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  1. #1
    Nighttime Rider
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    Headache after heavy exertion.

    It is not uncommon that I get a headache after I ride. Sometimes it's a real doozy.
    I've ruled out sunlight, high temperatures, and dehydration.

    I'm really not sure what causes it, but it's really annoying.

    Any advice? Pleeeze?

    CE

  2. #2
    Senior Member
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    Allergies. Sinus headache. My buddy gets 'em.
    Specialized Roubaix SL4 Disc, Cannondale T2000 (touring), Stumpjumper M5 (Mtn - hardtail), Cannondale Rize4 (Mtn - full susp)

  3. #3
    primum non nocere Puppypaws's Avatar
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    There are a zillion causes for headache:

    High bloodpressure
    arthritis in the neck
    familial tendency to migraine
    sinuses
    hypoglycemia or hyperglycemia
    spinal fluid leak
    arnold chiari malformation
    subdural hematoma
    other mass lesions.
    ....easy things first, check your blood pressure.
    (neurologist)

  4. #4
    primum non nocere Puppypaws's Avatar
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    oh, i forgot to mention "benign exertional headache" (similar to benign coital headache) thats what we call it when we've ruled out all the dangerous causes.
    Sometimes a nonsteroidal anti-inflammatory is used before the planned exercise, or a betablocker.

  5. #5
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    I get those I find that if I drink gatorade and some cliff shots I don't get them as bad. but if it's a really hot day and I'm over heated I still get some hay makers.

  6. #6
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    If you really are riding hard (like short sprints at 100%), it could be your breathing. Although I have not had a headache from riding, I have gotten one from weight lifting if I hold my breath during portions of the rep.

    Dave

  7. #7
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    For some people (including myself) who suffer migraines, vigorous exercise can be a trigger. In my case the headache starts several hours (up to 6) after finishing.

    In my case hydration, stretching, massage, electrolytes etc. have had no positive effect. It is not the most common migraine trigger but it is definitely one of them (as told to me by my neurologist who is head of the university/teaching hospital headache clinic). I don't get them all the time, but I have noticed throughtout my life that headaches after intense exercise were quite common for me. The migraines started only about 3 or 4 years ago (might of had them before but wasn't something that bothered me much.)

    Migraine is a different class of headache from others and and has differnet criteria for a diagnosis.

    Any form of alcohol is another trigger for me. That I have pretty much given up (not happy about it mind you) but I refuse to stop my bike and spinning workouts.

    Your headaches may not be migraine, just thought I would pass this info on to you.

  8. #8
    Senior Member z_hammer's Avatar
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    I sometimes get the same really bad headaches, my problem is low blood sugar or hypoglycemia as puppypaws mentioned above. Your doctor can check for this but you probably have to fast for 12 hours before they can do the test. Do you find you get similar headaches if you skip a meal, like lunch for example? I recently switched from Gatoraid (half water) to Powerbar endurance and found that I was getting headaches during my ride. I added just a little lemonade mix, 1/3 of the power bar scoop per 24 oz. and it fixed my problem.

    But getting it checked out by the doctor is the safest thing.

  9. #9
    primum non nocere Puppypaws's Avatar
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    Being an obsessive compulsive neurologist, I always get a MRI of the brain on my patients with exertional headaches. If it is normal, it gives me and the patient a great deal of peace of mind. I always say, "nobody gives you a medal for not checking the MRI."
    You might see if you can get your blood pressure checked after your ride, when you get your headache.
    Rising or falling sugar levels can trigger headaches....there are glucometers that diabetics use that can check the sugar level. Perhaps a friend has one.
    The posture of a road cyclist's head relative to his neck is extreme extension...so that can set off headaches for some.
    I really do suggest getting it checked out. If it all is ok, then 2 advil and some mountain dew (sugar and caffeine) before the ride might help.
    Its good that you have a doc and have had a good physical. Its nice to have a relationship established so you can go to them with concerns that come up.

  10. #10
    Wanna race? goldbam's Avatar
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    Quote Originally Posted by Puppypaws
    There are a zillion causes for headache:

    High bloodpressure
    arthritis in the neck
    familial tendency to migraine
    sinuses
    hypoglycemia or hyperglycemia
    spinal fluid leak
    arnold chiari malformation
    subdural hematoma
    other mass lesions.
    ....easy things first, check your blood pressure.
    (neurologist)
    This is true, but we are talking about a headache that is triggered after excersise. I would guess that it is most likely allergy related. I get them all the time. You should be asking your doctor though if they are to the point where you can't take it anymore.

  11. #11
    It's as easy as riding a dannwilliams's Avatar
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    For me it is getting food and liquid into mysystem BEFORE I start. The first long group ride I did I wound up witha serious migraine causing me to miss work the next day. The folks at the local bike shop advised getting a litre or so of liquid and something light to eat up to an hour before start of ride and have not experienced since.

  12. #12
    Senior Member Metro's Avatar
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    Quote Originally Posted by Puppypaws
    There are a zillion causes for headache:

    (neurologist)
    This is one of them......(Make that "The Naked City")

  13. #13
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    Puppypaws I have one question for you about exertional headaches.

    My understanding is that the ones you refer to as benign begin fairly soon after termination of the exercise. Would the same hold true to headaches triggered by exercise (biking) due to high/low blood sugar, neck extension, etc? or could those come on hours later as well?

    My neurologist is pretty sure mine are migraines (I started taking preventative medication for them about 8 months ago with mixed results).

