase in blood pressure), you pushed yourself doing household chores (increase in heart rate), you squatted down to unload the dishwasher (acute spike in blood pressure) and BAM, exertion headache. It's possible, that's my point. You still need to rule out aneurysms, thunderclap, and more sinus infection related complications, but from what you described, you may have had the perfect storm of "non-exercise" related conditions to get an exertion headache.
Please, keep us posted on the outcome of all this Kitti. Thanks for sharing, hopefully your victory over all this will help the next person do the same.
Does a lighter version of an exertion headache reset the clock for phase 1? I am a firefighter and am so afraid that I am going to have one of these bad boys at a fire… I had a light one earlier today and I have already rested for a week.
Unfortunately another flair up resets the recovery clock back to the very beginning. You have to take it easy. I'm a firefighter too. I don't know how your department works, but now may be a good time to volunteer to be on the Ambo or see if they can let you drive the wagon. Interior structural firefighting while recovering from an exertion headache is a bad idea. If the initial headache was on duty you may be ok to have some medical leave, worth looking into. Keep me posted.
About a year ago, I started getting these with back workouts but were confusing them with migraines because the headaches were on the same side of the temple that I get migraines (which are usually hormonally triggered). I think these were more of the "moderate" versions. About a week and a half ago during a heat wave, I felt like I exploded my brain at the end of an intense workout–classic symptoms. But because I confused them with migraines, I wasn't backing off working out until the Imitrex stopped working. Well, now I understand why the Imitrex wasn't working.
I am having success with acupuncture with these headaches when I haven't had success with acupuncture treating migraines before. I think what may make a difference for me versus others not having success with acupuncture is that my "punc" won't needle anything on my head. She just uses points on my arm and feet. Sinus pressure definitely re-triggered these headaches so massaging those points relieved the pain. Since I made the sinus connection, I have started some herbs for sinuses from the "punc". Now that I understand that my meninges are all upset, I am going to ask her about herbs for that as well as following the instructions in your article. I have an appointment with the dr, too.
Now, I am wondering if all of the years of migraines don't have an exertion headache component as I have lifted weights for the better part of 28 years–like my body is additionally stressed because of hormonal flux… Something for me to try to figure out…
Thanks for the great article!
A week ago (9/19/14) I finally pushed myself too hard and had my first injury since I started lifting again about 2 years ago. For me, it was a 10 rep set of 305lb deadlifts. I had just done a 405 1RM the week before. On the 9th rep is when I felt it. It wasn't severe.. but it was noticeable. I finished my workout without too much trouble (mil press, rear delt work). Over the weekend, I didn't even notice anything. I actually forgot about it. I didn't work out all weekend.
Then, come Monday, it was time to squat. First warm up set in (at like 40% weight), and I was reminded of what I had done on Friday. I did one more warmup set at 50% and noticed if I really concentrated on breathing it wasn't as bad, but I knew I wouldn't make it through so I just left.
Did a bunch of research, came across this page. Good info on here! Really disappointed to have to take time off, but I was due for a break anyway (about 1.5 years on 5/3/1).
Sex is a trigger for me as well, which really, really sucks. I also have highish blood pressure already, which I am on lisinopril for. I still haven't gotten it to the normal 120/80 range yet (it's often in the 140/80-90 range).
So I'm using the opportunity to get my dosage right and get my blood pressure under control. I was probably never hydrated enough in the gym, so I am working towards only drinking water and drinking lots of it (I had a lot of caffeine before). I had just reset my weight on the 5/3/1. I rarely ever get higher reaps than 6-8. I have no doubt my breathing was insufficient as well.
I want to document this since this is such a good resource. I did have sex last night, and the ache at the base of the back of the left side of my skull (the only place this has affected so far) hung out for an hour or so – the most severe of which subsided as soon as we were done. I know this technically resets my recovery, but I'm hoping not I feel like a lot of people here are describing much more pain than I experienced. The next week or two will be free of anything that may flare it up. I'll update you guys here soon.
Thanks for your comment. I've had a handful of folks say that acupuncture helped with the headaches, but haven't had anyone mention attempting herbal remedies to help with sinuses. Let us all know how that goes, everyone here is willing to do what it takes to get back in the gym, so if you have success with that the rest of us would be interested in knowing. Since the meninges are pressed on and aggravated by an acute forced dilation of the arterioles in the head, I wouldn't think that herbs for sinuses would have an immediate impact, but should help keep cranial pressure down in general which could help with the headaches. Allergies increase sinus pressure and that tends to make these headaches "foggier", so I'd imagine that herbs to help with any additional inter-cranial pressure would help. Let us know how it goes, I'm interested.
Mr. K,
The good news is that it sounds like you did a good job of listening to your body when it was telling you that something was wrong, you identified the problem before it escalated very far, you got in touch with the right resources to be educated on what happened, how to prevent them, and how to recover from the current injury, and you are following a plan that works to get back to pre-headache performance. Smart man.
You said, "I feel like a lot of people here are describing much more pain than I experienced," and I have a word of caution to add to that sentiment. Most people don't read this article until they are dealing with a severe headache. Many of them had a minor initial headache, much like what you are describing, and didn't respect it as a serious injury and continued training which led to full-blown exertion headache. It's like a partial ACL tear. Just because the thing didn't snap doesn't mean that it's any less critical to recover properly. The timeline may be shorter, but there is still a timeline, you can't just continue business as usual. So that's my word of caution. Be thankful it was a minor initial headache, respect that it could be MUCH worse, and be diligent in recovery. Keep us posted, and good luck.
Thank you Nick for your additional info. I know most of us here have gotten this injury doing something we love. It's hard to hear that we can't do it for x amount of time. We all hate to lose those gains we've worked hard for.
I wanted to add just a little bit of info myself, I was on my way out when I originally wrote. First, I said that it originally happened on a Friday and I forgot over the weekend. That's all true, but I just wanted to add that on Sunday, I had sex with no pain. It wasn't until after I went in and did 2 low rep warmup sets of squats (5 @40%, 5 @ 50%) that the problem started occurring during sex. And during sex I mean the moment I'm excited and ready to go, not the actual act.
That said, since I originally hurt myself I have felt that throbbing in the back of my head (left side) 2 times. Once Monday when trying to have sex (I stopped as soon as it crept up and told the Mrs. sorry), and once Thursday (sex again, to completion but didn't go all out and the wife let me keep it under 5 minutes). I'm staying away from all the triggers till at least the 5th (that'll be 10 days of rest). I can't promise I won't at that point test the waters and see if it's still going to be an issue during sex. If so, I'll take it slow and abort at the first sign of problems. I'm hoping that being careful in that regard won't totally reset the recovery clock on me.
If I don't have issues with that, I'm going to start back with some cardio and maybe some upper body work at light weight and just see how I feel from there.
Sorry for all the sex talk guys I noticed several other people mentioning it in their posts and I realize that the rise on blood pressure/heart rate is likely key. It must be a combination of both, because I can get a somewhat elevated heart rate (briskly walking up stairs at work) without any pain.
I have all the symptoms of an exertion headache and probably compounded it by continuing to work out hard for about 9 days after initial attack. (didn't have sense or knowledge to stop) I have finally got it in my head, yes literally, that I need to stop all exertion activities to recover from this. One symptom I am having and have not seen mentioned here much, is the light headedness I am experiencing along with the continued dull headache. I have an appointment with a neurologist next week to rule out other possibilities but was wondering if this light headedness can also be a symptom of an exertion headache. I have had vertigo in the past and it almost feels like a really light case of vertigo but came on with my headache symptoms and continues to persist. By the way, I was at the end of my workout, on my last set of 30 dumpbell presses, (doing 100 with lighter weights)on an incline bench, head down, when I was struck with a searing sharp pain on the left side of my head. I was dehydrated and at the end of a very strenuous hour and a half workout.
Thank you for this article it is 2am in the morning and I have been awake suffering the mild after headache, trying to research what could possibly be happening when I came across your article. Started last week during a training session with my PT, just completed a leg workout was finishing off with wall squats when I felt like my temples were going to explode. As I was at the end of the workout I didn't bother saying anything to my PT and suffered through the headache while stretching and driving home. Took nurofen on the drive home to help with the headache and all seemed ok, continued with running during the week, a couple of 5km and a10km run with no problem. Returned to PT for workout yesterday repeated process, leg workout, wall squats trying to push past 1 min and held my breath for the final 20 secs, when it happened again only this time the pain was so severe I couldn't ignore it or keep going. Whilst my PT explained to me about the holding of breath and blood pressure being the cause I really didn't understand it until finding your article. I should note I am already on a Beta Blocker as a migraine preventative and also suffer sinus, I visit a chiropractor once a month which also helps with my neck and the migraines. Your article has put my mind at ease I was starting to get really worried, now I understand and I'll take a week or so off training and running. Great article!
Hi I am my self is doctor (MBBS) and pursuing Md in microbiology for past 6 months I am working out I already had a fit body and I want to make it more muscular and I am using whey protein for past four months creatine for two months amino for 3 days.one week back when I was doing heavy benchpress I suddenly started having intense throbbing headache in left temporal region and since then when ever I do any kind of workout which last till next morning I also have same during sex and since I was feeling some gains in my body now so I am very upset about this new problem which is restricting me from workout inspite of being doctor I know nothing about this excertional headache so for past two days I was finding some information abt this headache. I got many links but none of them give information about how to get rid of this painfull and crippling problem and today I read ur article which some valuable information abt this problem now I will follow ur plan and will take rest from workout n sex.thank you so much.looking forward to get rid from this painfull curse. Such a bad throbbing headache righ now while typing this msg. But happy that now I have a way thank you again.
Mr. C,
The light headed feeling you mentioned, I think it may just be the "foggy" feeling that many describe as a side effect during the first few weeks. There is a dull headache and an overall foggy sensation, or light headed feeling as you phrased it. That is typical from my experience and those that have posted their experiences.
As always, I will encourage you to rule out anything more severe. If the medical evaluation reveals nothing serious, continue with the recovery plan in the article. Keep us posted regardless!
This is my second day after I stopped working out.I am having mild dull on and off headache.what else I can do to fasten recovery.
This article has been a huge help to me. I started experiencing exertion headaches a couple of months ago. While I can most likely point to it beginning at the end of one workout involving high-rep 225 lb DLs, I think I had felt it creeping up during the weeks before. I wonder if the DL workout was the entire cause of the headaches or if it was in fact just the proverbial straw the broke the camels back. I stumbled across this article pretty soon after I got the first headache but did not take the appropriate rest and suffered for many weeks after (stupidly). The worst part about these headaches for me is the fatiguing aspect of them. If it was just pain that would be one thing, but the pain of the headache was always accompanied by a mentally hazy component that would put me in a bad mood and affect everything else I wanted to do that day. I decided after almost 5 weeks of suffering to take your advice and take an entire week off. This was not easy at all for me to do as as I am following a pretty strict training program. I'm sure it is difficult for most reading this article as well. But taking that week off was the only thing that completely made the headaches subside. I went to my primary care doctor and she was not informed on exertion headaches at all but she recommended I go to a neurologist to rule anything crazy out. It felt weird knowing more than my doctor, but that's why this post has been so important to me. I would bet a doctor more in tune with athletes would know more about this, but don't assume that since your doctor has never heard of it that it's not real. Doctors are humans and there are thousands of conditions they need to be familiar with. The neurologist I went to afterwards was great and was very familiar with exertion headaches. She prescribed Naproxen to take before working out. It is basically a super anti inflammatory. During week two of my light cardio days I would take Naproxen before beginning and to my surprise I would not feel pressure building in my head like I had been previously when my heart rate would rise. I am awaiting my appointment to get an MRI/MRA, but I'm really relieved knowing that other people have been through this before (assuming that I do not have anything crazy going on in my brain-which I highly doubt I do!). If I could communicate anything to others reading this-it would be to listen to the advice here of taking an entire week off if you are getting these things. It's simple advice but hard to follow, and i just want to chime in and say that I'm an actual human being who listened and is very happy I did. I hope that can maybe help someone going through this. I'll update here with my progress because I know it has been very helpful for me to read other people's recovery timelines.
The article was very very explanatory and helpful and exactly pointed my problem.
great work.
Thanks for posting. You are very representative of the majority of people that will push themselves hard enough to even get an exertion headache. The fact that you pushed through after reading this means that you did what 90% of readers likely do. Of all the hits on this article, only a handful report taking the advice and say it worked.
You are right about primary care physicians. They have a million things to know and unfortunately in America the medical field has become more about CYA than patient care, so they are forced to err on the side of super caution.
I'm curious how the pre-workout Naproxen. Haven't heard that one yet. Still reduce intensity and volume. Hold off on compound leg movements. The time off is crucial, but so is easing back into training. Breathing, hydration, neutral spine, all matter. Keep us posted Ben, thanks brother.
Hi Nick,
Great post this is the best information I've seen anywhere on the internet. I think I experienced this today. I worked out. I didn't do anything high rep. Simple 5×5 routine the weights were only lbs heavier than my last workout.
I felt completely fine as i left the gym. About 45 minutes later whiel makgin a veggie smoothie. felt my vision going weird on my right eye. Nothing to serious just enough to notice it wasn't normal. That happened for about 30 seconds then stopped. Out of no where I got a splitting headache that lasted about an hour on the left side of my head from temple to middle of the head. I drank some water and lied down I was eventually able to sleep for a bit. My head still feels tender after a 2 hour nap.
Does this sound like an EH? One thing I'll note is I did not drink water during my workout which was about an hour long. Thanks!
Thanks for your comment. The workout you did is certainly strenuous enough to cause an EH, and dehydration is a huge factor for them as well, so I would not be surprised if this is a classic Exertion Headache.
What concerns me is the acute blurred vision and the delay in initial headache. You DEFINITELY need to visit the doc to rule out anything major. If all scans come back normal, which I would anticipate, follow the recovery plan and keep us posted.
Just wanted to give you guys an update. I think I made it another 6 or 7 days after I said I'd be going 10 before I gave in and had sex again. Good news was, no pain this time, and it has not reoccurred since.
I have not really been lifting however. I did go to the gym for the first time on the 14th of this month and did a pretty light (around 50-65% of where I'd usually be) workout. However, it was a fairly long workout and my heart rate did get pretty high several times.
