"weightlifter's headache:" migraines from certain workouts--how serious?

In My Humble Opinion
1

I’ve been on a journey of self-improvement that has included getting back in shape after a few years of neglect. I’ve started seeing a new primary care doc re: getting my blood pressure in check (which is down to the normal range now). I’ve made sure I was healthy enough to hit the gym, and I am.

I’ve been going to the gym a few times a week since late May. Things have been going well, and I’ve noticed some gains.

I recently discovered the chin-up assist machine–you sit on your knees on a padded platform and can adjust the level of weight to add (or subtract) to allow you to do chin-ups, with a variety of grip options for different muscle groups.

The first time I did the machine it kicked my ass! My chest, arms and lats were sore in a new way for a few days. I loved it.

I went back the next time and wanted to start on that machine, as I feel like it’s a nice combo to stretch and warm up.

This time, I had a sudden, shooting pain radiate from my left shoulder, up my neck, curving around my head and exploding into a nuclear reaction just above my left eye. I legit thought I was having some kind of brain aneurysm.

I went home and read up online, and I believe it was an “exertion migraine,” also known as a weightlifter’s headache.

I’ve never experienced it before, but it wasn’t a one off thing, either.
I went back to the gym a few days later and avoided that machine, but over the course of my workout I could feel that creeping pain.

That evening, I had my SO explore some knots under my left shoulder blade, and discovered a wicked knot that seems to trigger the pain above my left eye. The headache starts to manifest much more lightly just during normal work (I paint for a living so it’s slightly exertional).

Today, I felt great and I’ve given my body some time off. I’ve been treating my neck and shoulder with hot/cold packs, rubbing/massaging and have loosened that knot up a lot. I thought it would be a great time to work out.

I was doing ok until I tried that stupid chin up machine, and on my 8th rep the shooting pain came on so harshly and suddenly that I nearly fell to the ground. The pain felt so physically impacting over my left eye that my eye started weeping and my sinuses started running–I assume constricting vessels applied an actual “pressure” in there??

I had to immediately leave. Ice, heat and medication has me feeling stable but this dull migraine persists.

Have any of you experienced this?? I am contemplating talking to my doctor, but I don’t want to bog her down with something that a massage might fix. I do have a massage therapist who can treat me next week. I don’t know if it’s ONLY related to that knot in my shoulder or if I need to have a full MRI just to be safe.

You know how this stuff goes–you google the symptoms and it’s either NBD just straining at the gym! ~OR~ it’s a tumor!

My inclination is the knot is exacerbating something that happens to normal people–the exertion migraine–and that particular form of workout triggers it easier than other machines, as it requires a special kind of effort/strain. I’m hopeful I can do other machines/routines and this will have been a weird blip, but I’m concerned enough to get opinions here.

2

I know nothing about “exertion migraines” (I’ve never even heard of such a thing), but if you had described your symptoms without that explanation, I would immediately think that you are irritating the nerves around C1 when you are doing your chin-ups. A physical therapist might be able to locate the root cause of the pain.

3

You should see a physio.

When I saw the headline, I was worried. Weightlifters wear that corset to prevent busting a gut: for the same reason they tighten all their core muscles, while also tightening all their major arm and leg muscles. This gives them a high blood pressure pulse which can cause a brain aneurysm. A bit later, sometimes it kills them.

But you’re doing chin ups. I think you see a physio.

4

Wanted to give more info, as I’ve freaked myself out.

The headache has lingered all day. I have taken Ecedrine which use to help migraines, which I haven’t had in years. And added in a few extra aspirin. I can’t really function like this.

I think it’s akin to a cluster headache. It also sounds slightly like an aneurysm. Both are apparently easy to mistake for each other. But then there’s the 100% sure-fire trigger during chin-ups, so probably not an aneurysm.

I think I might shoot my doctor an email and see what she says…she’s very level headed and won’t have me come in if it’s not a big deal.

5

Here’s how that conversation is likely to go:

dontbesojumpy: Doctor, it hurts when I do that.
doctor: Don’t do that.

