Headache after working out / 'exertion headaches' ?

Hi guys,

I've started going to the gym, weightlifting, following the starting strength routine.

After Monday's session I felt pretty awful, I had a pounding headache (got this as soon as I started my chinups), and when I got home I was vomiting. I missed Wednesdays session due to induction, but all week I've been getting headaches, especially when going up stairs (I live on the 4th floor), and at any sort of exercise.

Today (Friday) I went to the gym again, and during the squats I was ok but during my shoulder press sets I was again getting this pounding headache.

It's still sore now, 1hr after I've finished. I took paracetamol and ibuprofen before I went by the way - neither seem to have worked. It wouldn't be dehydration either, as I drink lots of water, and I took a bottle with me.

Any advice/ideas on this? I've started taking whey protein too, but I doubt that is the reason.

Thanks guys.

It should leave you in a couple days time.

You don't lift too much do you?

And I'm also guessing you just started right?

i get them, i try not to lift a weight that i have to strain on, i drink during workout, make sure i breath properly, ive cut out flat chest press as thats when i used to get it most and replaced it with the inclined press

i eat more carbs on the days i do weights and i take a pain killer (co-codamol) 30 mins before i work out, i dont know if these last two make any difference but the past 2 workouts I've done I've done them and ive had no pain

Make sure you drink plenty, this maybe a sign of dehydration, also don't hold your breath when lifting, I used to do this and it caused me to get headaches also.

Is your diet well balanced? This could also be a cause.

The best thing I could say, is that if it persists go and see your gp

I don't lift much no, I'm new to it. The headaches do go down in a few days time but I am trying to find ways to stop them happening, as they are not nice!


Thanks for the advice about tablets - I think the issue is probably my breathing, from talking to other friends who lift. I think i was holding my breath before, especially when struggling on the last few reps (this feels natural to me), but my friends said to exhale when I push up and breath in when I come back down, so I'm going to try that.



Thanks! I think the breath thing is the issue. It's putting me off lifting to an extent, as the headaches can last for several days. I'll try again on Monday and really concentrate on my breathing.

Thanks guys! I've +'d you. Any other advice/posts would be welcomed too, thanks.

Exertion Headaches
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.* This article is not intended to replace a medical visit.
WHAT IS AN EXERTION HEADACHE?
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.
WHAT CAUSES AN EXERTION HEADACHE?
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 damaging the meninges.
HOW LONG WILL THE HEADACHE LAST?
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 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, all 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.
HOW CAN EXERTION HEADACHES BE PREVENTED?
To prevent an exertion headache:
Stay Hydrated: 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 (trunk) 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.
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 of the arteries and veins responsible for moving blood through.* 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.
HOW DO I RECOVER FROM AN EXERTION HEADACHE?
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.
Doctor Visit:* It is important to rule out any other underlying potential causes.* 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:* 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.
FINAL NOTE
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 in the gym, certain steps must be taken to transition the body back to a high performance level again. Hopefully you find this article to be helpful.