Please Scroll Down to See Forums Below 
IHateCrunches
New member
The first two to three paragraphs are nonsense.. but the rest give your good information about this
Exercise Headaches
Broadcast Monday 18 August 1997
with
Summary:
You can get it from jogging, playing tennis or pumping iron at the gym. You're at greater risk if you box, scuba dive or play footy or soccer. It can even happen during sex. It's an exercise-related headache.
Transcript:
You can get it from jogging, playing tennis or pumping iron at the gym. You're at greater risk if you box, scuba dive or play footy or soccer. It can even happen during sex. It's an exercise-related headache.
It's mostly a benign problem that occurs on a regular basis in about one percent of the population. But if you're physically active then the chances are that you've had one. It's an unpredictable and very painful event, and needless to say - it can really put you off your game...
This report by Dan Gaffney begins with the story of Robyn St Clare whose headache began when she started to spend more time in the gym lifting weights.
Robyn St Clare: I wouldn't get the headache straight away. I'd usually work out in the morning and then the headache would come on early afternoon and get gradually worse towards the evening. They started to happen a few weeks after I'd started doing the exercises. I noticed a bit of muscle tension in my shoulders and then I'd start getting a kind of dull ache and it would get worse and worse and more intense. Usually on one side of my head behind my eye and further behind on my head, behind that eye.
Dan Gaffney: You needn't run like Cathy Freeman or swim like Kieren Perkins to get an exercise head. Robyn St Clare is an active 30 year old who decided to tone up at the local gym. She learned how to properly use the equipment from a fitness trainer and she was conscious of warming up and warming down whenever she worked out.
Her story is still unfolding, but like all people who've had an exercise headache hers fits the general theme: all sufferers get their headaches when they're physically active, or shortly afterwards.
Some sports headaches are brief, intensely painful events that last a few agonising seconds; others slowly build to migraine-like episodes that can last days, even weeks at a time.
Dr Sandrino Zagami is a consultant neurologist at the St George Hospital in Sydney and he has a special interest in exercise headache. Here he describes the so-called effort headache.
Dr Zagami: This type of headache is usually felt on both sides of the head. It comes on often after exertion so it may not actually occur during exertion, but some time afterwards. It's fairly slow in onset, it's often throbbing, and as I said it affects both sides of the head. Now it may come on in people who are unaccustomed to exertion so, do something out of the ordinary, but can also occur in athletes who are well trained, and it can occur unpredictably. Say, sometimes they might exert themselves to some level and get a headache and other times not... and other times they may be resistant to the headache for various reasons.
Dan Gaffney: Well that's the effort headache, but if the pain is a sudden intense throbbing occurring while you're lifting a heavy object, or straining your body, the chances are you've had an exertion headache. It can last for a few seconds or up to a few minutes, and the pain then recedes to a dull ache that last's four to six hours. When it first happens many people report an aura or a sense of light or warmth. And the pain usually starts on one side of the head and later affects both sides. Like all exercise headaches the exertion headache tends to happen when you repeat the activity that brought it on initially. But here's the catch. It's also unpredictable. Some weeks you'll get the exertion headache and other weeks you wont. And Robyn too, found it for her, it was hit and miss.
Robyn St Clare: I'd work out like three times a week. It wouldn't happen every week. It might happen every second week... but not constantly.
Dan Gaffney: How long would it last for?
Robyn St Clare: Well, if I didn't take any medication for the last two or three days, and because I was at the beginning taking only Panadol, I would still have a dull headache, even if I had the Panadol, I'd still have it for a few days. If I had them when I went to sleep and I hadn't had any appropriate medication, I would wake up during the night with the headache and also in the morning.
Dan Gaffney: About two-thirds of people who get a headache from exercise will suffer from the effort or exertion variety. To get a handle on the cause and the treatment of these most common types of exercise headache, neurologists have zeroed in on the trigeminal nerve. It connects three main arteries that supply blood to the brain. It's normal job is to supply the muscles that let us chew food and feel sensation on our face.
