Making Headway Against Exercise Headaches

Thorny Throb

Q: I am a 42-year-old woman in relatively good health. Two or three times a week I work out for an hour to an hour and a half with fitness machines, weights, running, and cycling. I have a problem with headaches that appear after my longer bike rides over two hours at a pretty good pace.

I usually develop a headache anywhere from 45 minutes to an hour and a half after I stop riding. I tried drinking colder drinks while riding and patting my face, neck, and forehead with a cloth dipped in ice water; which seemed to help a little.

My sister also mentioned she gets "post-exercise" headaches. Would women be more prone to this than men for some reason? (My husband rides, too, and never suffers from headaches.)

S.W.
Houston, TX

A: Exercise-related headaches are fairly common and occur through a wide range of sports; from running, weight-lifting, and bicycling to contact sports such as soccer, boxing, and football. Most headaches that are not trauma-related are referred to as exertional, or effort headaches.

The precise cause is not known, but a great deal of suspicion has been cast upon sustained muscular tension in the head and neck. This may be particularly true in your case because your headaches come after long bike rides when your head is held horizontally to the ground.

The average head weighs around 11 pounds, about the same as a bowling ball. Take a bowling ball or the equivalent and hold it over your head with your arms straight. Compare that with holding the bowling ball straight out in front of you.

This is similar to the position you are holding your head in during the two-hour bicycle rides. The muscle tension involved restricts blood flow and causes muscle spasms in the neck and scalp, resulting in a headache. Clenching your teeth may also lead to headache by the same mechanism. Relaxing your jaw and varying your head and hand position on your ride may reduce some of the tension.

The pain-spasm cycle leads to stiffness and weakness of the neck muscles, and you may end up with a neck like a 39-cent chicken. You can tell if your headache is a muscle tension headache by massaging your neck and scalp feeling for pressure points-knots of extreme pain.

What can you do to prevent these headaches?

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