Why a lift gives you a headache. Bracing in silence under a heavy bar drives your chest pressure up for a few seconds, and it has nowhere to go but back up the veins draining your head. Direct measurements during max lifts have caught arterial pressures around 320/250 mmHg at the peak ¹. Some people are primed for it: about 70% of sufferers have a leaky valve in the neck vein meant to block that backflow, against 20% of everyone else ². The endurance version runs differently — hills, heat, and thin air push the brain's blood-flow control past its ceiling ³.

Once a doctor has cleared the dangerous causes, the prevention is nearly free.

Indomethacin works better here than other anti-inflammatories because it uniquely lowers pressure inside the skull ⁵. Building an aerobic base also raises the threshold at which the whole system fails ³.

The reason you don't just tough it out. A meaningful minority of first exertional headaches turn out to have a real cause underneath — an aneurysm, a malformation, a mass ⁶. A leaking aneurysm, the kind that breaks during a heavy lift or a sneeze, kills a quarter to a half of the people it reaches within thirty days ⁷. The ones scanned and treated within hours mostly walk out intact. A head CT inside the first six hours catches more than 99 in 100 of these bleeds ⁸. The window is hours, not days.

What the fix buys you. Within a few sessions of changing the breathing and warm-up, most people stop having the post-workout episode, and the lift you'd quietly capped yourself at stops costing the afternoon. Over months the improved conditioning raises the threshold further, and many cases burn out entirely ¹². The other payoff is the one you hope never to need: the person who walks into an ER within a few hours of a warning headache mostly walks back out of their life. The person who sleeps it off mostly doesn't.