Skip to Main Content

++

INTRODUCTION

++

In the beginner’s mind there are many possibilities, in the expert’s mind there are few.

Shunryu Suzuki, Zen Mind, Beginner’s Mind

++

Headache is one of the most prevalent pain conditions present at all stages of life. It affects the majority of the global population and is among the top 10 causes of disability.1 Despite this, the burden of headache has been largely underestimated, with headache disorders often dismissed as minor and undeserving of medical care.1, 2 Although athletes suffer from the same causes of headache as non-athletes, there are several key causes of headache that relate directly to exercise or to the sport itself. An additional factor to consider is that headache can impair both training and sports performance.

++

The International Headache Society (IHS) classifies headache into a range of disorders comprising three broad categories with more than 300 underlying headache forms.3 The majority of these disorders are not particularly relevant to an athletic population or the IHS definitions do not adequately cover the symptoms experienced by athletes.4 Figure 21.1 lists the broad classification according to the IHS and the common headache disorders seen in sport.

++
++

HEADACHE IN SPORT

++

The prevalence of headache directly related to sport has been poorly investigated or reported, although there is increasing attention in contact sport on concussion or trauma-related headache.5 In a New Zealand university setting, 35% of athletes surveyed reported headaches, both traumatic and non-traumatic.6 Importantly, 54% of people who reported headache associated with sport or exercise gave up their activity.7 In some codes of football, more than 50% of athletes experience regular headaches from matches and training.4

++

While the latest edition of the IHS headache classification is comprehensive, it is not aimed specifically at a sporting setting. Williams and Nukada proposed a simple framework for specific sporting headaches.8 This included:

++

  • effort-exertional headache

  • effort migraine

  • trauma-triggered migraine

  • post-traumatic headache.

++

An alternative sports-specific headache organisational framework has been proposed that incorporates the non-sporting as well as sporting headaches.9 Headaches are categorised as follows:

++

  • a recognised headache syndrome (migraine, tension-type headache, cluster headache) coincidental to sporting activity

  • headache arising from mechanisms that occur during exertion; these can be primary (mechanism unknown) or secondary where a causal factor can be demonstrated, such as a headache:

    • related to changes in cardiovascular parameters

    • related to trauma

    • arising from structures in the neck

    • arising from mechanisms that are specific to an individual sport.

++

CLINICAL APPROACH TO THE PATIENT WITH HEADACHE

++

Headache is an unusual condition being both a symptom and a disease, which can make diagnosis and management challenging. Of primary importance is identifying when headache is ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

Clinical Sports Medicine Collection Full Site: One-Year Subscription

Connect to one of the most renowned references in sports medicine and explore all aspects of diagnosis and management of sports-related injuries and physical activity. Subscription includes access to a library of sports medicine videos.

$65 USD
Buy Now

Pay Per View: Timed Access to all of Clinical Sports Medicine Collection

48 Hour Subscription $34.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.