Dr Zagami: It's called the Trigemino-vascular system. What this refers to is an intimate relationship between the nerve, the trigeminal nerve that supplies the brain and the brain structures with sensation, but also supply it with various chemicals called neuropeptides that could cause blood flow changes... cause changes in the cerebral blood vessels. Now this nerve innervates certain structures, some of which are pain sensitive, and these include major arteries, specially at the base of the brain, some of the veins in the brain, particularly the large veins, and also the covering of the brain, particularly the around the covering called the dura. So the dura actually invests the whole brain, it protects it, but it has nerves running in it and blood vessels running it, and they appear to be pain sensitive. So it may be that certain things that stretch these structures or put traction on them, or in other ways sensitise them, by transmitting through the trigeminal nerve, painful impulses back into the brain.
Dan Gaffney: It's no surprise that a classic course of exercise headache is from a blow to the skull. There are half a dozen varieties of these so-called post traumatic headaches. But a common one, the footballers headache, owes it's name to being seen most often in soccer, rugby and league players. If you catch a sharp blow to the front or side of your head, or your face, you'll probably qualify for one. It's no secret that they're part of the job description for boxers. The pain starts quite suddenly and can be excruciating. Sometimes out of all proportion to the blow that caused it. Sufferers often feel nauseous, and some even report temporary loss of sight. But if football or boxing can give you a pain in the brain, it's conventional wisdom in some circles, that having sex can help take it away. But a word of warning. The headache literature says that a headache can actually be caused by sexual intercourse.
Dr Zagami: Well, there are several types of headaches that can be related to exertion occurring during sex - one is: a type of headache that occurs as the person's sexual activity increases and usually occurs before orgasm and it's related to increasing muscle tension. So it's a muscle contraction headache. This can sometimes be followed by another form of headache, or this other form of headache may occur independently and that's an explosive onset of a throbbing headache that usually occurs at the time of orgasm. And we think that that is related to the benign exertion headache. So, more recently people have described patients who have both forms of headache, occurring either at separate times in their lives, or in close together. And thinking about why those type of headache might occur, both during exertion - there are changes that occur as well as during sex where you have changes in terms of increases in blood pressure, which can actually be quite massive. So, weight lifters can put their blood pressures up by 40 to 100 mm of mercury, and similar changes in blood pressure can occur during orgasm. So, somehow those changes in blood pressure and the accompanying changes in blood vessels seem to predispose to these type of headaches.
Dan Gaffney: Just like the common headache, most exercise headaches are harmless. But in some cases they might indicated underlying disease. Doctor Zagami again.
Dr Zagami: The other issue that we have to look at is that we're talking about here these benign forms, but we have to also take into account some of them can be symptomatic... that is secondary to another cause. So for instance, cough headache can be associated with structural problems, say for instance a problem at the base of the skull where the upper spinal cord meets the brain and the brain stem can have some problems there where it's narrow due to a particular abnormality where part of the brain is lower than it should be. And with a cough or sneeze or other strain, you put up pressures inside the chest, the abdomen, that leads to increased pressure there which is transmitted up into the brain, into the blood vessels, particularly the venous side of things, the veins, and acutely raises your pressure inside the brain and through a mechanism we don't quite understand, causes the cough headache. Whether it's due to increased pressure in veins that are distended or some other cause, we're not quite sure, but it seems to be related to the ways in intracranial pressure that occurs acutely and as soon as that wears off then the acute pain's gone to be left with some dull ache. One young woman I saw had to give up all of her activities, and she used to be a water skier, and she couldn't do anything, because any form of coughing or sneezing led to an instantaneous headache which occurred many times a day, and it wasn't until we were suspicious about this and we did a particular scan of the brain, a MRI, that it showed that part of her cerebellum was very low and she actually responded very well to an operation where they decompressed, or took the pressure off, and after a year and a half of being unable to do any sport or activity, she's now back to full activity.
