Exercise Induced Headaches (EIH), also known as exertion headaches, are terrible pulsating headaches that appear very suddenly, most commonly during intense exercise (and during orgasm). The pain is so intense and they occur so abruptly that they have been given the nickname of "thunderclap headache". For me, the pain originates in my neck at the base of my skull and seems to pulsate to the beat of my heart. Sounds like fun doesn't it? Disclaimer: I am not a doctor and I am not giving medical advice. I am a sufferer of EIH and am just collating my information. If you are suffering headaches then I always recommend visiting a doctor first.

What causes Exercise Induced Headaches?

Sadly, my research has failed to find a definitive answer as to what causes EIH. Some of the proposed reasons I have read include: pushing your body too hard, unlucky genetics for migraine sufferers, not warming up, dehydration, and poor technique during exercise. Let's look at each of these:

Proposed Theory 1: Pushing too hard?

I have recently started a high-intensity training program which involves me pushing myself to the point of failure in my weights routine. That is, I push until I could not go any further even if my life depended on it. But thousands (maybe millions) of people around the world follow this concept, including my most dedicated gym friends, without EIH.

Conclusion: Nope.

Proposed Theory 2: Unlucky genetics for migraine suffers?

The fact that the causes of migraines are still relatively unknown, or at least vary from person to person, causes immediate skepticism but I also have doubts based on my own migraine experiences. I contribute many migraines (mine included) to stress and anxiety and while some people may argue that pushing until muscle failure causes stress on the body I think it is a weak link at best.

Conclusion: Maybe.

Proposed Theory 3: Not warming-up enough?

My first occurrence of EIH was around 2007. It was during my gym routine (chest press to be precise) which started with 30 minutes cardio and stretching. Needless to say I was quite warm when it happened.

Conclusion: No, no, no.

Proposed Theory 4: Dehydration?

I drink lots of water. An average day for me is in the 2-3 litre range while at work, and then more when I exercise. During my first occurrence of EIH in 2007 I was drinking 1 litre of water throughout each workout. However the latest occurrence (Jan 2011) I may have been dehydrated so I wont completely rule this out yet.

Conclusion: Doubtful.

Proposed Theory 5: Poor technique during exercise?

I love my sports and exercise but I have not been much of a gym junkie. My first venture to the gym was 2006 and was mainly because I wasn't playing any sport at the time so I wanted to stay active and keep fit. Same again for 2010/11. So I am a relative muppet when it comes to weights. Sure I have done the research, read up on technique, and watched the pros, but is that enough? Probably not. Combining that with the fact that I have never had an EIH while playing sport makes me believe it is my poor technique at the gym that is the main culprit.

Another compelling argument for this is my lack of strength. I am naturally thin ("built for endurance" I was told in school) and my muscles are slow to develop, so when busting out weights at the gym I believe that my body compensates by using muscles other than the target areas to help.

Conclusion: Likely.

Orgasm/Sex headaches: The end of the world.

The news for EIH sufferers gets worse - it can happen during orgasm. I could probably handle getting the odd EIH at the gym, but appearing in the bedroom is a no-no. Sex is a wonderful thing and to have it ruined by a such a suddenly severe pain in the back of the head is just not cool.

My conclusion is that while headaches do occur during orgasms they do not create EIH but will aggravate an existing condition.

Interestingly, I never have this problem unless I have recently suffered an EIH at the gym. Some people think it is the exertion involved in sex that causes the headache and in their case maybe they are right. But my conclusion is that while headaches do occur during orgasms they do not create EIH but will aggravate an existing condition. For me it can even happens when I "ride the unicycle" which is not a very intensive physical activity.

Even with my conclusion that sex was not the cause, it is the very occurrence of an orgasm headache which sealed the deal and made me go see a doctor.

What my Doctor Said

My doctor's explanation was pretty simple. He said that through the neck runs big blood vessels (and nerves) that connect to the brain, and during certain activities (i.e. exercise) we can strain these blood vessels just like we can strain our muscles. When we have a particularly large strain in our neck we will often get headaches, most notably when we have large quantities of blood pumping through the area at high speed. Doubly so when the area is under tension. Which sounds very much like what occurs during high-intensity exercise and orgasms.

It made sense to me, and just like when straining a muscle, the recommendation was simple - rest. He recommended two weeks complete rest (no gym, no sex) to let the blood vessel recover from the strain. I followed his advice and sure enough my headaches were gone, but so was my confidence at the gym.

How to Beat Exercise Induced Headaches

I am not going to let EIH win. I want to be able to push myself to failure at the gym (because that is when you get the biggest gain from your muscles) without fearing another explosion of pain in my head. So here is my laundry list of things to do in order to overcome EIH:

Visit a doctor, preferably a specialist;
Assess blood pressure and make adjustments if necessary;
Rest again before recommencing weights workout;
Daily neck relaxation exercises;
Practice correct breathing technique during exercise; and
Focus on only using target muscles and relaxing everything else.

I will provide a progress report in a few weeks. In meantime, if you are an EIH sufferer then my heart goes out to you and if you have any tips, tricks or information that you think helps then I would love to hear from you.

Update 15/06/11: I took a little longer than a "few weeks" but I did manage to write a progress report on my EIH and how I beat it. Check it out here.