Table of Contents

Exertion Headaches

By: Nick Ryan | June 23, 2011 434 Comments

This entry is part 6 of 8 in the series The A.P.E.X. Way

UPDATE: This article was originally published by itself.  As of May 5, 2015 we decided to include it as a part of our series “The A.P.E.X. Way”.

Strenuous, intense physical training can result in what are known as EXERTION HEADACHES.  This article describes exertion headaches, what causes an exertion headache, what to do to avoid exertion headaches, and how to properly transition back into training after suffering from an exertion headache.  The majority of the article centers on exertion headaches that result from lifting weights; however, there is a CrossFit specific section towards the end of the article, updated March 2014.  Endurance athletes that experience exertion headaches after high intensity cardio will find the CrossFit section most helpful. This article is not intended to replace a medical visit.  In fact, if you are reading this because you recently experienced an exertion headache, take a moment and schedule a medical visit.


Exertion headaches are exercise-induced headaches that are correlated with training at a very high intensity.  They most commonly occur after a set of a compound leg movement (i.e. leg press, squat, deadlift) performed to failure or close to failure. Right after the set, sometimes on the final rep, an intense headache occurs typically in the back of the head or in the temples. What scientifically occurs is a forced dilation (expansion) of the blood vessels in your brain beyond their normal thresholds.  This puts pressure on the meninges, (small nerves that cover the brain) which causes the painful headache. Once the heart rate and blood pressure drop, the headache becomes less intense; however, the meninges remain extra sensitive, and are susceptible to future headaches if blood pressure or heart rate spike.


Exertion headaches occur when a combination of the following circumstances are true:

  • DEHYDRATION: Dehydration thickens your blood
  • VALSALVA MANEUVER (Holding Breath): This causes a dramatic spike in blood pressure
  • POOR NECK POSITION: Anything other than a neutral spine causes constrictions on the carotid arteries, the main arteries that deliver blood to the brain.
  • INCREASED HEART RATE: As a set progresses, your heart rate will steadily climb so that by the end of your set it can be close to (or above) your maximal heart rate.
  • HEAVY WEIGHT: The more weight on your body, the more blood pressure will rise while lifting it. Because legs are the strongest muscle group in the body, more weight is needed to reach a level of fatigue or failure.  The correlation between heavy weight and an increase in blood pressure makes compound leg movements more risky than other movements.

The combination of elevated blood pressure, heart rate, thickened blood and constricted arteries can result in a devastating surge of blood attempting to enter the brain, forcibly expanding the arteriole walls and putting pressure on the meninges.


Exertion headaches have three phases:

  1. INTENSE HEADACHE:  The first phase is the intense, painful headache that occurs during or immediately after an intense workout.  The pain is typically in the temples or back of head.  The feeling can best be described as a grenade exploding in the head.  The headache hits rapidly, and throbs painfully.  This headache will not go away until there is a decrease in heart rate, blood pressure, and all activity has ceased.
  2. DULL HEADACHE:  The second phase is a dull, fatiguing headache that can last for up to 2 weeks.  It typically lingers wherever the initial phase of the headache was felt because that is the area that the meninges flared up.
  3. FULL RECOVERY:  Full recovery depends on the severity of the initial headache and the quality of rest given to the body to recover.  If the body is given the opportunity to heal, dull headaches are typically gone in 1 week.  True full recovery, meaning the ability to perform at the same level as before the headache, will take approximately 2 months.


To prevent an exertion headache:

  • HYDRATE: Drink enough water that you’re urine is clear or faintly yellow (never dark golden) the day before your lift and the day of, and continue to drink water during your workout.  This will ensure that your blood can flow freely and smoothly through your blood vessels.
  • BREATHE: The valsalva maneuver is a valuable tool for creating stability in the thoracic cavity (torso area) that can help prevent lower back injuries during maximal lifts.  It should not, however, be used during sets of multiple repetitions. When performing multiple repetitions, exhale during the positive phase and inhale during the negative phase. You can find more detailed information on breathing techniques here.
  • NEUTRAL SPINE: Unless performing a neck exercise, there is no need for the neck to be bent. Maintaining a neutral spinal alignment allows for proper circulation through the arteries and veins responsible for moving blood in and out of the brain.  While “looking up” may mentally help keep the back straight during a squat or a deadlift, it is not essential.  Keep the head and neck in a neutral position.
  • CONDITIONING:  Developing a healthy heart and lungs that can handle high intensity training can be accomplished with regimented cardiovascular training.  General conditioning along with interval training can help reduce the risk of exertion headaches by developing an efficient and healthy cardiovascular system that can handle the stress.

