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  • Writer's pictureSam Kelokates

Exercising for Migraine Relief: A Structured and Safe Approach

Updated: Feb 15

It's a scenario I encounter far too often: a patient comes in, sharing that their doctor advised them to exercise as a means of managing migraine.

While this advice is well-intentioned, it's typically where the conversation begins and abruptly ends. There's a glaring gap - a lack of specific guidance.

No suggestions on how to start on this exercise journey, what types of activities to consider, or crucially, how to prevent exercise from triggering a migraine attack. The conversation lacks depth necessary with chronic migraine, leaving patients confused on where to start.

A woman in her is walking on a treadmill in a gym setting. She exhibits signs of confusion and appears to be experiencing a headache. She has one hand on her forehead, showing a look of discomfort and pain. Her facial expression conveys a mix of distress and uncertainty

This is where the problem lies. Exercise, undoubtedly, can be a formidable ally in the battle against migraine.

However, its effectiveness hinges on the presence of expert guidance and a structured approach. Without it, patients are often left to navigate the complexities of migraine management through exercise on their own, which can be daunting and, at times, counterproductive.

Recognizing this gap, I've dedicated myself to developing a methodical, step-by-step guide aimed at harnessing the power of exercise for migraine relief in a manner that is both effective and safe.

Drawing from my experiences with patients, this guide is to offer that much-needed structure and support. It's not just about telling patients to exercise. It's about guiding them on how to do it right.

Setting Realistic Goals

When starting on a journey of managing migraine through exercise, the first and perhaps most crucial step is setting realistic goals. Understanding one’s current fitness level and health status isn't just a formality. It's the foundation upon which a successful exercise regime is built.

This process is like plan out a trip on a map. It helps to clarify our destination, and anticipate potential obstacles.

In goal setting, the commonly used acronym is SMART, which stands for Specific, Measurable, Achievable, Relevant, and Time-bound. However, when dealing with chronic conditions like migraine, I adapt this to 'SMAR' goals.

Here, the 'T' for 'Time-bound' is intentionally omitted. This alteration stems from an understanding that chronic conditions, like migraine, may require flexibility in achieving goals.

The journey with chronic pain is often unpredictable, and rigid timelines can add unnecessary stress and pressure, which can be counterproductive, especially for individuals battling migraine.

By focusing on SMAR goals, we shift our emphasis to continuous progress rather than being bound by time constraints. It becomes less about reaching a milestone in three or six months and more about steadily moving towards our goals, at a pace that respects and accommodates the unique challenges posed by migraines.

This approach fosters a sense of patience and persistence, allowing individuals to focus on consistent improvement without the added burden of stringent deadlines.

"To begin with the end in mind means to start with a clear understanding of your destination. It means to know where you're going so that you better understand where you are now and so that the steps you take are always in the right direction." - Stephen Covey

This philosophy is particularly relevant in our context. Setting SMAR goals helps us to chart a clear and adaptable path forward, one that acknowledges where we are at present and gently guides us towards where we wish to be, without the pressure of racing against the clock.

Personalized Evaluation and Programming

A personalized evaluation is not just beneficial – it’s essential. This step is about crafting a program that is as unique as the individual it’s designed for.

It involves a comprehensive assessment by a healthcare professional, ideally one who understands both the complexities of migraine and exercise science.

The cornerstone of this evaluation is understanding an individual's migraine triggers. Migraine is individualistic. What triggers an attack in one person may be completely benign for another.

Thus, identifying these triggers is critical. This knowledge not only helps in tailoring an exercise program that avoids these triggers but also in recognizing warning signs early on.

Next, we delve into the individual's fitness history. This is not just about how often someone exercises or how fit they are. It’s about understanding their relationship with physical activity, their past experiences, and their attitudes towards exercise.

For some, exercise might have been a trigger for migraine in the past, and for others, it could be a largely unexplored territory. Recognizing this helps in setting a starting point that is challenging yet achievable, and most importantly, safe.

Lifestyle factors also play a pivotal role. This includes their daily routine, work demands, stress levels, dietary habits, and sleep patterns. All these elements can influence migraine patterns and exercise tolerance. A program that overlooks these aspects is often incomplete and less effective.

The importance of determining the right starting point cannot be overstated. Starting too intense, progressing too soon, or with the wrong type of exercise can not only lead to setbacks but can also exacerbate migraine symptoms.

The goal is to find that sweet spot where the exercise is beneficial without being overwhelming. This requires a delicate balance, one that is best achieved through a tailored evaluation and a carefully crafted program.

This personalized approach ensures that the exercise plan is not just a generic set of recommendations.

Establishing Exercise Parameters

After setting realistic goals and undergoing a personalized evaluation, the next step in effectively implementing an exercise program for migraine management through exercise is establishing clear exercise parameters.

