Headaches

Fifty-Plus Fitness Library

Library : Year 2 | Session 7: Monitoring your Fitness Program

Dear Dr. Bortz,

I am 60 years old and somewhat of a runner. That is, I still run at least once per week, sometimes 3 times per week. I belong to a health club so my running is on a treadmill. My schedule for working out is aerobic exercise three times per week and weight training twice per week. I have been running over 20 years. I really do enjoy it. I went from running marathons 20 years ago to a 30 minute run currently. I look forward to my run days and feel good afterward.

Recently, I purchased a heart rate monitor (a lot of club machines now have the heart monitor capability). When I joined this club in 1992, I was given a physical fitness test. The report I got back indicated my target hear rate should be between 114 and 132 beats per minute. Well, I never checked my heart rate all these years but the first day I wore my HRM was a run day and I set the treadmill heart rate monitor to a maximum of 132 and set my speed to 6.5 MPH (my normal warm up speed). In a few minutes I boosted the speed to 6.7 and started watching the HRM readout. It had jumped up to 135 and my speed falls to 6.5 (to keep me at my target heart). I stayed at this speed sometimes slower but I did not enjoy it. I felt I should be doing more. I talked to one of the fitness attendants. He said the target heart rate was not exactly scientific and thought I could run above the 132 mark but still below the 160 (220-age) mark.

Certain events in recent years have gotten me wondering and concerned. Maybe I have been overdoing it.

In early 1990s I had several echocardiograms because of leakage in my tricuspid. This was caught on my annual physical. One year I noticed I didn’t receive the echocardiogram so my next physical I asked and was told, “It disappeared”.

I like to warm up on my aerobic exercise day with ten minutes on the rowing machine. In order to track my progress, I watch my “calories used” on the machine counter. My average was 130. One day I felt good so I went for a new record and hit 137 calories but in the final minute or so the right side of my head felt like it was traumatized with a blow to the head. Needless to say, I made an appointment to se my doctor. He scheduled me for a brain scan with and wi/0 injection. It showed nothing and nothing more was said. I continue to row but now stay below 120 calories. Above that, the headache returns. This was in 1997. I do not have this headache while running.

In November of 1999, I bent over to pick up something. I might have stayed a few seconds. When I stood up I felt like someone hit the right side of my head with a baseball bat. I didn’t get sick but I did not feel like eating that evening. The headache reappears when I strain, like picking up too much heavy weights, and late at night just laying in bed. But it is not nearly as bad as when I stood up for the first time.

Are any of these events related? Am I blowing a head gasket? Or am I over doing my exercising? I see my doctor in two weeks for my annual physical.--Kenpatt

Dear Kenpatt,

Thanks for inquiring about your interesting clinical situation. By the time you read this, you will have already had your annual physical exam, so I am hopeful that your question will have been answered before.

The part of your story that grabs me is your recurrent headaches, which happen predictably with heavy exertion. Your negative scan exam is reassuring, but unfortunately doesn’t provide relief for your headaches. Maybe they have a muscular origin, or a vascular cause, or maybe something entirely different, but whenever a symptom doesn’t self-correct, I think that it is worth a more in-depth look. I would consider a consultation with a neurologist as a logical step.