Exercise Induced Headache (EIH): What You Need to Know

This is an important PSA about a health issue that could affect anyone while working out: it’s known as an Exercise Induced Headache, or EIH. If you ever feel yourself developing a headache while working out, stop the exercise immediately. Relax for a few minutes while closing your eyes and breathing deeply, and wait for the feeling to pass. Then, if you can no longer sense any trace of the headache, continue. If, however, you still feel even a slight head pain, then do not finish the workout. Take a few days off before attempting to train again. If you attempt to work through this head pain, it may develop into an exercise induced headache. An exercise induced headache can be twice as severe as a migraine, and can last anywhere from a few days to two weeks. Once you get an exercise induced headache, it becomes prone to reoccurrence.

Recognizing an Exercise Induced Headache

According to “Super Slow, the Ultimate Exercise Protocol” by Ken Hutchins, “The hallmark of EIH is its sudden onset. As many clients have described, it begins as a dull, low-intensity head pain. This pain appears to arise from the back of the head during an exercise. The subject continue the exercise with the mistaken belief that ‘I can work through this pain. It is a minor aggravation that I can ignore.’ Within moments, probably during the next repetition, this pain rapidly intensifies and radiates over the top of the skull and into the orbit of one or both eyes. It is severely painful, and seems to cause squinting with the sensation of impending impaired vision. And as one subject alluded: ‘it feels as though an axe head pierced through the top of my skull’. Often, this pain does not subside, even with cessation of the exercise, although continuance of the exercise — or any exercise for that matter — worsens the accompanying throbbing. The condition usually debilitates the subject until the following day, although it sometimes continues for as long as two weeks.”

Causes of an Exercise Induced Headache

It is not yet completely understood what causes an exercise induced headache, but we have some theories. According to the article “Avoiding Exercise Induced Headaches (EIH)” by Andrew Baye, “It was previously believed that EIH was related to tension in the muscles of the neck, similar to tension headaches, and was often addressed by performing a neck extension and/or flexion exercise at the beginning of the workout, to produce fatigue induced relaxation of the neck muscles. This was done to minimize tension in the neck muscles during the more intense exercises involving greater body masses, such as the leg press. Recent observations by Doug McGuff, MD suggest that EIH may be caused by stretching of the dura mater (outermost of the three membranes covering the brain and spinal cord) as a result of increased BP in the cerebral veins caused by retrograde venous flow towards the brain. The onset of EIH is usually experienced during intense exercises for the legs, hips, and trunk, during which there is a large amount of venous congestion in the pelvis and abdomen.”

Preventing an Exercise Induced Headache

Although we do not completely understand what causes an EIH and therefore cannot guarantee a way to prevent it, there are several steps that one can take to make it less likely to occur. And, of course, the last line of defense is always to cease exercise the moment you feel any head pain. To lower your risk of occurring an EIH, always observe proper form on your exercises, especially during the leg press and other high-load exercises, where EIH seems to be more common. Excessively gripping, grimacing, gritting your teeth, Val Salva, and neck tension appear to contribute to the onset of an EIH. Keep in mind that an EIH can still occur even when observing perfect form, so be sure to watch out for any sign of head pain while working out.

Talk to your personal trainer about EIH, and always inform your trainer if you have a headache before exercise starts or if you experience head pain while working out.

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