A dangerous bleeding in the brain can be the cause of a sudden and severe headache that comes on during weightlifting.

Now let’s suppose you’re a longtime enthusiast of building muscle.

You’ve been pumping serious iron for years and have always felt fine.

Then one day in the gym as you strain for that last repetition in the squat rack – BOOM!

A sudden, really bad clap of a headache. Out of nowhere.

After you rack the barbell the headache is still there and lasts the rest of your time at the gym.

“Sudden onset of headache with intense exercise needs to be investigated,” explains Dr. Brian Loftus, a board certified neurologist in Bellaire, Texas, who specializes in migraine headaches and multiple sclerosis.

“The first job of the physician investigating is to rule out an intracranial bleed,” continues Dr. Loftus.

“If the patient is seen at the time of the headache – this can usually be done with a CT scan of the brain along with a lumbar puncture.

“If the patient is not seen near the time of the acute headache, then it is harder to rule out a bleed.”

If during a weightlifting set the athlete experiences a sudden bleeding in the brain, the cause would be a tear in a blood vessel.

But this cerebral blood vessel would have to have a pre-existing weakness in its inner wall.

This weakness causes the vessel to bulge or become dilated (aneurysm) – and all the while, maybe years, the athlete does not know this.

Brain aneurysm. Shutterstock/Veronika Zakharova

Until that moment while straining during a weightlifting set: the blood vessel tears. This is an aneurysm rupture.

Rising Blood Pressure when Lifting Weights

When you lift hard and heavy, blood pressure will significantly rise. This puts pressure on the inner walls of blood vessels.

That’s okay, too, as long as these inner walls are sturdy and tough.

But an aneurysmal wall may simply give way one day. A brain hemorrhage results.

It’s important that you realize that bodybuilding, powerlifting, etc., do not actually CAUSE an aneurysm.

But if you have a pre-existing aneurysm … intense straining with weight workouts is a risk factor for a tear.

As far as the overall possibilities of causes of a really bad headache in the middle of a weight workout, Dr. Loftus says that “It is relatively uncommon to find a bleed.”

A dilated cerebral blood vessel is a rare occurrence, especially in younger adults.

Risk factors are smoking and hypertension – which don’t go hand-in-hand with health conscious people who take their muscle building seriously.

Sudden Bad Headache While Strength Training

Now if you don’t smoke, have normal blood pressure and are a younger adult – and one day you get hit with head pain at the gym – you should still see a doctor.

If the pain goes away, it’s not a torn aneurysm. It’s likely an exertional headache.

These are harmless, though they can be painful enough to stop the workout.

They can last briefly to a few days and are often throbbing.

The throbbing nature does not mean it’s any more serious than if it were not throbbing.

Recommendations for “Weightlifter’s Headache”

Dr. Loftus endorses a medication called indomethacin for these exertional headaches.

A headache that comes on gradually, slow in onset, is not an exertional type.

The cause may be dehydration, especially while working out in a hot environment.

Stressed neck and trap-area muscles can also be a cause.

To help avoid any kind of headache while lifting weights, be well-hydrated prior to the routine, and keep hydrated throughout.

Stretch your neck and shoulder area before you begin working heavy.

Dr. Loftusdr. loftus has a private practice in Bellaire, TX, and focuses on headaches, multiple sclerosis and hyperhidrosis (excessive sweating). He is also board certified in headache medicine.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


Top image: ©Lorra Garrick.
Source: ihs-classification.org/en/02_klassifikation/02_teil1/04.03.00_other.html

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