Overview

Exercise headaches occur during or after sustained, strenuous exercise. Some activities associated with exercise headaches include running, rowing, tennis, swimming and weightlifting.

Health care providers divide exercise headaches into two categories. Primary exercise headaches are usually harmless, aren't connected to any underlying problems and can often be prevented with medication.

Secondary exercise headaches are caused by an underlying, often serious problem within the brain — such as bleeding or a tumor — or outside the brain — such as coronary artery disease. Secondary exercise headaches may require emergency medical attention.

Symptoms

Primary exercise headaches

These headaches:

  • Are usually described as throbbing
  • Occur during or after strenuous exercise
  • Affect both sides of the head in most cases

Secondary exercise headaches

These headaches may cause:

  • The same symptoms as primary exercise headaches
  • Vomiting
  • Loss of consciousness
  • Double vision
  • Neck stiffness

Primary exercise headaches typically last between five minutes and 48 hours, while secondary exercise headaches usually last at least a day and sometimes linger for several days or longer.

When to see a doctor

If you experience a headache during or after exercise, consult your provider. Call your provider right away if the headache begins abruptly or if it's your first headache of this type.

Causes

Primary exercise headaches

The exact cause of primary exercise headaches is unknown. One theory is that strenuous exercise dilates blood vessels inside the skull.

Secondary exercise headaches

Secondary exercise headaches are caused by an underlying problem, such as:

  • Bleeding in the area between the brain and the thin membranes that cover the brain (subarachnoid hemorrhage)
  • Irregularities in a blood vessel leading to or within the brain
  • Cancerous or noncancerous tumors
  • Obstruction of cerebrospinal fluid flow
  • Sinus infection
  • Structural irregularities in the head, neck or spine

Risk factors

You may be at greater risk of exercise headaches if you:

  • Exercise in hot weather
  • Exercise at high altitude
  • Have a personal or family history of migraine

Prevention

Exercise headaches tend to occur more often when the weather is hot and humid, or if you're exercising at high altitudes. If you're prone to exercise headaches, you may want to avoid exercising in these conditions.

Some people experience exercise headaches only during the performance of certain activities, so they may prevent their headaches by avoiding these activities. A warm-up prior to strenuous exercise also can help prevent exercise headaches.

May 14, 2022
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  3. Ropper AH, et al. Headache and other craniofacial pains. In: Adams and Victor's Principles of Neurology. 11th ed. McGraw Hill; 2019. https://accessmedicine.mhmedical.com. Accessed Feb. 13, 2022.
  4. Cutrer FM. Exercise (exertional) headache. https://www.uptodate.com/contents/search. Accessed Feb. 13, 2022.
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