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Thread: Headache Onset with Worksets

  1. #1
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    Default Headache Onset with Worksets

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    Hullo Mr. Rippetoe, I would like to start by saying thank you for all that you have done with your books and content on the website. Who knows what silly bullshit I would be doing--or even worse not doing anything at all--without the knowledge that I now have because of you and your colleagues. In these trying times I am still able to train without any restrictions; my investment in a weight room full of Starting Strength equipment is paying off nicely right about now. However, I am not posting this thread just to thank you, even though it is well deserving.

    I encountered a problem in my work sets in the squat last Monday at 305 pounds. After having some pinching in the anterior hips due to a leg length discrepancy, I shimmed my platform (and later my shoe) to fix the problem. I reran an LP starting February 25 at 135 pounds and gained 20 pounds of bodyweight in the process. By the way I am 5'9" and 190 pounds as of this morning and also 17 years of age. Anyway, in this training session my warm-up squat sets felt perfectly natural and nothing out of the ordinary, and this was the case until the first work set. This set itself felt fine--especially in terms of moving the bar--but an intense headache was immediately felt after I racked it. The pain originated solely on the left side of my head and radiated down to the base of the skull by the neck. Throbbing is the best description of the type of sensation I was feeling, and similarly, I could feel my heartbeat in my throat. As I started the inter-set rest, I began to feel a bit nauseous and almost vomited my breakfast on the platform. I gave myself additional time to recover (12 minutes instead of my typical 10 minutes) and then proceeded to my second set. The results were largely the same except I kept my nausea at bay. Once again, I rested for 12 minutes to get myself in order to lift the last set. The last set moved well, but the last rep was a bit of a grinder. Walking back from the rack was pretty indicative of what I was feeling. My headache was worse now than it was after both of my previous sets, and after reviewing my video I could tell that I was staggering slightly. The throbbing grew really intense, and I decided to curtail my workout for that day. Two of my lifters that I am coaching currently came to my weight room after that, and one of them brought a heavy dose of ibuprofen, which brought total relief within an hour. Throughout the day, however, the headache came back, but it was dull and not relatively close to the intensity of what it was after squats.

    On the following day (Tuesday) I elected to finish my workout from Monday, which included bench press and power clean. Bench press gave me mild symptoms of what I had experienced squatting the previous day, but power cleans did not affect me whatsoever. I proceeded with the week's workouts on Wednesday with a light squat, press, and deadlift. The light squat elicited the same type of headache as my squats on Monday but to a lesser extent. Press was worse than the light squat but not as bad as Monday's squat, but surprisingly, deadlift did not result in any headache. I was unable to lift on Friday because I had to help my dad on the farm more than we both had anticipated, so I did Friday's workout this morning. The results were significantly better than last Monday. The headache was relatively miniscule and very manageable; although, the nausea returned but not until I completed all of my work sets at the end of my training session. Today is definitely a step in the right direction, but I would rather not chance an injury to my dome and risk becoming a tube-fed artichoke. What would have caused these headaches to happen and why? Should I be concerned about moving forward with training? I definitely do not want to halt progress and stop training if at all possible. I have never had a headache like this inside or outside of the weight room, which is even more concerning given that it came on so quickly. If you could shed some light on what might be happening to me, I would be very grateful

  2. #2
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    I don't know. Get it checked immediately.

  3. #3
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    When I first started "squatting", back in my mid 20's (before I knew how to squat), I developed a devastating headache that sounds similar to yours, except it was bilateral. Absolutely awful.

    After doing a bit of reading, I came to the conclusion that it was probably an exertion induced headache, brought on by a sudden increase in blood pressure.

    For the next few workouts, I popped a couple ibuprofen (I think 800 mg) about an hour prior to the workout, and the headaches never returned. After a few workouts, I stopped taking the ibuprofen, and to my delight, discovered I didn't need it any more.

  4. #4
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    That's probably what this is too. But it could be an aneurysm, and due to the nature of aneurysms, he needs to rule that out before he assumes otherwise. If he's "allowed" to, since a headache is "non-essential."

  5. #5
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    I greatly appreciate both of your responses and will take this matter very seriously. In my immediate family alone my mom is a PT, and my oldest sister is a PA. Both of them have some connections that we could exploit to try to get a consultation with a neurologist and possibly some imaging done. If not, maybe my situation will actually be "essential" after I blow a fuse in my head, but I would rather not take that risk given the clusterfuck of authoritative action happening now. Thank you for your advice.

  6. #6
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    He also probably has a shitty valsalva like me.

    The open mouth thing you recommend helps if my dumbass can remember to do it. Oddly enough, pushing my tongue to the roof of the mouth helps too. Fucking weird, I know.

  7. #7
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    He also probably has a shitty valsalva like me.

    The open mouth thing you recommend helps if my dumbass can remember to do it. Oddly enough, pushing my tongue to the roof of the mouth helps too. Fucking weird, I know.

    You were not far off the mark at one point in time, Soule. I had previously gotten terrible nosebleeds every time that I squatted heavy back in late 2019. After getting some advice from a former high school strength coach (one of the few good ones who also introduced me to Starting Strength), I recognized that my Valsalva was shit and needed some fixing. Particularly, I had too much pressure above the glottis and not enough below it. I would get stupidly red in the face, but a simple "breathe into your diaphragm" cue put an end to my nosebleeds. I reduced the weight and really focused on my Valsalva throughout my sets. I have not had a nosebleed since, which is why I did not point the finger at it specifically, and I found the open mouth Valsalva extremely helpful as well. Although, my Valsalva (or lack thereof) could definitely be a contributing factor.

  8. #8
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    That sounds like a perfect description of a migraine headache but without the traditional aura. Has anyone in your family suffered from migraines ?

  9. #9
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    Quote Originally Posted by Nockian View Post
    That sounds like a perfect description of a migraine headache but without the traditional aura. Has anyone in your family suffered from migraines ?
    When I described the headache to my girlfriend who regularly has migraines, she said that the sensation is extremely similar to a migraine as you have also pointed out, Nockian. However, nobody in my immediate family has had problems with migraines outside of the sporadic occurrence, and there is nobody in my extended family with these problems either. This also happens to be the first time that I have had a headache of that nature, and it is even more concerning that its onset was under the bar.

  10. #10
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    starting strength coach development program
    Men are 1/3 as susceptible to migraine headaches as men, so figure that into her advice. What did the neurologist/ER doc say?

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