Skip to main content

Advertisement

Log in

Headache in Sports

  • Secondary Headache (K Henry and M Robbins, Section Editors)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Sports- and exercise-related headaches are not unusual. Despite their frequent occurrence in this context, there are little epidemiologic data concerning sports-related headache. The recent attention of concussive injuries and associated post-traumatic headache has renewed interest in the study of those headaches occurring after head trauma; however, any primary headache type can also occur in the setting of contact and/or collision sports. The nonspecific nature of headaches provides unique challenges to clinicians encountering this complaint. It is, therefore, imperative that physicians treating athletes are able to distinguish the various headache types and presentations often seen in this population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Meehan WP. Medical therapies for concussion. Clin Sports Med. 2011;30:115–24.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Adams F. The genuine works of Hippocrates. New York: William Wood; 1886.

    Google Scholar 

  3. Williams SJ, Nukada H. Sport and exercise headache: part 1. Prevalence among university students. Br J Sports Med. 1994;28:90–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. van der Ende-Kastelijn K, Oerlemans W, Goedegebuure S. An online survey of exercise-related headaches among cyclists. Headache. 2012;52:1566–73.

    Article  PubMed  Google Scholar 

  5. Sjaastad O, Bakketeig LS. Exertional headache. I. Vaga study of headache epidemiology. Cephalalgia. 2002;22:784–90.

    Article  CAS  PubMed  Google Scholar 

  6. Williams SJ, Nukada H. Sport and exercise headache: part 2. Diagnosis and classification. Br J Sports Med. 1994;28:96–100.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders, 2nd edition. Cephalalgia. 2004;24:1–160.

    Google Scholar 

  8. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition; (beta version). Cephalalgia. 2013;33:629–808. The ICHD-III (beta) provides further refinements in the classification of primary and secondary headache disorders, allowing for more diagnostic specificity and clarity in clinical practice application.

    Article  Google Scholar 

  9. Meehan WP, d’Hemecourt P, Comstock RD. High school concussion in the 2008-2009 academic years: mechanism, symptoms, and management. Am J Sports Med. 2010;38:2405–9.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Varkey E, Cider A, Carlsson J, et al. Exercise as migraine prophylaxis: a randomized study using relaxation and topiramate as controls. Cephalalgia. 2011;31:1428–38.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Darabaneanu S, Overath CH, Rubin D, et al. Aerobic exercise as a therapy option for migraine: a pilot study. Int J Sports Med. 2011;32:455–60.

    Article  CAS  PubMed  Google Scholar 

  12. Domingues RB, Teixeira AL, Domingues SA. Physical practice is associated with less functional disability in medical students with migraine. Arq Neuropsiquiatr. 2011;69:39–43.

    Article  PubMed  Google Scholar 

  13. Soderberg E, Carlsson J, Stener-Victorin E. Chronic tension-type headache treated with acupuncture, physical training and relaxation training. Between-group differences. Cephalalgia. 2006;26:1320–9.

    Article  CAS  PubMed  Google Scholar 

  14. Andersen LL, Mortensen OS, Zebis MK, et al. Effect of brief daily exercise room headache among adults—with a secondary analysis of a randomized controlled trial. Scand J Work Environ Health. 2011;37:547–50.

    Article  PubMed  Google Scholar 

  15. Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia. 2007;27:394–402.

    Article  CAS  PubMed  Google Scholar 

  16. Rooke ED. Benign exertional headache. Med Clin N Am. 1968;52:801–8.

    CAS  PubMed  Google Scholar 

  17. MacDougall JD, Tuxen D, Sale DG, et al. Arterial blood pressure response to heavy resistance exercise. J Appl Physiol. 1985;58:785–90.

    CAS  PubMed  Google Scholar 

  18. Pascual J, Gonzalez-Mandly A, Martin R, et al. Headaches precipitated by cough, prolonged exercise or sexual activity: a prospective etiological and clinical study. J Headache Pain. 2008;9:259–66.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Doepp F, Valdueza JM, Schreiber SJ. Incompetence of internal jugular valve in patients with primary exertional headache: a risk factor? Cephalalgia. 2007;28:182–5.

    PubMed  Google Scholar 

  20. Halker RB, Vargas BB. Primary exertional headache: updates in the literature. Curr Pain Headache Rep. 2013;17:337. This thorough yet concise overview of primary exertional headache discusses history, clinical features, etiology, and treatment.

