Headache from Swimming

Have you ever experienced a headache during or after an enjoyable workout of swimming laps?

There are a few types of headache you may be enduring.

External compression headache is an unusual headache disorder caused by applied pressure over the scalp or forehead like from a headband, helmet, or goggles. For swimmers, it's usually the goggles or tight swim cap that triggers this headache.

According to the International Headache Society, this type of headache is not throbbing and resolves after the pressure is alleviated, so medication is rarely used. It's also not associated with nausea or light sensitivity.

Also, the pain of an external compression headache is constant, and if pressure is applied for a prolonged period of time, the headache may turn into a ​migraine. With a migraine, people may experience nausea and/or vomiting, as well as an increased sensitivity to light or sound. 

Goggles are the culprit in this unusual facial pain disorder. Supraorbital neuralgia is characterized by pain in the area supplied by the supraorbital nerve, which is located in the forehead. People with this disorder will have either a spasm of pain or constant pain over the nerve. Some people also experience sensory symptoms like numbness or tingling in the affected area of the forehead. 

Pain is relieved by either an anesthetic nerve blockade or nerve ablation.

You are more likely to develop this condition if you are a swimmer with a supraorbital notch, as opposed to a supraorbital foramen, which basically means that people with a certain facial anatomy are more prone to these headaches. A supraorbital notch exposes the nerve, leaving it vulnerable to compression.

In order to prevent a swimmer's headache, here are some useful tips:

• When you put your goggles on, place them on gently and carefully. Also, place them in different positions to avoid repeated pressure in the same areas on your face.
• Try out different types of goggles, especially ones that have a soft rubber and smaller area of seal around the eyes.

Swimmers can also develop primary exercise headaches from simply swimming, especially if it's strenuous. An exertional headache is throbbing, lasts less than 48 hours, and occurs during or after vigorous physical activity. It can be accompanied by nausea and is more common in men than women. It's also more likely to occur in hot weather or at high altitudes.

While rare, this is not a worrisome medical condition. Before making the diagnosis, though, your doctor will perform a thorough neurological exam and order brain imaging to rule out other more concerning and serious causes of a secondary headache. There are dangerous headache conditions that can mimic primary exertional headache. In other words, get it checked out first and do not self-diagnose. 

The treatment of primary exertional headache is indomethacin, a type of nonsteroidal anti-inflammatory medication, or NSAID. 

It's important to note here that primary exercise headache and supraorbital neuralgia are rare conditions. So besides an external compression headache, it's possible that your headache from swimming is really a run-of-the-mill  tension headache. Factors like heat, dehydration, or skipping meals are all known tension headache triggers. They can also be migraine triggers in certain susceptible people. 

In other words, your headache may not really be from swimming per say, but from a factor influenced by swimming. With that, be sure to hydrate, eat nutritiously, and be well-rested before engaging in physical activity. It's also wise to take sun breaks, even though you may be cool in the water. Finally, consider wearing sunglasses when floating around in the water to protect your eyes and prevent eye strain from triggering a headache. 

Swimming is a fantastic form of aerobic exercise and enjoyed by many. Some swimmers though are plagued by headaches that are caused by the strenuous nature of swimming or by their gear.

If you suffer from headaches during or after swimming and simple measures are not relieving them, please see your doctor for a proper diagnosis and treatment plan.