Headaches revisited

[indysteel]

Hi gang. I've read some past threads on this, but wanted to revisit the issue. Yesterday was the first sunny and warm day in a while, and I had a great 42-mile ride. However, I developed a headache several hours after the ride. To be precise, the ride ended around 2:30 and I got the headache around 9. The same thing frequently happened last year as well.

I tried to stay hydrated yesterday before, during and after the ride. By the look and frequency of my, well, pee, I did a good job with that. I drank both water and a sports drink. I had some Pepsi later, along with more water, too.

I've taken two rounds of sinus medicine and some Advil and Excedrin for good measure. Since none of that has worked, I plan to take my migraine medicine when I get home from work (it was prescribed to treat menstrual-related migraines). I suspect it will help, although it will also more or less put me to sleep. I hate taking it.

So, what gives? I don't typically get the headache until after the ride is over. I wear polarized, dark sunglasses, don't overtighten my helmet or clench my jaw. I don't get headaches from working out in general and I don't get them, if I remember correctly, when I ride in the cold. Obviously, I'm thinking it's a hydration/heat thing. If that's the case, then I guess I need to push even more water/fluids than I thought.

Does anyone else have any thoughts? Could it be some kind of vitamen/mineral deficiency that's made worse when I sweat a lot? I will admit that I've been lax on taking my multi-vitamen of late....

Thanks for your thoughts.

Kate

[GLC1968]

Very timely post.

I too get nasty headaches post-rides but now that you mention it, I haven't had a single one all winter. I was bed-ridden yesterday afternoon after my first hot and fairly long (64 mile) ride yesterday due to head pain. Excedrin did very little to help and that's quite unusual for me. I too am quite adept at remaining well hydrated and while my nutrition was off yesterday, there were no other unusual occurances outside of the exertion and the heat.

I did a little survey/research on a fitness site I belong to last summer and many felt that they were perhaps exertion headaches. These are typically triggered by an elevated HR for extended periods (and only for some people). If this were true, it would certainly explain why they are so prevalent in warmer months as I've noticed that my HR level remains naturally lower on colder rides. The only advice I got was to head them off with medication before they got out of hand. I found that for my longer rides last year, when I had about 1/3 to 1/4 of the distance/time left to ride, I'd take Excedrin. That seemed to keep the pain at bay (and I'd completely forgotten yesterday).

That said, I also have issues with heat rash that I cannot seem to prevent, so it may just be heat-related. I'm a northern girl living in a hot southern environment!

[Eden]

I get headaches from being under hydrated and over hydrated - crazy huh. If I do the 8, 8oz glasses of water a day thing I need to put electrolyte supplement in it. I usually put in 1/2 the dose as recommended for exercise in my regular water.

[BleeckerSt_Girl]

For what it's worth, and this may not apply to anyone else but me:

On Sunday, I went for a 20 mile ride. The Spring sun is getting brighter, and my new helmet does not have a visor like my old helmet from last year did. I wear prescription eyeglasses. I don't have prescription sunglasses or contacts.
I can do stuff easily without my glasses sometimes, shopping, walking around, etc, no problem unless I have to read small stuff closeup or far away.

So, it was sunny Sunday and I decided I didn't want the bright sun in my eyes while riding. I left my presc.glasses at home and just put on some regular $25 sunglasses (polarized). They seemed comfortable and I wasn't squinting or anything, it felt nice! Halfway through the ride though I started getting a nasty pounding headache right behind my left eye. It got worse and worse, and I decided to take off the sunglasses to see if they were causing it. Within 5 minutes the headache was totally gone. Weird. Not wearing those sunglasses again on my bike.

[Chile Pepper]

I also get headaches when I ride. I've been working on relaxing more on the bike, changing positions more often. I suspect, however, that the real problem is my sunglasses. My eyes have always been very sensitive to light and to the curvature of sports glasses. My current glasses are kind of old, so I'm going to try a new pair to see if that helps.

[pooks]

Re: glasses/sunglasses

If you usually wear glasses, you may be straining w/o noticing it, so eyestrain could be part of it. If it's bright, and you don't have on sunglasses, that might influence it. My eyes are sensitive to the light.

Next time your riding, reach up to your neck and feel the tendons. Are they tight and painful? What about your jaw? Are you clenching your jaw shut w/o noticing? That could cause tension headaches.

I have more headaches when it's hot than when it's not, so I don't have any real answers. I'm a fifth-generation Texan and I still can't handle the heat, so while I do believe in evolution, I don't think it's moving very fast in my genes!

[Jones]

I get headaches from riding when it is hot too. This year (we have already had several days in the high 90's) I started taking sudafed before I ride and I think it has helped. In the past I when I have gotten a headache riding I take sudafed, advil and an elctrolite replacement drink and the combo seems to help more often then not.
Jones

[lacyliz]

I, too, have been getting headaches an hour or so after I ride. Personally, I think it's because of the spring - the roads are still dirty and have the salt (or whatever it really is) on them, I'm breathing it in through my nose and into my sinuses- not to mention the dampness in the air. I've chalked it up to that. What has been helping a lot is that I use a saline nasal spray right after I come in from the ride. It has made a difference and I recommend it. It couldn't hurt - and it might help. I don't get headaches like this in the winter or in the summer after, say, May. Those are my .02 .

[Mr. Bloom]

Indy:

After yesterday's 52 mile ride, I had a severe headache (non-migraine) for 8 hours even after taking 3 Aleve. I fully attribute it to sinuses although my nose hardly ran at all on the ride (while Silver's did).

I agree with lacyliz...when I was in Indy last weekend, the roads were still nasty and salty. For me, I have the same symptons even driving in the car with all that stuff flying in the air.

So, IMHO I think it's sinus problems from poor air quality.

