Exertion headaches: symptoms and causes

Reviewed by our clinical team

What is an exertion headache?

If you’ve ever gotten a throbbing headache immediately after a heavy workout, then you’ve probably experienced an exertion headache, also known as a ‘primary exercise headache’.

Slightly different to normal headaches, they’re usually a sign from your brain that you’ve overexerted or overworked yourself. These headaches can range from a subtle pain to a more severe throbbing and are usually worse the more you’ve exerted yourself. 

According to The Migraine Trust, around 2-4 out of every 10 people who experience migraines find that exercise contributes to migraine attacks. Interestingly, others find that regular aerobic exercise reduces the regularity of their migraines. 

Some people get exertion headaches without ever experiencing a migraine. 

In this guide, we’ll look at the causes of exertion headaches and why exercise can trigger them. We’ll also look at how they differ from other types of headaches and migraines, and what you can do to avoid or mitigate their impact on you. 

Which activities cause exercise headaches?

Exertion headaches can be a response to any kind of overexertion and can sneak up during various physical activities that get your blood pumping.

In general, most doctors believe that they are caused by the rapid expansion of the blood vessels in the brain as the heart begins to beat faster and faster. 

Some common activities that might trigger exertion headaches include: 

• Running: fast-paced jogging or sprinting, especially in hot weather
• Weightlifting: heavy lifting or high-intensity strength training
• Swimming: intense swimming sessions, especially in cold water
• Rowing: the strenuous effort involved in rowing can sometimes lead to exertion headaches
• Tennis or other racket sports: the rapid movements and the intensity of racket sports can be a factor
• Cycling: long-distance cycling or uphill biking
• Hiking or climbing: particularly at higher altitudes 

It's worth noting that exertion headaches can occur during any type of exercise or overexertion, however, they’re more likely to occur if you suddenly increase the intensity of your workout, start without warming up, or exercise in extreme temperatures. 

Understanding your body's limits and gradually increasing the intensity of exercise can help stop exertion headaches and improve your exercise regime. For tips on how much exercise you need to maintain your health, check out our exercise guide. 

Symptoms of exertion headaches

You can usually tell when you’re experiencing an exertion headache as it will generally follow a heavy workout, or some kind of overexertion, such as rushing from place to place. 

Symptoms of overexertion headaches can be like other headaches and migraines, so be sure to tell your doctor not just what you're feeling, but also when you feel it. 

• Throbbing pain: a strong pulsating sensation, usually on both sides of the head
• Quick onset: the pain typically starts during or shortly after intense physical activity
• Short duration: anywhere from five minutes to 48 hours
• Neck stiffness: some people feel a stiffness in the neck along with a headache
• Nausea or vomiting: in more severe cases, you might feel sick or even throw up
• Vision problems: rarely, you might experience blurred vision or seeing double
• Sensitivity to light and sound: Just like with migraines, bright lights or loud noises can be bothersome 

It's important to note that everyone's experience with headaches is different. If you regularly experience headaches after exercise, or if you start getting headaches at other times of the day, it's a good idea to speak with your doctor. 

How long do exercise headaches last for?

The length of time exertion headaches last can vary from person to person. In general, they can last anywhere from a few minutes to a couple of days (48 hours.)

Exertion headaches don’t usually last that long. However, if you find that your headaches are lasting longer than usual, or if they're becoming a regular occurrence, you should speak to a doctor. 

Are exertion headaches dangerous?

Most of the time exertion headaches aren’t dangerous. They're more of a nuisance and usually resolve on their own, or by changing the way you exercise or go about your daily life. These headaches are a type of primary headache. 

However, some headaches can be caused by an underlying health condition - such as an issue with the blood vessels in your brain. These are called secondary headaches, and can potentially pose a risk to your health.

If you’re experiencing regular headaches, they're getting more severe, or are happening at random, this could be a sign that you have another medical condition which needs to be treated first. 

