Intense weight training can lead to exertional headaches


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During these frigid winter months, athletes take to the weight rooms. They spend their off-season training hard to get ready for the spring, summer and fall sports.

However, some find these intense workouts can lead to the phenomenon of exertional, or weight lifter’s, headaches.

Today, I had the chance to speak with WAKR morning show host Ray Horner about this topic. We discussed the differences between these benign headaches and those that are more significant, and what athletes can do to diminish the onset of exertional headaches.

Below is an audio file and transcript of our discussion.


HORNER: Let’s bring in our good friend, Dr. Joe Congeni, from Sports Medicine Center at Akron Children’s Hospital. Good morning, Joe.

DR. CONGENI: Hey, Ray.

HORNER: How are ya?

DR. CONGENI: I’m good. How ya doing?

HORNER: I’m doing very well — nice and warm in here in my studio. A lot of young athletes spend time in the winter indoors, and I know that’s where you want to go.

Dr. Joe Congeni

Dr. Joe Congeni

DR. CONGENI: Yeah, you know, we don’t see them out a lot this time of year. In winter sports, there isn’t quite the bulk of volume or as many kids playing sports, so you wonder what happened to all these athletes in Ohio and in the colder climates.

What they’re doing this time of year — the spring athletes, the summer athletes, even the fall athletes and the footballers — is they’re in the weight room getting ready to be bigger, stronger, faster.

That’s why we have such great athletes in northeast Ohio. They train hard in the off-season; they train hard in the winter in these little nooks and crannies in these schools. I mean, some have beautiful weight rooms, some have just these little corner rooms, but kids are working out real hard.

A real common complaint that I hear when I go out to the schools, even more than in my office, is gosh, every time I work out I’m starting to get headaches associated with the more aggressive workouts that I’m trying to do.

There’s a phenomenon called exertional headaches, or in some circles it’s called weight lifter’s headache. It’s very, very common this time of year.

Obviously, the first thing parents always ask of me, “How do we know for sure that it’s just this, you know, more benign thing called exertional headache [and not] a more concerning, significant headache of some structural problem?”

Headaches with numbness or weakness on one side of the body, that’s not exertional (weight lifter’s) headaches. That’s one that needs to be checked out.

The first thing [to consider] is kind of the onset. These are usually throbbing-type headaches. They start with exercise and usually start to decrease within 30 minutes of leaving the weight room if they’re the typical exertional or weight lifter’s headache.

The things that would be kind of red flags that you definitely [would] need to see your doctor about and get checked out [are] vomiting with the headache, double vision or blurred vision with the headaches, and headaches that get progressively worse after you’re done working out. Those need checked out.

Headaches with numbness or weakness on one side of the body, that’s not exertional (weight lifter’s) headaches. That’s one that needs to be checked out.

When [kids] get in to be checked, they need to have a blood pressure check, a heart check and a neurologic exam by their doc.

Some of them may have elevated blood pressure over a period of time. We know that when you’re lifting weights, there’s a short-term or transient increase in blood pressure, and there may even be an increase in cerebral blood flow.

But, the fact is that should go away in a short period of time. For some kids, that causes headaches.

But as long as it seems like it’s the rather benign and much, much more common form of exertional headache, there are a few things that your athletes ought to do.

  • No. 1: For a few days or a week or two, back down on the intensity of these workouts. Just cut ‘em in half and back down on the intensity for awhile. See if that helps.
  • No. 2: A short course of Aleve or Advil for 7 days, 10 days, something like that could help, even maybe perhaps before they’re lifting, as long as we make sure it’s not the concerning type of headache.
  • No. 3: Really be careful about the supplement use. All those kids that are in the weight rooms now, a lot of the high school kids, want to take something to get bigger. You know because you’re around the athletes, too. The No. 1 thing they take is whey protein, No. 2 thing is creatine. The hotter, newer one in the last five years is the NO2 or Nitric Oxide.

In order of causing headaches: protein supplements, then even more so creatine and the most is if there’s NO2 in any of their supplements. There seems to be a big dehydrating effect and a big incidence of exertional headaches. So, cut out the supplements for a few weeks.

When they do those two or three things, most times exertional headaches will go away. If not, then they probably ought to see their doc.

HORNER: Alright, great insight as always, Joe. We’ll catch up with you next week.

DR. CONGENI: Okay, Ray. Have a good week. Stay warm.

HORNER: You too. Dr. Joe Congeni from Sports Medicine Center at Akron Children’s Hospital.

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About Dr. Joe Congeni - Director of Sports Medicine

Dr. Joe Congeni is the Director, Sports Medicine; Clinical Co-Director, Center for Orthopedics and Sports Medicine at Akron Children's Hospital. For the past 25 years, Dr. Congeni has been the “go to” source for national and local media looking for information about pediatric sports medicine.

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