Training with a high level of intensity is part of improving the body’s performance potential, increasing size and strength; however, it can also create an opportunity for an exertion headache.  To avoid exertion headaches during high intensity training sessions, build a solid cardiovascular base, be hydrated, breathe correctly, and maintain a neutral spine. Also, consider performing the larger compound leg movements at the beginning of the workout.  Leg movements are inherently heavy, taxing exercises.  Performing them early in the workout is safer because fatigue, exercise-induced dehydration, and a peaking heart rate won’t be part of the equation yet.


There are some simple guidelines that will help with full recovery and full pre-headache performance:

  1. STOP:  Once an exertion headache occurs, STOP. Do not attempt to push through the rest of the training session, it will only worsen the headache and the duration of symptoms.
  2. MEDICAL VISIT:  It is important to rule out any other underlying potential causes.  Aneurysm’s, thunderclap headaches, and slipped discs may be potential causes for similar symptoms and must be ruled out.  If it is an exertion headache, physicians may recommend rest, plenty of fluids and ibuprofen taken every 4 – 6 hours daily to help with the swelling of the meninges.  Or, they may recommend something else which is why it is important to consult the physician.
  3. REST 1 WEEK:  The initial rest phase should be a complete week of total rest from all physical activity, including practices, strength training, cardio, as well as recreational and competitive activities.

If steps 1 – 3 are done without any interruptions, then the headache should subside and the head should feel normal after 1 week.  However, the body is still not ready at this point for pre-headache performance.  At this point, download the A.P.E.X. app and begin the INCEPTION workout progression designed by me specifically for recovery from exertion headaches.   Over the last decade I have fine tuned this program to incorporate the correct volume, introducing compound and lower body movements at the appropriate time, allowing for the highest percentage of full recovery within a 2 month window.  Here are some guidelines for building back up to pre-headache performance:

  1. PHASE 1 (2 WEEKS):  Take two weeks off from any lower body exercises, performing only upper body exercises at 50 – 75% of your pre-headache weight.  By the end of the two weeks, weight should be approaching pre-workout level.  Introduce light cardio, no more than 70% of your Maximum Target Heart Rate (220-Age), for no more than 20 minutes.
  2. PHASE 2 (2 WEEKS):  Introduce single-joint, isolateral leg exercises to the upper body strength program.  This includes leg extensions, leg curls, hip adduction and abduction.  This allows for strength maintenance without loading the frame. Attempting to do compound leg movements such as squats, leg press, or deadlifts prematurely can cause a flair-up of the meninges and another full-blown exertion headache.  Begin increasing intensity of cardiovascular training slowly during this phase.
  3. PHASE 3 (4 WEEKS):  Begin introducing compound leg movements at 50% OF PRE-HEADACHE WEIGHT.  Slowly add back volume and weight each workout.  Begin pushing the cardiovascular system.

If at any point during this recovery plan an exertion headache occurs, then go back to step one which was STOP.  Repeat with physician visit, rest, and slow recovery.  It is important to note that while 2 months of recovery does seem like a long time, these headaches can linger for over 6 months if the body is not allowed to heal.  2 months of strategic recovery is better than 6 months of bull-headed attempts to push through it.


Since the original post of this article in 2011, and my original post back in 2007, CrossFit has exploded in popularity and has become a huge part of the fitness culture.  WOD’s, CrossFit Games, and CrossFit Gyms have saturated the fitness world internationally.  The reason I mention this because we have noticed a gradual climb in emails, hits, and posts related to exertion headaches coming from CrossFitters.  None of our A.P.E.X. Coaches are CrossFit Certified, A.P.E.X. is not affiliated with CrossFit in any formal way at this point; however, we are all here to train at a high level and I have a tremendous respect for any athlete willing to push themselves hard enough to cause an exertion headache.  Here are some things to consider as a CrossFitter as it relates to exertion headaches:

