An Overview of Swim-Related Headaches

Swimming-related headaches have a few different causes with similar symptoms. One common cause is swimmer's ear, which can lead to headaches due to a bacterial infection that follows from water entering the ear canal.

Other causes include pressure from wearing goggles, irritation to chemicals, changes in pressure from diving, dehydration, or simply exercise itself. 

Here's a closer look at different types of headaches related to swimming, how they differ from each other, and what can take away the pain. 

Underwater view of mature male athlete swimming during morning workout
Thomas Barwick / Getty Images

Sinusitis 

A common after-swim headache, sinus headaches are due to clogged sinus cavities, which can lead to infection and pain.

Sinus cavities can be irritated by swimming in chlorinated water. Changes in pressure from swimming underwater and diving can also lead to inflammation of the sinus cavity, or sinusitis.

Bacteria and viruses can enter the nasal cavity during swimming, causing a sinus infection. If you have sinus pain that does not resolve with over the counter medication, see your healthcare provider. 

Over the counter pain relievers, such as Tylenol (acetaminophen), Advil (ibuprofen), or Excedrin, or nasal sprays such as Afrin, can help relieve the pain. In the case of an infection, your healthcare provider will likely prescribe antibiotics.

Swimmer's Ear

Otitis externa, also known as swimmer’s ear, is a bacterial ear infection of the outer ear canal. It occurs when water gets trapped in the ear. Symptoms include:

  • Itching
  • A feeling of fullness or fluid in the ear
  • Pain in the head or jaw

For many people with swimmer’s ear, headache or jaw pain are the primary symptoms. Headaches that center around the ear during swim season may be swimmer’s ear and should be checked by your healthcare provider. 

Over the counter pain medications, like Tylenol or Advil, can help to relieve the pain, but in the case of an infection, your healthcare provider will likely prescribe antibiotic ear drops.

Using earplugs made for swimming can help you to prevent swimmer’s ear. 

Tension Headache

Some headaches that occur after swimming are just run-of-the-mill tension headaches and not due to swimming at all. These are the most common type of primary headaches. They can be caused by heat, dehydration, bright sunlight, or skipping meals.

Tension headaches are typically a dull, aching pain and may include tightness or pressure across the forehead, sides or back of your head. Some people experience tenderness on the scalp, neck, and shoulders as well. 

This type of headache typically responds well to over the counter pain medication, such as Tylenol or Excedrin.

Be sure to hydrate, eat nutritiously, take breaks from the sun, and consider wearing sunglasses when floating in the pool.

Migraine

Swimming can sometimes trigger a migraine. Swim-related migraines may begin as tension headaches, but take the pain to a greater level, with throbbing or pulsing.

Migraines are often accompanied by other symptoms that may include:

  • Nausea and vomiting
  • Blurred vision
  • Lightheadedness that may lead to fainting

Migraines can resolve with Excedrin, though sometimes prescription medication is needed. 

Compression Headache

A headache caused by applied pressure over the scalp or forehead, like from goggles or a tight swim cap, can cause a relatively unusual external compression headache.

According to the International Headache Society, this type of headache is constant, does not throb, and typically resolves after the pressure is alleviated. 

Medication is not typically needed for this type of headache. However, if the pressure continues for a prolonged period, it may turn into a migraine.

Supraorbital Neuralgia

Another unusual type of headache, supraorbital neuralgia is a constant or spasmic pain in the supraorbital nerve in the forehead. Some people also experience numbness or tingling in the forehead as well with this type of headache.

Goggles are the usual culprit of supraorbital neuralgia after swimming and people with certain facial anatomy—a supraorbital notch in the facial structure—are more prone to this rare type of headache. 

Supraorbital neuralgia pain is treated with an anesthetic nerve blockade or nerve ablation. 

If you suspect this type of headache, put goggles on gently, rotate different placement to avoid repeated pressure on the same spots, and try different goggles—ones with soft rubber and a smaller area of the seal around the eyes can reduce pressure. 

Primary Exercise Headache

Strenuous swimming can cause primary exercise headaches, an exertional headache that throbs, lasts for less than 48 hours, and occurs during or after vigorous physical activity.

Studies suggest that these headaches are more common in females and typically aren't accompanied by nausea or vomiting, though some researchers have found a prevalence in males. Hot weather and high altitudes can contribute to the pain.

In some cases, these episodes signal a previously undiagnosed underlying medical condition.

Primary exercise headaches are rare and not a worrisome medical condition. However, they mimic more serious disorders and should be seen by a neurologist to confirm the cause. 

These headaches are typically treated with Tivorbex (indomethacin), a type of nonsteroidal anti-inflammatory medication, or NSAID. 

Summary

Swim-related headaches are not uncommon and can occur for a variety of reasons. Sinusitis is sometimes associated with the water exposure from swimming. So is swimmer's ear, which also may lead to headaches.

Less often, swimming can lead to a primary exertional headache, or a headache that's been caused by compression from goggles or a tight swim cap.

If you experience a headache after swimming, speak to your healthcare provider. It's important to ensure you have a proper diagnosis and begin any necessary treatment.

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