Is it safe to train with weights on a headache you got before the workout, and how about if the headache develops while you’re strength training?

Some Headaches Mean Danger
While Others Are Harmless

“Headaches come in all shapes and sizes, and some are actually relieved with exercise,” says J. Mark Anderson, MD, DABFM, of Executive Medicine of Texas and who is board certified in family medicine.

I second that last statement, in that more than once, I’ve felt either complete relief or a reduction in a sinus headache—from lifting weights—that I had been getting on occasion due to a mild recurring nasal infection.

It’s certainly safe to lift weights with a sinus headache. The activity will not make the infection worse.

The issue is how tolerant you could be while lifting with a headache that you know is benign.

Dr. Anderson continues, “Exercise can be a natural pain reliever. However, there are times that headaches are an underlying symptom of a bigger problem.

“For example, headaches can be caused from high blood pressure. Since exercise, specifically weightlifting, can cause a temporary spike in pulse rate and blood pressure, it’s best to have high blood pressure under control before going to the gym.”

How many strength training enthusiasts are meticulous about macros, when to take their protein powder and other supplements…yet don’t even own a home blood pressure device?

Do you even KNOW your typical baseline blood pressure? The lower it is, the less high your blood pressure will spike during strenuous lifts.

“If headaches occur while at the gym, but tend to go away once exercise stops, it may be wise to have a VO2 max stress test with your healthcare provider,” says Dr. Anderson.

“This test will not only check your blood pressure during exercise, it will identify the amount of weight you can lift before having a change in blood pressure or pulse rate.

“As for other exercise, a VO2 max will identify the METS (stands for metabolic equivalent: a measurement of exercise intensity based on oxygen consumption) at which you effectively exercise, a number which varies for each person.

“Staying within the correct METS level will help keep exercise safe and effective.”

If you’re getting headaches only after you begin your weightlifting regimen, another possible cause is dehydration.

Dehydration can cause a headache even while one is inactive. When you start pumping iron, you sweat more (whether you realize it or not).

Don’t rely on the presence or absence of thirst as a hydration barometer.

Drink up before you begin your routine, and if a headache occurs at some point during the weightlifting, drink up again and see if it goes away.

If you have a severe headache before you step into the gym, it’s advisable to avoid weightlifting until it goes away.

Waiting it out will give you a chance to see if it’s something that needs urgent attention.

For instance, if you wait it out at home, and additional symptoms start developing (e.g., blurred vision, slurred speech), at least you’ll be in a better setting from which to be taken to the emergency room.

Yes, severe headache with any new-onset visual disturbance and/or speech difficulty means get to the ER. Have someone drive you there.

If while working out you experience a sudden-onset severe headache, like a clap of thunder, stop exercising immediately! In fact, the pain will be so striking that you’ll stop automatically.

Do not try to work through any severe sudden headache. And a thunderclap-caliber headache may be a burst blood vessel (aneurysm rupture) in your brain or carotid artery and requires immediate medical intervention.

Another possible cause of less painful headaches that arise during a workout is a nerve irritation from the exercise that affects the neck, shoulder or arm. The irritated nerve will radiate pain to the head.

If you’ve been diagnosed with migraine headache disorder, discuss with your physician guidelines for gym workouts.

Dr. Anderson is coauthor of the award-winning book, “Stay Young: 10 Proven Steps to Ultimate Health,” and host of the nationally syndicated Staying Young Show which goes to podcast as Staying Young Show 2.0.
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.  

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Top image: Shutterstock/Viktor Gladkov