  1. OLYMPIC MOVEMENTS:  CrossFit incorporates big, compound, technical movements such as snatches, power cleans, jerks, deadlifts and squats
  2. VALSALVA MANEUVER:  Holding your breath can help protect your spine during Olympic movements by creating thoracic pressure, helping your abdominal wall create a stable core
  3. SUPER-SETS:  CrossFit workouts, in general, combine big movements with cardio movements, or big movements with other big movements
  4. NO REST:  CrossFit workouts tend to omit rest between exercises, thus heart rate and blood pressure steadily climb, also leaving no time for water consumption during the workout
  5. COMPETITION:  Competition can help by tapping into adrenaline, resiliency, and a never-quit attitude that can mask pain

Big movements that put weight on your frame cause a spike in blood pressure.  Holding your breath to improve posture during big movements also causes additional spike in blood pressure.  Doing multiple exercises back-to-back without rest causes an additional spike in blood pressure, but mainly an increase in heart rate.  An increase in both heart rate and blood pressure, in a competitive setting, while not being able to calm down or drink water, can lead to an exertion headache.  It will not be early in the workout when you are calm, energetic, and focused, but towards the end when blood pressure and heart rate are peaking out, and your trying to overcompensate to finish the workout by holding your breath as your core fatigues.

CrossFit philosophy dictates that variables 1, 3, 4 and 5 are part of what makes CrossFit workouts intense, and that will not change.  Many people have successfully completed WOD’s without causing an exertion headache; therefore, CrossFit workouts do not inherently cause exertion headaches.  The key to preventing an exertion headache during bouts of intense exercise is coming into the workout rested, hydrated, and mentally focused.  During the workout, you must maintain a good breathing cadence, making sure to exhale during the positive phase, and inhale during the negative phase of the movement.  Late in the workouts when your blood pressure and heart rate are climbing, you must remain calm and focused, regulate your breathing, and concentrating on good body mechanics.  If you do these things, you will be able to perform CrossFit style training free from exertion headaches.

If you do experience an exertion headache during a CrossFit workout, here is the recommended recovery timeline to get back to performing WOD’s at 100% pre-headache performance levels.

  1. STOP:  Once an exertion headache occurs, STOP. Do not attempt to push through the rest of the training session, it will only worsen the headache and the duration of symptoms.
  2. MEDICAL VISIT:  It is important to rule out any other underlying potential causes.  Aneurysm’s, thunderclap headaches, and slipped discs may be potential causes for similar symptoms and must be ruled out.  If it is an exertion headache, physicians may recommend rest, plenty of fluids and ibuprofen taken every 4 – 6 hours daily to help with the swelling of the meninges.  Or, they may recommend something else which is why it is important to consult the physician.
  3. REST 1 WEEK:  The initial rest phase should be a complete week of total rest from all physical activity, including practices, strength training, cardio, as well as recreational and competitive activities.

If steps 1 – 3 are done without any interruptions, then the headache should subside and the head should feel normal after 1 week.  However, the body is still not ready at this point for pre-headache performance.  Here are some guidelines for building back up to pre-headache performance:

  1. PHASE 1 (2 WEEKS):  Focus on cardiovascular conditioning, introduce light cardio, no more than 70% of your Maximum Target Heart Rate (220-Age), for no more than 20 minutes.  Jogging, running, swimming, and hiking are the types of cardio to do during phase 1.
  2. PHASE 2 (2 WEEKS): Begin pushing your cardiovascular system to closer to 90% of your Maximum Target Heart Rate, introducing rowing and other body-weight exercises (burpees, air squats, vertical jumps, lunges, jumping jacks, etc.).  There are “No Equipment” CrossFit workouts that you can test yourself on, seeing how well you can handle intensity before adding in weights.
  3. PHASE 3 (4 WEEKS): Week 1, do WOD’s at 50% of pre-headache WEIGHT and TOTAL VOLUME.  Week 2, do WOD’s at 50% of pre-headache weight, but normal VOLUME.  Week 3, up the weight to 75% of pre-headache weight.  Week 4, attempt with caution, pre-headache weights.

During PHASE 1 and PHASE 2, focus on hydration, breathing, and sleep, and listen to your body.  If you feel like a flair-up may happen, STOP.  The key is getting through PHASE 1 and 2 without a headache while performing at a high level.  Before moving into PHASE 3, you should be dominating body weight WOD’s without any fear of a headache.  For PHASE 3, use the following example for clarification.