[spazzdog]

Indy - it seems like a lot of time passed between your ride ending and the onset of your headache... too much to be a hydration thing I'd think.

I get bad headaches if I'm protein deficient... so if I don't fuel up properly after a long ride (or run back in the day), I get bad headaches hours after.

just my 1/2 a cent...

spazz

[SheFly]

I get these type of headaches with the change in weather - any barometric pressure change will send me reeling. With the spring weather fluctuations (here we've been going from warm and sunny to snow in the span of a couple of days), and the fact that you are starting to ride outdoors more often, could that be the cause?

Could also be as others have said - allergies. Things here are just starting to bloom, and I KNOW that over the next few weeks not only will I have headaches, I will also be reaching for my inhaler.

SheFly

[Wahine]

Indy - can you tell me where your headaches are or where they start? Are they all over your head or do they start at the temples or base of your skull?

When you get your headaches do they seem to be inside your skull or does it seem like your scalp aches?

Is there a word you can use to describe the pain, (for eg: throbbing, stabbing, dull toothachy pain)?

Do you get any other symptoms, (changes in vision, tingling, dizziness or vertigo)?

I might be able to help more if you can answer some of these questions. Or I might not be able to help at all.

[indysteel]

Indy - can you tell me where your headaches are or where they start? Are they all over your head or do they start at the temples or base of your skull?

When you get your headaches do they seem to be inside your skull or does it seem like your scalp aches?

Is there a word you can use to describe the pain, (for eg: throbbing, stabbing, dull toothachy pain)?

Do you get any other symptoms, (changes in vision, tingling, dizziness or vertigo)?

I might be able to help more if you can answer some of these questions. Or I might not be able to help at all.

Wahine, yesterday's headache was primarily concentrated around my left eye and left upper sinus. I would describe it as throbbing at its worst and a dull ache at its best. Given its location, I initially thought that it was sinus related, especially in light of the weather/allergy season. However, I didn't have any other allergy symptoms yesterday (when my allergies are bothering me, I mostly get a runny nose). As the day wore on, I felt a little sick to my stomach, but not terribly so.

When my headaches don't otherwise respond to OTC painrelievers or decongestants, I usually assume that it's a migraine. My migraines typically strike around my left eye as well, so it's hard to tell the difference between a congestion headache and a migraine. I hold off on taking my migraine medicine until all else fails (except when I'm on my period and I can safely assume it's a migraine) because the meds knock me out and cost a lot. My migraines typically don't cause any other symptoms, e.g., auras, nausea, sensitivity to light, etc. I'm lucky in that regard. The headaches suck, but I can function okay.

I should add that I took my migraine medicine when I got home from work yesterday, and the heachache was mostly gone in about 20 minutes. So, I can safely assume it was a migraine, but I'm obviously left with questions regarding causation. I do think it's telling that I tend to get them when it's warm outside. I don't remember getting them or getting them as often during the fall/winter months. I also don't remember getting them after shorter rides. The temps are supposed to drop this weekend to the 50s-60s, so I'll be interested to see if I get another headache.

Just a few further notes on Sunday's ride just in case anything jumps out at someone. For breakfast, I had coffee (I almost always start my day with about a cup or less of strong coffee), an English muffin with peanut butter and jelly, yogurt and right before the ride, a banana. During the ride, I ate another banana and a couple of Cliff blocks with caffeine. I drank water and CytoMax Energy drink during the ride. I did not drink a recovery drink after the ride, but I did eat a sandwich with a fair amount of protein within the hour. I also had some water, Pepsi and chips. Over the course of the next few hours, I drank about 16 more ounces of water. Since I ate a late lunch, I had a small serving of pasta and an orange for dinner. There may have been a handful of GS cookies thrown in for good measure.

I am very sensitive to light because of my gas permeable contacts, which is why I've invested in some good polarized and photosensitive sunglasses. I tend not to think it's an issue with light because I don't recall getting headaches on sunny but cool days.

Thanks for all your input. At this point, I may just have to play around with my hydration and nutrition as it gets warmer. I think I'll also try taking some Excedrin during or immediately after a ride.

[GLC1968]

Kate - we are very, very similar. You just described my pain, and pretty much my nutrition for my last ride day! I also get migraines around my period (though they have greatly lessened going off the pill).

I think the only difference is that my pain is more centered behind both eyes...and it hit me sooner (2 hours after the ride).

I don't normally use electrolyte supplements when I drink water unless its super hot or I'm out there a LONG time, but I'm going to play around with that a little bit going forward.

Keep us updated on your progress!

[Wahine]

Typically headaches that are related to more systemic causes, (dehydration, low blood sugar etc), are more global in nature. That is, they tend to be more evenly distributed over the head. They may be more towards the front or back but they are usually pretty even side to side.

Your migraines are atypical in that you don't get an aura etc and that it is more to one side. This makes me wonder if your very nasty headaches are related to changes in blood flow and neurological activity as migraines typically are. Not that it really matters. It wouldn't change any of the suggestions I have.

So what am I thinking so far. This is where things get interesting. From a PT trained in a Western University point of view you could be having a headache as a result of nerve irritation at the upper segments of the neck related to your cycling position. It's a nice diagnosis that accounts for the location and quality of the headache. Unfortunately, it does not explain why it's worse in the heat.

Get ready, cause we're about to get a little weird. So I switched out my brain for my Traditional Chinese Medicine (TCM) brain and I have to say that I think you are suffering from blockage of qi in the gallbadder meridian, with increased liver yang. This explains location, temperature dependency and the fact that it is worse with activity. This diagnosis is also often related to migraines, pms and menstral cramps.

If I were you, I'd go see a TCM doctor who practices acupunture and can prescribe herbals.

I'm going to try to find a link that helps locate TCM practitioners and post it.

I hope you're feeling better.