Migraine and Exercise

The relationship between migraine and exercise can feel like a confusing paradox. On one hand, you’re told that regular physical activity is one of the cornerstones of good health and can even help prevent migraine attacks. On the other hand, you may have experienced the frustration of a great workout triggering a debilitating migraine, or found that the mere thought of moving during an attack is unbearable. It’s completely normal to feel wary or even fearful of exercise when you live with this condition. This guide is here to offer a compassionate and balanced look at this complex topic, helping you understand how exercise can be both a trigger and a treatment, and how you can find a safe, sustainable movement practice that works for you.

How Can Exercise Help Migraine?

When done correctly and consistently, regular, moderate exercise can be a powerful tool in your migraine prevention toolkit. The benefits are numerous and work on several levels to make your brain more resilient to migraine attacks.

It Releases Endorphins: Exercise triggers the release of endorphins, which are your body's natural painkillers. These "feel-good" chemicals can help to reduce pain perception and improve mood.
It Reduces Stress: Stress is one of the most common migraine triggers. Regular physical activity is a proven way to manage stress levels, which can, in turn, reduce the frequency of stress-induced migraine attacks.
It Improves Sleep: Poor sleep and migraine have a strong, cyclical relationship. Regular exercise can help regulate your sleep-wake cycle, leading to better quality sleep and potentially fewer migraine attacks.
It Helps Maintain a Healthy Weight: Research has shown a link between obesity and an increased risk of chronic migraine. Regular exercise is a key component of weight management.

Studies have shown that regular, moderate aerobic exercise (like jogging, swimming, or cycling) can be as effective as some preventive medications in reducing the frequency and severity of migraine attacks.

Why Can Exercise Trigger a Migraine?

The frustrating flip side is the reality of exercise-induced migraine. This doesn't mean that exercise is bad for you; it means that for a sensitive migraine brain, certain factors related to physical activity can act as triggers.

Sudden, Strenuous Exertion: A rapid increase in heart rate and blood pressure from high-intensity exercise can be a powerful trigger.
Dehydration: You lose fluids when you sweat, and dehydration is a major migraine trigger.
Low Blood Sugar: Exercising on an empty stomach can cause a drop in blood sugar, which can trigger an attack.
Overheating: A significant increase in body temperature can be a trigger for some individuals.
Muscle Strain: Straining the muscles in your neck and shoulders, particularly with improper form during weightlifting, can lead to a tension-type headache that can then morph into a migraine.

A Patient's Story: David's Frustration

"I used to love playing basketball," says David, 36. "But it got to the point where almost every time I played a pickup game, I'd come home with a throbbing headache that would ruin the rest of my day. It was so frustrating to have something I enjoyed so much cause me so much pain. I ended up avoiding exercise altogether for a while because I was afraid of triggering a migraine. It took working with a physical therapist to find a routine that didn't push me over the edge."

A Gentle and Safe Approach to Exercise

The goal is to find the "sweet spot" where you can reap the benefits of exercise without triggering an attack. This requires a slow, gentle, and mindful approach.

A gentle reminder: It's always a good idea to talk to your doctor before starting a new exercise program.

Warm-Up and Cool-Down are Non-Negotiable: This is perhaps the most important rule. A proper warm-up of 10-15 minutes of gentle movement (like walking and dynamic stretching) allows your body to gradually adjust. A cool-down of similar length helps your heart rate and blood pressure return to normal slowly.
Start Low and Go Slow: If you are new to exercise or returning after a break, start with low-impact activities like walking, swimming, or using an elliptical machine. Begin with just 15-20 minutes, 3 times a week, and very gradually increase the duration and frequency as you feel comfortable.
Stay Hydrated: Drink water before, during, and after your workout.
Have a Pre-Workout Snack: A small snack containing carbohydrates and protein about an hour before you exercise can help keep your blood sugar stable.
Listen to Your Body: This is crucial. Pay attention to how you feel. If you feel the very first twinge of a headache or other migraine symptoms, it is okay to stop. Pushing through is not the answer.
Consider Mind-Body Exercises: Practices like yoga, tai chi, and Pilates can be wonderful options. They combine gentle movement with mindfulness and stress reduction, addressing multiple aspects of migraine at once.

A Final, Compassionate Thought

Please be patient and kind with yourself as you explore movement. It can take time to rebuild trust with your body and to find a routine that feels both good and safe. Let go of any expectations of what exercise "should" look like. A gentle 20-minute walk is just as valid and beneficial as running a 5k. The goal is to find a joyful, sustainable practice that supports your overall well-being, one gentle step at a time.

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