    If you don't mind me asking I do have one question with regards to exercise triggered migraines and preventative medication.

    My 1st attempt at using daily a preventative was a low dose beta blocker (nadolol). I started at 20mg daily and went to 40mg then back to 20mg. It worked pretty well at the beginning, but I found the side effects of lethargy, bad dreams, and always feeling very cold (especially in Canadian winters) to be hard to live with. I worked out hard almost everyday (intense spinning classes) and while the lower HR wasn't too much of a problem, I did not enjoy the feeling of having little or no zip. The feeling cold really bothered me the most, I have never felt that before.

    The then went to a combo of even lower nadolol (10mg) with Candestartin (8/16/27 and even up to 32 mg although I don't think I can take 32 or my BP will be too low. Seeing my family doctor about that one). The Candestartin works ok but not as well as the beta blocker I find.

    With my migraines I can go weeks and ocassionaly months without any headaches, then if I get 1 it begins a cycle of almost daily headaches that can take weeks to break out of. Any form of alcohol seems to be the worst trigger, exercise is not as bad, although if I am in a headache cycle then exercise can be (and often is) a trigger too. I have tried everything to get rid of the headaches when I get them and hate swallowing all that stuff). I have also gone cold turkey and had good results but eventually get into a cycle that I can't take and start back on abortives or pain meds.

    Any thoughts on the beta blockers and other preventatives. I have had MRI's and even though my migraines started late in life (I'm 53 and male) my neurologist is convinced they are migraines.

    If you feel uncomfortable getting into specifics I understand, it's just that my neurologist is not someone who works out and he doesn't seem to understand my addiction to exercise, he hasn't told me to stop, but he tells me there is no need to push yourself. I find that doctors who do not exercise much have that point of view. I have been checked every which way for heart disease and seem to be in the clear.

  14. #14
    Go Titans!! sunninho's Avatar
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    Oh dang, I'm starting to feel a headache come on just from reading this. Sympathy pain... ugh.
    One must live the way one thinks or end up thinking the way one has lived.
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  15. #15
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    I can sometimes get headaches from prolonged exertion, but I have been putting it down to coming off the 'runners high' of being on endorphins and adrenaline for several hours. I get the same effect after a day of skiing or a really intense day at the paintball field. Decent food and plenty of water will help to minimize the effect, but I can usually tell how big a day I had based on how bad the headache is much later. I'm interested that the delay is about what was mentioned earlier of about 4 to 6 hours. I don't think I have a nervous disorder, I always twitch like that.

    The only mad cow around here is my wife!
    He's not the messiah, he's a very naughty boy!

  16. #16
    primum non nocere Puppypaws's Avatar
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    Hi Baad Dawg.
    As long as we are understanding, i'm not trying to be anyone's doctor here...just sharing information...i dont mind sharing some generalities.
    That is super that you have been checked by a neurologist and have the reassurance of a scan. You have a doc-pt relationship so he/she is your doc. That is so important. Internet sharing is no subsitute for a real consultation with a doc.
    Migraines are typically: throbbing, associated with light/sound sensitivity. they can be on one side of the head or the other..sometimes both. sometimes with nausea. Sometimes preceded by vision changes.
    Some people are genetically predisposed. Then it is a question of how many triggers does it take to reach that migraine threshold. Some triggers are: heat, dehydration, fluctuations in blood sugar, nitrates, blue cheese, strong smells, glare, fatigue, sleeping in too late, stress, rises in blood pressure, pain in other areas of the head/neck.
    The purpose of those preventative meds it to raise the migraine threshold so that it takes a lot more to trigger a headache. Neurologists generally recommend preventatives if people are losing 4 days per month with headache. Betablockers are a good starting point, especially if there is a hint of high blood pressure. Calcium channel blockers can be used (verapamil). Recently Topamax has been FDA approved for migraine prevention...and it works pretty well in most cases. Specifically for exercise induced headaches, a dose of indocin is sometimes used an hour before exertion. Indocin is a anti-inflammatory medicine...so it has risk of ulcer, etc. I have some patients that use it before certain ...ummmm....activity...and it has been a blessing to them. On a more natural approach, there have been some studies that suggest magnesium, riboflavin, co-enzyme Q10 can reduce migraines. There is a commercially available supplement called Migrelief that is helpful for some of my patients.
    Re. the temporal pattern..spells of a bad week for headaches...we see that in migraines for some people. I notice it for myself...I have migraines.
    We also see it in "cluster" headaches. Cluster headaches are thought to be a variant of migraine...more common in men (especially men with hazel color eyes), typically extremely severe, onesided headache with watery eye, drooping eyelid on the side of the headache. Last for about 2-3 hours...then subside...only to come back the next day. They are strongly triggered by alcohol. They are called cluster, because the attacks come in clusters...daily for a few weeks, then they subside for perhaps a year or two. We use verapamil for those.
    "Geeks should be revered"

  17. #17
    primum non nocere Puppypaws's Avatar
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    What neurologists refer to as benign exertional headaches or benign coital headaches are generally during or immediately after the activity.
    I'm not sure about ones several hours later. No one has ever asked me that before.

    Many people get headaches just from being out in the sun and wind a little too long.

    As I mentioned above, I always "work up" exercise or coital headaches. Though it is uncommon, they can be cause by some structural issues that can be serious and treatable. I dont want to scare people, but I dont want people to feel falsely reassured if they've never been checked. Of course, I am obsessive compulsive...and this is just an internet chat.... I think i'll shut up now.
    "Geeks should be revered"

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