Dan Gaffney: People who have a weakness or defect in their upper spine or neck are at risk for headaches if they put stress on these areas... like weight training, water skiing, tennis, scuba diving, or rock climbing. These cervicogenic headaches are like the common tension headache. The pain starts in the shoulders or neck and then it radiates up into the head. If it's left untreated, it can last days, and even weeks.
Robyn St Clare: I have found since, that if I've a little bit of a headache, if I go swimming that often helps. And massage can help to.
Dan Gaffney: So seemingly loosening up the joints and the muscles around them seems to help.
Robyn St Clare: Yes, getting rid of the tension, basically. I'm probably a big tension builder in my shoulders, or something.
Dan Gaffney: What do you now put this exercise related headache down to.
Robyn St Clare: I'm still not sure. I think perhaps because I do tense up, I guess, in my shoulders. Maybe I have a tendency towards it, because I've had back problems in the past. At the time I just thought I wasn't doing something right.
Dan Gaffney: So Robyn found a treatment that worked for her. But others might require a pharmacological approach.
Dr Zagami: The benign exertional headache, or benign prolonged exertional headache can sometimes respond to indomethacin, but sometimes we use traditional anti-migraine agents, whether it be a blocker or one of the ergotamine containing agents, and sometimes they can be taken just prior to exertion. Likewise for effort induced headache, or effort induced migraine, again we can try prophylactic therapy, that is, taking something before the exertion. The problem with it being as we said before, that these things can sometimes be capricious, so you're not sure when it's going to occur. Obviously if you're having a run of them then it seems reasonable to try regular prophylactic therapy for at least for a short period of time, but then whether to continue or not is hard to know.
Dan Gaffney: Two years after her first symptoms, Robyn still doesn't have a definitive diagnosis. But she's found that drinking plenty of fluids, stretching properly, and breathing deeply when she does weights, helps prevent most of her headaches. If she gets pain, the anti-inflammatory agents give best relief. And having massage and swimming are now her preferred ways of dealing with the early signs of pain.
Norman Swan: Dan Gaffney made that feature on exercise related headache.
Exercise Headaches
Broadcast Monday 18 August 1997
with
Summary:
You can get it from jogging, playing tennis or pumping iron at the gym. You're at greater risk if you box, scuba dive or play footy or soccer. It can even happen during sex. It's an exercise-related headache.
Transcript:
You can get it from jogging, playing tennis or pumping iron at the gym. You're at greater risk if you box, scuba dive or play footy or soccer. It can even happen during sex. It's an exercise-related headache.
It's mostly a benign problem that occurs on a regular basis in about one percent of the population. But if you're physically active then the chances are that you've had one. It's an unpredictable and very painful event, and needless to say - it can really put you off your game...
This report by Dan Gaffney begins with the story of Robyn St Clare whose headache began when she started to spend more time in the gym lifting weights.
Robyn St Clare: I wouldn't get the headache straight away. I'd usually work out in the morning and then the headache would come on early afternoon and get gradually worse towards the evening. They started to happen a few weeks after I'd started doing the exercises. I noticed a bit of muscle tension in my shoulders and then I'd start getting a kind of dull ache and it would get worse and worse and more intense. Usually on one side of my head behind my eye and further behind on my head, behind that eye.
Dan Gaffney: You needn't run like Cathy Freeman or swim like Kieren Perkins to get an exercise head. Robyn St Clare is an active 30 year old who decided to tone up at the local gym. She learned how to properly use the equipment from a fitness trainer and she was conscious of warming up and warming down whenever she worked out.
Her story is still unfolding, but like all people who've had an exercise headache hers fits the general theme: all sufferers get their headaches when they're physically active, or shortly afterwards.
Some sports headaches are brief, intensely painful events that last a few agonising seconds; others slowly build to migraine-like episodes that can last days, even weeks at a time.
Dr Sandrino Zagami is a consultant neurologist at the St George Hospital in Sydney and he has a special interest in exercise headache. Here he describes the so-called effort headache.