Other than that, I've been taking the extra time off to make sure I heal right. I think I'm going to start going to the gym again 4x a week tomorrow, about a month after the original injury, but I'm still going to avoid the complex lifts (deadlifts and squats), and I'm still going to ease my way back into bench and military press over the next couple/few weeks. If all goes well, I'll start back on the squats and deadlifts then, at a reduced weight while working my way up. So, I may end up going beyond the 8 weeks when all is said and done.
Hoping a few months after, I'll be back stronger than I was before. Will be interesting to see how weak this break has made me.
Great write-up – so glad I found this. I'm just pissed I didnt stop when I first felt the "grenade" go off. I was hell bent on finishing my workout.
Again the headache started immediately during my next workout approx. 3 days later…. but I pushed through it (stupid! I actually thought to myself "when I'm done this workout I'm going to find out whats wrong with me. The back of my head might actually explode"). But by the time I was finished I was mentally exhausted and "hazy" – a lot like BEN was talking about in his comment above. I put it off for the weekend and guess what?… I opted to play a round of golf on the weekend instead of going to the doc. Anyone heard of an exertion headache brought on by driving a golf ball? hahah laugh it up.. totally happened!
Monday rolls around:
I got 15mins into my next workout and called it quits. Made a doctors appointment and found this post. Just like you BEN I doubt my physician knows what this is so hopefully the neurologist will.
I will rest and get better. But equally important: I am going to forward this post to the trainers at my gym and discuss it with anyone who will listen because no-one I spoke to at the gym knew what I was talking about. (To be honest I don't think I will mention it to the guys at the golf club though haha – thats just too embarrassing)!!
I think this article really helped me out.
I have only been training for the last month or so and already loving the life style. Seems like such a shame to have to stop and rest for so long…
Last Friday, I got my first headache after doing leg extensions, on reasonably light weights. It was so painful I didn't want to stay and finish my work outs. But I still tried to do sqauts, but started feeling dizzy so I called it quits.
Had a big weekend so didn't make it to the gym till Monday. Chest day. Within about the 5th rep, second set it happened again and felt worse. I was pretty scared to be honest, so I stopped what I was doing and left straight away. Seen a doctor the next day and he said he can't explain it, just that maybe I had pinched a nerve in my neck and that I should do neck exercises and lower the weights. So I went to the gym this morning for back and biceps, about halfway through my work out I felt it creeping up in the left side of the back of my skull, at this point I started self diognosing on google and stumbled across this article.
I've booked to see someone to have a look at my neck, the discomfort I feel makes me think it's out of line or something. Also just to rule it out.
Like I said I really don't want to stop. But at the same time I don't want to cause any damage or go through that pain every time.
I've emailed back and forth with Nick about this a couple of times over the past couple of months so I thought I'd post my experience here as well.
I am a natural pro bodybuilder and have been training heavily for ~13-14yrs, competing for over 10yrs. I had what in hindsite was an exertion headache doing high rep squats when I was 17. Dr's never found anything on the MRI or with any tests they ran and it just kind of got better after a couple wks. I hadn't really had any issues with these for over a decade until Sept 18 when I was pulling 435 for 3 sets of 8 on deadlifts and on the last couple of reps of the last set I felt a pain shoot from the top of my neck up over my head. After my set I was dizzy, couldn't think straight, and had the worst headache of my life. I tried to wait a few min and continue my workout, but it was so painful I had to end my workout early. Since it did go away and I didn't have any other symptoms I didn't go in to the Dr. right away. I took the next day off from the gym and tried to lift again 2 days later and it didn't take long before the back of my head felt like it was going to explode again. Again, I didn't go in; however, the following night I actually woke up in the middle of the night with one due to a bad dream or something because my hr was elevated at the time. I went to the ER and the Dr. didn't even do any tests on me. He just told me I had an exertion headache and pulled a muscle in the back of my neck. He gave me a prescription for muscle relaxers and sent me on my way.
About a week later I woke up and the entire back of my head was numb. I went back to the ER, had a CT scan which showed nothing out of the ordinary, and was told by the Dr. I was having a migrane. I tried to argue for more tests because I knew it wasn't a migrane, but I was just sent on my way and told to follow up with a primary. Unfortunately, I've had to wait over a month for that appt which is later this wk.
Since then, I've been doing minimal activity, drinking at least a gallon of water a day, getting chiro, ART, acupuncture, deep tissue massage, and I've also seen an osteo. I'm not in as much pain anymore, the numbness is gone for the most part, and the dull ache is starting to go away as long as I don't do anything; however, the mental fog/dizziness sensation is still bad. Nick mentioned this can last up to 6 months in some people so I'm still out of the gym trying to be overly cautious so this goes away in less than 6 months.
Moving forward, I have an appt with my primary later this week and I'm hoping to be referred to a neurologist to see if anything else is wrong or if I just need to keep waiting it out. Definitely the most miserable injury I've ever had in the gym.
Nick, thanks for the highly informative article. Your comments following the article are equally informative.
I got an exertion headache 10 days ago while rock climbing in the desert. The crack I was climbing required full body technique and I was completely maxed out. Fortunately, I was on top-rope and was able to be lowered to the ground quickly by my climbing partner. Had I been lead climbing, I likely would have fallen a long way since the headache was so intense I could not hold on to the rock. Of course, I am very worried about lead climbing in the future because a recurrence of the exertion headache at the wrong moment could lead to my demise — no joking around here.
I had the classic pre-cursors: 1) I was dehydrated from being in the desert. 2) My head was tilted up since I was looking up the crack for the next holds. 3) I tend to forget to breathe during the most difficult sections of a rock climb.
I did get the CT scan and spinal tap and they were negative for hemorrhage.
Here is my question: I am 51 and overall in good shape both aerobically and from climbing. Do you think your timeline and protocol for recovery is longer for older guys like me?
Thanks so much!
Thanks so much for this article and the follow-on thread with great responses. They have relieved a lot of anxiety for me as I've started experiencing these headaches the last few days, and I was very worried that I had a serious (potentially fatal) brain injury. Just for info: I'm 30 y.o., have been performing (and loving) CrossFit for almost 7 years now… not a competitor, but I would say I certainly have an above-average fitness level. Here's how it has gone down for me:
First headache was 3 days ago during an early morning workout involving heavy dead lifts and weighted walking lunges. Headache came on very strongly in the back of my head during the last set of dead lifts. Very intense, but I (stupidly) pushed through the last set of lunges… about 3 minutes later the headache had subsided, and I did some auxiliary work with no problem. Some other factors during this initial headache:
– I was on vacation and not following my normal (very strict) eating habits
– I was drinking heavily at a wedding 2 nights prior, and although I thought I drank plenty of fluids the following day, it probably was not sufficient
– I slept terribly the night before the workout
I was fine the rest of the day and even most of the next day, but I experienced a second (milder) headache in the back of my head during sex that night (right before climax). Luckily it subsided pretty quickly.
Third headache during a run, yesterday morning… about half a mile in, at a very good pace, it hit me again… although it was intense (about a 6 out of 10), I was able to slow my pace a little and finish the rest of the run. The headache seemed to slowly get better as the run progressed, but it didn't go away completely for another hour.
At this point I was pretty worried and saw the doc immediately (luckily I have pretty good access to medical care). She diagnosed me with exertion headaches and scheduled a CT scan for next Thursday to be on the safe side… oddly, though – she said it was fine to exercise immediately, although she did recommend taking ibuprofen 30 minutes prior in order to prevent an exertion headache.
So — feeling like it was no big deal, last night I took some ibuprofen and went to CrossFit. It was a WOD involving light-weight snatches, rowing, and wall balls, but nevertheless I felt a little bit of a headache as my heart rate started to climb. If I focused on my breathing, the pain seemed to go away, and I finished the WOD at near-normal intensity.
About 4 hours later (after the ibuprofen had worn off I'm sure), I was feeling confident that I was OK again and decided to have sex… MISTAKE. Very intense headache (7.5 or 8 out of 10), again in the back of the head, right before climax. The intensity gradually subsided over the next hour, at which point I was finally able to fall asleep. This morning, though, I still have a mild headache in the back of my head, and I'm very worried that I may have worsened a milder injury.
I plan to follow the plan listed in the article, and I will follow up with results of CT scan if anyone is interested.
– I'm curious as to why I was able to push through the headaches while working out, and even have them subside a bit, but then sex (which was certainly less intense) triggered the most painful and long-lasting headache.
– Anyone try fish oil supplementation to help with the inflammation? I regularly take fish oil, and I have had good luck with increasing my dosage to help with past injuries. I'll be trying that for this injury as well, but wondering if anyone has already done so.
– Does one of these headaches increase chance of future recurrence, even after a full recovery? I'm fine with following a 2 month recovery plan to get back to normal, but am I going to have to worry about this for the rest of my life? The thought of not being able to return to full-intensity training (or more importantly, sex!) is almost heart-breaking.
Thanks again for the great post!
I'm a climber too, and I can see how all the variables you mentioned would contribute to an exertion headache. It's a good thing you weren't leading, that could have been a disaster. The good news is that once you heal up, you should be able to climb at a high level again, with more intentionality about hydration and breathing.
In regards to your age of 51, that should not extend the recovery timeline. What it may do is make you extra sensitive until you fully recover. I have no science or case studies to back me up here, but it makes sense based on the definition of an exertion headache. The forced dilation of the arterioles in the head which put pressure on the meninges, causing the intense headache followed by weeks of a foggy sensation. The meninges are sensors, so age is irrelevant on them; however, the blood vessels at 51 have seen more mileage than a 25yo, and may be more susceptible to another headache while during recovery. After you recover fully, prevention is the only focus. Hydrate, breathe, be aware of your neck position, and climb away!
Thanks for your post. Here's some feedback on your three questions:
1) I agree that it is peculiar that sex had a greater affect than strenuous training; however, body positioning may have been a factor. Otherwise, I'm not sure.
2) I haven't dabbled with fish oil and it's affect on recovery. I haven't had many emails or comments about it either. Keep us posted, any tips we can add to this resource will help folks in the future.
3) Yes and No. Yes, you should be intentional about preventing exertion headaches for the rest of your life. It's part of "good form". Breathing, neck position, hydration, awareness of fatigue and limits. No, this does not mean you are going to constantly be dealing with these if you do all the right things. You may have a 1 or 2 year window that you're sensitive, but it's been almost 10 years since my last exertion headache and I'm good to go.
Keep us posted Andy, thanks and good luck.
Just wanted to do a quick follow-up to my post last month. MRI came back clear, and I've (knock on wood) been headache free since the last one I mentioned. I took off for a solid week, doing nothing, and then started going back to the gym, keeping my workouts lighter and less intense than usual… At this point, I would say my workout intensity has returned to 95% of what it was before the headaches… I still have not done any really heavy lifting (no less than sets of 5), and I am making sure to get lots of sleep, stay hydrated, etc. A little more aggressive than what was outlined by the article, but not much. Much thanks to the authors and other commentors on this post for giving me a great framework for recovery and some much-needed hope!
Hi Nick,
Thanks for your comment. To get back to your regarding the herbs and my sinuses, the herbs didn't do enough, and I ended up on Flonase, but that has made a huge difference with decreasing regular migraines–especially waking up with them.
I just finally saw the neurologist today, and he found something unusual. I've donated blood regularly for the last four years. I have very high hematocrit levels (15-17) so I've never worried about my iron levels. Well, it turns out that hematocrit actually measures red blood cells and not actual iron stores. My ferritin levels are freakishly low so I have extreme iron-deficiency anemia. The Dr. said that low iron contributes to the exertion headaches and headaches in general. He is still going to go through the MRI/MRA motions and is having me take Ibuprofen (instead of Indomethacin) an hour before working out, but I clearly need to up my iron supplementation (quantity and quality) and stop donating blood. That was a twist I would have never guessed.
I am training for Air Force Pararescue and i need to swim underwater for 25 meters. For 2 months i have been able to do my 25 meter underwater swim no problem. but lately, all of a sudden i have excruciating stabbing headaches (in the back of my head) at the end of each underwater swim. I went from not having this problem at all to it crippling me. Any advice? my test is in a few days and need immediate help!
Absolutely fantastic article with amazing information! This is the second time this has happened to me and i was originally advised it was a pinched nerve. After reading everyone's symptoms i have realized that it is an Exertion headache and i was using similar products. I unfortunately trained through the pain regardless of thinking i was about to die and sadly extended my recovery period & did more damage. I do cross-fit and was my first day back in the gym after my vacation, very frustrating. a quick question : Once the headaches & the consciousness of my temples and blood flow around my head go away, and if its before a week would you think it is safe to go give it another bash? Thanks again for a great article!
hi i was doing leg press and on the last set i had a pain at the back of my head and neck but the pain was realy bad.
it has been 2 weeks know and i still get headaches and that couses me to be nausea i was wondering can exertion headaches couse that
Very helpful article, and I'm blown away by how diligent you are in replying to everyone's comments.
I wasn't able to do any lifting for two months because I was travelling, but when I finally tried to get back to it after joining a gym where I'm temporarily living, I experienced a severe throbbing pain not only where the neck meets the head, but also in the throat. It felt very similar to a severe head cold or hangover headache in the entire area above the shoulders. It happened during my first set of back squats where my form was definitely not what it should have been. I continued through my routine, anyway. The pain disappeared soon after my workout and didn't return during the interval cardio that I alternate with lifting workout days. But the pain returned immediately during my first set of deadlifts on the next day of lifting, and a week later, it now happens even during body weight exercises. I think it must be strictly weight-exercise-related, because it never happens when I'm not exercising, and I was doing just fine with body weight during the two months before I joined this gym. I'm very glad I ran across this article. It describes my condition perfectly and I'm going to follow the recommendations here for taking a break and then gradual resumption. I'd like to use the sauna, steam room and Jacuzzi at the gym to get my money's worth during the break (and because I love the sauna, steam room and Jacuzzi). Would that affect my recovery at all?
Thanks again!
I walked/jogged very fast on the treadmill at 4.4 for 6 miles, 3 days in a row, with a mild incline. Since then have had a pounding headache in the center of my head. I took an advil felt some temporary relief for 2 hours and then the headache resumed.
