Are you experiencing headaches during or shortly after running?

“Exercise”, “Exertional”, or “Effort” headaches (EH) are actually relatively common among distance runners and affect both men and women equally. While their cause is not really known, they do follow a pattern – most often following prolonged exercise of a lower intensity (like an LSD run) and coming on gradually and growing progressively worse over 3 – 6 hours. Also, such headaches occur more frequently in people over 40.

As I said, the exact cause of these headaches is not known, but there do seem to be some common factors involved:

Neck tension and improper form while running - A lot of runners don’t pay much attention to the muscles in their neck and shoulders, and it comes as a surprise to many that our heads actually weight about as much as a bowling ball! During long runs, improper head position, jaw-jutting and shoulder tension can cause sustained muscular tension in the neck and jaw, which leads to EH.

To correct this, pay attention to the position of your head when you run, be conscious of any tension in your shoulders and neck and correct such patterns as jaw clenching or holding your shoulders too high. Do range on motion exercises to restore flexibility to your neck and use resistance moves to help develop strength.

Some runners – especially those prone to injury - swear by having regular chiropractic adjustments as well.

Dehydration, over-hydration, and nutrition - EH can also be brought on by improper hydration or low blood sugar. In runs lasting 1 hour or less, water is your most important need. Weighing yourself before and after your run is helpful here. If you lose weight after your run, you’re not drinking enough water before or during exercise. As a general guideline, consume 8 -16 ounces of water before you run and see if this effects the incidence of your headaches. If you find that you have actually gained weight after your run, you may be drinking to much water.

On runs longer than one hour blood sugar will need to be maintained. Consume carbohydrates (200 – 300 calories per each hour of activity), along with electrolytes – especially when running in warmer weather. Sport drinks, Nuun tablets, and gels are a good choice for on the road replenishment, and be sure to drink at least 8oz of water for every gel pack that you consume.

Immediately following your run, drink 2 ounces of water for every pound of weight loss. Muscles restore glycogen best in the 2 hours immediately after running, so be sure to replenish carbs and electrolytes as quickly as possible with sport drink, fruit juice and carbohydrate rich foods like a bagel and jam, yogurt, bananas, or cereal and milk.

There is also evidence that low sodium levels can be the cause of exercise headaches. Some physicians suggest that runners who experience this problem may actually be peeing (and sweating) out a lot of sodium without realizing it. Adding a salty snack before and after your run (like salted pretzels) may provide some relief. You may want to have some labs done by your doctor to determine if low sodium is the cause of your headaches. Note that over-hydration (hyponatremia) will contribute to a low sodium condition so again, pay attention to your water consumption.

Scarier stuff - I would be remiss if I didn’t tell you that there are some very serious conditions that can be causing exercise related headaches including abnormalities in the blood vessels leading to or within the brain, brain tumors, obstruction of cerebrospinal fluid flow, and internal bleeding. We have the Mayo Clinic to thank for this information.

Thankfully these conditions are pretty rare. If you find that the above-mentioned approaches do not work for you, if your headaches do not really seem to follow a pattern, or if they become progressively more severe and frequent, you should seek immediate attention from a physician.

Less scary stuff – Documentation also exists showing sinus infection to be one of the possible causes of exercise headaches. This can be easily confirmed and treated by your doctor or other healthcare practitioner and is definitely something to have checked out.

Finally, and perhaps most obviously, if you or someone in your family is prone to migraine headaches, or if you are moving through a “triggering event” like menopause there are medications, and supplements you can try as well as changes to your diet that can help. Seek the assistance of your healthcare practitioner or a sports nutritionist for assistance.

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Tags: headache, exercise headache, exertional headache, effort headache, hydration, hyponatremia, glycogen, nutrition, sodium