Strength Training for Migraine Management
Migraine is a neurological disorder, often characterized by an agonizing headache. While headache is the most commonly known feature of migraine it is not the only one. Migraine is accompanied by other symptoms such as nausea and/or vomiting, and sensitivity to noise (phonophobia) and light (photophobia).
While the exact cause of migraine is still not completely understood, we do know that triggers play a role in migraine attacks. If you want to read about the difference between cause of migraine and migraine triggers read this: Migraine Cause vs Migraine Trigger
There are many triggers that are uncontrollable, like weather changes. However, there are modifiable triggers, or triggers that we can attempt to have positive influence over. These would include our sleep habits, stress management skills, diet, and physical activity levels.
By addressing these factors people living with migraine can often reduce the frequency and severity of symptoms. It’s been demonstrated in medical research that lifestyle modification or change can be an effective complementary approach to migraine management, and can often reduce the need for medication.
One of the more active approaches that can be taken to improve overall health and reduce the burden of migraine is through strength training. Also referred to as resistance training or exercise, strength training can provide numerous benefits in migraine management.
By incorporating strength training into a healthy lifestyle, individuals may be able to reduce their risk of migraine attacks and improve their overall quality of life.
Living with migraine is a daily struggle. Attacks can bring on debilitating symptoms and make it difficult to carry out everyday activities. Engaging in regular strength training has numerous benefits beyond just increasing muscle mass, overall fitness, and reducing stress.
Research has shown that resistance training can also help to improve sensory processing, improve the body’s pain modulation pathways, help to regular sleep patterns, stimulate mitochondrial biogenesis, and improve the neuroendocrine response.
In this blog we’ll dive into some of the more specific benefits of strength training for migraine, the variety of ways to perform strength training, and how to get started on your own program!
Benefits of Strength Training for Migraine
Variations of Strength Training
How to Get Started With Strength Training
Benefits of Strength Training for Migraine
Strength training has been shown to have several benefits that contribute to better overall health. This includes improved muscle function, stronger bones, improved cardiovascular health, and improved mental health.
But there are other benefits to strength training that many don’t talk about.
Many healthcare providers preach about the need to be physically active in the management of migraine. But many providers don’t take time to explain the “why” or “how” exercise improves migraine disease.
Exercise can have a profound impact on neuroplasticity.
Neuroplasticity is how the brain adapts to various experiences. It’s the capacity of the brain to reorganize its structure, function, and connections in response to the demands placed upon it.
Neuroplasticity can occur at different levels, including cellular, molecular, and cortical. These changes occur throughout the lifespan, and can be both beneficial for chronic pain when exercise is appropriately prescribed.
Here are 5 benefits of strength training that apply to migraine pathophysiology.
Improved Sensory Processing
Migraine has been described as a sensory processing disorder.
Studies have shown changes in how the brain processes these stimuli, and that those with migraine may have altered sensory processing pathways suggesting that dysfunction may be a key factor in the migraine pathophysiology.
Sensory processing is the ability of the nervous system to receive and interpret sensory information from our environments.
This would include light, sounds, touch, and vestibular stimuli. Strength training has been shown to improve sensory processing, which can have a positive impact on migraine.
In one recent study by Sun et al, found that resistance exercise was able to relieve symptoms of vestibular migraine by improving the patients’ vestibular function.
These results suggest that strength training can help reduce symptoms of vestibular migraine and may have broader implications for migraine management.
Improved Pain Modulation
Strength training can provide benefits to the body’s pain modulation pathways through several mechanisms. One of the primary mechanisms is the release of endogenous opioids, also known as the natural painkillers of the body. Physical activity can increase the release of these compounds, such as endorphins.
Another mechanism for enhanced pain modulation is the activation of the cannabinoid system, which has been shown to have pain-relieving effects. Exercise can increase your natural production of endocannabinoids. So, no need for CBD when your body can produce its own.
