Sports and Headaches: A Risky Business Quiz

According to a study by the National Collegiate Athletic Association Injury Surveillance Program, headache is reported in about 90% of sports-related concussions. The lowest percentage was reported in men’s baseball (75%), while the highest percentage was reported in women’s field hockey (100%).

Source: Wasserman EB, Kerr ZY, Zuckerman SL, et al. Epidemiology of Sports-Related Concussions in National Collegiate Athletic Association Athletes From 2009-2010 to 2013-2014: Symptom Prevalence, Symptom Resolution Time, and Return-to-Play Time. Am J Sports Med. 2016;44:226-233.

Short-term neurological problems and long-term behavioral and psychological effects of concussion related to football have been recognized for over a century. The first football helmet was invented in 1893 and consisted of a moleskin hat with earflaps. Over 100 years ago, recognition of a significant number of concussions and deaths related to football lead for calls to outlaw the game or make it safer.  The first epidemiological study of concussion and football was published in the Boston Medical and Surgical Journal in 1906. Conducted by doctors for the Harvard football team, it highlighted the high frequency of concussions per game.

Sources:

Harrison EA. The first concussion crisis: head injury and evidence in early American football. Am J Public Health. 2014;104:822-33.

Nichols EH, Smith HB. The Physical Aspect of American Football. Boston Medical and Surgical Journal. 1906:1.

Footballer’s migraine refers to migraines with aura triggered by a minor blow to the head. These migraines can occur in any sport in which head impact occurs, such as hitting the ball with the head in soccer. Posttraumatic migraine like footballer’s migraine is associated with longer recovery time, as well as cognitive, neurobehavioral, and somatic symptoms.

Source: Evans RW. Sports and Headaches. Headache. 2018;58:426-437.

An exertional headache can be brought on by any strenuous exercise like running, rowing, swimming, etc. It can last from a few minutes up to 48 hours, is often bilateral, and not usually associated with nausea and vomiting (although exercise can trigger migraines in migraine-prone individuals). Risk factors include high altitude, hot weather, extreme exertion, and decreased fluid intake.

Source: Evans RW. Sports and Headaches. Headache. 2018;58:426-437.

Weightlifter’s, or cough, headache is precipitated by a Valsalva maneuver and usually bilateral and posterior, has sudden onset, peaks almost immediately, usually lasts from a few seconds to a few minutes (but can last up to 2 hours), and mostly affects individuals over aged 40 years. A first-time thunderclap weightlifting headache should raise suspicion for subarachnoid hemorrhage.

Source: Evans RW. Sports and Headaches. Headache. 2018;58:426-437.