So, while exertion headaches are generally not a cause for concern, if they continue to be a nuisance or begin to affect you in other ways, you should check in with your doctor to rule out a more serious problem. 

How are exertion headaches diagnosed?

Diagnosing exertion headaches can be difficult, as they only occur after exercise or overexertion. Most of the diagnosis will be based on a straightforward chat with your doctor. 

The general process for diagnosing exertion headaches is: 

• Medical history review: your doctor will ask about your health history, including any previous headaches and your exercise habits
• Symptom discussion: they'll want to know about your headache symptoms – like where it hurts, how long the pain lasts, and what the pain feels like
• Physical examination: this might include checking your blood pressure and heart rate, especially after exercise
• Neurological exam: the doctor may perform checks to see how your nervous system is working. This could include testing your reflexes, muscle strength, and senses.
• Ruling out other causes: part of the diagnosis is making sure that other health issues aren't causing your headaches - this is especially important if you're having secondary exercise headaches
• Imaging tests (in some cases): if your doctor thinks there might be more going on, they might order a scan, like an MRI or CT scan, to look at your brain 

A headache diary can be invaluable in tracking your headaches and helping you express your concerns to your GP. Keeping track of when and where your headaches happen can make it much easier to identify the cause. 

Getting a proper diagnosis is key to managing headaches effectively, as the right steps to take can differ depending on the type. 

How can you prevent exertion headaches?

Preventing exertion headaches is mostly about understanding and listening to your body. Usually, these headaches aren’t caused just by exercise, but by exercising too hard or without proper preparation.

Here are a few steps that might help keep those exercise-induced headaches at bay: 

• Warm up properly: before jumping into intense physical activity, start with a gentle warm-up - this can help your body get ready for more strenuous exercise
• Stay hydrated: keep yourself well-hydrated, before and during exercise (dehydration can be a big contributing factor to headaches)
• Manage intensity: gradually increase the intensity of your workouts rather than pushing too hard, or too fast
• Cool down: after exercising, take time to cool down - this helps your body ease back to its resting state
• Monitor your environment: if you're exercising outside, be mindful of the weather - extreme heat or cold can bring on headaches
• Regular exercise: keeping a consistent exercise routine can also help, as sporadic bursts of activity might increase the risk of headaches 

Remember, while these tips can help, they might not work for everyone. If you're still getting headaches after trying these strategies, your next step should be speaking with your doctor. 

Treatment for exertion headaches

If you're dealing with regular headaches, several treatment options can help ease the pain or prevent the headaches from happening. You can take these on top of lifestyle changes, such as the ones above, for the best results.

• Over-the-counter pain relief: medications like ibuprofen, paracetamol, or aspirin can be effective in treating exertion headaches
• Prescription medications: in more severe cases, your doctor might prescribe stronger pain relief medicines.
  • Beta-blockers: these are sometimes prescribed to prevent exertion headaches or migraines, particularly if you have them frequently
  • Triptans: If you have a history of migraines, triptans such as Sumatriptan or Rizatriptan can be effective. They are designed to treat migraine symptoms and might be prescribed if you’re regularly experiencing severe headaches.
  • Other migraine treatments: if your doctor suspects a deeper problem could be behind your headaches, they might prescribe another migraine medication such as Rimegepant/Vydura. For more information about migraine treatments available through Online Doctor, check out our migraine guide.

Conclusion

Although exertion headaches can be frustrating for those of us who enjoy hitting the gym or pushing our bodies further, these types of headaches are not usually dangerous, and can generally be prevented with a few small changes to the way you exercise.

If you’re looking for more information on headaches and migraines, as well as how they can be linked to exercise and physical activity, take a look at our article on the various types of migraine, or our guide to the different stages of migraines. 

References

https://migrainetrust.org/understand-migraine/types-of-migraine/other-headache-disorders/headache-associated-with-exercise/
https://patient.info/news-and-features/what-are-workout-headaches-and-how-can-you-prevent-them
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590146/
https://www.nhs.uk/medicines/propranolol/