Strength training can also have a positive impact on peripheral and central sensitization, both common among those with chronic migraine and tension-type headache. This sensitization of the nervous system can lead to an amplification of pain perception, even from sensations that would normally not be perceived as painful, such as brushing your hair.
Exercise has been shown to decrease sensitization of the neck, head, and face with proper prescription.
Improved Sleep Regulation
Poor sleep is reported to be one of the most common migraine triggers. Sleep is necessary for our body’s to heal and recharge both physically and mentally. Regular exercise has been shown to have several positive effects on sleep.
First, exercise has been shown to improve sleep initiation, sleep efficiency, and sleep quality. All important metrics in monitoring sleep.
Secondly, exercise is associated with improved regulation of the circadian rhythm, our body’s natural clock that controls the times of many bodily functions, including our wake/sleep cycles.
Regular exercise, especially in natural light, helps to synchronize the circadian rhythm. This improves alertness during the day, and helps to improve sleepiness at night.
Stimulates Mitochondrial Biogenesis
You may be asking yourself, what does this have to do with migraine? Well, studies have shown that mitochondrial dysfunction may impair the energy supply of the brain.
This brain energy deficit has been theorized to increase migraine susceptibility.
Our brains already have a huge energy demand, accounting for about 20% of our body’s energy needs a day. The energy demands increase when trying to process sensory stimuli, think through complex tasks, or manage stressful situations.
Habitual exercise has been shown to stimulate mitochondrial biogenesis. This is crucial for creating additional mitochondria in response to increased energy demands, helps to replace damaged cells, and reduces cellular dysfunction.
Enhanced Neuroendocrine Response
The neuroendocrine system plays an important role in how we response to stress. When we are under a lot of stress, the neuroendocrine system is activated to release various hormones in response as a way to cope with these stressors.
This is sometimes known as the “stress response” or “fight-or-flight” response.
The stress response is designed to help the body effectively respond to acute stressors. However, chronic and prolonged stress can disrupt this system leading to dysregulation of hormone levels. This can contribute to various health problems.
Hormones released by the neuroendocrine system, such as cortisol and serotonin, can influence blood vessel dilation, inflammation, and pain sensitivity. All of which are believed to be involved in migraine pathophysiology.
Evidence suggests that exercise can influence the stress response. Single bouts of exercise are known to be a stressor that activates the neuroendocrine system, leading to the release of stress hormones.
Chronic exposure (aka frequent exercise) has been shown to cause positive adaptations in the stress response.
This has the potential for managing chronic stress-related issues. These exercise-induced stress adaptations may contribute to the health benefits of exercise in managing migraine.
Variations of Strength Training
Strength training, or resistance training, or resistance exercise, is designed to emphasize building muscular strength and endurance. There are various types of strength training exercises that can be performed using a variety of equipment, including free weights, machines, bands, and even body weight.
Weight training entails using dumbbells, barbells, or machines to provide resistance to the muscles. These exercises can be adjusted in terms of weight, repetitions, and sets to customize the person's fitness level and intensity appropriate for their goals.
Resistance bands are stretchy bands, made of rubber or latex, that provide resistance when stretched. Bands come in a variety of tensile levels. A mix of exercises can be performed by pushing or pulling against stretch.
Bands can be easily modified to adjust the resistance and intensity, making them suitable for people across fitness levels. Another benefit to bands is that they are more portable than free weights or machines.
Bodyweight exercises are strength exercises that use an individual’s own body weight as resistance. These exercises can be performed just about anywhere, without the need for equipment. Examples of bodyweight exercises would include variations of push-ups, squats, pull-ups, and lunges.
Some equipment can be used for body weight exercises such as parallel bars and suspension straps. These can be used to modify the intensity and resistance depending on fitness level and desired intensity of exercise.
How To Get Started Strength Training for Migraine
Wen it comes to starting a strength training routine for migraine it’s important consider a few key factors to ensure a safe and effective approach. By keeps these considerations in mind, those living with migraine can better tailor a strength training routine to their specific needs.
