Suffering from intense pain in the back or other part of the head during or after you complete barbell squats? This could be serious.
First off, if you get a sudden headache in the middle of a squat set, never attempt to finish out the set.
Immediately cease, if for no other reason that struggling to continue the set can result in a form break, causing a back injury.
If you suffer from exercise-induced headaches, you should see your doctor.
When exercise is the cause, they are sometimes referred to as exertional headaches. But don’t self-diagnose; that’s a doctor’s job.
The Exercise Headache
“Usually a pulsing headache affecting both sides of the head,” says Dr. David Beatty, MD a retired general practitioner with 30+ years of experience and an instructor of general medicine for 20 years.
“Thought to be due to dilatation of blood vessels in the brain. More common in hot conditions and at altitude.
“Also more likely with a history of migraine. Dehydration or low blood sugars may play a part.”
The type of exertion most likely to bring on this kind of headache stems from straining on a big compound move, such as the back squat, deadlift, leg press or bench press.
This is why you don’t hear about weightlifters getting exertional headaches from a set of biceps curls, cable triceps moves or dumbbell side lifts.
Squat Head Pain from Other Causes
Your head pain isn’t necessarily a mere exercise headache.
One’s heaviest squats should not cause pain in the head.
This is never a normal response no matter how much the athlete is straining.
The only “pain” you should feel when squatting is the burn in your legs and glutes, and some tension in your core.
There are two other not-so-serious causes of head pain when doing the squat.
Migraine. “Classically this will cause a throbbing pain on one side of the head,” says Dr. Beatty.
“It can be preceded by a visual aura, when the person sees flashing lights or zig zag lines in the visual field.”
Cervicogenic headache. “Typically affects the back of the head and is caused by nerves arising from the neck being pinched by muscle tension and spasm, or by the vertebrae or a protruding disc in the cervical spine,” says Dr. Beatty.
A protruding or herniated disc may sound like a serious matter. But compared to the next two possible causes, it’s nothing to lose sleep over.
More Serious Causes of a Squat Headache
Subarachnoid hemorrhage. “This is a severe life-threatening emergency which requires immediate hospital care,” begins Dr. Beatty.
“The person develops a sudden severe headache over the back of the head.
“It’s described as like being kicked in the head or hit over the back of the head with a bat.
“There may be neck pain, neck stiffness, nausea, confusion, loss of consciousness, seizures, sensitivity to light or a stroke-like picture with loss of power or feeling in one side of the body.
“It’s caused by bleeding from an aneurysm in the brain.
“An aneurysm is a swelling or dilation arising from one of the arteries.
“If there is only a small leak, the symptoms may not be so obviously worrying.”
Bulging blood vessel in the brain. Shutterstock/Veronika Zakharova
When a brain aneurysm ruptures, it’s called a hemorrhagic stroke. Shutterstock/Blamb
Brain tumor. “Tumors sometimes contain lots of blood vessels and, if these leak, it can produce a similar picture,” says Dr. Beatty.
“If I was getting a significant headache after exercise I would want a brain scan.”
More on Brain Aneurysms
If over a period of weeks, you’ve been getting headaches during or after sets of squats, you do not have an aneurysm with a major rupture.
That’s because once a full-blown rupture occurs, you’ll die without immediate medical treatment.
With a major rupture, you simply will not be able to function. You have minutes to get emergency help.
However, the sudden expansion of a brain aneurysm, without bleeding, can cause a headache.
Dr. Beatty has worked in primary medicine, surgery, accident and emergency, OBGYN, pediatrics and chronic disease management. He is the Doctor of Medicine for 
