Exercise HeadacheFor as long as I can remember, my head feels like it has been stuck in between a vice and cranked down after hard weekend rides. The calm before the storm is great. I pack up my gear, head out to get something to eat with friends…and everything seems fine.

Once I finally get home…about two hours later…a splitting headache/mild migraine steps in and takes over the rest of my day. About the only thing I really want to do is sit on the couch and close my eyes as it feels like my head is caving in. It doesn’t happen after every ride, but it is frequent and a real pain in the ass. Finally, I decided to take a look around online to see what the “experts” say to try to combat this issue that apparently a lot of riders have after pushing their body to the limits out on the trail.

What Is A Riding (Exercise) Headache?

Riding headaches (more commonly known as exercise headaches) can be caused by a lot of different things while you are out on the trail. Often times, the headache occurs after riding and can even be known to start affecting you while you are still out on the trail.

These exercise headaches:

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

According to WebMD.com

When you exercise, or exert yourself physically, the muscles of the head, neck, and scalp need more blood to circulate. This causes the blood vessels to swell, which can lead to a condition called exertional headaches.

Headaches that most frequently occur due to exercise or over-exertion include jogger’s headache and orgasmic headache (sex headache). While these may occur in isolation, they are most common in people who have an inherited susceptibility to migraine (one or both parents have migraines).

It has been found that most exertional headaches are benign and respond to usual headache treatments. Some exertional headaches are particularly responsive to Indocin (indomethacin), an anti-inflammatory drug available with a doctor’s prescription. Still, in order to rule out other medical causes — some of which can be life-threatening — a doctor should evaluate your headaches.

So what can I do to prevent these headaches?

The answer…not too much really. According to everyone from WebMD to running magazines to About.com, exercise headaches are more commonly found in riders that are already more prone to migraines. If you are, about the only thing you can do is take some over the counter pain meds and ride it out.

However, the most common cause of riding headaches among riders that are not migraine prone is dehydration.

Howard LeWine, MD, a clinical instructor of medicine at Harvard Medical School and Boston’s Brigham and Women’s Hospital, explained that the pain from a water-deprivation headache may occur at the front or back or just on one side of the head, or it may be felt throughout the entire head. Bending the head down or moving it from side to side often worsens the headache.

It’s not known precisely how dehydration causes headaches. According to some experts, it’s a by-product of the body’s effort to maintain adequate fluid levels. The blood vessels narrow, reducing the brain’s supply of blood and oxygen. According to LeWine, the brain can’t feel pain, so the headache discomfort may result from pain receptors in the lining that surrounds the brain. The loss of electrolytes may also contribute to dehydration headaches.

The trick…drink enough water. While there are a ton of opinions on how much water you should be drinking an hour to get in the right amount of fluids, the truth is that varying conditions (exertion, sunlight, etc) can impact the “perfect amount” so keeping your body full of fluids at all times is essential. If you are starting to feel thirsty, you are already behind the 8 ball, so the trick is to drink and drink often…especially at the beginning of the ride when you might feel like you don’t need as much.

Other Factors Resulting In Headaches

While dehydration is the most common cause, you can also be susceptible to other headache triggers while on the trail including:

  • Exposure to direct sunlight for prolonged periods of time.
  • Over exertion (sudden sprints, longer distances, etc.)
  • Improper Breathing
  • Lack of nutrition (or bad diet)

As always, consult a doctor if things get worse or you feel like something is seriously wrong. For this rider, it looks like I am stuck with the ride it out and pop a couple of pills when I get home technique to try to keep down the pain.

Do you get riding headaches? What have you found to ease the pain?
12 comments

12 comments

Winding Machine January 28, 2011 - 4:55 am

“: I am very thankful to this topic because it really gives great information ‘””

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Bio November 6, 2010 - 10:56 am

I used to get terrible headaches a few hours after running a half marathon. I would spend the rest of the day in bed – not much fun!

I gave up all caffeine (took a week of withdrawal headaches when I thought I was dying), and I never got a post-exertional headache again. Apparently in my case,the exercise and dehydration was resulting in a sudden release of caffeine into my system and causing capillaries in the brain to constrict – hence the pain.

