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Thursday, August 09, 2007

I am getting headaches when riding my mountain bike

I have recently come across your blog and I am impressed. In the world of misinformation you are providing real world advice. Thank you.

I am a mountain biker that has been riding for a couple of years and am getting to a point where my longer rides are taking 2 to 4 hours long. These are generally adventures in some back country somewhere but not always. My problem is that I am getting headaches on these long rides which last the rest of the day. I do not notice them if I am moving but I notice them when I stop.

I used to be a competitive swimmer (which I gave up 8 years ago and got fat till starting mtb again) and was training for 2 to 3 hrs 10 times a week and never experienced this. It seems to happen more when climbing hills (maybe because I am overheating, or sweating more, or exerting more). I have had shorter rides in the heat where it has happened as well. However it doesn't seem to matter how much water I have they still happen.

Could it be that I am not getting enough sodium or electrolytes? I am going to start experimenting with good endurance drinks to see if that makes a difference, however the ride yesterday it didn't stop the headache (but it did stop my usual bonk around 3 hrs). I had a Horleys made up drink 750mls and a new mizone (higher carb one) and 2 litres of water over a 3 hr trip time but 5 hrs ride time. My head was buggared and very tired by the end and got progressively worse during the evening. It got better after I had some meatballs, bread and panadol, but my head was very tired, and still is today.

I am about 183cm high and 96kg. I don't drink much caffeine as it makes me jittery and ruins my sleeping pattern, however a cup or two of Dilma english breakfast tea a day has been nice. Usually in the mornings or afternoon though. I have to admit sometimes I have had lots of caffeine though, however I have not noticed a correlation to these rides. Maybe though.

No neck or shoulder injury ever.

The two rides that I remember were on the weekend. My head ache disappeared after the food and the panadol, however my head was still very tired. I was probably dehydrated but on other times I haven't been able to keep up enough fluid to stop these headaches. I feel like drinking coffee after it to make my head feel better. It feels like when I get the flu sometimes, when you get a headache and a fuzzy tired head.

The other recent time I got this was up in hanmer for 2 days. The first day I got a headache for the rest of the day and no matter how much water I had (I was up all night peeing!!) I could not get rid of it. I did not have any panadol then though so I had to live with it. The next day I was fine. Over night sleeps seem to get rid of it. The next day we rode and I didn't seem to get it, which is curious as we were out for longer. The only difference was that I had a normal Mizone that day and we went on a track that was more climbing than mtb. We were literally pushing our bikes for hours.

I was also thinking that I get light headed when standing up (at random times, not when biking) when I have been doing a lot of biking at the moment. My doctor wasn't worried and thinks its just typical low blood pressure or something that people get when training a lot.

So my question is, do you know of any other athlete who is having similar problems? What the solution might be, if its a quick fix or do I need to go get a check up by somebody (maybe bloody work, blood pressure etc).

Gary Moller comments:
Jono: There are several possible things going on here and without seeing you in the flesh, we are reduced to making some educated guesses. The advice that follows needs to be applied with a touch of common sense and try to consult the various experts in your area who might be able to help you apply this advice. No harm should come from any of this advice. In fact, you should become fitter and healthier even if some of the measures suggested end up having nothing to do with the head aches!

Mountain Biking is hard on the neck
Prolonged hill climbing is inherent in the sport and this can cause a kink in the neck, cramping the neck and shoulder muscles and jamming the nerves. This can cause migraine-like headaches. This is exacerbated by the seat and stem and handle bar setup on your bike not being quite right. Even a few mm of adjustment can make a world of difference. Cross-country bikes are a compromise between design for climbing and design for descending and it is a real art to get the adjustment right for different body types, sizes and riding ability. Being a full suspension bike, you might find even the slight sag in the tail while hill climbing has your seat position such that you are having to pull excessively with the arms and shoulders. With your body weight, the sag could be very significant. Try locking out the rear suspension when doing long climbs and see if there is a difference.

When climbing all but the steepest hills, you should be able to lean forward on the handlebars with the palms resting relaxed without the hands having to grip the bars. If you can't do this then look at your climbing technique and get a bike setup expert to adjust your setup, including set post, seat angle and handle bar stem length. I do this for cyclists in Wellington.

After climbing and kinking the neck and straining the shoulders while climbing there is usually a period of high speed slamming your way downhill. The tired neck muscles have to work very hard holding that heavy bowling ball on your shoulders steady so that you can see where you are going! As you can imagine, the neck and shoulders can become cramped and exhausted from all of this punishment and it is hardly surprising that you develop headaches a few hours into a ride. Other than checking the softness of your front and rear suspension to smooth the big hits, there is little to be done with the bike. Read on.

