How to move: with migraines
Migraines can be debilitating, but exercise may help limit their frequency and intensity. Here are some points to consider
- In the How to move series, experts offer advice on exercising without exacerbating pain and fatigue
Migraines are the most common form of headache that can cause severe throbbing pain – usually on one side of the head – and severely affect quality of life. A migraine attack can last hours or days and often comes with nausea, vomiting and extreme sensitivity to light and sound.
According to a 2018 Deloitte Access Economics Report, almost 5 million people in Australia live with migraine, with 7.6% of them – around 400,000 people – experiencing chronic migraine, which means more than 15 migraine days per month.
Migraines are much more common in women than men and more prevalent in working-age people.
“During a flare, all people want to do is lie in a cold dark room and not do anything,” says Adnan Asger Ali, a physiotherapist and the deputy national chair at Musculoskeletal Physiotherapy Australia. But research shows regular exercise may have a preventive effect in reducing the number and intensity of migraines. One of the main reasons physical activity may help relieve migraines, says Ali, is that the body releases endorphins (natural painkillers) during exercise.
“Physical therapy can complement the pharmacological management of migraines,” he says. “It might mean that they take two Panadol instead of two codeine, and that’s still going to be a win because they’re not taking the hard stuff.”
A proper physical assessment is necessary to tailor a treatment plan to the individual, and individuals should consult with a health professional before embarking on a new exercise regime, but here are some suggestions on physical exercise that might help manage migraine.
The class: yoga and tai chi
Ali says slow movements, meditation and relaxation have significant beneficial effects on people who suffer from migraines. That includes activities such as yoga and tai chi.
In a recent randomised clinical trial that involved 114 patients aged 18 to 50 years with a diagnosis of episodic migraine, researchers found that people who practised yoga as an add-on therapy had less frequent and less intense migraines than those who received medical treatment alone.
Tai chi can also serve as a preventive measure for migraines. In a 2018 randomised controlled trial of 82 Chinese women with episodic migraines, researchers found that after 12 weeks of tai chi training, the women experienced significantly fewer migraine attacks.
The move: chin tuck
Neck stiffness and postural issues can be a driver for migraines, says Ali. He suggests the chin tuck, or cervical retraction, exercise to strengthen neck muscles and improve mobility.
The chin tuck exercise can be performed standing or sitting. Begin by sitting upright and looking straight ahead, keeping your neck and shoulders relaxed. Place a finger on your chin and gently glide your chin down – tuck your chin to your neck. Don’t hold your breath, move your head up or down or bend your neck forward.
You might feel a gentle pull at the base of the head and top of the neck. Hold the position for about five seconds and repeat the exercise 10 times – as long as it doesn’t cause any pain.
The activity: walking, jogging, running and cycling
Aerobic exercises such as walking, jogging, running and cycling might help mitigate migraine.
A systematic review of studies on exercise and migraine published in The Journal of Headache and Pain in 2019 found that moderate-intensity exercise – physical activities that elevate your heart rate and cause you to breathe harder but still allow you to carry on a conversation – can decrease the number of migraine days.
“Any activity that people will do consistently and that they enjoy will be good for them,” says Ali.
The hard pass: high-intensity interval training
Ali warns against HIIT workouts, which alternate short bursts of intense cardio exercise with rest or lower-intensity exercise. “Very high-intensity exercise is discouraged if it triggers your migraine,” he says.
In some people, high-intensity exercise can trigger a migraine attack. But research has shown that regular HIIT workouts might be more beneficial than moderate exercise for others, highlighting the importance of a personalised exercise plan.