    Article  PubMed  Google Scholar 

  21. Thomaides T, Karapanayiotides T, Spantideas A, et al. Are transient increases in blood pressure during the treadmill stress test associated with headache? Cephalalgia. 2006;26:837–42.

    Article  CAS  PubMed  Google Scholar 

  22. Smith ED, Swartzon M, McGrew CA. Headaches in athletes. Curr Sports Med Rep. 2014;13:27–32.

    Article  PubMed  Google Scholar 

  23. Donnet A, Valade D, Houdart E, et al. Primary cough headache, primary exertional headache, and primary headache associated with sexual activity: a clinical and radiological study. Neuroradiology. 2013;55:297–305.

    Article  PubMed  Google Scholar 

  24. Heckman JG, Hilz MJ, Muck-Weymann M, et al. Benign exertional headache/benign sexual headache: a disorder of myogenic cerebrovascular autoregulation? Headache. 1997;37:597–8.

    Article  Google Scholar 

  25. MacGregor A, Frith A. ABC of headache. Oxford: Blackwell Publishing Ltd; 2009. p. 46–50.

    Google Scholar 

  26. Diamond S, Medina JL. Benign exertional headache: successful treatment with indomethacin. Headache. 1979;19:249.

    Google Scholar 

  27. McCrory P. Headaches and exercise. Sports Med. 2000;30:221–9.

    Article  CAS  PubMed  Google Scholar 

  28. Allena M, Rossi P, Tassorelli C, et al. Focus on therapy of the chapter IV headaches: primary cough headache, primary exertional headache, and primary headache associated with sexual activity. J Headache Pain. 2010;11:525–30.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Pascual J. Other primary headache disorders. Neurol Clin. 2009;27:557–71.

    Article  PubMed  Google Scholar 

  30. Hindiyeh NA, Krusz JC, Cowan RP. Does exercise make migraines worse and tension type headaches better? Curr Pain Headache Rep. 2013;17:380. The authors summarize current literature evaluating the effect of exercise on migraine and tension-type headache in an effort to understand the benefits and disadvantages of exercise in these primary headache disorders.

    Article  PubMed  Google Scholar 

  31. American Headache Society. Epidemiology and impact of headache and migraine. 2014. Available at: http://www.americanheadachesociety.org/assets/1/7/NAP_for_Web_-_Epidemiology___Impact_of_Headache___Migraine.pdf.

  32. Lipton RB, Stewart WF, Diamond S, et al. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache. 2001;41:646–57.

    Article  CAS  PubMed  Google Scholar 

  33. Gordon KE, Dooley JM, Wood EP. Is migraine a risk factor for the development of concussion? Br J Sports Med. 2006;40:184–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  34. Schneider KJ, Meeuwisse WH, Kang J, et al. Preseason reports of neck pain, dizziness, and headache as risk factors for concussion in male youth ice hockey players. Clin J Sports Med. 2013;23:267–72.

    Article  Google Scholar 

  35. Kucziynski A, Crawford S, Bodell L, et al. Characteristics of post-traumatic headaches in children following mild traumatic brain injury and their response to treatment: a prospective cohort. Dev Med Child Neurol. 2013;55:636–41.

    Article  Google Scholar 

  36. McIntosh TK, Hayes RL, DeWitt DS, et al. Endogenous opioids may mediate secondary damage after experimental brain injury. Am J Physiol. 1987;253:E565–74.

    CAS  PubMed  Google Scholar 

  37. Packard RC, Ham LP. Pathogenesis of post-traumatic headache and migraine: a common headache pathway? Headache. 1997;37:142–52.

    Article  CAS  PubMed  Google Scholar 

  38. Krymchantowski AV. Headaches due to external compression. Curr Pain Headache Rep. 2010;14:321–4.

    Article  PubMed  Google Scholar 

  39. Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance—United States, 2011. Morbid Mortal Wkly Rep. 2012;61:1–162.

    Google Scholar 

  40. University of Minnesota. Report on health and habits of college students released. Science Daily. 2007. Available at: http://www.sciencedaily.com/releases/2007/11/071115125827.htm.