What to do to relieve the headache? I am not a bodybuilder or anything just been exercising for a few months and lost 50 pounds already.
Thank you so much for this! I am 17 and have been tested for normal blood pressure. I have recently been eating 4 eggs every morning to try and bulk. Do you think all of that cholesterol could have a negative affect on my recovery?
This is the most helpful article I have found.
Thanks alot
I am 5 days after the headache by the way and am wondering if I should watch my cholesterol even though my blood pressure tests normal.
Hi. Firstly thanks for this. I think I am experiencing this. I've read all over the Internet and saw pretty alarming things which scared the hell out of me but I think this is it, if someone could comment back so I could be sure I'd appreciate it.
I was doing incline leg press with my friend a few days ago. I normally do 2 45 plates on each side but he immediately started me on 4 plates on each side, did that for 2 sets then he made me do 5 plates on each side. Might I add this was extremely hard for me. After that he immediately took off 3 plates on each side and made me do 25 reps and on the last rep I got an instant pounding headache that eased but did not go away into the night. The next day I guess I had a dull headache but still went to the gym and as soon as I started working out the headache came back so I stopped, I've been resting but still have this dull headache and a little neck pain. Thoughts??
First off I'd like to thank you for the article. I had my last exertion headache 2 days ago, and figured I'd be good to lift today, but after coming across this I thankfully decided not to.
My first onset was a bit different than what I've read in these comments. I had been able to exercise with high intensity just fine, and wasn't getting any headaches or anything. However, a couple days ago I went into the sauna and stayed in there way too long. I had been hydrating all day as I usually do on days I sauna, and took breaks, but did a 30 minute stint because I was talking to some people in there. This turned out to be a bad idea, as when I got home I had an intense migraine. The next day, I went to go lift and other than some abnormal sweating, everything went fine. That is, until about halfway into the workout when I felt the "grenade in my head" go off. I chalked it up to dehydration from the day before, and pushed through, finishing the workout. That night, I had an intense migraine, coupled with a fever.
I went in 2 days later and tried to work out again, because I felt fine that morning. 20 minutes in my migraine came back and I had to go home. That was two days ago, and now I'm following the method outlined in your article. I was just wondering if walking or light cardio would delay my recovery time?
Hi Nick,
Thanks for the article. It was very informative. I recently got my first exertion headache while doing pushups a couple of weeks ago and I am currently in recovery. I have read elsewhere that caffeine might be an obstacle to making a full recovery, and might also be part of what caused the exertion headache. I don't use a lot of caffeine–just coffee in the morning and maybe another cup in the afternoon–and I never use it to workout. But it has been suggested that I stop taking it altogether and use naproxen sodium or another NSAID pain reliever about 20-30 minutes prior to working out because these help with blood circulation and should help prevent the onset of another exertion headache. Have you heard anything about caffeine causing problems of this sort? Do you agree that I should cut it out completely? What about the ibuprofen while training? The exertion headache freaked me out quite a bit, and I haven't dared to try any training since it happened. Any advice would be helpful. Thank you.
Caffeine is a stimulant, and can have the acute effects of a spike in heart rate and blood pressure, both of which can hinder healing while recovering from an exertion headache. That being said, everyone responds differently to caffeine. If you are sensitive to it, then it may be good advice to back off. You mentioned you consume 2 cups (probably 4 measuring cups), and that does not sound outrageous. If you drank 3 more Mt Dews with meals and slammed a Red Bull before workouts, then I would be concerned. It all depends on the person regardless. The other side of this is because caffeine is a stimulant, and is therefore a drug technically, we all can become addicted to it. Abruptly cutting off any drug causes withdraw, and caffeine withdraw can cause some very severe headaches… Not exactly the goal when you are recovering from exertion headaches as well…
As far as Ibuprofen goes, absolutely use it as a tool to help with reducing the swelling of the meninges. It's the "20-30 mon prior to working out" part that I disagree with. Like most pitbull-headed people giving themselves these headaches, it sounds like you are attempting to train through this injury. Bad idea. It will only drag symptoms out longer. Better advice on Ibuprofen would be to take the maximum recommended dose every day for the first week after the headache while resting and drinking copious amounts of water. The following week, continue to drink and rest, but reduce the Ibuprofen intake. Then, continue to take the Ibuprofen in moderation while re-introducing mild activity week 3. Then follow the recommended recovery plan in my article.
I've never had someone email or post on the forum that my recovery plan failed them. However, I have had plenty of people try to train through this, cause additional flair ups, extend their recovery timeline by 3-6 months, and then ask for help in dire circumstances. Don't be that guy Lance. From one pitbull to another.
I apologize for the late reply. If you still are checking on this, I would say that you should not be worried about eggs for 2 reasons. First reason is that cholesterol in food does not affect cholesterol in your body. For years that was the nutritional gospel, but what dietitians are finding now is that its not the eggs that are causing high cholesterol in people, but the sausage and bacon we eat WITH the eggs. Cholesterol in food does not increase blood serum cholesterol levels
Second reason is that at 17 years old with normal blood pressure, I would not be concerned about cholesterol affecting your recovery. What you must do is be diligent about your recovery, following my plan strictly. The reason I am so familiar and knowledgeable about these headaches is because I pushed through 3 of them early in my athletic career. My first was while lifting for football in high school when I was 17 years old. I pushed through and got another on my freshman year in college. I became a personal trainer and gave myself my third and final exertion headache my senior year in college. I put together these findings and have been tweaking the formula for almost 10 years, so believe me, this is some tried and true advice young man. Apply it and get back to training sooner rather than later.
A few comments slipped by me, I apologize for the late response. This may be too little too late, but the only issue I would foresee is that saunas and steam rooms can dehydrate you acutely, and that may thicken the blood and make you more sensitive to flair ups. Load-bearing strength training absolutely causes acute spikes in blood pressure. It's not easy to measure, but I've dabbled with taking a blood pressure reading during leg press where my arm was relatively still with a machine-style cuff, and my typical 120/80 was all the way up to 220/90. I'd imagine it may go even higher with Deadlifts, Squats, and other Olympic lifts. If you are still checking on this thread for a reply, did you go ahead with the sauna? Did it affect you at all? That may help the next person, I did not experiment with that when I was recovering from my headaches, so I can't advise from personal experience. Thanks Mike.
I missed this comment, and I apologize since I know that I wasn't able to help before your test. Underwater swimming can cause a mild spike in your internal pressure just from the water weight on your frame. You're a professional swimmer if you are training for Air Force Pararescue, so I am confident you are aware of the fact that you do still sweat while in the water, so dehydration is still relevant. The stress of the test also may cause a spike in resting heart rate and blood pressure. All this adds up to very similar conditions for causing an exertion headache. Even if I did reply in time before your test, I'm afraid that there was no miraculous advice I could have given you to make things better before your test. If you are still checking in on this thread, what was the outcome? Did you push back your test date, or power through with ibuprofen?
Like a few others that slipped by me, I apologize for the late response. Quick answer is no, a week of recovery is not enough rest before "another bash" brother! Exertion Headaches are an injury, just like a broken leg. You look and feel normal when not training, but inside your head, all the sensory receptors in your head are on high alert, and the blood vessels have recently undergone forced dilation, impinging on the meninges. This isn't only irected to you Justin, but to everyone reading this. You would never try and do squats on a broken femur. But we dabble with the idea of training after an Exertion Headache. You look normal in the mirror, but you are not healed until you go through the paces of the recovery plan laid out in the article. You are not the exception. You are the rule. That goes for everyone, including myself.
Sorry for the late response. Without knowing too much about the context of that workout, you mention "last set" of leg press, which leads me to think you did anywhere between 3-6 sets and experience a headache on the last few reps of your last set. With that being my assumption, I'd say that sounds like a perfect storm for an exertion headache to hit. Experiencing a "foggy" headache 2 weeks after the initial injury is common. Nausea may or may not be felt by everyone. Make sure you visit a doctor to make sure that nothing more serious is exposed.
Sorry for the late response. Late may be better than never in your case. Losing 50 lbs in a short period of time is an awesome feat. One thing that is often overlooked with weight loss is that your body gets accustomed to its current weight, and all your hormonal systems, down to water and temperature regulation, all become accustomed to your current weight. With weight loss, the mathematics get thrown off, especially if the weight comes off quick, especially when the total amount lost is a significant amount of weight. You may have experienced an exertion headache, but I am more inclined to believe that what you are experiencing is some dehydration and perhaps some hormonal imbalances that your body is trying to cope with. Any updates? I know this is a super late response, again I apologize I missed this comment.
I think I replied to your email, but I'll go ahead and post here too while I play a little catch up. My second exertion headache was doing a nasty leg press drop set, much like the one that your friend had you do. I remember finishing up the workout, after throwing up with a pounding headache, and somehow managed to make it home. I missed 3 college classes that afternoon as I laid in bed in the fetal position, worried that I can caused an aneurysm… Not a fun day… Or a fun few weeks and months following. Your dull headache a few weeks later is typical to exertion headaches. Have your friend read this article to help him/her help you.
Like most people that get these headaches, it sounds like you are going to try and walk a fine line. Please don't. 2 weeks of no exercise at all, lots of water, ibuprofen, good sleep and nutrition. Then, follow the plan. The reason we exercise is to enhance our fitness and human performance, to make our lungs, heart, and musculo-skeletal system more awesome. When you are having to tip-toe around an exertion headache while training, you are not making your body any better than 2 weeks of healing would do. Once you have an exertion headache, you are locked in to a 2-month recovery timeline minimum. Trying to speed it up will only extend that timeline. So the question is, what would you prefer. 2 months of tactical recovery, or 6 months of bull-headed, sub-maximal performance? Those are the only 2 options. I realize that you did not get the headache during a workout like most, which is why you may think that light cardio may be OK. It may be. But it's not worth the risk in my professional opinion. Stick to the plan that works.
Great article. I wanted to tell you what a relief this article has been for me. I have suffered from terrible exertion headaches for 22 years. I have had all kinds of testing and nearly lost my military career due to these headaches. Throughout these 22 years though I have always received a shoulder shrug from my doctors and I feel that even though they have been sympathetic, my training partners always felt like I was crazy or something. This article has been the most accurate article to describe what I experience when these hit ( I get about 2 or 3 per year) and truly made me feel like I am not alone in dealing with this type of headache. That being said, I wish there was a faster way to recover. My most recent episode occurred this morning attempting crossfire open workout 15.2 and now I feel like I have lost the entire open season!
Anyways, thank you for your article. I will visit this site often.
Thanks for your comment, wish we could have met even 10 years ago, could have prevented a decade of headaches! Thanks for sharing your history with the rest of us. Sounds like you have battled through your fair share of headaches, do you find my recovery plan to parallel what you have done to get back to training? Any insights would be great brother!
..great article and thanks for the all the comments .. they were helpful … here is my story: I am male, aged 47, being doing crossfit for 15 months .. on sat was doing overhead squats and felt this headache coming on .. felt it once or twice in my life before, and once because of the OHS .. anyway, tried to work thru it but it was too painful and had a lingering headache most of sat and on sun was ok and went for a jog .. just starting to get the blood going and it hit again at the base of the skull up into the eyes and over the top of the skull .. went to the doc today mon .. he did all the range of motion tests (neck is fine in terms of bones) and gave me solpadeine to take until say wed, 2 tablets three times a day .. he said he thinks it muscle/ligament related because of the OHS movement "pulling" down on the ligaments under skull and causing swelling etc .. he said though that altho it should calm down, if I still have headache by wed or later that I was to come back and he would then look to have scans done .. he also said BP was fine as that would indicate a "bleed" which is the other cause .. he asked did the headache come on as a "BAM" or gradually .. mine came on quickly, but, not as a "BAM" … getting a "BAM" one is not the best it seems as could indicate one has "burst" a blood vessel .. .. the one thing that I will say was that I do krav maga and I had done a 2 hour training sess the nite before the sat morning and I am convinced that I was dehydrated going into cf that sat morning .. so, thanks for the article, it helped me .. suggest to anyone else to go to doc, always hydrate well before CF and avoid that damn stooopid OHS movement !! I have also booked myself into see a cranial osteopath to assist the neck muscles … note to self: retrain as osteopath because all of them booked up for weeks and weeks !!
Thanks for your comment. One quick thought for CrossFitters and anyone doing Olympic lifts. These lifts put more pressure on your body than traditional strength training, even if you are using the same weight. Think about a 225 lb back squat done under control for the purpose of hypertrophy with a relatively high time under tension of a 3 second negative and a 1 second positive. Throughout the range of motion, breathing is methodical with steady exchange of oxygen and can be done safely with a tight abdominal wall but otherwise relatively "normal" breathing. Now think about a 225 power clean. At the bottom and through the first pull, most coaches would encourage the valsalva maneuver to help keep firm thoracic pressure to protect your lumbar region during the rapid acceleration leading to the second pull and ultimately the catch. If done for reps, this can amount to 10 reps with a high internal-pressure and spike in heart rate. Coming into a workout like this dehydrated from other activities, or performing the exercises as part of a super-set, can exacerbate the condition further. The point is that while a heavy back squat can cause an exertion headache, so can a lighter load from an Olympic lift that demands the valsalva maneuver to safely execute the movement, especially when done for sets for conditioning. I agree David, a doctor visit and caution with Olympic lifts is great advice for people recently experiencing an exertion headache.
Thank you for the article. I believe I experienced my first exertion headache last week while doing a form of squats in a barre class. I exercise regularly but typically more aerobic and kickboxing. The barre class is intended to bring your muscles to the point of shaking which is what was happening when the headache came on. I assumed I had pulled a muscle in my neck but the pain traveled up my neck to the left side of my head and behind my eye. It did not bother me the rest of the week during kickboxing and running but as soon as I began the barre class last night it started again. I was just wondering if this type of exercise could result in an exertion headache as I was not lifting any weights but working my core to the point of failure. Please let me know your thoughts.
Thank you!
yes…I think you laid out the recovery process pretty well. I am sure it is a little different for each of us. I know for me that I can often continue to run, even intense running but any type of physical exertion, even simple things like pushups or air squats (or even talking too loudly) and the headache comes thundering back. I spend a good 2 weeks trying to be very calm. After about 2 weeks I will try a few simple workouts but if I even get a hint of the headache I stop and wait another couple of days. I am generally down and out for a month or so.
