Exercise Induced Headaches – A Path Forward?

I found an interesting discussion between Doug McGuff and Drew Baye on YouTube. One of the topics they covered was exercise-induced headaches. This is something I experienced regularly when I did High Intensity Training. It is also the reason that I traded that intensity for more volume at a lower intensity.

Doug McGuff MD Talks with Drew Baye About HIT, Cardio, and EIH

Dr. McGuff explains what causes these headaches in technical terms around the 30-minute mark. The simple version is when the intensity gets high enough, the blood returning to the heart exceeds its capacity – the stretch in the heart. At that point, the blood will “jam up” and rise above the nipple line. And if that happens with enough pressure, it stretches part of the sinuses, which causes the headache.

Something that was not discussed was the role that temperature plays in these headaches. Probably because they both keep their gyms at 61 F, which is about 10 degrees cooler than my gym. I fought for years to get my gym to lower the temperature, but they wouldn’t. I learned that the gym temperature is set for the comfort of the staff and that I was the only one member complaining.

So I stopped complaining and stopped exercising to failure. See my 2013 post: Why I Traded Volume for Intensity at the Glitter Gym. Other gyms, which are less convenient for me, *might* be a few degrees cooler, but not enough to justify the higher cost and commute.

I made this on DALL-E.

2 Tips

The McGuff + Baye discussion did have 2 tips. The first was to save the exercise that is most likely to trigger the headache for last. For me, that was always the leg press. This tip seems obvious in retrospect. If I can pre-fatigue with the other exercises, then even if I get a headache on the last exercise, I can still have a good workout. Plus that fatigue would have the benefit of reducing my intensity a bit.

The second tip was new to me. McGuff explained in detail how increasing neck strength could help deal with the pressure as the blood goes to stretch the sinuses.

I’m probably like most gym patrons, in that I never do strength work on my neck. I don’t even think about it. My gym doesn’t even have a neck machine. Do any modern gyms have one still?

I’m now interested in seeing if building a stronger neck might give me a path back to some of the “go-to-failure” exercises that I had to abandon years ago. I’m heading over to YouTube now. If you have any tips – either on avoiding exercise-induced headaches or building neck strength (without a dedicated machine) drop a comment.


Add yours

  1. The Iron Neck device looks interesting. It’s all over my instagram because Rogan did one of those 10-second unsolicited mentions. It looks legit. And a lot safer than neck bridges or hanging weignts from a strap around your head. It’s a bit expensive though, so maybe you can get your gym to buy one. Separately, I’ve head good success with bands anchored to a door. But I have a weak neck, so I don;t need much resistance.

  2. Neck bridges are pretty good exercise for building strong neck. Also rotating in neck bridges, as some fighters are practicing, is also good choice (can be done on wall for those with weaker neck muscles).
    George Hackenschmidt in his bok The Way to Live also describes Bench press done in neck bridge- but this I would recommend just to hardcore trainees.

  3. @All – I’m going to pass on the Neck Bridge. There is a video on the Athlean X channel explaining the risks.

    Before I drop serious money on an Iron Neck, I’d like to “earn my gear” with a cheaper solution. My gym hasn’t bought anything new in a decade. They barely sweep the floor. Since I only pay $12/month, I can’t complain.

    I might start neck work with a towel. Ease into it.

  4. Bill DeSimone is wary of going overboard on neck training, and due to my injury from neck training over ten years ago, I agree with him.
    Manual resistance might be a viable option, but not to failure…in fact nowhere near. As Bill says, the neck is not really meant to be trained that way. I suspect that not many gyms have neck machines due to the possibility of legal ramifications from incorrect use.
    Apparently Roger Schwab, if I’m not mistaken, only trains neck extension, rather than flexion, this is probably an attempt to combat postural issues brought on by too much screen time.

  5. @Stuart – I think you are correct. There are a lot of downside risks with getting this wrong. And the benefits that I am seeking may still not be accessible in a gym that is still 70 F.

  6. I think folks who participated in wrestling (bridges) or football (neck machine) in high school or college could probably safely pick up neck exercises again later in life.

  7. FYI, all:

    The two aforementioned men are strongly opposed to any traditional cardiovascular conditioning. In few words, the barbell is THE cardio tool.
    This is laughable except for the fact cardiovascular disease is the number 1 killer of people in the United States. These men are misinformed about cardiovascular conditioning and their ideas on cardiovascular conditioning should be dismissed as having no merit.
    Anyone misunderstanding basic cardiovascular conditioning principles such as venous return would obviously be read with several grains of salt in regards to exercise induced headaches. Is it not ironic that these unsupported views as to the causes of exercise induced headaches are not congruent with other knowledgeable experts.

    Not all references are reliable

  8. @Marc – Their view on cardio comes from the work of Ken Hutchins. I haven’t read (or plan to to read) his book, as I would have no way of knowing how credible it is.

    What is your view on exercise induced headaches?

  9. “Their view on cardio comes from the work of Ken Hutchins.”

    Unfortunately, the HiT anti-cardio rhetoric started long before Hutchins. Hutchins’ ilk do not understand cardiovascular physiology. However, Arthur Jones was of the belief that more muscle mass increased endurance. As a side note, he also believed more muscle increased strength and speed. Of course, this is erroneous logic. So the genesis of anti-cardio logic emanated from Nautilus jargon circa 1970’s.

    Exertion induced headaches are most likely due to exertion of unprepared participants. Training to failure, isometrics, and pushing after the movement ceases causes extreme blood pressure increases. Exertional headaches thusly cause dilation of blood vessels to allow more blood flow. The expansion and increased blood pressure create pressure in the skull, which causes the pain.
    Furthermore, the brain’s blood vessels dilate to increas flow to bring in more oxygen and get rid of heat. Blood vessels that are more pliable due to cardiovascular conditioning can help here.

    Finally, the very act of resistance training causes increases in blood pressure and decreased venous return. Decreased venous return hinders cardiac output, thereby decreasing cerebral blood flow. Wonder why exertion headaches cease after intense exercises.


  10. I bought a simple head harness and just walk around with a light weight on it being careful not to make any quick neck movements. (I did this after reading that cultures where woman carry weight on their heads have no osteoporosis. Both of my parents had osteoporosis so this was of interest to me. The one I bought cost less than $20.)

  11. @Marc – Thanks for the explanation.

    @Grubby Halo – Thanks. I’m almost ready to buy one. I’m going to start with hand resistance first.

  12. This is a link to a 3-minute series of neck exercises/stretches; can’t hurt!


  13. @Mike – THanks. I’ll start with a routine like that.

  14. How has the neck training been going? This reminded me of a video Jeff Nippard did on the subject (https://youtu.be/gimeRpdqWQw). He did mentioned that training his neck helped him reduce headaches, but that’s anecdotal. I’m curious about the claims that stronger necks can help with things like concussions, whiplash, head injuries, whether there is research to back it up. Very light training is part of my weekly routine; I use one pound ankle weights and I don’t go crazy.

  15. @zenhobbit – Honestly, I lost interest quickly. Too many things to focus on. I had a big set back in my training, which will the topic of an upcoming post.

  16. MAS: I googled my name about something and a number of your posts came up. Thanks for the good words.
    About neck training: I’ve recently noticed several videos on neck training re race car driving.. the go to exercise seems to be a weighted hold with the neck in normal posture for 5 seconds,, rest 5, repeat, with the trainer taking the weight prior to failure.
    From what I can tell from the biomechanics and sports medicine textbooks I use, there’s some merit to that approach.
    IF you’re going to lift weights with your head. Since I’m not in a collision sport or grappling anymore I personally don’t.
    Best, Bill DeSimone

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.