This is where the exercise plan starts to take a more defined shape, tailored specifically to the individual's needs, capabilities, and migraine triggers. A key component of this process is the use of objective measures, such as heart rate monitoring, to personalize exercise intensity.

Monitoring exercise intensity is an invaluable tool in this context. It provides real-time feedback, allowing for precise regulation of exercise intensity.

This can be don't by monitoring heart rate or rate of perceived exertion (RPE), repetitions in reserve (RIR) for weighting lifting. By keeping track of exercise intensity, individuals can ensure they are working within a safe and effective range.

This is to help maintain the delicate balance between pushing the body enough to gain health benefits but not so much that it triggers a migraine attack.

Self-regulation of effort is another critical aspect of establishing exercise parameters. It's about being attuned to one's body and understanding its signals. Individuals learn to recognize the signs of overexertion and to adjust their effort accordingly.

This skill is especially important for those dealing with migraines, as they may need to modify their exercise intensity or duration based on their current condition.

For instance, on days when a person feels more vulnerable to a migraine attack, they might opt for a gentler, more restorative form of exercise or short duration of exercise, while on days they feel stronger, they might engage in more intensive activities.

It's important to remember that self-regulation doesn't mean underperforming or constantly holding back. Rather, it's about mindful exercise management – knowing when to push and when to ease up.

This approach not only helps in avoiding potential migraine triggers but also ensures a more sustainable and enjoyable exercise experience.

This thoughtful and personalized approach to exercise intensity and effort is what makes the journey towards managing migraines with exercise both effective and empowering.

Monitoring and Modification

The journey of managing migraine through exercise is not a set-and-forget routine. It necessitates continuous monitoring and the readiness to adjust the plan as needed. This step is pivotal because it acknowledges that managing migraine is an evolving process, and what works today may need refinement tomorrow.

Continuous monitoring plays a role in this adaptive approach. It may involve keeping a detailed record of exercise sessions, including their type, duration, and intensity, along with any corresponding changes in migraine patterns.

This ongoing tracking helps in identifying correlations between specific exercises and migraine occurrences or relief. For example, a certain type of exercise might consistently trigger migraine attacks, or conversely, some activities may prove to be surprisingly beneficial. By meticulously tracking these patterns, individuals can fine-tune their exercise regimen for optimal results.

The importance of this monitoring extends to understanding how different exercises impact the individual over time. As the body adapts to certain types of exercise, its response to these activities can also change. What started as a trigger might become tolerable, or an initially beneficial exercise could lose its effectiveness.

The exercise plan should not be static. It should evolve based on these ongoing observations.

The role of communication between the patient and their healthcare provider is important early on in programming. This dialogue is a two-way street, where the patient shares insights from their monitoring, and the healthcare provider offers professional guidance to adjust the exercise plan accordingly.

Open and honest communication ensures that any adjustments made are informed and strategic, taking into account the latest developments in the patient's condition and response to exercise.

Monitoring and adjustment are about flexibility in the exercise plan. It's about being responsive to the body’s cues and being willing to make changes for continued progress.

Through careful monitoring and open communication, exercise becomes a dynamic tool in migraine management, one that adapts to serve the best interests of the individual at every turn.

Dealing with Challenges with Expert Guidance

Starting an exercise routine while managing migraine can present unique challenges, including the possibility of triggering migraine attacks. However, these challenges shouldn't stop you.

They are a part of the journey towards finding what works best for your body. As an experienced healthcare professional specializing in migraine management and exercise, I can provide the expert guidance necessary to navigate these complexities.

In my practice, I focus on identifying exercise-related triggers unique to each individual. I understand that adjustments in your exercise plan, whether it’s the intensity, type, or timing, can make a significant difference in managing your migraines.

Through a personalized approach, I ensure that your exercise routine enhances your health without exacerbating your condition. If you're struggling to balance exercise with migraine management, consider reaching out for specialized support.

In my practice, you will receive a tailored exercise program and ongoing guidance. This approach is crucial for effectively integrating physical activity into your lifestyle while taking care of your specific health needs.

Remember, expert guidance can transform your exercise journey, making it a supportive part in your migraine management strategy. Together, we can create a plan that’s not just about managing symptoms, but also about enhancing your overall well-being. Feel free to contact my practice for a consultation, where we can start tailoring an exercise regimen that works for you.

About Me:

Hi, my name is Sam Kelokates, PT, DPT. I am a licensed physical therapist and owner of Kelos Physical Therapy, located in Philadelphia, PA. I specialize in the non-pharmacological management of headache and migraine disorders.


This blog post is for informational purposes only and should not replace professional medical advice or treatment. Always consult with a qualified healthcare provider for personalized guidance and recommendations.

**I may earn commissions for purchases made through the links in this post**

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