EXAMPLE:  WOD – 10 rounds, 10 snatches @ 100 kilos / 30 seconds of speed rope

  1. PHASE 3, WEEK 1:  5 rounds, 10 snatches @ 50 kilos / 30 seconds of speed rope (50% WEIGHT & VOLUME)
  2. PHASE 3, WEEK 2: 10 rounds, 10 snatches @ 50 kilos / 30 seconds of speed rope (50% WEIGHT)
  3. PHASE 3, WEEK 3: 10 rounds, 10 snatches @ 75 kilos / 30 seconds of speed rope (75% WEIGHT)
  4. PHASE 3, WEEK 4: 10 rounds, 10 snatches @ 100 kilos / 30 seconds of speed rope (100% WEIGHT)

The key is to slowly re-introduce weight while under stress.  PHASES 1 and 2 should have prepared your blood vessels for the increase of heart rate, but the spike in blood pressure comes with additional weight on your frame.  Remember, if at any point you experience an exertion headache, you are back to STOP, a MEDICAL VISIT, and 1 FULL WEEK OF REST, so don’t try to skip ahead, it will only delay your full recovery.

FINAL thought

Those of us that have experienced exertion headaches are like pit bulls. We have a high pain tolerance, we push ourselves beyond normal limits, and we are stubborn as hell if we are told to take some time off for any injury, especially one that doesn’t involve a torn muscle or a broken bone.  We all believe we are the exception, and that we can heal like Wolverine.  Remember, an EXERTION HEADACHE is an INJURY TO THE BRAIN. If not taken seriously, it won’t go away and can become worse. Just like any other injury, certain steps must be taken to transition the body back to a high performance level again. So from one pit bull to another, please take the next 2 months to slowly recover and get back to pre-headache performance levels.  If you think you are the exception, you’re not.  Hopefully you find this article to be helpful. If you have any questions, email me at You can also find other helpful articles on our website at Thanks!

Nick Ryan, CSCS

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  • derra

    Hi @apexllc:disqus patiently awaiting a response from you,
    ps hope you enjoyed the holidays

  • Nick Ryan

    It may not be an exertion headache from holding your breath while swimming. Let me know if you are still having headaches, but I’d imagine things are back to normal for you by now. Sorry for the late response, been with family over the holidays.

  • Nick Ryan


    The reason I don’t push anyone towards Aspirin or blood thinners period is because with exertion headaches, the worst case scenario is that you have an aneurysm, so having a blood thinner could expedite death via brain bleed. There is no amount of medication that can speed up sensitive meninges. Ibuprofen for swelling, water, rest and time. I realize you can’t take time off, but this will force you to take time off, otherwise it will linger for years of sub-maximal performance…

  • Felipe

    Thanks! Happened to me yesterday for the second time after a year. Pushing myself beyond my limits when doing squats, again… Is it good to take aspirine to make your blood thinner as a Pre workout? I cant take time off

  • Steven Welford

    thanks Nick, i have deleted my post to save confusion. Well done & good luck with this!! looks like you’ve helped & helping a lot of people. Steve.

  • derra

    No Probs, Ive recently had a flare up lets say roughly 3 weeks ago since then ive stopped going to the gym and doing any exercise however ive had minor problems sleeping mainly due to consciously worrying about it and have been tkaing unisom/doxylamine succinate nightly to help encourage more deep sleep,,,,could this be a culprit in delaying the process? also ive gotten several adjustments done with a chiropractor so i have more less ruled out an alignment issue as being the cause.
    Im hoping to recommence the gym in about 2 weeks time can you suggest anything other than taking ibuprofen to maximize the recovery process for the next few weeks? should i fully abstain from cardio such as an hour football practice and no sexual activity including masturbation etc should i really go as far as that? im willing to do all it takes this time around.
    Its frustrating waking up with dull pain behind both eyes that dont respond to ibruprofen whatsoever Please God i will overcome this shortly with the help of you and others here


  • Nick Ryan


    We have switched clients recently and some older formats did not import. What can I do to help?

  • derra

    Hi @apexllc:disqus why has my comment been deleted???

  • Nick Ryan


    I’m familiar with the Buteyko Technique, essentially tensing all muscles and then exhaling to relax. It can help with essentially forcing CO2 out of the body. Unfortunately this is counterproductive for folks dealing with exertion headaches, because the very act of forcibly flexing all muscles in your body will actually cause an acute spike in blood pressure, and could push sensitive blood vessels in the skull over the edge, potentially leading to a fatal aneurysm. Exertion Headaches are a beast of their own. I appreciate the brainstorming though, but in this case, it could do more harm than good.

