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Exertion Headaches in Children: The Potential Downside of Exercise

Considering the growing obesity epidemic among America’s youth, exercise is typically considered to be a great thing – it increases blood flow, helps manage weight, boosts energy levels – the list goes on and on. However, for children suffering from exertion headaches, exercise can quickly become the enemy.

Exertion headaches are a generalized head pain that occurs during or following physical exertion (running, jumping) or passive exertion (sneezing, coughing, moving one’s bowels, etc.). While most exertion headaches are benign, they do vary in severity, duration (from 15 minutes to 20 hours), and associated symptoms (some children will experience nausea, vomiting, and light or sound sensitivity). Although these headaches may occur in isolation, they are most commonly associated with patients who have inherited susceptibility to migraine and are often triggered by sustained physical exertion that is uncharacteristically strenuous for the particular individual’s conditioning.

According to Dr. David Rothner, Director of the Pediatric Headache Clinic and Director Emeritus of Child Neurology at the Cleveland Clinic Foundation in Cleveland, Ohio, about 12% of adults experience exertion headaches from physical activity. However, exertion headaches tend to be underreported and underdiagnosed in children and adolescents. To ensure your child makes the best of their exercise regimen and reduces the risk of headache without discontinuing the athletic pursuits that are so important to a child’s self-esteem, the NHF suggests certain precautions for those prone to exertion headaches:

  1. Avoid exertion in hot weather or at high altitudes.
  2. Hydration needs to be maintained! Drink lots of water.
  3. Make sure to have a prolonged warm-up period before strenuous exercise.
  4. Avoid jarring exercise such as running or jogging. Instead, go for a walk or take a bike ride.
  5. Try yoga accompanied by breathing exercises or other relaxation and biofeedback techniques.
  6. Two to three hours before an event that typically provokes a headache, take a therapeutic dose of a nonsteroidal anti-inflammatory (NSAID). Naproxen is typically recommended at 10 mg/kilo (1 kilo equals 2.2 pounds).
  7. When a headache occurs, treat it like a migraine. This can involve bed rest, a cold compress, diphenhydramine (Benadryl®) for sedation, and an NSAID.

Exertion headaches can, in some instances, be a sign of abnormalities in the brain or other diseases including aneurysms, tumors, or blood vessel malformation. As always, the NHF encourages you to consult a physician if your child is experiencing frequent and/or severe exertion headaches.

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