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What to Do When a Headache Strikes in the Middle of a Workout

So you’re at the gym in the middle of an intense workout and all of a sudden you get this pulsating headache out of nowhere. The fighter in you says you should ignore it and keep powering through. But the pain is stubborn and doesn’t relent. What’s going on?

Sounds like you’re suffering from an exertion headache—a type of head pain triggered by exercise. Exertion headaches aren’t as well known as migraines or stress headaches. But they can be just as painful, lasting from five minutes to 48 hours and putting a dent in your workout or the rest of your day.

Exertion headaches tend to happen when you’re sweating your hardest; they’re caused by increased pressure on the blood vessels in the brain. They generally occur during strenuous exercise like biking, running, or weightlifting, according to the American Migraine Foundation. Here’s what doctors say you should do if you develop one of these skull throbbers, plus how to keep them from coming back.

Stop and cool down

An exertion headache is your body’s way of telling you it’s being overexerted, so if one strikes, take a break. If it goes away, you can try getting back into your workout—but warm up first. Warming upbefore any type of exercise, strenuous or not, gradually increases your heart rate and gets your blood flowing to prepare your body for activity, which can also ward off exertion headaches.

Find your triggers

Working too hard is the main cause of exertion headaches. But like migraines, this type of headache also has triggers, Clifford Stark, DO, sports medicine specialist in New York City, tells Health. Dehydration, sleep deprivation, blood pressure issues and your food and drink choices (such as chocolate, alcohol, caffeine) could all trigger an exertion headache.

“Exercising in hot, humid conditions or at high altitudes when your body isn’t acclimated yet,” can also bring one on, says Dr. Stark. Erin Manning, MD, assistant attending neurologist at the Hospital for Special Surgery in New York, recommends keeping well-hydrated, eating regularly, and getting enough sleep, then seeing if these changes keep the head pain at bay, she tells Health.

Correct your workout form

Exertion headaches can also be brought on by small mistakes you’re making during your workout, Steven Coppolecchia, physical therapist at Spear Physical Therapy in New York, tells Health. “A lot of times, in particular with lifting but you’ll see it with running as well, people sit with the head sitting far too forward or an arched back,” says Coppolecchia. “I work with patients to correct their posture and that’s going to improve blood flow up to the brain and also reduce some of the muscle tension.”

Try OTC pain meds

“Sometimes over the counter medications like Advil, naproxen, or Tylenol can be helpful for people,” says Dr. Manning. The American Migraine Foundation suggests taking naproxen 30 to 60 minutes before you plan to hit the gym. But it might be a good idea to fill your doctor in on this, since even over-the-counter pain meds can have side effects.

Dr. Manning adds that if OTC pills don’t help or aren’t an option, “sometimes people actually need medication that they take either right before strenuous exercise or regular medication that they take on a daily basis to help prevent these from happening.”

Check in with your doctor

“Anytime you have a severe headache that feels like the worst headache of your life, or something that came on very suddenly, or it causes other symptoms beyond the headache that you’re not used to like visual symptoms, you need medical attention right away because it could be something serious,” says Dr. Stark. If the head pain isn’t quite that bad but it hits you frequently and eliminating triggers doesn’t help, see a physician.

“I would say if this has happened more than a couple of times, then it’s probably a good time to see a doctor,” advises Dr. Manning. You can start with your primary care doctor, or see if you can find a neurologist, headache specialist, or someone who specializes in sports neurology.”