  • Steven Welford

    Hi Nick, thank you so much for this!!. i’m a part time circus entertainer and have noticed a steady increase in the
    dull headaches over past 10yrs (yes fog, yes neck positions) and had my 1st two exertion headaches last year after Show finale’s… I’m 49yrs old and need to change how i do things. Being a pit bull & an alchemist (always want to solve my own problems before going to the Doc) I’ve found a way to relieve the dull Headaches with INSTANT RELIEF. When this started i always got ‘Monday headaches’. I’d do activity at weekends: gardening, sport with the kids etc and did a sit down job during the week. After trying all sorts, I eventually found an article on ‘Buteyko technique’ describing Oxygen/Carbon dioxide exchange that helps Asthma and headaches. Noticing a link i wondered if Carbon dioxide was being retained in my muscles after the weekends activities and not going anywhere on Mondays. So when i felt the dull headache coming (around lunch time) & still do, I GENTLY TENSE MY WHOLE BODY for ~5 seconds, stop, then notice increase in breathing but its mainly ‘sighing’ (Carbon dioxide release) & there’s an instantaneous relief of the headache (DULL HEADACHE ONLY!!). Only thing is, one has to do this again in ½-1hrs time depending on severity. I don’t know how this effects the Blood vessels/meninges but wondering if it’s related to the relief one gets after vomiting??. Be careful doing this in public, people may think you’re taking a dump right in the middle of the office!!!. i’ll be interested in anybody’s opinion… Thanks SteveW

  • GradGuy

    Hi Nick, I suffered an exertion headache approximately 11 days ago with minor flare ups 6 days ago and today. My question does not revolve around the pain as much as the fogginess that has been nonstop since the incident. How long until this goes away, and is there any way to speed up the process to clear the fog? This is awful as a graduate student.


  • II

    Hello Nick,
    I’m 42 and in decent cardiovascular shape, though I don’t really work out at all usually. I’ve started getting headaches from doing as few as 15 or 20 pushups and nothing else. I start to feel it as I’m doing the pushups and then stop immediately.

    It seems like these symptoms would qualify as an exertion headache, though it’s nothing too intense or grenade like as others have described, more of a sudden generalized tension in the brain and some temple throbbing. It starts to subside after an hour or so, and is completely gone by 3 or 4. This has happened about 5 times in the last couple weeks (before i knew you were supposed to stop completely if you have these symptoms). I also tried taking a couple Aleve prophylactically about an hour before I did pushups, and that seemed to work to prevent the trigger.

    I guess my question is– is there such a thing as a mild version of the exertion headache (small intensity and very short duration) or is this more of a warning that if I tried doing heavy squats or one of the typical triggers that people describe below, I would likely trigger the real deal? From the descriptions listed, I’d really like to avoid the apparent major life event that a true long term exertion headache entails.

  • Santa-san

    I just had a flare-up after being ok for four months. Damn it! And I was just doing pull-downs . Seems I need to work on the Conditioning part (?). I thought/think I have pretty good stamina, since I go fo a couple of runs every week. Was it the water bit? I don’t want to gulp down litres of water before going to the gym. I wasn’t thirsty at all when I got to the gym today. This is BS. I hate being weak like this. I have severe problems sleeping, could that be it?

  • Perry Brashear

    Hey Jean I have been taking Curcumin to combat inflammation with good results. May want to give it a look as an alternative to ibuprofen. This allows me to take ibuprofen a lot less now but I can combine it when I really need some extra relief.

  • Perry Brashear

    I wanted to add something that maybe will help others as well. This info helped me a lot so I hope to contribute back to anyone else who may notice this. I was/am and avid caffeine drinker. In order to give my blood pressure a rest I cut back on coffee. Down to about a single large per day. This also caused me to notice that iced drinks tended to exacerbate symptoms. Warm drinks tended to alleviate. So overall cutting out iced drinks seemed to really help.

    Also don’t go too cold turkey on the coffee like I initially did. That just causes more headaches!

