Migraine sufferers (or migraineurs as we often refer to ourselves!) can find exercise a tricky beast. On the one hand, we know it helps us feel better in a myriad ways. On the other, exertion, heat, sunshine, dehydration and noise can all trigger migraine attacks and therefore leave us a little wary.
In 2018 I stopped exercising other than very gentle incidental walking, and occasional one on one Pilates. This was a huge change for me, as I really enjoy moving my body and used to practice yoga every day, long walks regularly and strength training a couple of times a week. As my migraine frequency increased, my physical activity decreased. This is actually a common phenomenon, and something detailed by the largest longitudinal study that considered migraine, the HUNT study. Eventually I reached a point where I felt that my life with chronic migraine was becoming unsustainable - I was constantly being drained of energy and felt like I had no way to refill my cup.
2019 began with a decision to work with the things in my life I could control that might help me feel better. Nutrition, movement and mindfulness practice were the key things I chose. I read Heal Your Headache and it was an eye-opener. I started on the protocol, took all the supplements recommended (see Migraine Strong for more info) and adjusted my diet (check out The Dizzy Cook for recipes). At the same time, I joined the local gym. I’ve never been a gym bunny - I’m a yoga teacher, Pilates enthusiast, indoor rock-climbing and bodyweight exercise fan. However, I needed something different.
Six months in and I’m feeling better. Not a huge dramatic change, but generally overall better. Slightly fewer migraines, definitely more energy, happier and more positive, and determined to keep going.
So how did I start exercising even though I had chronic migraine? I tried to remember 3 things.
Consistency is everything for the migraine brain
A small amount is better than none
Set limitations, and stick to them (or do even less)
The migraine brain is hypersensitive, particularly when it is in a state of chronic migraine. Ups and downs can trigger attacks. More sleep than usual, less sleep than usual, more caffeine or less, or a huge burst of stress and then the return to baseline - all of these shifts could set off the migraine chain of events in the brain. So as a migraineur, it is important to try to keep things level. This applies to your exercise routine too. You are better off doing a little each day at a similar time, than you are doing one long burst of activity each week.
Warm-up is also essential, taking our brain slowly from sedentary to work-out without a big jump in intensity. Start really slow and simple, build up for at least 5-10 mins and then continue to climb from there. Even when you are actually exercising, best to try to keep the intensity low-moderate (more on this in a moment).
Less is More
If we overdo it, we are likely to throw in the towel and give up on the routine. This makes sense - who wants to exercise if you associate it with migraine? Yuck. So stick to a small amount to start with, something that you can comfortably manage without getting an attack. Every little counts, when starting from sedentary even a small amount is so much better than nothing! 5 minutes around the block is better than staying on the couch, 10 minutes to the shops is preferable to driving if you can manage it. Set small achievable goals and build from there.
I’m aiming for 20 minutes of aerobic exercise 3 times a week. This means 20 minutes of moving my body in a way that increases my heart rate and uses my large muscle groups 3 times a week. Could I do more? Maybe, if I really pushed myself. Will I increase this? Yes without a doubt, my eventual goal is 40 minutes 3 times a week (including 10 minutes of warm up), as that is the protocol supported by a recent study. However, when balancing chronic migraine and the potential benefits of exercise - less is more. Pushing yourself may well overtax an already stressed out and sensitive brain. Remembering the first point - our brains love consistency, so we want to gradually increase the amount we are exercising until it becomes the new baseline.
I’m on my way and building gradually. So far I’ve only had a couple of gym sessions early on trigger migraines, because I pushed too hard and lifted weights when maybe I shouldn’t have (more on that another time!). Hopefully by starting small, building gradually and remembering to warm up I will be fitter and stronger by the end of the year. I hope that you can feel better with exercise too.