  41. Evans RW, Couch JR. Orgasm and migraine. Headache. 2001;41:512–4.

    Article  CAS  PubMed  Google Scholar 

  42. Gilkey SJ, Ramadan NM, Aurora TK, et al. Cerebral blood flow in chronic post-traumatic headache. Headache. 1997;37:583–7.

    Article  CAS  PubMed  Google Scholar 

  43. Taylor AR, Bell TK. Slowing of cerebral circulation after concessional head injury: a controlled trial. Lancet. 1966;2:178–80.

    Article  CAS  PubMed  Google Scholar 

  44. Seifert TD, Evans RW. Post-traumatic headache: a review. Curr Pain Headache Rep. 2010;14:292–8.

    Article  PubMed  Google Scholar 

  45. Faux S, Sheedy J. A prospective controlled study in the prevalence of post-traumatic headache following mild traumatic brain injury. Pain Med. 2008;9:1001–11.

    Article  CAS  PubMed  Google Scholar 

  46. Mihalik JP, Stump JE, Collins MW, et al. Post-traumatic migraine characteristics in athletes following sports-related concussion. J Neurosurg. 2005;102:850–5.

    Article  PubMed  Google Scholar 

  47. Register-Mihalik MA, Guskiewicz KM, Mann JD, et al. The effects of headache on clinical measures of neurocognitive function. Clin J Sport Med. 2007;17:282–8.

    Article  PubMed  Google Scholar 

  48. Kontos AP, Elbin RJ, Lau B, et al. Post-traumatic migraine as a predictor of recovery and cognitive impairment after sport-related concussion. Am J Sports Med. 2013;41:1497–504. This cohort study investigates the predictive value of post-traumatic migraine in the recovery after sport-related concussion. Their findings provide further evidence suggesting that PTM is associated with cognitive impairments and protracted recovery from this injury.

    Article  PubMed  Google Scholar 

  49. Lucas S, Hoffman JM, Bell KR, et al. Characterization of headache after traumatic brain injury. Cephalalgia. 2012;32:600–6. This thoughtful study shows that most headaches after TBI may be classified using primary headache criteria. Migraine/probable migraine encompasses the majority of headache following TBI.

    Article  PubMed  Google Scholar 

  50. Gladstone J. From psychoneurosis to ICHD-2: an overview of the state of the art in post-traumatic headache. Headache. 2009;49:1097–111.

    Article  PubMed  Google Scholar 

  51. World Anti-Doping Agency. The world anti-doping code: the 2014 prohibited list, international standard. 2014. Available at: http://www.wada-ama.org/Documents/World_Anti-Doping_Program/WADP-Prohibited-list/2014/WADA-prohibited-list-2014-EN.pdf.

  52. Conidi FX. Sports-related concussion: the role of the headache specialist. Headache. 2012;52 Suppl 1:15–21.

    Article  PubMed  Google Scholar 

  53. Queiroz LP, Rapoport AM. High-altitude headache. Curr Pain Headache Rep. 2007;11:293–6.

    Article  PubMed  Google Scholar 

  54. Cheshire WP. Headache and facial pain in scuba divers. Curr Pain Headache Rep. 2004;8:315–20.

    Article  PubMed  Google Scholar 

  55. Di Fabio R, Vanacore N, Davassi C, et al. Scuba diving is not associated with high prevalence of headache: a cross-sectional study in men. Headache. 2012;52:385–92.

    Article  PubMed  Google Scholar 

  56. Speer MC, Enterline DS, Mehltretter L, et al. Chiari type I malformation with or without syringomyelia: prevalence and genetics. J Genet Couns. 2003;12:297.

    Article  Google Scholar 

  57. Keen ME, Gnatz S. Poster 127: football player with symptomatic Arnold-Chiari malformation: a case report. Arch PMR. 2003;84:E27.

    Google Scholar 

  58. Callaway GH, O’Brien SJ, Tehrany AM. Chiari I malformation and spinal cord injury: cause for concern in contact athletes? Med Sci Sport Exerc. 1996;28:1218–20.

    Article  CAS  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Dr. Tad Seifert declares that he has no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tad Seifert.

Additional information

This article is part of the Topical Collection on Secondary Headache

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Seifert, T. Headache in Sports. Curr Pain Headache Rep 18, 448 (2014). https://doi.org/10.1007/s11916-014-0448-x

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11916-014-0448-x

Keywords

Navigation