Hi. I had my first exertion headache on Jan 31 while doing a superset on the seated leg press. The following 2 days I experienced coital headaches, so I stopped everything for a week while waiting for MRI/MRA to rule out secondary/serious issues. All good there. I resumed sex a week later (week 3) with no problems, but symptoms of a sore neck / rear-head ache began, usually in evening. Ceased sex again, and still no exercise, for all of week 4. Started sex again in week 5, but the next day a pretty intense foggy / light-headed feeling struck. That sensation, sort of like being medicated or sorely needing a cup of coffee, has persisted (albeit seemingly improving) for 10 days. So once again I'm refraining from sex.
So, to sum up, I'm nearly 6 weeks in and still having a foggy, light-headed sensation — is this also normal, or at this point (6 weeks) is this maybe being caused by something else?
The Barre-style training that you mentioned focuses on isometric holds to fatigue the entire body. It's a very tough training style and has been used by some of the most amazing dancers in the world to maximize functional muscle tone. While not typically causing exertion headaches, I can certainly see this style of training having the possibility for one. Neck position, fatigue, dehydration, maximal effort with lower body movement, isometric holds that incorporate holding your breath at times to assist, and intensity. I would not think that the "initial headache" would be as severe as one received during a 500 lb 1RM Squat, for example; therefore, the recovery timeline may not take as long. You should still take all the same precautions and ease back into training. Be mindful of your breathing in the future, making sure to not rely on holding your breath to help hold the positions. If you don't mind, check in with us in 2 weeks and let us know how the recovery is going.
It is not abnormal to still have the foggy, light-headed sensation after 6 weeks. Sex, strength training, intense cardio, anything that can cause a spike in blood pressure and/or heart rate should be avoided until the foggy headache is gone. For most people, 2 weeks of dedicated rest typically minimizes that foggy sensation, although you will likely sense a mild fog until you fully recover which could take 2-6 months, depending on whether or not you cross the line at all during the recovery process causing setbacks. This foggy sensation is your brains self-defense mechanism, a way of subtly reminding you to stay calm and let it heal. If you push it, the same swollen vessels that pressed on the meninges will start letting you know, like Josh mentioned below. Back off, and know that you probably set yourself back a week. A good rule is to think about what you want to do and when you feel ready to do it, wait another week with tactical rest. Good luck brother, I know this is bad news, but the sooner you heal, the sooner you can get back with your honey and back in the gym.
What a great article. I've been to the ER and had a cat scan and they found nothing. You're article paints a perfect picture of what I believe I am suffering from. Thank you!
Hello. First of all please excuse me for my English, I'm European. After a lot of search on the net I finally found this site where I hope it can help me. To start, I'm a male, 26 and i have been working out for almost six years. Last year I bought a weighted vest (10kg) I started doing pushups and pullups with this. I was putting alot of effort and i was increasing my repetitions. In an afternoon At the start of Summer of 2014 and while I was working out, after my last set I had this kind of Headache, which felt like a pressure in my head and also in my ears. After this i stopped for about two weeks. And then i started again with decreaded weight and reps. Suddenly after my routine I felt the same headache/pressure again. This time it never left actually. I have completely abandoned all kinds of exercise except sex and walking.
I went to a cardiologist where we made a series of examinations checking my blood pressure and I had a 24-hour cardiogram. Everything was normal and he said that feeling was probably of stress and anxiety (which I have a LOT). I wasn't pleased with his diagnose and I also went to a chiropractor, where he said that my feeling was due to a straight neck i have. He did two injections on my back and he also said that Im very nervous and anxious and that I have to calm down. Six months later, with no exercise, i had a constant feeling of this pressure in my head (not too much pain) most of the time. Then again, I went to see a neurologist, he saw an MRI that I had two years ago (having the same pain again) and he said that, if it was an aneurysm we should have seen it two years ago. He examined me and like the others he said the same, that this happens due to stress and anxiety.
Im desperate now and I dont know what else to do. My family thinks Im crazy and started get bored of my situation thinking that no more help or doctor advises are needed. Today i started ibuprofen, I also quit coffee and alcohol last week, and Im going to continue, to see whats gonna happen. To mention you that this kind of pain bursts when im having cold showers, when I get angry or Anxious and when I run stairs up. It can also appear after I have a long walk. I don't have any problems with sex, I think it relaxes me and somehow makes me forget of it!
Once again, sorry for my English, but this site looks like it can help me!
What do you think?
Thank you, Demetrios.
Thanks for the comment. Let me know if you need anything.
No need for any apologies, your English is great. At this point I don't have any additional feedback for you, you are doing all the right things. Can you check in with us again in 2 weeks after taking ibuprofen? Then I will give you an update if anything needs changing.
Checking back in. I've been resting 3 weeks now and I still have a light headed / dull headache feeling. Is this really normal? I'm starting to get scared now.
The dull/foggy headache can last for 2-3 months. It doesn't feel like a headache, but more of a fuzzy pre-headache that lingers. You may even have started some of the easy workouts and have it linger. This is your bodies way of staying on high alert, and it keeps you from pushing too hard too soon. For those that push too hard to soon, I've had people say that a foggy headache has lasted as long as 6 months! To answer your specific question, yes, feeling light-headed 3 weeks after the initial headache is very normal. In fact, expect the foggy feeling to be present for another 5 weeks. Most people have that foggy feeling for the first 2 months after the initial exertion headache. It feels less and less foggy over time, but you will be able to tell week 7 that you still have a slight foggy sensation. Keep us posted.
Great article. I'm 46 y old male. I started CrossFit around 9 months ago, lost 15kg weight since (97->83kg). Few weeks ago I started to have headache during wod's. But at the same time as had flu so I tough that it was the cause for the headache. Around a week ago I started to do push ups, after few I had exploding headache which started like storm from clear sky. I hardly got up from floor and it felt like my head will explode. After less than hour I checked in to local hospital and had head CT. CT was normal so likely this was exertion headache? Since the event I have had slight headache all the time, ibuprofen helps a bit but not enough to stop the headache.
Blood pressure right after the headache was around 160/95.
Last weekend I measured 4 day average blood pressure which was 120/72, heart-rate was around 62. This was great improvement as 9 month ago measurement was 145/85, hart-rate 85. Anyway seems that blood pressure outside wod's are perfect?
Now I need to follow your recovery instructions for few week.
I have a comment for Demetrios…I think you may want to consider seeing a psychiatrist about your issues. It sounds to me like you could have Generalized Anxiety Disorder (GAD). Those who have this are often tense, get headaches easily, have periods of high blood pressure, get hot flashes and can have anxiety/panic attacks which can feel much like a heart attack. If the ibuprofen route doesn't work, and your symptoms persist, seeing a psychiatrist or a mental health professional wouldn't hurt. GAD is very treatable and you could see a massive improvement in your situation.
Cheers xx
Thanks for submitting your reply, and for caring enough about others to share some insight into one of the members here on the forum. I can not shed any light on GAD, it is out of my scope, but every bit of information can be helpful when working through this. Thanks for the post Jenn, hopefully this helps Demetrios.
Thanks for your post. Keep us updated on your recovery. Blood pressure at rest should be at normal levels, that is typical. Let me know if you have any other questions.
It's been a week since the worst exertion headache attack. I managed to complete the final Crossfit Open task without problems supported by 1,5g Ibuprofein. But there's daily headache, sometimes stronger sometimes just noticeable. This even with zero training activity. Yesterday no activity and today woke up with headache again:(
I'm fully aware of Nick advise to start the long recovery plan, but like Nick said you always think you are a special case. Getting time of from training you have done almost one year is hard, you are afraid that you will loose all what you have gained and you have to start from zero again.
Hi checking back in. It's been 7 weeks since my initial exertion headache. I think I may also be suffering from chronic tension headaches. After seeing the neurologist he told me the pain in my neck could be related to the daily headache I get for a few hours do I've been seeing the chiropractor who found a strain in the neck and every session he worked on it the headache was usually aggravated. When I'm not getting the headache I do notice the light headed/foggy sensation still.
I rested complete my these past few weeks. Only started back going to the gym last week and thankfully do not get the pounding headache while lifting.
But have you ever had someone suffering from tension headache + exertion headache at the same time?
I want to echo those who say this is the best explanation of exertion headaches on the internet. Thank you for laying this out so clearly and completely. I suffered exertion headaches on three separate occasions while doing TRX training. The training was new for me, and my body wasn't ready for that level of intensity. I've never had the headaches before, and the third one just didn't go away. I'm at day 11 and it's the first time I've gone most of the day without a headache, though the tinge is back tonight.
I saw my GP and a neurologist and had MRAs of the head and neck that came out clear. The doctors simply tell me that I can resume exercise and to continue a 10-day protocol of indomethacin. I'm going to follow your timeline for getting back into activity. I can see now how continuing to workout through the headaches was a mistake. I knew that jumping too quickly into strenuous exercise could be a problem, especially at 46, but my concern was my knees. As it turns out, my knees are fine, but my head needs some babying for awhile.
Thanks again.
46 year old woman trying to get fit after lumbar surgery. Six months in with the aid of a PT I felt sick after one session of intensive training. The following day I have a headache which can only be described as feeling 'hungover'. Concerned as this is the first time I have experienced it. Guessing I just have to cut down and drink more.
It is not uncommon for folks to report back saying that there was a correlation between spinal alignment "tension headaches" and ultimately exercise-induced exertion headaches. A good chiropractor and a patient gradual recovery process usually does the trick. Keep us posted.
The good news is that you caught on early. Be patient with your recovery, and just remember that you are the rule, not the exception. Get your head healthy, and ease back into training. A few months of tactical recovery is better than months of wasted time with a dull headache… Strong work for pushing hard at 46 though! You'll be back to your beast-mode ways, just take your time getting healthy first. The sooner you are healthy, the sooner you can train full speed again.
Since you are recovering from lumbar surgery and since you did not mention a "grenade exploding" in your head, and you are working at a post-therapy low intensity yet highly specialized training level with a physical therapist, I'm not convinced that you have an exertion headache. This may be a headache that results from alignment issues in the spine that impinge on the nerves and cause headaches. My advice would be to coordinate with your PT, meet with a chiropractor, and tell them that you are getting dull headaches. Exerti
This is definately what i have this is second week i feel this dull headache in my head and my neck kinda aches or its a lil bit stiff rather im currently on ibuprofen. It all started when i was doing push ups with my legs elevated on a chair morning and night. On the 4th day on my last set and rep i felt the banging headache then i stopped immediately. Still went ahead to push up the next day felt it ws normal. Then pow felt it again. After reading i have decided to rest but i still feel the lingering/dull headache. What can i take to heal or get rid of the dull headache and hw long would it last? and again what can i do about my lil bit stiff neck? i guess it might also have an impact on the dull headaches im experiencing. I knw my a lil bit stiff is neck is as a result of the form while doing push ups. Thanks for this article. Its sincerely appreciated bless. Awaiting ur response.
This is the best info on exertion headaches. I've had these for 7 years now. IIt started when I had sex. But now I get them from 5 minutes with 5 pound weights. I have stopped everything before for the recommended times just because I was afraid. My bp goes up while I have had these to 235/125. I still get them. Today I got on treadmill for a stress test. They did save me from a full blown stroke though. They found a 90% blockage in my left carotid artery and 40% on my right side. Had the left side surgery procedure but my dr. was right. Nothing to do with the headaches. Don't know what or where to go now. Maybe it is my neck muscles or posture when doing certain things.
Thanks for all the information. I was afraid I was developing migraines but my dumbbell induced headache was a true match with your description of an exertion headache. I am a new fan of APEX
Everything you described sounds like classic exertion headache. The "last set and rep banging headache" and the "pow" after trying to push through are all very descriptive of how this feels when you get it the first time. The lingering/dull headache is also very typical after the initial exertion headache. To answer your question about what you can take to heal, ibuprofen, sleep, and water will be good friends to you for the next 2 months. That's about how long it lasts, depending on whether or not you have setbacks from trying to workout again too soon. As far as the stiff neck goes, you may also benefit from visiting a chiropractor to rule out any alignment issues that may be contributing to your headaches. God bless to you as well, and keep us posted!
The fact that sex or weights as low as 5 pounds is causing headaches for you is not common for exertion headaches. It seems like you may need to troubleshoot your baseline blood pressure and make sure that it is within normal ranges before beginning physical activity. The 90% blockage on the left and 40% on the right is evidence that your body likes to cholesterol and atherosclerosis is a reality for your blood vessels. Have you talked to your doctor about blood thinners, or dietary changes that can lower your cholesterol? I'm sure that you have, but with what you've mentioned I have to assume the simple things first and we can go from there. You mentioned your neck being stiff. Have you visited a chiropractor?
Glad we could help, keep us posted on your recovery, let me know if there is anything I can help you with.
Thank you so much for your reply! I have checked my bp before exerciisng and was normal. I can play tennis for hours!! And I don't get a headache.. So I'm back playing . I was on thinners at first but took me off. I was on Crestor but I went off against my dr.s wishes because I felt it was giving me tmj. But considering going back on I did get my cholesterol down to 143 total.. My neck is stiff probably because of the way I sleep and have some arthritis. Also my surgeon and my other drs. Tell me they don't want anyone messing with my neck. I did though because my chiropractor said when I turn my neck to see something that he is doing less to me than that. It didn't really help that much but I love chiropractors and massage helps me. I had patch angioplasty on left side. By the way my diet is pretty good. I rarely eat sugar and chicken and fish is my staples. Lots of veggies. I don't really get why my body likes to produce cholesterol. I will go back on the Crestor or some other one. Because after my surgery I had broken heart syndrome day after. Pretty sure a piece of plaque traveled there. Don't want that happening again. Thanks again for all your help.
I was doing pull-ups with weight on my legs when I was 20yrs old. I got the initial headache but decided to "push through" and keep going. It was about 6 months before I could do pull-ups again. So I can validate what is said here for recovery time and to never "push through". Recently, I did a set of legs and decided to do heavy dumbbell presses for a large number of sets. My third set was bench and on the last rep felt something went off in my head. Headache was only for a moment but I felt 'fuzzy' sort of vertigo after. I am currently in the dull headache phase but it is getting better slowly each day. Great article here. Thank you for posting.
