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I would like to find resources for reducing exertion headaches while having arthritis in my neck (C2-C3). I was diagnosed with this 10 years ago and I don't do the kind of strength training I would like to because it doesn't take much for the workout to cause a cervicogenic headache (lasting hours to days). Pull-ups give me headaches, pushups give me headaches, ab workouts with any sort of boat pose give me headaches. There are plenty of resources for exercises to strengthen my neck, and exercises to do as an old person, but I'm in my 30s and these resources aren't what I'm looking for. I would like to find tips on strength training that will reduce the chance of a headache the next day. My muscles can handle the exertion I just can't handle the long-lasting headaches that come the next day.

For context, this isn't my first attempt at getting help. I have seen doctors, I've done PT, and I make sure to drink enough water. I'd just like to do more reading on the matter.

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  • Have you tried wearing a neck brace while working out?
    – MWB
    Aug 23, 2019 at 3:16
  • This is the kind of answer I was looking for. Please post it as an answer so I can give you credit.
    – yake84
    Aug 27, 2019 at 2:09

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@yake84 I experience neck pain myself, but not headaches. Gwendolene Jull is the expert on neck pain and cerviogenic headaches. Listen to her here. I encourage you to read her scholarly research articles.

Now, I'm going to throw out a topic that is worth thinking about: There is quite a bit of interest in the relationship between co-contraction and neck pain. As you probably know, you have opposing muscles around each joint (agonist and antagonist muscles). Your brain sometimes activates muscles that oppose each other because that can make you more stable. When two opposing muscles act at the same time, it is called co-contraction. Of course, if you want to move your body fast, your brain needs to tone down the antagonist muscle and ramp up the agonist muscle so that you can move easily and smoothly.

If you are experiencing long term pain in your neck, then it almost a certainty that the muscles of your neck are co-contracting more than they should. Your nervous system is bracing (stiffening) your neck for extra stability (protection) because it is fearful that your neck might be weak or vulnerable. The downside of excessive co-contraction is three fold. 1) It fatigues your muscles 2) it makes movement less coordinated and 3) it puts extra pressure on your joints, which in the case of your neck would be your disks. Excessive co-contraction has been measured in the lumbar spine, knee and neck.

When I go to the gym, I see all the guys straining and tightening/stiffening their necks; they are co-contracting hard. You can see the manifestation of this in a prominent sternocleidomastoid (SCM). I don't know if there is any biomechanical advantage to co-contracting your neck while you are doing, for example, biceps curls; It seems to just be an automatic response of your nervous system when you are straining against any load.

If you are getting cerviogenic headaches from going to the gym, it may help to deactivate this automatic neck co-contraction that happens when you strain. So, here is my own personal suggestion. First, become familiar with your SCM. Palpate it and relax it regularly during the day. Observe other people's SCM's at the gym. Now, when you exercise, try to keep your SCM relaxed. If your SCM is relaxed, then I believe you will have less co-contraction in your neck musculature.

Notice, that the SCM is an accessory breathing muscle - meaning that the SCM can help your diaphragm during breathing. If you diligently keep your SCM relaxed, you are going to find that breathing becomes more challenging because you have to do all your breathing with your diaphragm. Nothing wrong with using your diaphragm. It is a good practice to master.

Anyway, I practice SCM relaxation myself at the gym. Not necessarily in every lift, but in many of them. It may not solve your headaches, but I believe you'll find it an interesting discipline. Let me know what you find.

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  • @yake I added to my comment.
    – Chris
    Aug 29, 2019 at 4:16
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Welcome to my world! Like you I'm in my thirties (okay so it's more late thirties these days) and I have osteoarthritis in my neck (C1 -> C7), and I know all too well the headaches that come with it!

What has worked for me is Yoga - I do a "full" (1hr+) practice perhaps two-three times a week but do gentle neck rolls and side neck stretches at least daily - and especially before and after I do any other physical training (if I'm doing a long session I will also take a break to do them in the middle as well)

I realise this is likely to sound a bit evangelical of me but it really has been like night and day and I can't recommend it enough!

There's a wealth of guides (written and video) on the internet but I'd be wary of these (at least as a first step) - the neck is not an area to mess around with, so working with an experienced teacher (at least at first) who is aware of your condition is a must. That way you can ensure you aren't doing anything in a way that's likely to cause you problems and they can work with you to modify exercises around any mobility restrictions you have.

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  • I appreciate your insight however I am looking for a specific type of resource at this time.
    – yake84
    Aug 27, 2019 at 2:13
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Late 30’s here too... I actually prescribe to the notion that while I have osteoarthritis and two herniated discs, motion is lotion. Swimming and weightlifting provide amazing relief time and again. It may only last 1-2 days, but it helps every time.

I no longer suffer from the headaches, although I still have the stiffness from time to time. I attribute barbell overhead press, face pulls, and rows to alleviating those issues.

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