You’re just getting into your workout groove and then it kicks in—an exercise headache that forces you to dial it back or cut your session short.
Although it may not be as debilitating as an exercise-induced migraine, workout-related headaches can get pretty bad, ranging from kind of annoying to downright painful. And if you’ve ever experienced one, at least you’re not alone.
“These kinds of headaches are common, to the point where most athletes get them at some stage, even if they’re only for a few minutes,” Ilan Danan, M.D., sports neurologist and pain management specialist at the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, tells SELF.
These exercise headaches—the aching-but-not-migraine headaches that are brought on by your workouts—are known as primary exertional headaches, and can occur either during or after your workout, whether we’re talking strength or cardio, high intensity or low intensity. A study published in Cephalalgia of about 1,800 people from Norway found about 12 percent of participants had experienced an exercise headache at least once in their lives. Exercise headaches typically mean pulsating pain that occurs on both sides of your head, and can last anywhere from five minutes to 48 hours, according to a review of headache types published in the journal Current Pain and Headache Reports.
Dealing with an exercise headache can be a real, um, pain, especially if it’s forcing you to cut your workouts short—or if the dread of experiencing one is keeping you from exercising in the first place. But before you learn how to ease that pain, you first need to understand what’s going on in your body that causes these head throbbers in the first place. Here, everything you need to know about exercise headaches—and what you can do to return to your workout without that discomfort.
Why can exercising cause a headache, anyway?
There are lots of unknowns with headaches, and exercise headaches are no different. “To be honest, we don’t have a good answer for exactly why they’re happening, but there are some solid theories based on the physiological responses you’re experiencing as a result of exercise,” Dr. Danan says.
First, think about what happens to your body when you’re exercising. As you work out, exercise increases your heart rate and increases the oxygen demands on your muscles and brain, which causes your blood vessels to dilate for the increased circulation, Dr. Danan says. That sudden shift might increase pressure in the blood vessels in your brain, he adds, and a short-term headache can result while it does.
Exercise also temporarily increases inflammation and the hormone cortisol (which is associated with stress), which can jolt the brain into triggering signals that make you feel pain, he adds. (In the long term, though, regular exercise has actually been linked to lower levels of inflammation and stress.)
The way you breathe when you’re exercising, especially while strength training, may play a role in developing these exercise headaches, says Dr. Danan.
“People have a tendency to unconsciously hold their breath during effort, like when you’re doing core work, for example,” he says. “This can increase your intracranial pressure, and the body’s response is a headache.” It’s that tightness that causes a dull ache.
There are also a few ways that people commonly tense their muscles or hold positions that could contribute to exercise-induced headaches, he adds. For example, cranking your neck up when you deadlift (say, to look in the mirror) or rounding your shoulders when you row can cause your neck, traps, and muscles around your shoulders to tense up, which can trigger a headache, Dr. Danan explains.
“Go slower and get your form down, make sure your technique is there,” says Dr. Danan. “A headache might be coming from being out of alignment in some way.”
It’s also possible that non-gym factors play a role in your exercise headaches.
Although headaches can be caused by multiple factors, it’s helpful to focus first on common causes you can easily adjust, New York-based family practice physician and personal trainer Michele Reed, D.O., C.P.T., tells SELF.
The biggest culprit is often dehydration, she says. Some people may start to drink water once they begin exercising, but that means they could be kicking off a workout session already slightly dehydrated. Fun fact: When your brain gets dehydrated, it can actually swell a bit, and exertion can make it worse.
Fatigue is another headache trigger, and it can often pair with dehydration, especially after late nights out that involve more alcohol and less sleep than you’re used to, Dr. Reed says.
Dr. Reed says she can “almost guarantee” that working out with even a mild hangover, especially when coupled with lack of sleep, will result in a headache.
“In that case, you’re better off not exercising at all that day. Just drink a ton of water and take a nap instead,” she says.
If you are well hydrated and caught up on sleep, a headache during your workout might be brought on by stress, Dr. Reed adds. Being stressed means that you have higher cortisol levels, according to the Mayo Clinic, and since exercise can drive it up even more, that can increase your chances of getting a headache when you work out.
“Stress is very powerful in terms of the havoc it can wreak on your body and your brain, even when you’re not exercising,” says Dr. Reed. “Then you add a workout, which is basically controlled stress, and it might put you over the top.”
