Part 1 in our series in partnership with Miles for Migraine
Has it been a while since you’ve exercised? If you have migraine, it’s not hard to guess the reasons why. Nearly 40 percent of people with migraine have experienced exercise-induced attacks. The fallout from such attacks can be so profound that many people with migraine develop kinesiophobia, a fear of movement, making the prospect of exercise even more daunting.
Yet research has shown that regular, moderate exercise is beneficial for people with migraine. Some studies have even shown exercise to be as good for reducing migraine frequency and intensity as doctor-prescribed preventive medications.
“We know that exercise is a good preventive,” says Shirley Kessel, executive director of the national awareness and advocacy group Miles for Migraine, whose year-round events largely revolve around exercise and activity. “It is really an act of self care.” By following a few guidelines to keep you in tune with your migraine brain and body, you too can start exercising with confidence.
Exercising for Migraine Essentials
“Exercise is one of the most challenging lifestyle changes for those living with migraine to make,” says headache specialist Dr. William Young of the Jefferson Headache Center. “But, in my experience, the addition of even modest movement can make a big impact.”
Pacing yourself during exercise is essential for reducing your risk of exercise-induced attacks. That’s because your migraine brain is highly sensitive to change. Lots of sudden environmental ups and downs can cause your brain to perceive a threat and overreact – like a spike in oxygen demand, or a fall in blood sugar, or a burst of activity followed by inactivity. So when introducing exercise changes, bear in mind a few guiding points:
- Roll out changes to your exercise habits gradually, in small enough increments that it doesn’t set off alarm bells in your overly vigilant brain.
- Once you introduce a small exercise change, continue doing it, so that the brain will come to see it as part of your body’s familiar, steady routine.
- When you feel adapted to that exercise change, you’ll be ready to introduce another small change.
In that way, slowly and methodically, you can create, maintain, and build an exercise habit.
Finding Your Perfect “FITT”
The movement routine that’s right for you is one that will allow you to gain the benefits of exercise, while also lowering the risk of your exercise sessions bringing on a migraine attack. Finding that balance has four components. Together they create your perfect exercise “FITT.”
Frequency. Migraine research encourages 3 to 4 movement sessions per week to reap the benefits of exercise. However, the true goal is creating and maintaining consistency, so choose a frequency you can maintain over time. If it’s been a while, try starting with two sessions a week and see if you can build from there.
Intensity. Your goal for migraine health is a moderate intensity, such as a brisk walk. But it can be easy to overdo it while exercising. That’s why it’s important to start slowly, know your limits, and learn to stay attuned to your body’s signals while exercising, so you can pull back before you’ve pushed your body harder than your brain is ready to handle.
- A rule of thumb for cardio is that you should be able to hold up your end of a conversation. If you’re breathing too hard to speak, dial down your intensity.
- Lifting weights? If you haven’t done so in a while, start with lighter weights and build from there. Overly stiff and sore muscles can contribute to migraine.
Time. The US Department of Health and Human Services’ new guideline for cardiovascular health suggests that you aim for 30 minutes of moderate physical activity at least 5 days a week. Consider it a long-term goal that you may need to work toward. If you haven’t moved in a while, start with two minutes per day. Gradually work your way up to 150 minutes per week, divided however you like. For example:
- 30 minute sessions, 5 times per week
- 38 minute sessions, 4 times per week
- 60 minute sessions, 3 times per week
Type. What type of exercise should you choose for migraine health? Simple: Whatever type you enjoy, since that makes you most likely to do it consistently. Then, when you’ve managed to maintain an exercise routine of 3 to 5 times per week for 2 to 4 weeks, add on a second type of exercise, to keep things interesting and magnify your exercise benefits. Suggestions include walking, cycling, swimming, yoga and tai chi.
- Yoga and tai chi are exercises with the additional migraine benefits of mindfulness. Miles for Migraine offered both in a free virtual series this year. You can watch and move along with the full playlist of videos here.
As you begin exercising, use our downloadable exercise log to help find your FITT. Jot down your type of exercise each day, time spent, and intensity level, as well as any notes about how you felt afterwards. Tracking these important factors will help you figure out what’s working best for you.
Staying the Course by Setting Goals
Setting short and long term goals are important for getting where you want to be. One strategy for setting short-term goals is to incrementally move yourself along the FITT spectrum. For example, your goals could be:
- Frequency: Increasing from three days per week to four
- Intensity: Increasing from a slow walk to a brisk walk, or from a brisk walk to a jog
- Time: Increasing from 5 minutes a day to 7, or from 25 minutes to 30 minutes
- Type: Adding a yoga session to your weekly walking routine
Achieving each of those steps can get you closer to a longer-term goal you can set for yourself. A long-term goal is something you want to achieve in six or 12 months, or even farther into the future. For example, those might be:
- Losing excess weight and keeping it off
- Attending (and dancing at!) someone’s wedding
- Participating in a local run/walk event
For a run/walk goal that also connects to migraine, Miles for Migraine holds events throughout the year, via 24 chapters around the country. Since 2008, Miles for Migraine has raised over $1 million for migraine research and education through events that revolve around fitness. “Exercise is something people with migraine can work up to for their own health, and share their success,” says executive director Shirley Kessel, who herself keeps a daily fitness routine to manage migraine. “The idea is to get people together to feel supported.”
About 7,000 participants attend Miles for Migraine events each year, which includes a 10K run, a 5K run, and a 2-mile walk. If you’re not feeling up to any of that, you can also opt to “relax,” in which you accrue “miles” by doing self-care activities. There’s no judgement and no pressure, just an appreciation for where you are right now – since in this crowd, respecting your body and its changing limits is a shared priority. For more information and to register for an upcoming virtual Miles for Migraine event, click here.
To download our Migraine Exercise Log, click here.