Dr Zagami: This type of headache is usually felt on both sides of the head. It comes on often after exertion so it may not actually occur during exertion, but some time afterwards. It's fairly slow in onset, it's often throbbing, and as I said it affects both sides of the head. Now it may come on in people who are unaccustomed to exertion so, do something out of the ordinary, but can also occur in athletes who are well trained, and it can occur unpredictably. Say, sometimes they might exert themselves to some level and get a headache and other times not... and other times they may be resistant to the headache for various reasons.
Dan Gaffney: Well that's the effort headache, but if the pain is a sudden intense throbbing occurring while you're lifting a heavy object, or straining your body, the chances are you've had an exertion headache. It can last for a few seconds or up to a few minutes, and the pain then recedes to a dull ache that last's four to six hours. When it first happens many people report an aura or a sense of light or warmth. And the pain usually starts on one side of the head and later affects both sides. Like all exercise headaches the exertion headache tends to happen when you repeat the activity that brought it on initially. But here's the catch. It's also unpredictable. Some weeks you'll get the exertion headache and other weeks you wont. And Robyn too, found it for her, it was hit and miss.
Robyn St Clare: I'd work out like three times a week. It wouldn't happen every week. It might happen every second week... but not constantly.
Dan Gaffney: How long would it last for?
Robyn St Clare: Well, if I didn't take any medication for the last two or three days, and because I was at the beginning taking only Panadol, I would still have a dull headache, even if I had the Panadol, I'd still have it for a few days. If I had them when I went to sleep and I hadn't had any appropriate medication, I would wake up during the night with the headache and also in the morning.
Dan Gaffney: About two-thirds of people who get a headache from exercise will suffer from the effort or exertion variety. To get a handle on the cause and the treatment of these most common types of exercise headache, neurologists have zeroed in on the trigeminal nerve. It connects three main arteries that supply blood to the brain. It's normal job is to supply the muscles that let us chew food and feel sensation on our face.
Dr Zagami: It's called the Trigemino-vascular system. What this refers to is an intimate relationship between the nerve, the trigeminal nerve that supplies the brain and the brain structures with sensation, but also supply it with various chemicals called neuropeptides that could cause blood flow changes... cause changes in the cerebral blood vessels. Now this nerve innervates certain structures, some of which are pain sensitive, and these include major arteries, specially at the base of the brain, some of the veins in the brain, particularly the large veins, and also the covering of the brain, particularly the around the covering called the dura. So the dura actually invests the whole brain, it protects it, but it has nerves running in it and blood vessels running it, and they appear to be pain sensitive. So it may be that certain things that stretch these structures or put traction on them, or in other ways sensitise them, by transmitting through the trigeminal nerve, painful impulses back into the brain.
Dan Gaffney: It's no surprise that a classic course of exercise headache is from a blow to the skull. There are half a dozen varieties of these so-called post traumatic headaches. But a common one, the footballers headache, owes it's name to being seen most often in soccer, rugby and league players. If you catch a sharp blow to the front or side of your head, or your face, you'll probably qualify for one. It's no secret that they're part of the job description for boxers. The pain starts quite suddenly and can be excruciating. Sometimes out of all proportion to the blow that caused it. Sufferers often feel nauseous, and some even report temporary loss of sight. But if football or boxing can give you a pain in the brain, it's conventional wisdom in some circles, that having sex can help take it away. But a word of warning. The headache literature says that a headache can actually be caused by sexual intercourse.
Dr Zagami: Well, there are several types of headaches that can be related to exertion occurring during sex - one is: a type of headache that occurs as the person's sexual activity increases and usually occurs before orgasm and it's related to increasing muscle tension. So it's a muscle contraction headache. This can sometimes be followed by another form of headache, or this other form of headache may occur independently and that's an explosive onset of a throbbing headache that usually occurs at the time of orgasm. And we think that that is related to the benign exertion headache. So, more recently people have described patients who have both forms of headache, occurring either at separate times in their lives, or in close together. And thinking about why those type of headache might occur, both during exertion - there are changes that occur as well as during sex where you have changes in terms of increases in blood pressure, which can actually be quite massive. So, weight lifters can put their blood pressures up by 40 to 100 mm of mercury, and similar changes in blood pressure can occur during orgasm. So, somehow those changes in blood pressure and the accompanying changes in blood vessels seem to predispose to these type of headaches.
