KEY CAUSES There are several theories as to why primary exertion headaches occur. These include blood vessel dilation in and around the head, which puts pressure on the nerves that cover the brain. They could be caused by straining or the over-stretching of the neck ligaments and tendons when muscles contrac – perhaps during the last couple of repetitions of an intense strength-training session. Holding your breath could also be responsible.

Ahmed believes they could be caused by a release of chemicals as well. Exertion headaches may be related to the release of chemicals such as adrenaline and serotonin,’ he says. Diversion of blood to the muscles amy cause reduced blood flow to the brain with the release of chemicals.’

Heat can be another contributing factor. Heat and altitude are known to contribute to an increased risk of primary exertion headache,’ adds Brewer.

Some types of exercise can increase your risk, too. CrossFit is particularly risky as it includes exercising at a high heart rate, little recovery time, low hydration opportunity and overhead heavyweight lifting elements,’ says Ratajczak.

Overdoing it when you exercise could lead to a debilitating headache that stops your training in its tracks ith many of us juggling busy schedules, it’s easy to see why shorter, more intense exercise sessions such as HI IT (high-intensity interval training) and Spin classes are so popular – they are time-efficient and torch the calories.

But those benefits come at a cost if you overdo it. The price for me was a sudden and severe headache. During a sprint interval in a Spin class, I felt a pulsating pain so severe I had to stop. Although the pain eased, the headache lasted a week, and even low-intensity cardio would worsen the symptoms. My GP referred me for an MRI scan, which was clear, but the diagnosis was a primary exertion headache. contributing factor to headaches as it can reduce the blood’s ability to flow freely through your blood vessels.


If you get a severe headache, it’s important to see your GP to rule out any underlying cause, especially if it feels you’ve been hit on the head (this is known as thunderclap’ headache). You’ll need urgent medical attention, as a bleed on the brain cannot be excluded,’ warns Dr Fayyaz Ahmed, educational officer at the British Association for the Study of Headache.

Fortunately, primary exertion headaches are unlikely to have any serious long-term effects. We believe there are no side-effects beyond the pain – which can be very debilitating and can last for a week,’ says Dr Ratajczak, deputy medical director at Nuffield Health.

When it comes to returning to exercise, Brewer advises caution before training hard. Anyone thinking of embarking on a HIIT programme should get checked out by


Headaches brought on by exercise can be divided into two categories – secondary headache and primary exertion headache. The first may include vomiting or vision problems and can relate to serious s, such as an aneurysm, so it’s important to seek medical help straight away.

Primary exertion headaches affect 12 to 30 per cent of exercisers, according to the Migraine Trust, and are usually linked to the high-intensity exercise.

HIIT increases heart rate and blood pressure and, if prolonged, can raise core temperature and increase the risk of dehydration,’ says John Brewer, professor of applied sport science at St Mary’s University. Dehydration is often a


If you do suffer from a primary exertion headache, stop and rest. Most doctors advise a week of rest,’ says Ratajczak. Activities that quickly increase pressure in the skull, such as weight-lifting or interval training are best avoided for two to four weeks. You can try steady-pace cardio workouts, but if the pain starts, stop immediately and restart the recovery process.’ If you suffer from primary exertion headaches regularly and exercise daily, beta-blockers (that prevent a surge of adrenaline which can trigger the headache) may help prevent the symptoms.

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