  • Eric


    This article hit the spot. I experienced this about 8 years ago and was just a young college kid. I tried to fight through it then and eventually saw my family doctor a couple times and did a CT scan which didn’t show anything, so his only suggestion was to take a rest. Unfortunately, I continued to work through it and it lasted about 6 months and eventually went away. Well 8 years later I just experienced it again but apparently haven’t gotten any smarter about working out and am victim to your conclusion in this article. I was trying to work in front squats on a new routine and on the 5th and final set felt it hit. I of course fought through it and finished the workout and continued to work out for the last 3 days until I found this article. While I hate taking a day off let alone a couple weeks and then also the idea of a 2 month recovery sounds awful, I am going to do it as I know its the right thing to do. Since I didn’t follow the first step will that prolong how long I should completely rest before starting your program? Thanks for your advice and saving me a $500 trip to a headache specialist that I had set up for next week.

  • Polio Askal

    hi nick..i got this pain around my head and my neck,sometimes on my temple after biking for just only 30mins..and its almost 3 days now and the pain is still there… what should i do?

  • Jean Henri Pinchand

    Thanks for the info .
    I begin getting exertion headaches shortly after achieving a new 3RM on my deadlift followed by sex several times the following day. It’s hard to pinpoint where it started – I’m thinking the deadlifts. Anyway, I have had it for 2 weeks and done the odd training session where all of them have ended early (because of headache) I’m also recovering from gastritis (which seems to have mostly passed) from excessive use of NSAID’s (so I’m not sure I can use any anti-inflammatory drugs. Given that I am still getting the headaches, I am going to take a break from the weight room SO I was wondering will be I be ok without the ibuprofen ?

  • scramjetuk

    Great info, thanks! Just got to day 3 of training with background headache after getting an explosive one during first session back (towards the end of a circuit training session in the pressups). I’ll take your advice. Thankyou.

  • John

    Ok, so I’m into my 9th rest day. Headache and neck pain is around 95-98% gone. Foggy head is gone. Glad, because those horror stories of having a small headache for weeks/months was freaking me out a bit. Going to keep resting and taking ibuprofen. Will check back in after my rest period is over and I start working up to working out again.

  • John

    Thanks for replying, Nick. Yeah, I’m going to baby the crap out of it. I’ve dealt with various physical issues all year, so this is just the icing on the shit cake I guess. Definitely don’t want to trigger that awful head grenade again.

  • Nick Ryan


    My apologies if you are getting 2 responses from me. Switching over on our web format, so may have some redundancy.

    Anything that increases heart rate or blood pressure should be avoided during the first 2 weeks. This includes sex. After the first 2 weeks, have an honest conversation with your partner and let them know that sex may be cut short if a headache creeps in. If you give yourself 2 weeks of intentional healing, normal sexual activities can resume for most people after the first 2 weeks.

  • Nick Ryan


    When you meet with your doctor, if all is clear and good with brain scans, I would get a referral for a chiropractor. With your blood pressure being that low, and with pain on bending/standing, and the location behind the eyes/neck, you may have a cervical alignment issue contributing to the headaches. Keep me posted, here to help.

  • Nick Ryan

    That’s not a bad idea to give it another week. Once you do start training again, take things very slow, and don’t be frustrated if you don’t finish a workout. It’s better to get in a little bit of easy work and walk away before a headache hits than to do too much too soon and restart the entire clock.

  • John

    Alright so it’s a few days later. The diminished headache is still present (but not as bad as it was that first day or two). Still very sore neck (never gets this sore from working out). Mostly clear-headed, but when I’m hot and tired the foggy mind returns. Obviously, I definitely still need lots of rest. Staying hydrated and keeping the ibuprofen down. I’ve decided I may take 3 weeks off instead of 2, just to be sure I’ve let it fully heal. Will check in in a week or so.

  • Duane Dean

    So 4 days ago I was doing my normal leg routine. I got what I thought was a sinus headache, due to the weather being screwed up. So I pushed through 3 more days of workouts after until yesterday. Cardio was ok…. but then once I started lifting a lot of pressure was in my head, like a vice on the back of my head…… every day got more painful. It feels like when you go too deep under water and your ears pop and you can feel the pressure in your head. Then I thought my pre-workout was causing problems, as I still use a DMAA supplement, which can raise BP. I took my BP and it was 102/67 with a BPM of 56. That ruled out that problem. Now it hurts when I bend down, or stand up from sitting for a period of time, sit up in bed. Intense pressure on the back of my neck and behind my eyes. It has now caused light sensitivity if I stare too long at a computer screen or phone. I am now dehydrated, with a constant pressure headache. I just now searched and found this page. I am going to make a doc appointment today hopefully to rule out those more serious issues of aneurysm. Now this has me kind of nervous. Also experiencing mental fogginess that I thought was from my recent lack of sleep. Hope everything turns out ok. Thanks for the article.