Gradually incorporating resistance exercise into their lifestyle management can improve migraine frequency.
Here are 5 things to consider when starting a strength training program.
Set Realistic Goals
Strength training can go a long way in the management of migraine disease. However, it can feel impossible at times when goals are set too high. When starting a new program, set goals that are simple and you know you can achieve.
ACSM guidelines for strength training recommendations are 8 to 10 exercises for major muscle groups. Using 1 set for each, performing 8 to 12 repetitions. Training 2 to 3 times a week, but not on consecutive days.
This is probably not an ideal place to start for those that have chronic migraine or high-episode. However, that could be the goal to work towards over several weeks to months.
A program would start with a much reduce version of ACSM strength training guidelines. Such as 2-3 exercises, performing 8 reps, training 1 day per week. And then adding exercises and days gradually until you reach the goal you set.
Remember the Rule of Too's
Exercise induced flares or attacks can set back well-intentioned strength programs. The Rule of Too’s is a good reminder on how to avoid the 3 most common mistakes when starting a new routine.
TOO hard, TOO soon, TOO often.
While a good goal in the long term is to strength training 2-3 times per with using 8 to 10 exercises, you probably aren’t ready for that yet if new to exercise. So, start small, and let your body adapt to exercise first.
Especially for chronic migraine, one may be very sensitive to even slight increases in stressors. Be patient with yourself, even if you don't "feel" like you're doing anything. You don't have to feel like you're killing yourself at high intensity to be benefitting from exercise.
It's not All-or-Nothing
You don’t have to force yourself to go exercise for 45 minutes 2 times a week in order to experience the benefits of strength training for migraine management. If you start, and need to cut sessions short because you don’t feel right. That’s okay.
A little exercise at a time can be just as powerful as doing a lot.
It's also okay to miss a day because you're too tired. It's okay to skip a workout because your in the midst of an attack. It's okay to skip when you know it will trigger one today. It's okay to start a session, and lower the weight and do fewer repetitions.
Strength training with a chronic condition is hard. Give yourself grace, and don't worry about being perfect.
Be Mindful of Other Triggers
Many triggers for migraine revolve around a build up of stressors. People often blame physical activity as a trigger for attacks, but it is rarely the sole trigger.
It’s more likely that a combination of triggers with the addition of physical stress let to an attack.
Being mindful of triggers during exercise can make a significant difference in success with training. Common triggers that can be exacerbated by exercise include dehydration and low blood sugar.
Other triggers that you should consider is how the loudness and brightness of the exercise location, the temperature (too hot, too cold) of the location, and exercising when too fatigued.
Many times I’ve had clients they hadn’t considered these other factors when migraine attacks kept occurring when attempting to exercise.
Considering other triggers of the environment can help to avoid exercise-induce attacks.
Conclusion
Strength training, or resistance exercise, can be a valuable part of a comprehensive migraine lifestyle management plan.
Not only does it provide generalized health benefits, such as increased strength, but it also provides benefits that directly target migraine pathophysiology.
Strength training has been shown to improve sensory processing, pain modulation, sleep regulation, improve stress response, and stimulate mitochondrial growth. All of which can contribute to reductions in migraine frequency.
Incorporating a strength training routine into a lifestyle plan can be a proactive way to manage migraine for many. However, it is important to remember that everyone’s needs and abilities are different.
It is essential to design an individualized strength program that is safe and effective for you. Consulting with a healthcare provider or trainer can help you create a personalized strength training plan for your specific condition to address your specific goals!
Are you interested in receiving a personalized strength training routine to manage your migraine? Reach out today, and let’s start your journey towards a stronger you!
As a licensed Physical Therapist, and certified exercise physiologist I’m here to help you create a personalized program that fits your specific migraine presentation, goals, and abilities. Whether you’re a beginner or experienced lifter.
I’ll work closely with you to develop a program that best fits your unique migraine.
With the right guidance and support we can build strength, increase energy levels, and potentially reduce the frequency of migraine attacks. Let’s get started on your customized strength program!