Exertional Headache After Exercise: Causes and Treatment
after exercise (or so called exertional headaches or headaches on
exertion) are very common in modern athletes and people who exercise (Turner, 2003).
The cause of the headache may sometimes relate to allergic triggers in the air or
some other environmental effects on the human body. However, most of the cases
of headaches after exercise are due to reduced oxygen levels in
the brain during and after exercise. Over 180 Russian MDs
tested hundreds of their patients and found that such
headaches exist only in people who have less than 30 seconds for the body oxygen
Why could brain oxygenation get reduced? It is all in the way we breathe during
exercise. Once we start to lose carbon dioxide (via overbreathing), brain-oxygen
levels immediately drop. Later, breathing remains heavy (after exercise), and
it also causes pain in muscles and slow recovery rates.
image on the left (done with PET scan) shows the effects of one minute of
hyperventilation on oxygen availability in the brain. (PET scans reflect oxygen
content in cross-sections of the brain). The cause of
low oxygen levels in the brain is low
arterial CO2 (hypocapnia), which leads to constriction of blood vessels (arteries
and arterioles) and reduced blood and oxygen supply to the nerve cells.
Have you done running, cycling or cross country
skiing together with very fit athletes? What is their
noticeable difference? Their breathing patterns are lighter
and easier. They do not gasp for air. Many of them have no
problems talking and exercising at the same time. Lighter breathing increases
CO2 and O2 levels in the brain. Really healthy people have light and easy
breathing at rest too.
Key factor for headache after workout
most people mouth breathing during exercise
reduces arterial CO2. Only very fit athletes are able to keep high CO2 in
the blood during exercise due to their lighter and easier breathing even at high
intensities. Therefore, oral breathing has the same effect on brain oxygenation
as hyperventilation (or overbreathing). It causes reduced CO2 and O2 levels in
the brain cells. Since oxygen and carbon dioxide are fundamental for normal
nerve cell functions, headaches on exertion are body cries for more oxygen and
breathing retraining or breathing normalization.
In order to test these ideas, go for a lighter form of exercise, but with nose
breathing only. Most people can eliminate these
headaches if they use strictly nasal breathing
(in and out) and slightly reduced intensity of physical exercise. With over a certain
seconds for the body-oxygen test, it is very unlikely that one can
get headache after exercise. You can find this exact number in the next paragraph as your bonus content.
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Turner J, Exercise-related Migraine, Curr Sports Med Rep. 2003 Feb;2(1):15-7.
Indiana University Center for Sports Medicine, Indianapolis, IN 46202, USA.
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