Thanks for your comment and echoing the fact that these headaches take time to recover from, and pushing though them is a bad idea. 2-3 months of tactical recovery is better than 6 months of bull-headed submaximal pushing. Let me know if there is anything we can do to help.
Thanks for the update. It sounds like you are doing all the right things with your diet, and that you have reached out to all the right doctors for help. 143 total cholesterol is evidence of good nutrition, and the hours of tennis are great for your heart, lungs, blood vessels, and muscles as well. If you can do that with no issues, keep at it! With the blockages that you are now handling through angioplasty, diet and exercise, you may find that the blood pressure spikes during sex and strength training are not as severe, and the headaches do not accompany them. It may just take some time blockage-free for your body to adjust. As far as why your body is susceptible to atherosclerosis despite diet and exercise, sometimes genetics can overcome good behavior, which is not fair at all. You will just need to monitor this, keep all the right doctors in your corner to help with it, and be diligent about diet and exercise. All the things you already know and are already doing. I wish I had a magic answer for you, but all I can really say is keep up the good work, and thanks for commenting on the thread. If you don't mind, can you check in with us a few months from now after your body has had some time blockage-free to adjust? Most folks get these headaches from one bad workout with poor neck position, dehydrated, holding breath, bad form, etc. For you, there is more to it, and I think that your story could benefit others, which is why I'm requesting you check back in.
I had the surgery almost 2 years ago. Headaches are still there and as bad. I had one on my stress test thursday. Waiting for results now to see if there is any changes when It happens. And thank you for your interest and this blog. It's the most I've gotten anywhere.
It's now 9 weeks since the exploring headache episode. Since then some level of headache everyday. 1st thing you notice in the morning is the headache. Also if waking in the night I feel the headache. My doctor said that at least I do not have any tension headache. Tried different pain killers, not really helping. Just tried indometacin but did not really help. Headache is more annoying than painful. I have done the normal crossfit wod's, no change to the headache. I have head vessels MRI scheduled for next Wednesday.
My utmost gratitude for your Article
Before every work out I stretch for a couple of minutes do 5 minutes of cardio and always do a warm up set. I'm very sensitive to breathing and form. With all of that said I had an exertion headache on my last reps of Bench press this past Sunday. I pushed through it and finished my whole workout with the headache diminishing through-out. The following day Monday I started with Pull ups and on my 1st set last 2 reps again the same headache but more severe however, I pushed through it again. On a scale of 1-10 of most pain I've ever felt it was a 9 ½ for a short burst. I've had some pretty severe injuries racing dirt bikes over the years and have pushed through many injuries and have taken the same approach to working out. I thank god for this article as I will not be back in the gym for a 2 weeks as my brain is a pretty important thing for me and I need to preserve all that I have left. If it wasn't for your article I would be in the gym now punishing myself day after day. After finding this article I went to the Chiropractor Tuesday and he gave me an adjustment on my right c4-c7 and he said there was a lot of tightness on my right trap and said not to work out until at least Friday based on how I feel and to go only about 50%-70% again on how I feel. I went to the doctors the same day and the took my blood pressure and did a EKG along with full blood work – all perfect. They did order an MRI which has not been scheduled yet and I may cancel it but I'll see how I feel when they contact me. I'm definitely in a fog but my head ache is defiantly down to a 1-2 level now while taking the ibuprofen regiment. I will not take any caffeine before the gym in the future. I was using NO Xplode which I will miss dearly but I'm certain that contributed to this as I was only taking it for about 4 weeks. I had the same headache problem back in 2008 or 2009 taking NO Xplode but didn't know what was causing my head ache at that time and stopped working until 6 weeks ago. Im on a mission to get back into the best shape I ever was so nothing will stop me and as much as its killing me not to be in the gym for 2 weeks I will follow your marching orders. Any thoughts on still getting the MRI ? Sincere Thanks
Hello, first off really good article very helpful. I will be enlisting in the marines within the next 3 months and just recently had a bad exertion headache in the gym while lifting really heavy on the fly machine and leaning forward for more upper body stimulation. Although there's no way I'm gonna be lifting heavy like that again for awhile, would it be okay to do lots of push ups, pull ups, lunges, running, cardio in the meantime to be ready for bootcamp? or is that doing more harm that good and going to prolong my full recovery time? Any advice would be appreciated. cannot afford a medical visit.
Are you shipping out in 3 months, or signing up in 3 months? My advice will vary depending. Regardless, take the next 2 weeks completely off with water, sleep, and ibuprofen being the priority.
Sounds like you are a veteran lifter, you know your body, and you push yourself to the edge. Strong work. As far as the MRI goes, it never hurts to rule out more; however, it sounds like a classic exertion headache to me so an MRI will likely come back clean as well. I've had a few folks report pulled facial muscles, but they also had twitching behind the eye and lockjaw issues accompanying their exertion headaches. If you are exclusively dealing with the post-incident foggy sensation, then you are in the majority. Pre-workout supplements across the board increase heart rate and dilate blood vessels, among other things. Those are good things that enhance performance during a workout, but as you mentioned, can also make you slightly more susceptible to getting an exertion headache. Use discretion on using these supplements. That's a whole other conversation. I'm working on a supplement article at the moment, among many others, so stay tuned. Thanks for your comment, keep us posted on your recovery and let me know if you need anything.
Having never experienced headaches in my life this last month has been total hell. I own a CrossFit box in the U.K and on Saturday (3 weeks past) I experienced my first exertion headache in a 8min AMRAP that was the final qualifier for a CrossFit competition so I pushed on. The pain was a 10, Id say im generally very good with pain , heavily tattooed and pain isnt really ever an issue in wods etc I such it up pretty well, so i struggled to the end of the workout winching to my judge as I tried to mutter what I was going thru. I put it down to dehydration, Id had a 3 beers the night before and im not really a drinker. I left the gym once the pounding had stopped (15mins as my heart rate came down so did the pain) but spent the rest of the day in bed with a pain level about 3/4 and a foggy feeling I suspected might have been a mini hangover.
The next day, sunday, i returned to the gym and managed to hit a deadlift wod but after this I was having sex with my girlfriend and as I got closer to finishing the job the pain started to intensify, on organism I dropped to the floor the pain level turned up rapidly from 3- to 7 – to 10 for a full 15mins. Again i went and slept it off.
Following on, I had a foggy feeling that was ongoing, I started to panic and read up some scary stuff online. Not 1 for doctors I decided to take a few days rest but on the tuesday began having sex again and about 3/4mins the pain moved up again from the foggy 3/4 towards a 7. We stopped as it was clear going any further would bring it back on gain full blast 10.
I rested wednesday and on thursday I did 10 pull ups in the gym, it started to rise again so i stopped, it reached a 7. This was now recking my life. I took friday and saturday off, foggy headed I was still hoping it would pass but on saturday night I attempted masturbation more as a test to see what the hell would happen. Boom 10 again , on my knees agony. Id had enough so on the following monday, 9 days out from my 1st headache i went to the doctor. The doctor suggested I go straight to hospital, he suspected that I may have a brain aneurysm. OS – im going to die. A panicked rush to the emergency room and a CT scan showed nothing. I spent the night and following day in hospital waiting on a lumbar puncture to rule out bleeding. At this point I found this website post. I read the complications of a lumbar puncture and the pain, taking an educated decision based on the info i found here and the doctors lack of answers on how i wasnt dead yet if i did in fact have a brain bleed (im 28, train 6 days per week for the last 10 years and ive always been in good health) I then decided to sign myself out.
My foggy head has left, im in my fourth week. I can go mountain biking, sometimes i feel my pulse in my head, a 4/5 out of 10, i stupidly tried to have sex again at week 3 and mad the headache rise to a 7 before stopping. I plan on taking 1 more full week off just to be sure but I qualified for the crossfit comp which is now 4 week away today (2 months from my initial headache but probs only 5/6 weeks since my last 1)
Im firstly very grateful for this article, i feel it is amazing that you have spent the time writing it and whats even better is that you have responded to all posts (thank you, you don't understand how much it has helped me and im forever grateful, its be a horrible time, my box just opened and ive felt for moments that i would never crossfit again).
do you think its at all possible i could make it back for the comp in 4 weeks? im not looking to win, obviously it will be hard but id do it more for fun at this stage. I even consider not training right up until the day before then testing myself and seeing. At the moment I don't have any foggy head issues that last for a full day but it can be foggy when i wake up for the first 30mins.
Thanks for sharing your story. I'd encourage others to read MT's story. He is a competitive CrossFitter, UK Box owner, and has had shared a timeline with details pertaining to training, sex, and recovery that most will find encouraging to feel they are not alone.
If I were you, and I had a competition coming up in 4 weeks, what I would do would be to take 3 weeks completely off, focusing my attention on sleep, water, ibuprofen, and try to heal up as much as possible. Week 4 I would test out my heart rate and see if I could push myself a little without instigating a headache. Day 2 or 3 of week 4 I would dabble with upper body lifts and see if I could push myself a little. I would dabble with legs later in the week. If week 4 I couldn't dabble with lifting, I would have no issues withdrawing from the competition. Regardless, in the competition, I would not plan on pushing too hard, but would rather just pace myself and enjoy being part of the culture of the competition, knowing that this is not the one I will win. Food for thought, let me know if there is anything else I can do to help.
thank you. I suppose I just have to sit back relax and go by feel. I will follow your advise and report back. Just spent a few days out biking (3 hours each day in week 4). Heart rate got high and only a very mild headache in the evening. It seems blood pressure is now more the issue than cardio which relates directly to your 6 week plan. I will report back before comp. speak soon MT
Actually plan on being shipped out to bootcamp in the next 3 months, currently a poolee. I've had thoughts about extending the process, but don't want to if it's not necessary and I can come to a full recovery in time. When it first originally happened, I had an intense pain in the back of my head for about 3 hrs after the incident. currently it only starts to come back when i reach exhaustion or try to lift heavy whatsoever. Was actually at the gym the other day just to test the waters and could only squat half of what my max was without the pain subsiding. Haven't been there since. Its been about a week and a half. Sleep, water, and ibuprofen have been definite priorities lately. Again, any advice is appreciated.
The good news is that heart rate doesn't affect the headaches for you, so take this time to work your heart and lungs, but give the rest of your frame a break from weight lifting, since that is what causes the spike in blood pressure that affects the headaches.
I wish I could tell you that you would be 100% before bootcamp. You probably won't be. The fact that you gave yourself an exertion headache shows me that you have been training extremely hard. That means that you are in good enough shape to take 3 weeks COMPLETELY OFF and will still be in great shape. That will give you the best chance to enter bootcamp without headache issues.
Throughout bootcamp, you need to be very mindful of your breathing, never holding your breath, always exchanging air. For the first few weeks when everyone else is out of shape, pace yourself and treat the first few weeks as your re-introduction to training. The good news is that initially you will be doing mainly body weight movements, lots of running, and playing lots of mind games. If you pace yourself, making sure you are not the first guy to finish, but also not the last guy to finish, you should be good after a full 3 weeks off with water, rest, and ibuprofen, and 2-3 weeks of pacing yourself at bootcamp. You won't be ready for a heavy deadlift, but you should be good to go for heart rate increases. Big thing is staying calm and pacing yourself. If you go in and push too hard, you will get washed out, so don't do that to yourself. I had a good friend of mine push himself too hard at bootcamp, trying to be the top dog, and he ended up getting an exertion headache at bootcamp and got medically discharged, and apparently they treat the medically discharged like crap and drag out that process, so you don't want to be that guy.
I went through a 6 month fire academy, wearing 70 lbs of gear, in the summer, for a high speed dept just outside of Washington DC. My business partner did 4 years in the Marines. We were both platoon leaders at the academy/bootcamp, and I can tell you from both our experience, pace yourself. You are entering bootcamp at a disadvantage with an exertion headache, so pace yourself to make sure you finish.
Hi Nick
Its been 10 days since my last work out / Headache. I had a MRI and a MRA yesterday and im awaiting the results. I should have them before the end of the week. I had a little down turn yesterday with pain from 2-4 but today 0-1 pain scale. I dont believe the test will show anything but ill let you know either way. Looking forward to Monday as that will be my 2 week marker.
Bye for now
Hi Nick,
I just wanted to say a huge thank-you for your guidance which has been far greater and more useful than what any doctor has given to me back here in the uk. For all other readers wondering what is going on in their head like i was heres my story…
I was competing in a fairly low level CrossFit competition and it was a friends birthday the night before so. I had around 6 beers with the meal and went to bed about 11pm. I woke up early and without food grabbed a large filter coffee on the way to the box where i was competing. On arrival i found out the first workout was 1 Min Back Squat, 1 Min rest, 1 Min Front Squat, 1 Min Rest, 1 Min Overhead Squat. You choose your weight and score= Reps x Kg
A little tired i warmed up poorly but i knew when the 3,2,1 go went i would go for it… i completed 43 reps at 60kg Back squat, 32 at 50kg Front Squat and 30 at 40kg Overhead Squat. This is important just to illustrate the volume and load. On completion of the last rep and slamming the barbell down i felt what can only be described as an explosion go off in my head. The worst headache i had ever experienced. This lasted for about 8 hours even though i had taken more Nurofen than the shop had in store. I couldn't stand people talking i was irritated by almost anything. Each day later i would wake up and now a dull headache would be present on the 3rd day i began to worry and decided that i would have to bite the bullet and go hospital After lumbar puncture and MRI still no diagnosis. After this i thought best give myself a week of rest, then one evening i was with the mrs in bed started having sex and boom i could feel the headache coming up the back of my neck into my skull again. I quickly lay still (awkward) and gradually the headache subsided back down my neck. I know this sounds weird but i felt i could actually control it but not allowing my heart rate and blood pressure to rise.
So… i start reading and this is where i found this article amongst many many others. I followed the rehab programme for CrossFit and i have not seen the headache return. What have i learnt? That preparation is key and not to be a complete douchebag. Once again a massive thanks to Nick this is by far the worst and most frustrating injury i have ever sustained.
MRI and MRA should nothing related to the exertion Headache.
