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The prevalence and nature of headache in sport is largely unknown. The only published study on sport related headaches was a survey performed on university students participating in varsity sport. The authors found that headaches were reported by 35% of all respondents with no gender effect evident.1, 2 There have also been anecdotal case reports of migraine and other headache syndromes occurring in a variety of sports.3–6
Community studies also note exercise as a potent trigger of migraine and other forms of headache. Despite this, the precise epidemiology of this phenomenon is unknown in community studies.7
Previously published epidemiological data on sport related headache suggests that headache in this setting is common, although the precise nature of the headaches and epidemiology remains unclear.1, 2 One would intuitively expect that in contact and collision sports that the prevalence of headaches would be high, however, prospective epidemiological studies remain to be performed.
Few studies in sport have utilised the International Headache Society diagnostic criteria to ensure uniformity in headache categorisation.8 Furthermore, such research based criteria remain to be tested in the sporting situation.
The accurate diagnosis of headache syndromes in sport has important treatment implications.4, 5 In professional sport, many conventional headache medications (such as beta-adrenergic antagonists, caffeine, codeine-containing preparations, dextropropoxyphene, narcotics, and opioids etc) are banned agents under International Olympic Commission rules. Accordingly the ability of a team physician to accurately diagnose and treat the specific headache requires an understanding of the symptomatology and nature of headaches that may present in these situations.