Ponytail headaches are real. Here's how to prevent them while still keeping your hair off your face.

By Isis Briones
December 11, 2019

I’m a creature of habit. I never stray away from my regular black iced coffee order, The Office and Gossip Girl will forever be in my Netflix queue, and I’ll never give up my favorite pair of jeans. Since I travel every week for work, I like having constants in my life and, quite frankly, I don’t have time to switch things up.

Last month, I stepped outside of my comfort zone and began training for my first half-marathon with my boyfriend. I was miserable and not only because I was taking on several miles every other day, I noticed that I started getting headaches shortly after every run. Even though it’s been many years since my track and field glory days, I figured I could just go back to how I used to do things. How could I go wrong with pulling my hair back in a high ponytail and rocking my standard all-black workout look?

After complaining to my best friend, she pointed out that my workout hairstyle of choice was the likely cause of my headaches. She handed me a set of soft velvet pink scrunchies and told me to switch out my signature high ponytail for a low ponytail. I immediately realized I was wearing my hair too high and too tight. 

“The main reason that a headache occurs is due to the traction or force placed on the scalp when hair is held tightly in a ponytail,” says Lauren R. Natbony, MD, an assistant professor of neurology at the Center for Headache and Facial Pain at The Mount Sinai Hospital in New York City. Called an external traction headache, those who often get migraines are more prone to getting them, Dr. Natbony says. “This is due to a baseline level of hypersensitivity of the nerves around the face and scalp, a phenomenon called cutaneous allodynia or the perception of pain due to an otherwise non-painful stimulus.” 

Dr. Natbony points out that allodynia can spread all over the head, making any contact with that area uncomfortable. “Any stimulus, including wearing a ponytail or even brushing the hair, may become painful,” she says. “For those with frequent migraines who have allodynia, it’s possible that ponytails, headbands, or braids can trigger a migraine attack.” 

While hair type doesn’t affect your level of head pain, certain hairstyles do make a difference. “I would recommend styling hair to minimize the amount of traction placed on the scalp,” Dr. Natbony says. “That means avoiding anything that constricts the scalp. Loose ponytails or buns at the nape of the neck or braids that are tied at the end of the hair are preferable. If you choose to wear a style that puts pressure on the scalp, give your head a break and don’t wear it every day." And yes, it does help to take your hair down.

If my head is ever really pounding, I’ll give up and completely leave my hair down, but R+Co co-founder Garren recommends some solid compromises. “If you get a headache when working out, try parting down the middle and creating two loose braids,” he says. “You could also see if doing one very loose braid down the back of your head helps, so you’re not putting tension on it.”

Next time you see me training for my marathon, I'll be wearing a very chic, scalp-friendly low ponytail.

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