The pro football running back Trent Richardson was recently in the news because of migraine headaches. Richardson is just another of many athletes who regularly experience migraine headaches. Dwayne Wade, Percy Harvin, Troy Aikman, Serena Williams, Terrell Davis, and many others are known to have chronic migraines.
Richardson said “I’ve been taking migraine medicine my whole life, like a normal person would do if they had migraines. Migraines are one of the worst things that you can ever have, he said. They’re real tough. It doesn’t come that often, but when it does, you’ve got to catch it at the right time or it sticks with you.”
In contact sports head and neck trauma are common. With direct trauma to the head varying degrees of injury leading to several different types of headaches can take place. We’re going to look at the 3 most common scenarios related to athletes who develop migraines.
Prolonged Exertion as a Trigger to Migraine
Some athletes with a predisposition to migraine may have prolonged exertion as one trigger for a typical migraine. The headache does not typically resolve when the activity is discontinued. The headache may occur minutes or hours into the activity, or after completion of activity.
Effort migraine was seen in 9% of 128 subjects in a study by Williams and Nukada. In the study population, such headaches often began in childhood or adolescence with the average age of onset 15. Aura was noticed by all, nausea by the majority, and vomiting and neck stiffness were frequent. The headache was generally throbbing, moderate to severe, and lasted for hours. Spontaneous migraine, which did not relate to sport or exercise, was experienced in 55% of subjects, with a positive family history in 64%. The authors suggested that low oxygen tension may trigger effort migraine by an as yet unknown mechanism.
For a headache to occur with prolonged exertion, additional triggers may be required. Such triggers include heat, altitude, bright light, dehydration, or low blood sugar. Swain and Kaplan reported headache development after use of certain types of athletic equipment. Poorly fitting mouth guards, tight helmets, and goggles were noted as potential triggers for the athlete with migraine.
“Goggle” migraine has been described by neurologist Alan Pestronk. He developed a migraine headache beginning 1 to 2 hours after exercise and occurring only on days when he swam. His father, a retailer of sporting goods, noted anecdotally that his customers frequently complained of headache associated with the use of ill-fitting swim goggles. When Dr. Pestronk changed to a goggle not requiring a tight head strap, he had no further migraine headaches.
Next time we’ll take a closer look at 2 other types of migraines that are common in contact sports and the possible solution.
Some estimates suggest 25% of the population has a headache right now!
A comprehensive U.S. study reported that 10 million Americans suffer moderate to severe disability from various forms of headaches. It’s time that people know there is an answer to their headaches other than potentially harmful medications.
- Lombardo JA, McKeag DB. Football player with a persistent headache. Phys Sports Med 1987; 15: 75-79.
- Mathews WB. Footballer’s migraine. BMJ 1972; 2: 326-327.
- Saunders RL, Harbaugh RE. The second impact in catastrophic contact sports head trauma. JAMA 1984; 525: 538-539.
- Swain R, Kaplan B. Diagnosis, prophylaxis, and treatment of headache in the athlete. South Med J. 1997;90(9):878-888.
- Pestronk A. Goggle migraine. N Engl J Med. 1983;308(4):226-227.