  • John

    So it’s the next day and I just wanted to report my headache has lessened about 30-50%. I’ve noticed that when I’ve exerted myself a bit doing random things that I get a slight throb back there inside the skull. Still a little hazy mentally. The ibuprofen really doesn’t seem to affect the headache at all (and I realize it’s more for swelling anyway). The headache itself isn’t bad, just a slight dull ache that goes away for the most part when I’m relaxed and not moving. I probably have the same hope as others, that this awful malady will go away sooner than later.

  • John,

    You are absolutely right and have a solid attitude going into the process. Let me know if you need anything.

  • John

    So this is my newest hurdle in my quest for excellence, eh? Yeah, this happened to me a couple of days ago doing squats. Intense pain in the back of my head where the neck joins. Had to lay down for a few minutes, and now I have the foggy head/low headache in same spot/sore neck and shoulders. Super appreciative of this website. So today is day one of my two week rest period on ibuprofen. I’ll check back and give you an update as to my condition. Frustrating, but I figure you just have to learn from it, focus on recovery, press on (tentatively).

  • Giang,

    The first 2 weeks are really critical to recovery from an exertion headache. Doing too much too soon can cause a flair up, and restart the entire recovery timeline. Anything that increases heart rate and blood pressure can cause a flair-up, which includes sex. To ensure a swift recovery, it is best to take a couple weeks off. Talk to your partner and let them know what you are dealing with, have them read the article as well, and feel free to contact me with any questions. I’m here to help.

  • Derra,

    4-out-of-20 pain should be a safe place to begin easy/mild cardio. As far as the “hot blood sensation goes,” that is not felt by everyone, but I’ve heard of it happening. Basically your blood vessels are dilated in extremities, thus causing more heat to be carried away from your core, causing the hot sensation in fingertips. The comments should be visible now.

  • Giang

    Hi Nick,

    I really appreciate about your information. I just experienced exertion headache today and found your article. I also digged the internet and found something like: we should take complete rest, stay away from any physical activities that could make our heart rate high included sex. I am wondering if it’s true Nick? No sex for 1 week is not a big deal to me, just be curious.

  • Derra

    Hi Nick…can i train with the foggy 3/4 out of 20 sensation….and also is it normal to have random hot blood sensations in the tips of fingers like blood is boiling lasts for a few seconds only….i cannot see any more of the comments anymore also

  • Chevon,

    I’m glad the article provided comfort and clarity, and that you are giving yourself the proper rest to recover. That’s the hardest part.

    Yes, there is a chance you will get another exertion headache and that an argument can be made that you will be at an increased risk because you’ve had one already. No, your brain is not internal bruised now, so it will not be bruised later. What happened is a forced dilation on a blood vessel in your head that put pressure on the meninges, leaving them ultra sensitive. Even after the blood vessel heals, the meninges will remain sensitive, causing the foggy sensation and the increased likelihood of another flair-up during the year following the initial headache. Yes, it is possible for arteries in the head to burst, which is known as an aneurysm or to a less extent, a thunderclap headache. Both of these can lead to death, which is why I recommend anyone with exertion headache symptoms to see a doctor to rule these out, because they can be fatal. If the doctor says all is normal, you have ruled out the worst case scenario and can move forward with the exertion headache recovery plan.

    All that being said, I experienced a series of exertion headaches in my early 20’s (which is why I have all this dialed into a science), and am now 31 and haven’t had an exertion headache since and am stronger than I was back then. I use my own app to train, currently doing the IRON LEGEND progression and am halfway into BLOOD BATH, and am smart about sleep, hydration, and nutrition BEFORE I train, as well as body position and breathing WHILE I train. I would encourage you to very cautiously begin INCEPTION, it is a workout progression I designed specifically for exertion headache recovery. While you are easing back into training, read up on some of the articles I’ve written about Proper Breathing, the CNS, and Advanced Overloads. Once you begin to see the big picture, you’ll get more out of the app workouts and can train at a high level while avoiding exertion headaches in the future. I’m here to answer questions too, so don’t be afraid to ask questions. I love to talk shop!

    Keep us posted on your recovery and let me know if there is anything more I can do to help.