Its been 2 weeks and 3 days since my exertion Headache. I worked out (Chest & Tri's) for the 1st time this morning at about 75%-80% of my normal weight and i held off on pushing out the last 2-3 reps on each set. I eliminated caffeine and all my pre-work out supplements before my work out. I took 1 Aleve 35 min before work out. I kept my spine aligned and was concentrating on breathing though out. When i had my 2 exertion headaches they both happened when my head was tilted looking up and on my last 2 reps- 1st on Pull-ups and second time incline bench. I now keep my head looking straight on all exercises.
Note: i have been getting dull head aches in the late afternoon even as yesterday. But so far so good today and i don't feel even a hint of one now. This worked for me and i really hope this helps others.
one more thing – I drank a lot of water before and my urine was clear before starting and i also drank more water during.
UPDATE from March 9, 2015 8:19 am
ok, see above for the full history, but, happy to report that I am 98% mended ! However, take my advice and follow the above advice ! March 09 to say, May 09, it WILL take the full 8 weeks so go easy on yourself, cut out shop caffeine (I cut out the big shop cups), go to doc, go to osteo and have a massage and watch your posture and ease back into it slowly and you will be fine .. go at it mad and you will continue to have problems .. thanks for this site, it really helped and the best to anyone suffering from this, it will get better but you cannot rush it, and if you do, it will set you back weeks !
Thanks for taking a moment to check back in now that you are feeling better and can confirm the timeline. Often times no news is good news, but I do appreciate you posting some good news to boost morale of those suffering from this. Keep us posted, folks will be encouraged to hear that you are able to train at higher levels than before the headache after a full recovery.
Thanks for your comment and for the reinforcement of the CrossFit-specific recovery plan. Keep us updated on how you are doing.
I have had these type of headaches after deadlift routines. I am able to complete the routine with no symptoms but get a headache about an hour later and it doesn't go away until about 4 hours later. It has happened to me twice now and that is the reason I am researching about it. The first time it was a routine trying to reach my 1 rep max weight. The second time was a routine that included several reps at about 60% of my 1 rep max. In both occasions I went back to regular training the very next day since the headache was gone. According to your article I shouldn't have done that. I now how taxing deadlifts are to the nervous system, but is there one specific cause you can identify to getting these headaches during deadlift routines only? I perform every other type of lift and routine at the same performance level and never had this happen.
Hi Guys,
I wanted to check back in to update everybody. This blog has been a great help for me and I want to update my story.
See MT above to get part 1.
Part 2
Quick recap. I had my first exertion headaches two months ago today. I had 5 in the proceeding two weeks following that which resulted in a night in hospital, a brain scan (clear) and a lumbar puncture which I rejected on finding this blog (as eminem once said – spinal fluid is important you dont get it back LOL).
With the help from Nick I got back into training cardio only in week 4, light weights in week 5. In week 7 which was 1 week out from my CrossFit comp I went back to test the same loads I had been lifting pre-headache. During the workout itself I felt ok, no major pain but after and for the preceding few days I had a headache that was dull (4/10), it was very annoying and precent all the time. I took the next 3 days off and rested for the comp.
The comp WODs were ok, but a 1 rep max clean and jerk (110kg /242) gave me (5/10) headache that again has lasted for 4 days, not thunderclap just a buzzing dull feeling . I havnt trained since the comp and intend to take a full week off then work my way back into cardio giving myself more time to heal. Its very frustrating, I think 2 full months recovery is needed. I work crazy hours running a box and get 7 hours sleep split into 4 hours at night then 3 in the afternoon. (this is changing next week as my health is too important). If you are suffering from these headaches you have to remember it takes time, Ive tried to rush back slightly and it results in a foggyness again that is experienced in weeks 1-4. Its frustrating to think that I cant train the sport I love and everyday I have to coach people in it. I think changing my sleep will be a big step and hopefully the correct 1 to make these headaches go away for good. I havnt expereinced anything like the intial 5 headaches at the start but my head does not feel fixed yet. I keep getting strange pains etc although they are mild they are very frustrating and I doubt il ever have the confidence to push like I did before which is heart breaking. Nick you you think stress plays a part in these headaches?
Deadlifts are a large compound movement that incorporate all of the risk factors of an exertion headache. Neck position, holding breath, heavy weight on frame causing a spike in blood pressure. All of these factors can contribute to getting exertion headaches. Dehydration can also contribute to these risk factors. All that being said, it is odd that you are getting the headache an hour later, and that it only lasts 4 hours. It may be something other than an exertion headache. Exertion headaches are typically sudden and linger with a dull headache for months. That is not what you are describing. Regardless, being intentional about your breathing, neutral spine, and hydration will only help. Taking some time off will also help. Keep us posted on your recovery.
Thanks for the update, I'm glad that you were able to participate in the competition, although not at 100%. Stress and lack of sleep may hurt your ability to recover, but are not directly impacting the headaches. The dull fog can last a long time. It's your bodies way of giving you a subtle reminder that it is still not happy with you, and that if you push too hard it will bring you right back to that painful initial headache. I had a very similar experience when I was getting these headaches back in my early 20's. It's been 10 years of hard training since, and I have not gotten another headache and am stronger than ever. While it is a setback, it is not a permanent condition. As a leader in your box, you can help others avoid these headaches, or direct those that are recovering. Your updates are helping others all over the world, so thank you for taking the time to check in. I appreciate it. Keep us posted on how things are going a month or so from now. Thanks.
Really helpful article, I had my first headache that matched these descriptions just over a month ago. It seems to come on most severely for me doing bent over rows. Although I do get it mildly when doing squats but not as severly as some others have described. Ended up being swamped with uni work so didnt gym for about 2 weeks although I continued with rugby training and playing. While pushups at training did leave me with a headache the cardio work didnt seem to effect me too much. At the gym monday bent over rows once again gave me a pretty sever headache which subsided fairly quickly so I assume rest is needed again. Just wanted to know if, as my cardio from rugby is not really causing much of a headache, is it safe to continue with that? Team is struggling with injury at the moment so not really a good time to drop out especially with headache being an excuse.
This article has been very informative. I am kind of on the opposite end of the spectrum here but i am pretty sure i am suffering from an exertion headache. I am 39 years old an run a produce pack house during the summer in New Mexico. It is very hot and stressful. Last week i am pretty sure i had my 1st initial headache- Excruciating pain, light sensitivity, nausea, stiff-stiff neck. I tried to push through it for a week and on the 6th day went to ER. Blood work showed i was very dehydrated. I was given fluids and a pain killer for my headache through IV. I am in day 8 now and feeling better but still have the dull headache which worsens the more i exert myself throughout the day. I feel after reading this thread i can take necessary precautions and see warning signs. However my question is do you think the heat itself can onset the headaches now that i am recovering.. i work some days in 98-100 degree heat.
Hi, I have been experiencing exertion headaches for nearly 4 weeks now. They are becoming less intense but I have to fly in a few days and am wondering if it is safe to do so??
I started getting these headaches about a year ago. I've stopped my workout routines for some 2 weeks, went for an MRI which came out clean, then started exercising slowly again and it was okay for a while. Then it came back, same thing, stopped then started again, good again for a few months. Got it again some 3 months ago, stopped again, started again gradually, however this time the pain was still there. Went on vacation for 2 weeks, no exercise whatsoever, came back, started exercising again, the pain was still there. So for the past 3 months this has been bothering me quite a lot. One thing I've tried when exercising, I'm wrapping an elastic bandage tight around my head, from the base of the neck to the forehead. This seems to help, by restricting somewhat the blood flow to the head. Honestly not sure if this is a good thing to do, however it works for me, as I've lost my patience with this.
Thanks for the article. Very rare you read an article which explains certain conditions so well in such simple words.. Really appreciated !
It was two days ago, I was doing squats. Felt like a pulsating pain in left/ back area of my neck coming all the way to left eye through left side of head. Initially I thought, the bar pressed some vein or something so I massage the area. The pain was extremely intense for the a couple of minutes. I rested for 6/7 minutes and went back to squats but this time with dumbells and the pain was there in background and emerging everytime when I was near 70% of my set completion and therefore was not able to take those to failures, I try managing it by drinking lot of water ( I knew I was dehydrated for last 2,3 days) and trying neutral neck position. During next exercise (incline leg press machine) I was able to complete it till failure without any prominent headache. But it was there again during leg curl. Somehow I manage to complete legs and went to lats; which I was not able to train to failure but quite near, with not much pain.
Yesterday same thing happend when I tried to warmup for shoulders. Then I skipped shoulders training and trained arms. Pain was sever for the first 5/6 sets then it was manageable and eventually was not very prominent after 40/45 mins of exercise. However since then everytime my BP/ HR spikes a little (even sudden standing up), pulsating pain starts in no time and always there in background. One thing during workouts is that after I am done 50% of the exercise, headache seems very dull as compared to initial 6/8 sets.
Is it typical exertion headache ? Thanks in anticipation.
After an exertion headache, you can expect a dull headache for at least 2 months. The sooner you take time off to heal, the sooner you will be 100% and headache free. I'd recommend NOT walking the fine line of trying to see what you can get away with. Trust me, and the many others before you. You are not the exception, so rest up so that you can get back to training at a high level ASAP.
The restrictive elastic bandage is very clever, and evidence to me that you are truly hard core about training. It sounds like if you've been dealing with them for a year, you are not giving yourself enough time to bounce back 100% before you start pushing too hard. It is better to have 2 months of tactical recovery than a year of sub-maximal headache babysitting… I'd recommend extending those two weeks to a month with lots of sleep, water, and ibuprofen before you begin with some very mild cardio. The goal should be headache-free training, so if you still feel dull and foggy, you are flirting with another headache…
I'm not sure if you have already taken that flight, I apologize for not replying sooner, I missed a few posts while I was putting in a push with my other job, just to be real. I would think that after a month of recovery that a flight would not aggravate the headache. I'd be diligent about hydration and sleep leading up to the flight, then take some ibuprofen before hand just to keep all swelling down. If I did miss you and you were able to fly with no issues (or if I was wrong and the flight re-kindled the headache), can you give us an update? I'm sure you are not the only one that is dealing with these headaches that has flights planned. It would be nice to have documented some experience around these headaches and flights, good or bad.
Heat can cause dehydration, and exerting yourself while dehydrated can lead to an exertion headache. Heat alone typically will lead to heat stroke before it would lead to an exertion headache, although it is certainly a risk factor. Dehydrated blood has to compensate with increased blood pressure to circulate the blood, plus your body is working extra hard internally to evacuate heat through your head, feet, and hands which is why you notice your veins bulging towards the skin when hot. All these things are not guaranteed risk factors for exertion headaches, but all can play a role in them. I hope this helps.
Be careful during the strain of the scrum, making sure to not hold your breath. Outside of that, Rugby should be OK. During your bent rows, keep your neck neutral with the rest of your spine. Neck positioning is a risk factor for these headaches, so make sure you are not straining to look forward at a mirror or a spot on the wall like some coaches may encourage. Pick a spot on the floor, and be mindful of your low back angle, but keep your neck straight with the rest of your spine not matter what. Same goes for squats or other forward bending movements that looking up may be tempting. Control your body, keep a neutral spine.
I am 6'3 and 65 kgs, so i started working out and taking a mass gainer. The starting 3 days in gym was all fine though i wasn't hydrating myself properly. The 4th day after my workout, i felt like blood rushing to my head but there was no headache. When i returned home, i had eye bags down under my eyes. It gone after a while. That night while having sex i felt my first headache. It was so terrible, i felt like a bullet in my head. It got over in a while. I took a day rest from the gym. The next day when i went to the gym when i started working out, it was severe pain. I stopped myself and took a rest for 10 minutes, it was gone. I thought maybe some problem was qith my posture. I completed my workout and went back home. The next day in morning when i tried doing some pushups, after a while the headache started, it was the most severe headache ever. I took a disprin and it was some relief. My question now is what should i do now, should i quit working out, should i stop taking my supplements. Please help me out.
Hey, so I know this topic has been going for sometime and I'm happy to see responses ark coming hopefully I can get som closure myself and maybe be able to ease a few other people. It started about 16 days ago I had been training for 3 months using machine weights, felt like I had made some great strength gains and decided it was time to start using free weights. I had two weeks off due to fatigue and a holiday . On my return day to the gym within 40 mins of waking up I had had a omelette and was eyeing up a set of chin ups to warm up most likely dehydrated and bit niggly of 5 beers the night before and 2 weeks of eating and drinking rubbish I start where I left off and go straight in no warm up after about 6 chin ups I feel like someone is filling my head with air the last chin up booooom felt like my brain had been ripped from my skull eyes went hazy and I had to sit down . After 3 -4 mins of extreme pain I started to recover but instantly left with a dull ache, the worst descition I made was not wanting to look like a newbie in a gym full of pros I carried on for about 45 mins , every single exersice bi curls, rows happens exactly the same, in between sets I was doing reserch on phone and could see breathing was a factor but I feel the damage was done. I left the gym and went to work to start my two weeks of hell. Dull aches all day I decided to go to gp next day who immediately sent me for a ct brain with dye I had the done the following day so 48 hours after my first head ache. I then started to research on the net my symptoms and let me tell you as he all probably know it's not pretty. So combined with the fear of dying and my dull headache it wasn't pretty. I then on night 3 had another headache not as intense as the first on lasted around 2 mins whilst straining on the toilet this took me to the ER , they wired me up to esg , did my bloods all my obs for stroke and kept me in overnight till they could find my cat results. They came back fine , which is wher I wish they left it , she then went on to say because there was a 48 delay there's a chance the potential hemorage could have moved already , this imediatly made me worse they sent me home on the understanding that I return for spinal tap if I get any more head pains or headaches get worse .