I also stopped getting withdrawal headaches on a Saturday morning…worked for me, but won’t be the reason in many cases I’m sure. However, if you drink a lot of coffee at work during the week, it may be worth thinking about reducing it to see if it helps. I stopped all tea/coke/chocolate as well, as they all contain caffeine.

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Matt October 28, 2010 - 11:20 am

I’ve suffered from headaches riding for a decade or more and more widely, migraines two or three times a week that left me often unable to reminder how I’d driven home. Pretty bad.

Turns out it was my jaw joint (TMJ) which was dislocating, resulting in tension across the head and neck. If you have a clicking jaw, don’t discount it – your dentist is best placed to dianose this sort of thing as I had neurologists, chiropractors, physio, you name it who all pooh-poohed the idea to a greater or lesser extent.

After jaw realignment (which was very simple and involved no pain at all) I was almost immediately pain-free for the first time in a decade and these days rarely suffer headaches at all. Ultimately I needed my teeth moving to realign too – this involved wires etc. but was well worth it.

So, for some people at the extreme this might be the answer. Obviously the exertion can exacerbate the condition through the strains from rough terrain and posture.

As others have said, avoiding dehydration also makes a big difference for headaches in general.

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Montymtb October 26, 2010 - 10:40 pm

I rarely get headaches outside of riding, but often get them after a ride – mostly in hot and humid weather. I am very diligent about hydration, often emptying a hundred ounce bladder on a 3 hour ride. The temptation to pop the top on a cold beer immediately after riding is strong, and I have found that doing that exacerbates the problem. Since alcohol is a diuretic I have to think that it is somehow hydration/electrolyte related.

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MC October 26, 2010 - 6:31 pm

I agree with the correlation between migraines and exertion headaches, since i suffer from both.
often the exertion headache could turn into a migraine if not responded to.
Proper hydration, and nutrition before and afterwards do help. however if i push hard i will get the post ride headache. what i have found that works the best for me is to stay in strong shape. i need to ride consistently. if i go more than four or five days without riding, i will take it slower than usual my first ride back.

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Anonymous October 26, 2010 - 3:19 am

I get headaches after rides where I ride fairly hard. I drink lots of water with electrolytes, way more than my riding buddies and I still come away with mean headaches. It’s no fun to go out for an early ride and come home and just want to spend the rest of the day in a dark room.

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Dengleman October 26, 2010 - 2:08 am

The other possible cause is a headache from sinus congestion and may be caused by allergies in combination to dehydration resulting in sinus congestion. The solution is aggressive post ride hydration and use of pseudophed. Just my experience.

David E. M. D.

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Greg October 25, 2010 - 2:23 pm

Interesting article. I don’t think I’ve ever experienced these sort of headaches. It must have a lot to do with heredity…. which stinks for those people who are susceptible to them.

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UltraRob October 25, 2010 - 1:46 pm

I very rarely have headaches after rides but when I do I think it’s from dehydration or not eating enough after finishing my ride.

I think some newbie riders get headaches from being too tense on the bike. Staying loose on the bike will help you handle the bike better plus reduce tight neck and shoulders after riding.

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koko October 25, 2010 - 1:44 pm

Mine is mostly due to dehydration and exhaustion. I stopped getting my headache after I started to take care of my water intake, and started consuming suppliments during long rides(perpetuem/endurolite). Now I also diligently take recovery drinks after a major ride.

Man, and to think I used to scoff at those who swears by such nutrient regiment.

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Rustywouters October 25, 2010 - 12:57 pm

As a Doctor of Chitopractic I get many patients that come to me with headaches of all varieties. Some of them include exertional headaches. Almost all of the headaches are caused by two things: neck tension and dehydration. Neck tension can be caused by poor posture aka leaning forward on the bike for prolonged periods. Dehydration can be caused by a lack of water OR an imbalance of electrolytes (whether high or low).

As a mountain biker who has also suffered mind numbing headaches after rides over 4 hrs. I have found that keeping good alignmnet in my spine, reducing my forward head posture and drinking 2 hrs before/ during/ and for at least 2 hrs after a ride can prevent exercise induced headaches.

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Yogaguy74 October 25, 2010 - 12:23 pm

it always seems to help me if I pop a couple of salt sticks/endurolytes after riding/running as well as during for longer rides/runs. And no the salt around the rim of a margarita doesn’t count.

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