Regular exercise can reduce the frequency and intensity of headaches and migraines. When one exercises, the body releases endorphins, which are the body’s natural painkillers. Exercise reduces stress and helps individuals to sleep at night. Stress and inadequate sleep are two migraine triggers.
A recent study conducted by Varkey, Cider, Carlsson, and Lindy (2011) found that exercise, regular relaxation exercises, or the use of topiramate were equally effective in reducing the rate of migraines. Those participants in the exercise group exercised for 40 minutes three times a week. Therefore, exercise can be an effective intervention in the preventive treatment of migraines.
Some people may get headaches or migraines when they exercise. One possible reason for this is that a part of the physical reaction may be the elevation of blood pressure. This is not a reason to avoid exercise, which is good for general health. Instead, headache and migraine patients need a plan for preventing headaches or migraines when they exercise.
When exercising, follow this plan to prevent headaches:
- First, stay hydrated before, during, and after exercise. Make sure that your mouth is not dry and that you sweat. If you are thirsty, that is a sign that you have a substantial fluid deficit and may trigger a migraine. If you do not sweat when you are exercising at a moderate to vigorous level, it is a sign of dehydration.
- The second part of the exercise plan is to eat sufficient food about an hour and a half before you exercise. Exercise causes one’s blood sugar level to decrease, and it is important to have a source of energy. Foods with protein, such as a protein bar or nuts, are good snacks prior to exercise. If you get cramps when you have eaten too soon prior to exercise, you’ll need to schedule your meals and exercise more carefully. A regular schedule is always beneficial in headache and migraine management.
- The final part of the exercise plan is to warm-up. Do not jump into sudden, vigorous exercise if that triggers a headache or migraine. This means walking for five minutes at a slow pace of two and a half to three miles per hour before walking at a faster pace or jogging or stretch or gently lift light weights before doing more intense resistance training.
If you get headaches or migraines every time that you exercise, it may be helpful to talk with your doctor about whether you need a daily preventive migraine medication. In rare instances, a headache during exercise can be a sign of a more serious health problem. Call 911 and go to the nearest hospital emergency department if you get a headache during exercise and one of the following apply:
- You have never had a headache during exercise before.
- You had an exercise headache before but the current headache is different in the way the pain feels, the location of the pain, or other new or different symptoms.
- You injure your head during exercise, which results in a headache.
The President’s Council on Physical Fitness recommends a minimum of 150 minutes of exercise per week. This can be broken down into five sessions of 30 minutes. You also can meet this goal by doing ten minutes of continuous exercise for three times per day.
Ideally, an exercise program should include elements designed to improve each of these components:
- Cardio-respiratory endurance.
- Muscular strength and endurance.
Cardio-respiratory endurance can be enhanced through activities such as brisk walking, jogging, running, cycling, swimming, jumping rope, rowing, or cross-country skiing. You will want to work up to cardio exercises that are tend to be more vigorous in intensity. If you can talk while performing it, it’s moderate intensity. If you need to stop to catch your breath after saying just a few words, it’s vigorous. As you reach distance or intensity goals, reset them higher or switch to a different activity to keep challenging yourself. You can increase muscular strength most effectively by lifting weights, using either free weights like barbells and dumbbells or weight machines. Exercises to improve your endurance include calisthenics (conditioning exercises), weight training, and activities such as running or swimming. You can increase your level of flexibility through stretching exercises that are done as part of your workout or through activities such as yoga or Pilates.
The way to stay motivated for an exercise program is to choose activities that you enjoy. Determine what exercises may fit your personal style. If you like to socialize and have fun, you can join a walking or hiking club, play tennis, take exercise classes, go dancing, or play a round of golf with friends. If you prefer solo activities, you can go walking or jogging, bike riding, and swimming. If you like mental focus, racquet sports, downhill skiing, martial arts, yoga, and Pilates require concentration and discipline. For those who like spontaneity, mountain biking, outdoor hiking, and cross-country skiing are unpredictable and fun.
Technology can help with fitness. You can get an exercise DVD from the library, gaming consoles, and put your favorite tunes on a MP3 player to keep motivated. There are apps for smart phones and tablets that can structure your fitness routine that have free trials and are inexpensive to purchase. If you are goal-oriented, plan to run or bike in a race. Many charities sponsor races in which they will train you if you raise money for the charity. Challenge yourself with distance, time, and weight goals. Use the track at a public school. Use a pedometer and try to increase the amount of steps that you take each day.
Make it convenient to exercise. It may be helpful to schedule a time that is best for you and keep to the schedule. Some people prefer to exercise in the morning and get it out of the way. Others prefer to exercise after work. If you want to join a gym, find one that is a convenient location with convenient hours. Many health insurance plans or employers have arrangements with particular fitness centers and offer discounted rates. If it is hard to leave the house to exercise, consider getting equipment that you can use at home such as a treadmill or exercise bike. You may wish to work out while watching TV. Buy inexpensive equipment like jump ropes, hula-hoops, weighted vests, and balls to throw.
Make a plan to help you to stick to exercising. Set a reminder for yourself that you won’t be able to ignore. Some people put a sticky note on the bathroom mirror. You might set an alarm on your phone, computer, or clock. Make plans with an exercise buddy. Work with a personal trainer, if you can afford one.
Protect your exercise time. If you have children, you could get someone to watch the kids so you can exercise. Consider notifying anyone who may be affected by your time commitment so that they will plan around your activities, if needed, and will not interfere with your exercise program. Politely, but assertively, say no to anything that conflicts with your exercise or activity schedule. Log your exercise and reward yourself. You may wish to set a weekly goal and mark it on the calendar or a log sheet.
So, get moving!
© Lucy Rathier, Ph.D.; 2014. All Rights Reserved
Director, Behavioral Medicine Clinical Services, Lifespan, Providence, RI
Clinical Assistant Professor, Alpert Medical School, Brown University
last updated July 23, 2015.