Why am I getting headaches when weight lifting?

November 1, 2010 9:56 AM

Why do I sometimes get massive headaches when weight lifting?

I'll start by saying I HAVE seen my Dr about this.

This started happening in May. I'm in very good shape but haven't exercised with any regularity in several years. I'm just naturally in good shape.

In May I started working with a trainer. Within a week or so, I started getting worsening headaches when I lift. It got to the point that as soon as I started on my first set of my first exercise it would kick in and I had to stop. If I pushed it it would get so bad that I would be nauseous and it would last the rest of the day. I took about a month off to get an MRI which cleared me of any possibility of an aneurism. After the month, I went back to try again and I was totally fine.

Until now. It started happening 2 weeks ago again. I took the last week off completely and went back today and right out of the gate on my first set (weighted leg lifts- not even very heavy) it hit again so I gave up weights and jumped on an exercise bike for 30 minutes at a pretty moderate hill level. Got my heart rate in the 140-155 range for most of the ride. Nothing happened. No headache.

My breathing is fine. My diet is apparently fine. I've read about exertion headaches and they say to take a couple weeks off and it usually goes away. I don't know if this is what I'm dealing with. I haven't found anything that has even explained WHAT an exertion headache is or what causes it.

If anybody has any idea what I'm dealing with, I'd like to know. I may go back to my Dr and address it again but with a clear MRI, what else could it be?

posted by Thrillhouse to health & fitness (22 answers total)

This might be obvious, but are you drinking enough water?

Even though your profile says Boston, exercise-induced headaches are also really common at high altitudes.
posted by schmod at 10:05 AM on November 1, 2010

Seconding water intake. What's your blood pressure like?
posted by matty at 10:11 AM on November 1, 2010

Are you gritting your teeth hard when you're lifting?
posted by amro at 10:16 AM on November 1, 2010

Oh man, dude, this sounds very much like what would trigger the thing that I have. Was the MRI just of your brain? Or was it head and neck (i.e. cervical vertebrae)? Where are your headaches? Any chance they're at the back of your head?

I have a Chiari Malformation, and I get (or got, past-tense, now that I'm more careful about triggers and am on really good meds) headaches at the back of my head (though this isn't a requirement) and I would get them from moving my head too wildly, jumping around a lot, tilting my head back, and ESPECIALLY lifting anything heavy. It's not an exercise/heart-rate triggered thing for me, it's very specific movements and actions that set me off. Symptoms can manifest in a lot of different ways for different people. Do you have any balance problems? That was my other big one.

Go back to your doctor and get an MRI of the head and neck, as that's the only way Chiari can be diagnosed. It may in fact just be something like dehydration like schmod suggested, but this just sounds so familiar to me. Feel free to memail if you want more info. Keep us updated.
posted by phunniemee at 10:19 AM on November 1, 2010 [1 favorite]

Here are several articles on the etiology of exertional headaches. Perhaps one of them might be useful. After scanning them it seems to be a rule out process and then identifying one or more of the multiple secondary causes. Hopefully you will be able to continue lifting and your exercise program
posted by rmhsinc at 10:23 AM on November 1, 2010

Are you holding tension in your neck, shoulders or jaw when you lift?

I get headaches from running because I hold all my tension in my jaw. Now that I know the cause, I blow raspberries every few minutes to release my jaw and remind myself to relax the tension. And yes, I'm sure I look ridiculous blowing a raspberry in the middle of race. It's better than a post run headache.
posted by 26.2 at 10:32 AM on November 1, 2010

This happened to me when I didn't get enough potassium. Can you try eating a banana before you work out?
posted by null terminated at 10:38 AM on November 1, 2010

Phun, the headaches are all in my temple and eye area. The MRI was of the full head and neck so I would think (though I could ask) that they would have picked up on something like that.

rmhsinc, I've got some reading to do there. THanks for posting that.

Everyone else, I'm not grinding my teeth when I lift but I sometimes do when I sleep. I wonder if thats related...

As for the water- it very likely COULD be the cause.
How would I know if I wasn't? I've always felt that I dehydrate easily. Is there some sort of gauge/test/whatever I can use to tell how dehydrated I am? I can do the skin snapback thing and it snaps right back but, ya know, dehydration isn't an all or nothing deal.
How long does it take to get to proper hydration once you start consuming more water/liquids?

Thanks all for the great responses!!

Oh, my Blood pressure is normal.
posted by Thrillhouse at 10:44 AM on November 1, 2010

26.6- That could be something I need to keep an eye on when I'm there. I don't really know if I do this or not. I'll be aware of it next time.

Null- Actually, just the opposite, I eat bananas far more frequently over the last couple months than I ever have. I would THINK that I have plenty of potassium. Hopefully!
posted by Thrillhouse at 10:46 AM on November 1, 2010

Temple and eye area sounds very much like trigger points in the trapezius muscle which could be very active and worsened by the strain of exercise.

There's more information here

The site is commercial and selling a book which is excellent for self treatment, but I'm not affiliated with them...it's the best info on it I know.

Good luck.
posted by Not Supplied at 10:51 AM on November 1, 2010

Oh by the way, the site shows how to treat one point which will hopefully give relief, but I've found that you need to treat other more substantial trigger points lower in the trapezius muscle to keep it away which you may need to get the book for, unless you can search for the info on the google book of it.

