Given that women suffer twice as many severe headaches as men, and that physical exertion can contribute to flare-ups, it’s no wonder many female runners are headache prone.
“Most headaches triggered by running or other exercise occur in women who are prone to headaches, like migraines, in general,” says Carrie Dougherty, M.D., a neurologist and headache specialist at MedStar Georgetown University Hospital. In these cases, Dougherty says it’s typically not one factor that causes head pain, but rather a combination of changes to the body.
Fortunately, we can take simple steps to limit these factors’ effects on our nervous system and prevent headaches from interfering with our goals.
Ease Into Physical Activity
“Often women are trying to make the most of their time, so they just walk out the door and start running,” Dougherty says. “But individuals who are prone to migraines [and other headache disorders] are sensitive to changes in their body’s environment, including increases in heart rate, body temperature and/or blood pressure.”
According to Dougherty, one of the best things headache sufferers (migraines or otherwise) can do to reduce the onset of symptoms is to ease into physical activity. Taking the time for a deliberate warm-up (of 10 to 15 minutes, or more if the workout will be particularly intense or long) gives the nervous system a chance to adjust to a state of exertion.
Low blood sugar can contribute to the onset of a headache, so aim to eat small, frequent meals throughout the day to avoid fluctuations in blood sugar levels, suggests Dougherty. Try having a small meal one to two hours before running and a snack within 20 minutes of finishing your run.
Electrolyte imbalances can also upset your nervous system, so if you’re running for longer than an hour and especially in hot weather, consider taking an electrolyte supplement.
Practice Good Alignment
A prolonged forward head position activates the posterior neck muscles, which can aggravate nerves that then transmit pain to the neck and head. Add to this the repetitive pounding of running, and you’ve got a headache in the making.
Pay attention to head and neck alignment throughout your daily routine. If you have a desk job, make sure to set up an ergonomic workstation, take frequent breaks and look up from your computer.
See A Physician
“If you experience severe headaches that are exclusively triggered by exercise, you may be experiencing primary exercise headache, and this warrants further evaluation by a neurologist,” says Dougherty. “Primary exercise headache can be just that—a headache triggered by exercise, but rarely it can be due to a secondary cause like an abnormality of the brain or blood vessels.”
Dougherty also recommends seeing a neurologist if you’re experiencing headaches on a weekly basis or if your symptoms include numbness or weakness.
If your symptoms seem to be related to head position, your doctor may refer you to a physical therapist to work on correcting your alignment and reducing tension.
Chest Down, Head Up
Runners who mistakenly elevate their chest are more prone to a forward head and shoulder posture, as a runner must then bring her head down and forward in order to view her surroundings, says physical therapist Biana Smolich of MedStar Georgetown University Hospital. “Faulty forward head and shoulder posture creates tension in muscles around the neck with referral of pain to different areas around the cranium, manifesting as headache pain,” Smolich says.
Practice the following alignment cues from Smolich while running to help keep your head in good alignment.
First, Correct An Elevated Chest
Relax your belly so your rib cage can come down and sit on your belly. Your ribs should be positioned directly over your hips and not jutting out in front of you. Maintain this rib cage position while bringing your shoulders into a better position so that your shoulder girdle sits upon your rib cage.
Then, Correct Forward Head Position
Elongate the back of your neck (like a turtle drawing into his shell) while simultaneously tucking (retracting) your chin back.