Low Blood Pressure (Postural Hypotension)
It is common in athletes to suffer semi-blackouts when standing up quickly. This is most often attributed to dehydration. I disagree in most cases. This condition is most often associated with an irregular pulse and aching muscles or muscles that have painful knots in them. This can be indicative of mineral depletion, principally magnesium which is essential for cellular function, including muscles and nerves.

Low magnesium shows up as weak muscles, muscles that are painful to press and prone to cramping and aching. Low magnesium is a factor with irregular heart rate and low blood pressure. It is likely that adrenal function is low. An associated factor is vitamin D deficiency which is a certainty among student cyclists living down South. Vitamin D supplementation is cheap and safe.

Drinking lots of water, even if it has some electrolyte in it, may add to the problem by flushing out mineral salts from the body.
Try a course of mineral supplementation with added magnesium with a complementary quality B Group vitamin supplementation. The benefits, if any should be obvious within a few weeks.

Go easy on the sugars and refined carbohydrates
I would go very easy on the sugary drinks as well because they are shocking for teeth and gums. Your athlete diet should be low in sugars and refined carbohydrates and high in quality whole natural foods.

Read my e-books on endurance training and train your body to run on its reserves. You should be able to ride three hours on pure water only with no need for sugary stuff. If you are a junk food addict then you could be suffering killer sugar lows as the ride progresses despite the sugar drinks. As blood sugar plummets, you will ache terribly, including the neck muscles and may develop headaches. You will feel weak and concentration and decision-making will suffer.

Drinking far too much
When riding up a hill you may quickly become drenched in sweat. This is partly because of the extra hard work, but also because there is little or no airflow to evaporate the sweat. You may get the impression that you are losing sweat by the gallon; whereas the truth is it may be just a a few cups worth during the climb.

If you drink too much water before, during and after a ride then you may be placing your health at risk. That you described having to get up several times in the night to pee is a sure clue that you might be drinking too much.

Excess fluid flushes critical minerals and other nutrients, like the water soluble vitamins, out of your body. More dangerously, you risk developing hyponatraemia (I call it soggy body syndrome or SBS). One of the symptoms of hyponatraemia SBS is headache and the other "heady" symptoms that you describe.

Drink only what you need to stay hydrated and no more. Ignore the experts and the sports water companies who advise you to mimic a fish. Learn to go by thirst (I know this advice will cause howls of protest in some quarters; but let's be sensible for once!). Hyponatraemia SBS kills healthy athletes, so it is irresponsible to give the impression that guzzling endless gallons of water is essential for sport and a cure-all for everything.

You might like to get a gauge of fluid loss during a ride by weighing yourself before and immediately after a ride. After deducting a Kg for each liter drunk during the ride, you can tell exactly what your fluid requirements are. You might be surprised at how little water you actually need during a ride. A 2-4% overall weight loss during a ride is fine and your body will get used to it with time.

Caffeine withdrawal
As with bottled water, sports drinks and carbo gels for athletes, do not believe everything that is churned out by the commercially driven research! Caffeine is not all peach and cream. It is a highly addictive drug and you might be hooked!

One reason headaches and migraines and generally feeling rotten happens more often during weekends is because the routine of caffeine ingestion is interrupted. While the amount of caffeine is a factor, so is the regularity of ingestion. If you take a even small amount of caffeine daily, then your physiology adjusts to that. If you then get up early for a long ride without your scheduled caffeine shots, it is possible that you will start to suffer the aches and pains, headaches and loss of energy and concentration that is part of drug withdrawal.

Please read my articles about caffeine, including the guidelines for assessing your possible addiction to caffeine and follow the advice for getting yourself free of caffeine's grip on your physiology.

Possible neck and shoulder problems
I have worked with a number of top swimmers over the years and shoulder and neck problems abound. While flexible and loose is beneficial and common, this does not mean that a swimmer is not without painful knots and inflammation. These do not disappear with rest and can bother an ex-swimmer years later with neck and shoulder pain. This pain can be in the form of tension headaches due to irritation of the nerves that supply the forehead and scalp.

Jono: Being a student, sitting for long periods, staring at a screen all day, just adds to the tension. As does slamming and rattling the skull for several hours on a mountain bike and kinking the neck during steep hill climbs!

The solution is all of the above, plus a course of deep tissue massage of the shoulders and neck. Generally, you need three sessions per week each lasting about an hour for a few weeks. This can then reduce to about twice a week for a few more by which time the muscles (assuming they need working on) will be in fantastic condition. If in Wellington, I provide this service. I am not sure of who you can see down South. Look for an experienced massage therapist with suitable qualifications. You need a person with strong hands who is prepared to spend the time and effort without hurting you. A brief tickle and rub might feel great; but will do nothing of lasting benefit.

So, Jono, now you have much to work on. It is a bit like playing detective with your body. Please let me know how you get on and let our readers know what works and what does not.

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