Not sure how old you are and it’s not necessarily age related, but it might be. It might also be the case that you are either not fit enough to be doing this exercise, or that you should not be doing it at all due to some anatomical anomaly you have. If you feel you MUST work on your back and lats, try a pull-down row machine instead of an assisted chin-up machine. See if that feels better and build up to chin-ups. Or maybe don’t do them at all.

Anecdotally, I’ve been a gym rat my entire life and chin-ups/pull-ups have been a staple of my routine. I’d become quite good at them over the many years. Just this past year, I managed to cause myself a serious injury that required surgical intervention specifically related to the pull-ups. So I know whereof I speak.

6

I wrote my doctor a message, particularly because I was awoken this morning with that flare of pain above my left eye in the same spot, but without any exertion.

I just sent them a message over the “mychart” access point online. They called within a few minutes and are having me come in first thing in the morning. So I’ll report back I guess.

7

Well? Is it a tumor?

8

Won’t know until after the MRI.

Doctor has referred me to a neurologist and is scheduling “MRI BRAIN WO CONTRAST & MRI ANGIO BRAIN ARTERIAL WO CONTRAST” ASAP (just gotta jump through the insurance hoops)…hoping they’ll have a timetable later today.

She tried to be reassuring that these things usually turn out to be no big deal, but we just have to figure out what is causing it, which apparently is a “secondary exercise/exertional headache”–that is, there’s some underlying cause of the pain. The severity, quick-onset and isolated area attributes knocked my simple explanations down outright. She dismissed any possibility it’s myofascial trigger points, which I was figuring was the problem, since they contributed to migraines some 7 years ago, but no luck. “The body is a series of systems that all tend to affect each other in some way, but this kind of head pain is not related to knots.”

So…for now, I get to try to “not worry” while I await my brain scans. The bottom line seems to be yes, certain actions (such as exercises) can trigger it, but there’s some underlying reason it’s happening. It’s not a regular exercise headache, and doesn’t manifest in any of typical ways.

I’m only allowed to do cardio until we figure out what’s going on. Today’s been fun. :confused:

9

Well, damn. :neutral_face:

Whatever it turns out to be, I hope it’s trivial and easily addressed with no lasting negative impact.

10

What’s the good news?

11

Nurse called really early and they are doing an MRA on the 22nd (they are keeping me in their network for insurance cost reasons and that’s the next nearest appointment. I am on a stand-by list for a quicker appointment if something opens up).

I asked about the regular MRI and she said it was still in the insurance approval pipeline, but they they feel like the angio is going to show what they need to see (vessels–everyone seems to be banking on this being a vascular issue). I get to wait for now.

I’ll update the thread when I know more.

12

Guess who has two thumbs, A1-segment aplasia, but isn’t going to die over it?! THIS GUY!

I saw the neurologist today and they seem pretty certain it’s SUNCT:

Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) is a rare headache disorder characterized by extremely frequent attacks of unilateral head pain and autonomic activation

(bolding was embedded in the cut-and-paste from here).

The MRI (MRA) revealed no sign of aneurysm nor AVM. So it’s not something I’m going to die from or anything like that. The physical “pressure” was helpful in figuring out the relation to the ophthalmic division of the trigeminal nerve, which is why I wince and close my left eye/tear up when under attack.

“A1-segment- is-aplastic” – basically half of my Circle of Willis didn’t form (doc calls it a ‘congenital malformation’ but it is not anything to get worked up over and is probably unrelated). I’ve been cleared to go back to normal strenuous activities including work.

We are starting a preventive medication for now and they are running a battery of blood tests to further winnow down anything more specific.

@QuickSilver wanted to type this out because we had talked before and I owed you an answer.

I’m kind of relieved they actually think they know what was going on. Fully figured a “shrug. Don’t do that anymore and we’ll just see…” Happy they really have a plan of action.

13

In my mind, I thought it was a nerve compression disorder, but in my heart, I was sitting here thinking – he’s GONNA DIE, he’s dead, he’s dead, he’s dead – it’s been 2 weeks since the MRI was scheduled and boy, I’m glad to hear back.

14

Thanks for the update. So glad it’s not a tumor. :wink:

Be well.