Dan Gaffney: Just like the common headache, most exercise headaches are harmless. But in some cases they might indicated underlying disease. Doctor Zagami again.
Dr Zagami: The other issue that we have to look at is that we're talking about here these benign forms, but we have to also take into account some of them can be symptomatic... that is secondary to another cause. So for instance, cough headache can be associated with structural problems, say for instance a problem at the base of the skull where the upper spinal cord meets the brain and the brain stem can have some problems there where it's narrow due to a particular abnormality where part of the brain is lower than it should be. And with a cough or sneeze or other strain, you put up pressures inside the chest, the abdomen, that leads to increased pressure there which is transmitted up into the brain, into the blood vessels, particularly the venous side of things, the veins, and acutely raises your pressure inside the brain and through a mechanism we don't quite understand, causes the cough headache. Whether it's due to increased pressure in veins that are distended or some other cause, we're not quite sure, but it seems to be related to the ways in intracranial pressure that occurs acutely and as soon as that wears off then the acute pain's gone to be left with some dull ache. One young woman I saw had to give up all of her activities, and she used to be a water skier, and she couldn't do anything, because any form of coughing or sneezing led to an instantaneous headache which occurred many times a day, and it wasn't until we were suspicious about this and we did a particular scan of the brain, a MRI, that it showed that part of her cerebellum was very low and she actually responded very well to an operation where they decompressed, or took the pressure off, and after a year and a half of being unable to do any sport or activity, she's now back to full activity.
Dan Gaffney: People who have a weakness or defect in their upper spine or neck are at risk for headaches if they put stress on these areas... like weight training, water skiing, tennis, scuba diving, or rock climbing. These cervicogenic headaches are like the common tension headache. The pain starts in the shoulders or neck and then it radiates up into the head. If it's left untreated, it can last days, and even weeks.
Robyn St Clare: I have found since, that if I've a little bit of a headache, if I go swimming that often helps. And massage can help to.
Dan Gaffney: So seemingly loosening up the joints and the muscles around them seems to help.
Robyn St Clare: Yes, getting rid of the tension, basically. I'm probably a big tension builder in my shoulders, or something.
Dan Gaffney: What do you now put this exercise related headache down to.
Robyn St Clare: I'm still not sure. I think perhaps because I do tense up, I guess, in my shoulders. Maybe I have a tendency towards it, because I've had back problems in the past. At the time I just thought I wasn't doing something right.
Dan Gaffney: So Robyn found a treatment that worked for her. But others might require a pharmacological approach.
Dr Zagami: The benign exertional headache, or benign prolonged exertional headache can sometimes respond to indomethacin, but sometimes we use traditional anti-migraine agents, whether it be a blocker or one of the ergotamine containing agents, and sometimes they can be taken just prior to exertion. Likewise for effort induced headache, or effort induced migraine, again we can try prophylactic therapy, that is, taking something before the exertion. The problem with it being as we said before, that these things can sometimes be capricious, so you're not sure when it's going to occur. Obviously if you're having a run of them then it seems reasonable to try regular prophylactic therapy for at least for a short period of time, but then whether to continue or not is hard to know.
Dan Gaffney: Two years after her first symptoms, Robyn still doesn't have a definitive diagnosis. But she's found that drinking plenty of fluids, stretching properly, and breathing deeply when she does weights, helps prevent most of her headaches. If she gets pain, the anti-inflammatory agents give best relief. And having massage and swimming are now her preferred ways of dealing with the early signs of pain.
Norman Swan: Dan Gaffney made that feature on exercise related headache.