Here’s how to prevent exercise headaches from happening.
Pinpointing a headache cause takes time, but putting together data can help speed up the process, says Dr. Reed. She suggests keeping a small notebook handy and jotting down all the information about your workout, including non-exercise factors.
That includes how much sleep you got last night, what day of the week it is, what you ate before exercising, whether you have your period, how long into your workout you were before the headache came on, how long the headache lasted and the type of pain it was (stabbing or throbbing, for example, or just achy like a tension headache), if it’s worse with cardio versus strength training, and any strategies you tried to make it better, such as drinking extra water for a few hours pre-exercise. That way, Dr. Reed advises, you can start to change the variables.
For example, if cardio during your period is a headache trigger, maybe you switch to strength training that week instead. If circuit workouts cause the pain, cut your work time—and increase your rest—to see if that works better.
Notice pain comes on when you skimp on fluid beforehand? Be sure not to ignore your thirst—thirst is a simple rule to hydrate enough. The American College of Sports Medicine also recommends consuming 16 to 20 ounces of fluid at least four hours before exercise, and to drink when you’re thirsty during your workout.
Then, take a look at how you started your workout: Did you go right into the good stuff and skip the warm-up? That can be a problem, since you’d be risking that sudden blood vessel dilation in your head, says Dr. Danan. Warming up allows that process to happen more gradually, as you increase blood flow to the muscles and get your circulation ramping up. So make sure you take the time to warm-up for at least five to 10 minutes with a focus on dynamic stretches—which means that you’re moving as you stretch. For example, if you’re going to run, jog in place for a few minutes and then do walking lunges for a few minutes after that.
If your headache came on while you were trying out a new exercise for the first time—say, something that popped up on your Instagram feed—your form may be a little off, messing with your body alignment, tensing up your muscles, and bringing on the pain. You may want to take a quick video or use a mirror to see if you’re doing it right—or best of all, ask a trainer to double check your form, Dr. Danan suggests (or take a look at legit sources like SELF to check out how the moves should be done safely.)
And pay attention to your breath during any exercise—specifically, make sure you are not holding it throughout the move, says Dr. Danan. The standard recommendation during strength training is to “exhale on the effort,” which means exhale during the strenuous part, and inhale on the easy phase.
Here’s how to know if an exercise headache is something more serious.
If those tweaks aren’t working, your headaches continue to persist for more than a few weeks, and you’re popping pain relievers regularly—which could be leading to rebound headaches—Dr. Reed suggests making an appointment with your doctor, especially if the headaches are getting progressively worse. That headache log you’ve kept, along with the tweaks you’ve made to try to help, will be very helpful to your doctor in evaluating your headache.
The good news is, primary exertion headaches are the most common headaches brought on by exercise, Dr. Danan says. And according to the Mayo Clinic, these are usually harmless and not tied to any underlying health condition.
But there are other causes of headaches that might mimic exercise headaches that you should know about. If your headache hasn’t let up for about 48 hours, you’re likely dealing with the category of secondary exertion headaches, which means they’re not based on exercise, but instead have some other cause that exercise exacerbates—such as TMJ, dental issues, or sinus congestion. This is usually what’s going on if you’ve tried a variety of fixes and haven’t gotten relief, Dr. Danan says, and that’s where your doc can help pinpoint the real cause.
Then there’s the category of “drop your weights, grab your bag, and get to the emergency room NOW” kind of headache.
That’s characterized by very sudden onset of the worst headache of your life, says Dr. Danan. That’s called a “thunderclap headache,” which can be accompanied by dizziness, blurred vision, vomiting, stiff neck, auditory changes—such as people talking right next to you but sounding very far away—foggy thinking, and feeling like you’re about to faint.
The concern there would be a sudden brain bleed, stroke, or a tumor, he says. “Don’t wait if this is how you’re feeling, don’t try to rest or hydrate, or see if it will pass,” advises Dr. Danan. “Get to the ER immediately.”
Fortunately, the vast majority of exercise-related headaches are the type that fade quickly as soon you slow down or switch up what you’re doing. But, he adds, that doesn’t mean you should ignore them and push through anyway.
“Any kind of pain, including headache, is a signal from your body that you need to pay attention,” he says. “It’s a clue something has to change.”