Message me if you want to go through what I know.
posted by Not Supplied at 11:05 AM on November 1, 2010

The same thing was happening to me (in good health as well, blood pressure normal, etc.) I assumed it was neck strain because I get occasional headaches at the base of my neck/skull. My solution has been longer warm-up periods and a couple of lighter reps before really digging into the heavy stuff. And really make sure you're not holding your breath when you lift.
posted by Civil_Disobedient at 11:10 AM on November 1, 2010

I dehydrate easily and don't get thirsty, a pretty awesome combination. I aim to drink a gallon of water a day, I know if I'm peeing multiple times a day and it's very light yellow and clear (TMI?) I'm probably pretty good.

On top of what everyone else recommends I suggest you make sure you're breathing properly. Take deep breaths, hold for the eccentric (lowering) part of the movement, exhale for the concentric ("exertion") part of the movement. If you're doing squats or bench, you hold your breath when the weight goes down and release when you push back up.
posted by schroedinger at 11:20 AM on November 1, 2010

I hate to contradict schroedinger on anything weightlifting related, but if you're moving heavy loads, don't exhale until the rep is done. Particularly with something like a squat, coming out of the bottom is when you need that pressure in your torso the most.
posted by telegraph at 11:58 AM on November 1, 2010

Okay, folks. I'm going to go with the water recommendation to start.
I'm going to down an ungodly amount of water (I'm just kidding, I'll drink responsibly) for the next few days and then try again... Wish me luck!
I'll also keep an eye on where I strain and do some reading on how to alleviate it.
Thanks everyone!
posted by Thrillhouse at 1:38 PM on November 1, 2010

You say your blood pressure is normal, but have you checked it immediately after lifting, when you have the pain?

Blood pressure can vary enormously, depending on the stress your heart is under. I would seriously advise you to have a blood pressure check under stress. See your doctor.
posted by Decani at 1:54 PM on November 1, 2010

I am going to go way, way out on a speculative limb for you here and try to give an answer that will work for both this question and your very first question about a 15 year chronic cough that just won't go away.

In that first question you said: "It feels a little like post-nasal drip the just won't go away. I can always feel something in the middle/back of my throat."

A friend of mine had a chronic post nasal drip that went on for years and also got exertional headaches.

She turned out to have a chronic cerebro-spinal fluid leak from the very top of her nasal sinuses. The drip was the CSF running down the back of her throat. She was a singer.

Well, that limb may be a little thicker than I first thought.

A 2002 page at Neurology Reviews.Com claims that

SPONTANEOUS CEREBROSPINAL FLUID LEAKS MAY PRESENT AS EXERTIONAL HEADACHE

CHICAGO—“Spontaneous cerebrospinal fluid (CSF) leaks are increasingly recognized, and a broader clinical and imaging spectrum of the disorder is emerging,” said Bahram Mokri, MD. “Headache, typically orthostatic, is the most common clinical presentation,” he added, “but recent evidence suggests that spontaneous cerebrospinal fluid leaks may sometimes present as exertional headaches.” Dr. Mokri is a Professor of Neurology at Mayo Medical School, Rochester, Minnesota.

Good luck.
posted by jamjam at 3:30 PM on November 1, 2010 [1 favorite]

I had something similar. Sudden splitting pain in head while lifting weights, nausea. The doctor couldn't identify anything going on. She just recommended taking it easy, and taking ibuprofin as necessary. And ibuprofin did seem to be the right thing... I had tried aspirin, acetaminophen, and they didn't do anything.

So it gradually went away after I took a short break and resumed at lower intensities. Stretching the affected area, and warming up a bit longer seemed to help. Along with keeping the head in a neutral position, with a minimum of tension; looking straight ahead, not up or down at all.

'Weightlifters headache's' does seem to be pretty common.
posted by Hither at 8:45 PM on November 1, 2010

Is this a Valsalva maneuver-related headache? That would explain why you don't get it from cycling.
posted by en forme de poire at 3:14 PM on November 2, 2010

You're not holding your breath by any chance - or 'bearing down'....Valsalva maneuver seems to be 95% of headaches in the gym.
posted by filmgeek at 7:43 PM on November 2, 2010

+1 for valsava, or bearing down, when you lift.

It increases intracranial pressure (inside your skull), and also inside your eyes. If you see stars after lifting, you need to modify your technique.
posted by flutable at 3:11 AM on November 4, 2010

I had a VERY similar situation several years ago. Terrible exercise induced headaches, getting an MRI, etc. The doctors & other specialists were unable to figure out what was going on. Through my own frustration-fueled research, I discovered the problem was muscular and was able to fully address it through stretches and touch. Once I learned the anatomy, it really seemed like a textbook case of bad form combined with desk-job postural issues, and I was surprised none of the professionals I visited had considered this possibility.

The muscles that are acting up can vary, but likely culprits are: trapezius (as mentioned by other posters), SCM, pec minor, supraspinatus, and scalenes. It's worth reading up on each and see if any of them are sore or restricted on your body.

Definitely read up on "forward head posture". I've seen several people eliminate chronic headaches by addressing this.

It could also be an issue of overemphasized upper chest breathing, which can lead to excessive stress on the neck muscles that result in headache.
posted by yorick at 1:37 PM on November 27, 2010