What is a Migraine ?

4.9 million people in Australia suffer from migraine. 71% of migraine sufferers are women and 86% are of working age. 7.6% of migraine sufferers experience chronic migraine (≥15 migraine days per month). The total economic cost of migraine in Australia is $35.7 billion.

While there are multiple different types of migraines and different causes, there are common factors that contribute to the symptoms experienced by most people with migraines.

Migraines are also often confounded with other types of headache presentation including tension-type or cervico-genic headaches risk factors - such as muscle tension, altered breathing patterns and neck joint stiffness.

Because of this, there are some general management strategies that are proven effective in alleviating many of the common symptoms.

How can Exercise help?

Evidence suggests that moderate exercise can reduce the frequency and severity of migraine attacks in some people, and regular exercise can be effective in preventing migraine. Recent studies have shown that exercise stimulates your body to release natural pain controlling chemicals called endorphins and natural anti- depressant chemicals called enkephalins. This could mean that embarking on a well-planned exercise program could enable you to reduce your drug intake, particularly drugs taken daily to prevent migraine.

Targeted exercises that aim to restore dysfunctional postures and mechanical factors that may contribute to migraines (muscle tension and neck joint dysfunction etc) are also a useful addition to migraine management plan. Often, people will have improvements in symptom severity, frequency or duration from restoring and optimising the movement/posture of the neck and upper cervical spine

Dosage

Aim to exercise for around 30 minutes at a moderate intensity, beginning 1-3 times a week. You should begin your exercise program gradually, building up the momentum over several weeks with an aim of performing 30 minutes of exercise on most, if not all, days of the week. Starting with shorter, more frequent sessions to build initial tolerance regularity is an effective method.

We know that exercise has both immediate and longer term effects, and with migraines a lot of the benefits take some time and consistency to gain the beneficial effects. Aim to give yourself at least six weeks to see how your body responds before making any large changes.

Migraine Diary

Some people find that using a diary to record migraine symptoms assists in measuring the effect of medications and lifestyle changes. Even if this isn’t something you have done/do - keeping a migraine and exercise diary, recording both your migraine attacks (pain and/or dizziness) and exercise you have undertaken can be useful at first to figure out what types of exercise work for you. This will give you an idea of the effect aerobic exercise has had on your migraine and any steps to take to help ensure that exercise is not a trigger for you. It will also act as a record of whether you are decreasing or increasing migraine medication.

Details to record include:

the date and time of your exercise,
how you prepared,
the type of exercise (Walking,swimming, rowing machine etc.,)
and duration of exercise.
While this doesn’t need to be an ongoing habit - it is often useful in the initial stages of starting new exercises. If you haven’t exercised recently or haven’t tried exercise to manage your migraines, it would be useful to get in touch with. a physiotherapist or exercise physiologist who can get you on the right track.

If you haven’t used a migraine diary before there are a few general bits of information that are worth recording to build a strong migraine management plan.

Other information that can be included:

when the symptoms started
how often they occur
where the pain is
the type of pain (throbbing, piercing, etc.)
if there are other symptoms (such as being sick or having vision problems)
how long the attacks last
what treatment you take
how effective treatment is (or isn’t).

It is also helpful to record as many aspects of daily life as possible, such as:

what and when you eat (think about missed or delayed meals)
medication you take for other conditions  how much sleep you have  exercise you perform
social and work activities
other factors, such as the weather
females should record details of their menstrual cycle and any timing related patterns .
if you did anything different prior to the attack such as missing a meal. The 6-8 hours before the migraine attack are particularly important to record.

Breathing exercises for headache

Deep breathing may be beneficial as a relaxation strategy for those suffering form migraine especially when stress is identified as a trigger. Research has shown that deep breathing type relaxation techniques are easily adopted and effective in managing migraine symptoms.

Check out our Breathing Basics blog for more information on how your breathing patterns could be affecting a range of different bodily functions.

Remember to:

Eat at least 75-90minutes before exercising, leaving time for your body to digest the food for energy as well as ensure your stomach is not still heavily digesting the meal. Eating enough quality food will keep your blood sugar at an appropriate level as low blood sugar can be a trigger for a migraine.
Drink fluids before, during and after exercise. Dehydration from a lack of adequate fluid replacement, especially from overheating or excess sweating, is a common migraine trigger. Drinking water is usually sufficient but occasionally an isotonic sports drink may be useful. Check out our Recovery Strategies (Part 1) blog for more information on keeping hydrated.
Warm up before and after exercise. Warming up the cardiovascular system and allowing blood flow to the muscles and joints of the body is important to avoid triggering migraine from sudden overextension. Gradually building up your intensity after having done a few mobility/range of motion drills can prevent this sudden spike in blood pressure as well as prevent muscle/joints becoming overloaded. Doing the same thing when finishing exercise - gradually slowing down and finishing with some stretching/flexibility activities can reduce the likelihood of triggering a migraine from blood pressure/intracranial pressure changes and musculoskeletal contributors.
Plan ahead and organise your routine so that you can ensure that exercise is built in to your lifestyle along with regular meals and regular bedtimes. In this way you will also be able to monitor the affect it is having on your migraines.

Exercise is also beneficial for overall health and reducing the risk of developing diseases like high blood pressure, diabetes, depression and obesity. Benefits also include reducing stress, reducing cholesterol levels, improving the quality of sleep patterns and producing a feeling of wellbeing.

If you have found that you have learned to avoid exercise if you have identified it as a trigger, you may still be missing out on the benefits that exercise can bring to your migraine symptoms and overall wellbeing. If this is the case - it would be beneficial to get in touch with a physiotherapist or exercise physiologist who can get you on the right track.

If you’d like more information on any of the information above or would like a better understanding of how movement can be medicine for you, keep an eye out for more content like this or get in touch to book an appointment for a personalised plan of action today.

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