I started to get lower back pain, That brings me to 4 days ago when mastabating again hit with a pulsating headache all on the right side of head throbbing with pulse till blood pressure drops then dull headache , I had been so stressed and not sleeping and doing endless reading on google lead me to storm into my GP and demand more tests so had an mri done and mor blood tests mri was 100 % normal showing no signs eye test 100% bloods normal showing abnormalities in unrelated areas regarding liver. Still no further forward doc ssid could be Custer migrane but can't give mess as wants to monitor back pain. Happy with this and with the stress of not thinking I'm going to die my head has finally stated to clear till tonight during again sex was hit with another pulsating one this time it went after 30 seconds but left with headache on right side of head. Looked at exertion headaches and found this . What do you think do you think I just need to cut it all out for a month I'm not exceeding at all over last two weeks as I was put off the gym . But comes back whenever my bp gets higher . Do you think I can take relaxation in the CT with die and MRI being clear that it's not something sinister. And that its just a exertion/cluster migrane and that I should rest up befor doing anything stupid cheers for reading my essay feels good to get it of my chest
Thanks for sharing your story. It sounds like you have done all the major tests to rule out anything more severe, and everything came back clear. The best way to deal with an exertion headache is ibuprofen, rest, and avoiding things that cause a spike in blood pressure and heart rate (sex, exercise, poor diet) for 2-4 weeks until the foggy headache subsides. Unfortunately there is no magic answer other than rest and time that heals this injury. Keep us posted on your recovery, and thanks again for the post.
Nick, thank you very much for this information. I have searched the internet for information on exertion headaches and have never found anything helpful like this. I have spent the last 2 hours reading everyones comments above, and I'm truly glad to know I'm not alone.
I am a 21 year old male. My exertion headaches started 18 months ago in the gym. I believe it was doing pull-ups, at first I felt a grenade like pain in my temporal area, and then had the same feeling later in that workout doing a leg press. I took a week off from the gym, and a week later when I tried to bench press I had that exact same terrible feeling. I saw my primary doctor, then went to the ER after I started regularly experiencing these headaches EVERYDAY with or without exertion. I have had multiple CTs and MRIs done, all came back clear. I have been to 2 separate neurologists, who originally diagnosed me with Occipital Neurolgia. I then went to see a pain management specialist in this field, and had a radio frequency obliteration of the nerves stemming from the base of my neck into my head (I forgot to previously mention that I have also experienced the neck tightness and stiffness, but it has went away). In between seeing 2 different neurologists, I also underwent PT for 5 weeks, then Chiropractic treatment (3 times per week, acupuncture) AND took a period of 6-8 weeks off from physical exercise–and had no change. After recently trying different medications from my recent neurologist such as blood pressure medicines, muscle relaxers, etc, I continue to have a dull headache. Every single day. Working out in the gym makes my head 10x worse, but I bring a headache INTO the gym, my headache is not first started in the gym. I am not able to lift any "heavy" weights when I do exercise, I cannot squat, bench, dead lift, or leg press. I have a dull headache that occasionally spikes into the grenade feeling once or twice a week. And this has been going on since February of 2014. My neurologist has recommended I get a second opinion from a "headache specialist" neurologist. My head has truly not felt "normal" since my first exertion headache in the gym 18 months ago. I have no idea where to turn or what to do anymore, so any advice would be so greatly appreciated. I would not wish this feeling on anyone in the world. Thank you all and God Bless.
i have to stop lifting for months ???… that would've mess up my gains….. after that im going to start all over gain and go back to zero :(((( … gotta have to blame this on my horrible form on my squats… fuck now i have to pay the price
i has same headache last 6days after during hard workout in gym and still it is there. can you suggest me what to do?
This has been the most helpful article, thank you so much for putting this information out here for us to find. I suffered my first exertion headache 3 weeks ago, my Dr did the normal blood work, CT scan, all the good stuff. We did find that my blood pressure is elevated and are treating that but even my Dr was at a loss as the cause of the headache. I am so relieved to find that there is hope to return to the training that I love. Thank you again for this valuable information.
Hi Everyone-I have solved my exertion headaches, maybe it will work for you all.
The fact that MRI's come back negative (no indication of anything wrong in the brain) does indicate something vascular/nerve pathways. I found a muscle knot in a cranial muscle on the back right hand side of my head that is in the region of my exertion headache throbbing pain. I think that maybe the presence of the muscle knot, or trigger point, will exacerbate impeded function on the vascular pathways to the brain, during periods of vasodilation during increased heart rate/blood pressure. Thus the nature of exertion headaches is a physical impingement on these paths, please I urge you to feel around the muscles of your head using a hard, spiky massage ball and try and find any 'clicks'/'knots' and if so, massage them gently/moderately and please report back!!!
Also, any criticism regarding my speculation is much appreciated, and I have thoroughly enjoyed/learned alot from APEX!
I think that these knots, in context with muscles of the head/neck, stem from poor general posture, but also poor posture during exertion/lifts/running.
Thanks for the article! It did put me at ease a little bit. 2 months of lost time is not ideal, but a promise to get back to my current weights is good enough. I was doing legs a few days ago, when after the first set I felt that throbbing headache. Of course I thought it was just a coincidence and powered through the whole 1.5 hours session. Needless to say that by the end of the session the pain was unbearable, I also felt dizzy and very nauseous. Panadol didn't help at all and the pain persisted the next day. Then today, I woke up pain free and naturally rushed to the gym. The pain came back during the warm up with very light weight. This time it was clear that physical exercises are causing the pain so I stopped right away. I'll give next week a rest and go see my GP. Thanks again!
I experienced an exertion headache. Worst feeling in the world. Shooting lighting bolts from the back of head to front and side of temples. Took a few days off after taking it slow, less weight, fewer reps….. But headache would appear as soon as my body required more effort. It was so frustrating and scary. Why after all these years of working out was I now getting headaches. Finally a friend suggested that I might need a neck adjustment. I really don't like going to the chiropractor but I was desperate. Made an appointment with a sports medicine chiropractor specialist in Malibu. Had a hour deep muscle massage on neck and traps by the physical therapist. My muscles were extremely tight. Then the Dr. Adjusted my neck and body. I did feel relaxed. He said that my cervical vertebrae c2 was rotated. Those neck vertebrae has arteries that run through hole openings on each side, supplying blood to brain and there also loads of nerves in that area. Well, if it's rotated, blood supply is less and nerves are on high alert. How did my vertebrae rotate??? Squats, too heavy weight across my shoulder and neck, wrong body alignment, and I was holding my breath because of the amount of weights. All of this struggle, especially the pressure of the bar rolling up on my neck (free weight squats with long bar) was too much. Now I do other exercises for glutes, quads and hams because I learned that I need to strengthen my neck muscles. I should have known better, but that one slip up caused the worst head pain ever ( my head felt like it was going to explode)
Also the doctor gave me to pills to take. All natural. I don't like taking Tynenol. I would rather sleep off a headache, but these all natural /homeopathic pills are truly miracles workers. One is for natural relief of muscle tension spasms called Formula 303 natural relaxant max strength and Zymain which supports soft tissue repair.
I would never endorse anything, but that's just how great they are. I was so happy to return to my 5 am workouts without headaches and able to give it my all and feel good again. Having those exertion headaches can truly change your momentum and good spirit about your workouts.
So my advice, if you never had headaches before and have workout for years…. Maybe it is just a simple adjustment that you need. But you should go to your Dr. To rule out anything else. If he says MRI is fine, go have an adjustment. And take body alignment, breathing, staying hydrated, weight amounts seriously. It is work and should be respected. Believe me, when you experience an exertion headache you learn a new respect for your body. Protect it.
God Bless,
Thank you very much for a very informative article. This is exactly what I am feeling these days. I never ever felt this until about two weeks ago. I was doing a squat, when I suddenly felt ultra-tight tension in the back of my neck and base of my scull, followed by choke-like feeling of muscle hardening on the front side of the neck, followed by a severe headache. This is happening everytime I do squat (not other training caused it so far). I thought it had something to do with the pre-workout supplement, i was taking and I stopped, even then I am having the same symptom. Now I realize i had fallen victim to this issue.
While I was doing biceps I had a terrible headache . The pain was at the backside of the head . what should I do now I'm feeling worried
Step one is to visit the Dr to rule out anything major. If that comes back clear, rest, water, and use the recovery plan to get back to training. Keep us posted.
I'm very unfit and overweight and have recently started to get into some training (I'm female by the way. if that makes a diffence). During a lightweight session with a PT I was doing 10kg biceps barbell curls when I got the strangest pain in the back of my neck and about halfway up my skull. It felt cold, like an icecream headache. I sat down for a bit and it eased to just a dull throb so we left that and moved to some other exercises. After I left the gym I had a headache that left me alternating ibuprofin and paracetamol until the next day when I had a neck massage and visited the chiro. I think it helped. A few days later while doing a fitness test where I had to row 500 metres on a rowing machine it started again. A week after that I rowed (slowly and taking care of posture and technique) it started again after about 300m. Another week and I tried again, giving up at about the same point. I stopped quickly as soon as I felt a faint pain in the back of my neck but it started up again as soon as I tried bench squats (remember, I'm doing really basic stuff here). My heart rate gets up fairly quickly as I'm unfit, but I don't have a problem with my blood pressure. My PT wants me to have Xrays and ultrasound as she feels it may be a pinched nerve (I've had a few neck issues since a car accident years ago, but it really does sound like what you are talking about here. Should I mention the information in this article to the GP or should I just let him choose his investigations (if any)? Look forward to hearing from you.
September 8th 2015.
I was doing some push-ups in the morning at Gym and at the end of the session , there was a catch at my head . Pain was not sever but a slight head ache and a kind of fatigue and a numbness on my left cheek . I went to work and it was slightest of headache and an exhaustion throughout the day
September 9th 2015.
Morning I felt fine and did some moderate exercise , no issue at all
September 12th 2015.
I didn't go to Gym for last 2 days and went to Gym on 12th morning , while doing small weights ( 10 kg ) dumbbells at the end of the session similar caught at head and I stopped doing it .
September 13th 2015.
I felt bit more tired and too the appointment with a neurologist . After the check up and MRI Brain and MRA Head doctor ruled out any underlying issue but suggested to take rest for 2 week .
2 weeks went very well and I felt I recovered well .
27th September
I have started my Gym with brisk walk at treadmill for 30 minutes and a 5 minutes jogging and went well for 3 days .
30th September
I was tired and felt a numbness on my left cheek and I took off for Gym for 2 days and felt okay
October 2nd 2015
Played cricket for 2 hours but not so aggressively and in the afternoon I felt again a bit tired but no numbness on my cheek
October 4th 2015
In the evening I went to Gyn and had a walk in Treadmill for 30 minutes and felt perfectly alright , but next day morning onwards I felt the same numbness on my left cheek and felt a bit of exhaustion and slight catch on my head . I also feel a slight swelling on my left cheek . its now 3rd day ….expecting a recovery
Would value your suggestion …
Finding your article has been so helpful and calmed my fears. I'm in my early 50's and in decent shape and had been used to doing regular toning routines with lightweight dumbells, and regularly cycling 50 miles per week along with horse/farm work. Very active. I thought I would join a more hard core weight training group at work. All was going ok during the first session, until the trainer pointed to the chin-up bar and told me to just hang from it, if I didn't feel I could do chin-ups yet. I hadn't been on a chin-up bar since the elementary school fitness tests, and should have listened to my gut feeling and walked away. Instead, I was hanging on it and struggling but determined to knock out 20 seconds. When I came down, my head exploded. I sat down and it quickly subsided, within about 90 seconds, leaving a dull residual. The group leader said it was because I had not been breathing correctly. He advised drinking some water, taking some deep breaths, and then go do some bench presses, using weight I'd never been near before. Feeling silly, I powered through.
The rest of the day I had a dull headache and felt "off". Middle of the night I awoke dizzy and nauseous. I put that down to panic attack and made myself rest and try to sleep. Next day, dull headache but not terrible. I got into the doc 48 hours later and he immediately admonished me for not coming in sooner, and sent me for a contrast CT scan to check for aneurysm. The scan was fine. He suggested 2x Aleve morning and night. For 4-5 days I had the headache and a sense of being off balance, sort of in a tunnel. I never had vision disturbances or vomiting. I took Dramamine (meclizine) as that has helped me before during some minor vertigo bouts. It helped lessen the dizziness.
Flash forward a week later and I woke up with what felt like the worst migraine ever. Now doc started to be concerned. He heard an abnormal "whooshing" in my neck pulse and sent me for a vascular ultrasound, on neck and head. This turned out fine. I've always had a good 110/70 blood pressure, but it was elevated to 130/85 (no doubt nerves). He put me on a low dose blood pressure med Toprol XL, and instructed oxycodone for that night if my headache hadn't subsided. Interestingly, it subsided an hour after I took the first Toprol tablet. He had intended to send me for a spinal tap but backed off when the Toprol seemed to solve it.
I still have a dull headache, with little twinges in various spots of my head. Also a sore, stiff neck. I'm still debating on the spinal tap to completely calm my fears. Getting some massages this week may help. Doc has said no exertion until I have two headache-free days in a row I haven't been toning or cycling or riding the horses; trying to be completely low-key as the dull head seems to want to remind me that it'll be back if I do anything stupid. Needless to say, I'm bored…
Thank you for this article; reading it and also reading everyone's comments has kept me grounded when my mind starts to worry that I may have caused myself an aneurysm. I will be flying in two weeks and hope things will be settled a bit more by then.
Thank you!
This is so helpful. This is exactly what happened to me last Wednesday (Today is Monday) when I was doing a total body fitness class. 10 minutes or so after non stop cross fit exercises, I started having this massive headache, dizziness. I stopped right away. Every since then, I have been getting this dull ache on my left temple only. It doesn't hurt or anything. It just there and it's just annoying. I found stretching helps get rid of it for a little while. The ache is gone when I got to sleep. Then it comes by for a few hours here and there through out the day. I was going to go to the gym after work today, but after reading this I think I will skip it.
I'm 29. 5'8″ and 71kg.
I have been been training since the age of 16 and even though not a professional athlete of any sort, have been fairly athletic. I have an avg. of 5 training sessions a week. (3 weight training + 2 Rugby practice sessions)
I had to stop all training due to a fractured finger for 5 weeks and started training again two weeks back. Due to the injury, I had to focus mainly on leg workouts. Didn't think this would be a problem because intensity-wise I have done far worse.
I experienced the headache for the first time a week back and didn't have a clue what it was. I stopped training immediately and went to the gym again after two days. Got the headache in the first set of lunges and stopped training again.
The other aspect I changed in the routine is taking a new supplement called Anabolic Peak which is a weight gainer dietary supplement with Creatine. (Unable to attach an image of the contents) Prior to this I have only taken whey proteins.
1. Could the supplement be a cause for headaches as well?
2. Could the intensity of the workout have caused the headaches? (I didn't feel like I was out of form so I didn't take it slow!)
3. Could I start running in a week? If not how long should I wait before I start running?
I had this buildup of pressure in my head for a while. I could feel it while on the toilet, getting out of bed, tying my shoe laces etc. During exercise I could only ever feel it while setting up for the bench press. I would have periods of a few days / weeks where the pressure would go away and then return for a similar amount of time.
Two months ago I got int a car accident (I was rear ended while stopped) and the back of my head hit the seat cushion thing pretty hard (lost memory of where I was coming from, what day of the week it was as well as some visual problems, flickering lights). I went to the hospital after and the doctor there said I was fine after checking my blood pressure and making me do a few stretches.
After the accident the pressure in my head would start increasing during exercise. I no longer felt it in the bench press but it started showing up during squats, especially high bar squats.
I went to a doctor again who again took my blood pressure and it was fine. He took a blood sample and made me have a CT scan, both fine.
The pressure has evolved into a full blown headache and the pain is similar to the migrane I get but located in the front of my head (as opposed to the nose-side of my right eye).
I was wondering if the pre-accident pressure might have been something else but the accident caused the veins in my head to expand beyond their limits, giving me exertion headaches when I work out. Or could the pressure just have been a minor exertion headache which then got worse after the accident. Should I have an MRI as well to rule out anything major?
Are you suggesting to take Ibuprofen
even if you don't have a headache during
the recovery time?
I had a severe EH with sex a couple of
weeks ago, but didn't know what it was.
Today, I had a severe EH doing slow isolated
biceps for 1 minute with 80% max weight.
Nothing else. I do Body by Science workout,
which I like.
I'm willing to do the recovery plan, but don't
like to take too much Ibuprofen. That stems
from a fear of rebound headaches. I get idiopathic
ocular migraines every 3 or 4 weeks and I had
one last night. I'm wondering if my EH today
was related to the migraine last night.
I realize you can't diagnose me but it has helped
me to read all the other 200+ posts here and see
your responses. I appreciate what you have here.
I've had these headaches everyday throughout last week. Now how long should I rest?
Thanks for the comment. You will want to completely rest of all activity for a full week, if the intense headache persists, take another full week off. Then follow the plan for slowly introducing physical activity.
Thanks for bringing up a good point about Ibuprofen. Ibuprofen does more to assist in reducing the swelling than it does to calm the headache. So yes, I do suggest taking Ibuprofen for the initial few weeks of recovery, as recommended on the bottle, to help with the swelling, not to combat the headache. Reduce the swelling and the headache feels less severe, so indirectly Ibuprofen helps with the headache.
This does not sound like an exertion headache. This sounds more like an alignment issue involving the nervous system. Chiropractor and Acupuncture are two camps that will be better at handling this issue than me. Your symptoms overlap, but if there was never an exertion headache episode, where during a workout, you pushed to hard, held your breath, had your neck in poor alignment, etc., then you are likely not dealing with an exertion headache. I hope this helps.
Pre-workout supplements do not inherently cause these headaches; however, they allow you to push a little harder, get one more rep, and if not properly hydrating can leave you dehydrated, and these variables absolutely can lead to an exertion headache. I use pre-workout supplements, and my advice is to make sure you hydrate, enter the workout well rested, and avoid the supplements that leave you feeling jittery and out of control. Be in control, listen to your body, remain calm during the lift, and push yourself while being mindful of your limits.
As far as running goes, some people feel flair ups when their heart rate increases, others do not. Everyone feels flair ups pending when there is an increase in blood pressure, so things like strength training and sex tend to trigger a flair up for everyone. So to answer your question, a week or two is typically enough to begin mild cardio for most people. But listen to your body, and if you feel a flair up coming, you're done. Try again in a few more days.
With there being no exertion episode other than push-ups, I would lean towards believing that this may be more related to spinal alignment than an exertion headache. Have you seen a chiropractor since this started?
It's unlikely that these headaches you are experiencing are from the bicep curl training session. That may have stressed your alignment and may be influencing the headaches, but does not seem like the culprit. I hope this helps.
I have anxiety and also felt the need to walk immediatly from leg presses to lie down as my head felt like it exploded inside ..i had to leave work the day after due to a headache which moved from the lower back skull to my temples…i felt bad but also just wanted to knock someone out from the pain
I was having…going to dr. Today
I started experiencing exertion headaches around a year ago. My first bout lasted 4-6 weeks and was dependent on what type of exercise I was doing.
Last week they started again, however this time they are much more manageable as I have found I can somewhat control the severity through breathing techniques.
My question is, would it be suitable to continue exercises which don't cause the headaches? Thanks
This has been a most helpful article and thread. Thank you to all who have left their story and even better, an update on time table and progress. I am also so impressed with the time both Apexllc and Nick take to respond to comments.
I experienced my first exertion headache in May of 2015 on the last rep of pull-ups. The weekend before was a guys trip where there was plenty of drinking. I dropped to the floor in pain and was very confused to what had happened. I tried to continue after a few minutes but that was not possible. I actually came across this article in May but there was no way I was going to take a week off from exercise! I did take a couple days off and when I returned to the gym I took is slow and all went well. I did not really experience the dull headache for anymore than a day or two and soon enough I was back at my normal routine.
My second exertion headache happened December 21st, 2015 while working on the incline bench. Again, the weekend before we were out celebrating a birthday and I probably did too much drinking. Another headache. I stopped immediately and was prepared to take a few days off and return to the gym like I did back in May. This time around the dull headache, which was not a problem before, has not diminished. I was foolish and probably did too much drinking and eating over the holiday and new year while also mixing in some light weights and cardio. I did not get an exertion headache but, I have now had a constant headache since the 21st.
This constant headache, temples and back of head, is what has me worried. I have not exercised or consumed alcohol (or even had sex which just brings about more pressure in the head) since the new year and I just cannot make progress with the pain. I am seeing the DR today and I assume they will recommend a scan of some sort. From the other comments left above it sounds as if the scans all come back clean. The cost worries me a little as well.
Hard to have patience! I will update when I learn more.
My first full blown exertion headache was when I was in college. I was a personal trainer at the local gym and was doing a drop set on the leg press with another trainer, really getting after it. Grenade went off in the back of my head, I finished the final drop, and called it when I had to crawl to the leg extension machine with a pounding headache… Laid in the fetal position next to the leg extension machine for a little while, waving people off that I was OK.
I tried to go to class the next day, but got in the car and my head was still pounding, so I texted a classmate and climbed back into bed with a bottle of water and ibuprofen…
I feel your pain Shawn. I've been there. Twice. Then I learned how to recover, got my findings reviewed by an ER doctor, and for the last few years have been able to help people all over the world bounce back from these headaches in roughly 2-4 months (with no setbacks). Hang in there.
At this point it sounds like you are probably in the 6-8 week window of recovery, so I'd say yes, if you are able to perform headache-free exercise, then do so cautiously. If you feel a flair up coming, ease back and be done for the day. You will be walking a fine line, and the risk of causing another full blown exertion headache is pending. So be careful, because a flair up resets your clock, so taking it easy for another few weeks is wiser in the long run.
Thanks for your comment. Like all the other pitbull-headed folks out there that can't take a week off, welcome to the club! Keep us posted, it sounds like you've put in some time reading others comments and my replies, so I won't add anything else other than good luck. Water and ibuprofen and diligent sleep will be good buddies for you for the next couple weeks.
I saw Dr and she recommended MRI/MRA. Already got the results back and all is clean! I am wondering if you Nick, or anyone else reading the thread, has made any gains using a chiropractor in the recovery period? I still have a constant headache…I am able to work and complete my daily obligations but it sure is making the days long and tiresome.
Finally, my DR prescribed Indomethacin to take before a workouts (when I return to the gym). Anyone else using this drug and finding success?
Thank you!
Thanks for the update. A chiropractor visit has helped many in their recovery process. It's possible that alignment issues are a contributing factor to the headaches, so getting that all squared away with a chiropractor is at least worth a consultation. All that being said, the constant foggy headache can last for as long as 2 months, and if you re-trigger another headache by trying to do too much too soon, that 2 month clock will start over. My first exertion headache took 6 months to fully recover from because I kept trying to do too much too soon. Many others share in my stubbornness and have similar stories. Keep us posted.
Today was my first day training with a trainer in a long time and while doing the initial strength training test, specifically a wall plank, I felt a shooting pain from the back of my head to my neck! It was very painful for a few seconds then in for better slowly and gradually. I have never felt anything like it! After reading this information it sounds a lot like an exertion headache, but in hesitant to call it that as I was only doing a wall plank! Have you heard of anything like this? Do I need to follow the recovery steps you listed? I told the trainer I was dizzy at the moment and we stopped but I pushed through the workout a few min later.
ADVICE NEEDED – I had a very fatigued workout on the Jan. 9th with a low headache, went back the 11&12 and it was like I was instantly hit in the face after the 8th rep. Took off, went back on the 14th, same thing (dull headache the rest of the night). I stopped for a week, went back on the 21st, and just felt like crap, although the headache didn't come. So I took off another week, and plan to go back on the 28th. Been taking in extra water, will focus on breathing, and form. BUT, I would like to take something 30 min before going back.
What is the best medicine for excursion headaches… Ibuprofen, Aspirin, Aleve, Tylenol?
I recently had what i believe to be my first exertion headache. It started about two weeks ago when doing leg press. I have had a dull headache ever since that seems to move around different areas of my head. The headache has seemed to lift a couple of times in the past week, but when it does I seem to get tingling sensations in different parts of my body (hand, foot, knee, elbows). I was very alarmed when this first started occurring and went to emergency – all scans came back negative. Has anyone else had these symptoms? How long can i expect this dull headache to last? I've stopped exercising, but not sex which doesn't seem to make it any worse. Is it possible that the sex is extending the duration of my symptoms or would I notice the headache getting much worse right away?
Thank you very much and just wanted to say that this has been a great resource for me!
Thanks for your comment. The dull headaches can last for months. Think of those dull headaches as a warning sign from your body that you are not ready for strenuous activity. As far as the tingling sensation in hands, feet, etc., that MAY be a sign that you have some alignment issues in your back or neck. Many folks have reported neck/back alignment issues being a contributing factor for getting the exertion headache in the first place. You may want to schedule an appointment with a chiropractor and get their opinion. Good luck and keep us posted.
Thanks for your comment. The instant headache that you had on the 11th sounds like a possible exertion headache. To answer your question about what is the best medicine for exertion headache, Ibuprofen. Exertion headaches are the result of the forced dilation of the blood vessels in your head which put pressure on the meninges. It is these swollen blood vessels that causes the sustained dull headache; therefore, medications that help with swelling will be the best option to help alleviate the pain.
Thanks for your comment. Most trainers do not become aware of exertion headaches until they either give themselves one during a training session, or one of their clients experience one. So use this as a learning experience for you both. Direct him/her to this article, have him email me if he has any questions on how to move forward, I'm glad to help.
As far as getting the exertion headache during a wall plank, I agree, that is not typically the kind of stress that causes these headaches; however, fatigue, dehydration, spinal alignment, all can cause exertion headaches, and you may have had a perfect combination that triggered the headache.
Thanks Nick,
I'll schedule an appointment with the chiropractor and see what they have to say.
Would one notice an immediate increase in headache pain as a sign of over-exertion after the initial episode? As I mentioned, i don't notice this increase in pain during sex (haven't tried working out yet). Would this be a good gauge or could it be extending my dull headache symptoms? Just want to know if I should stop having sex for a while and if i could try going back to the gym and taking it easy.
I agree, it pisses me off the way the idiotc public and ignorant / arrogant doctors do not take some things seriously.. the first time I had such a headache I instantly new this was serious, I felt like throwing up and wad dizzy (by the way I have been training since the age of 10) and I am experienced in weight training, running, martial arts and nutrition.
Thanks for the blog and the info for exertion headaches. I had a few of these skipping rope (probably not enough to drink, and definitely poor neck posture) and had the ct scan and lumbar puncture come back okay. My dull headache has been going on for about a month now, it gets worse with going upstairs too fast, having sex, lifting something too heavy etc. It also gets worse by the end of each day, I think just from holding my head up (I think I irritated some neck muscles when skipping). I've also noticed that pressure on my head from laying on a pillow or wearing a hat also make it worse. Wondering if this is what others have experienced too? I have taken a break from having sex, but that has led to some nocturnal emissions which seem to also make my dull, back of the head headache worse. Wondering what to about this as I'm ready to be done having this baseline headache. Thanks!
I'm 15 and today at weights for football I was doing powerpress and i had 115lbs on each side and the workout was 3×8 and after I got done with that I had the worst headache I have ever had. I got out of the machine then I walked around holding my head and didn't tell anyone or any coaches because I thought they would just tell me it was nothing. So on my last set i had 135lbs on each side and I only got to my 7th rep and I had to get out of the machine because my headache was 3 times worse than the first one. I didn't feel good and I feel like I was gonna throw up so I walked outside real quick and I didn't throw up and my head was still killing me but after about 5 minutes it went down but not by a lot and I went to a different lift and it kept hurting and it still hurts right now. I don't know if I got an exertion headache or not but my friends told me that it might be that I'm not breathing enough and my coach said it was just the way I was moving my back. My mom me some asprin to help it and it went away for about 2 hours and I'm trying to go to bed but it hurts to bad. Should I take any more asprin or not and whats wrong with my head. Thanks.
One of the main reasons that most doctors don't have an answer is because all the scans they have available to them come back normal. That's because the things that they are looking for with the scans are not affected by exertion headaches. The scans are to rule out anything more serious, so it's still worth doing them. But once you know that everything has come back normal, you can begin the slow recovery process from the exertion headache without the fear of having a brain aneurysm or a slipped disc in your neck. I understand the frustration though… I've been there before…
You didn't mention whether or not you've been taking ibuprofen. That can be a big help during the first few weeks.
Everything you mentioned sounds like a classic exertion headache, very similar to my first back when I was in high school. Is there any way I can talk/email directly with your coach? You are going to need to do some very specific things to recover in a timely manner, and if I can help your coaches understand the process, it will result in less setbacks for you. Send me an email Gus at firstname.lastname@example.com with the name, phone number, and email address for your coach and give him the heads up that I will be contacting him.
Yes I did take ibuprofen the first few weeks, then tapered it back.