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  • Writer's pictureSam Kelokates

Unlocking The Benefits of Exercise for Migraine: Graded Exercise For Migraine Management

Migraine can significantly impact the lives of those living with it. One often prescribed non-pharmacological treatment is regular physical activity or exercise.

This is because it has been shown to have numerous benefits for those living with migraine, including reducing frequency and intensity of attacks.

Research has also shown that regular exercise has been able to reduce chronic migraine to episodic migraine.

However, many individuals with chronic migraine feel apprehensive about starting a physical activity or exercise program due to fear of exacerbating their migraine condition or triggering attacks. But there are strategies to help prevent this.

Graded exercise exposure is a promising approach for reintegration into a physical activity program for managing migraine.

I want to talk about the benefits of exercise for individuals with migraine. Taking a dive into concepts of graded exercise exposure, and discussing how it can be implemented in the management of migraine.

What is Graded Exercise

Graded exercise is a graduated approach to increasing physical activity levels for those who are returning from a period of inactivity or who have never done an exercise program before.

This approach involves gradually increasing parameters of physical activity over time. These parameters include frequency, duration, volume, and intensity of exercise. This allows the body to adapt overtime and become stronger while lowering the risk of adverse setbacks.

The rationale behind graded exercise is to avoid overwhelming the body with too much activity too quickly. As this could lead to injury, burnout, or a migraine flare. By starting with a low baseline level of activity, and gradually increasing over time, the body is better able to adjust and adapt to physical stressors.

Graded exercise is often used in rehab settings following acute musculoskeletal injury, but it can be applied to those with migraine to improve tolerance to exercise and reduce the sensitivity to physical activity triggers. This can be beneficial for those with chronic migraine as it provides a structured and manageable way to increase physical activity and improve health.

A graded exercise program involves developing a customized exercise plan that takes into consideration your unique migraine presentation, current fitness level, additional medical history, and triggers. Then a step-by-step exercise plan is implemented, starting with low intensity activities and gradually progressing into larger volumes and higher intensities over a period of time.

Starting A Graded Exercise Program

Starting an exercise program when you have chronic migraine can a challenging endeavor. Physical activity can sometimes be trigger for migraine attack.

That's why it's essential to start with a graded exercise program that gradually allows you to increase your physical activity level while minimizing the risk of triggering future migraine attacks.

Assessment of current fitness level

Before starting any exercise program, it's important to assess your current physical activity / fitness level. This will help to determine where to start with an exercise program as to avoid triggering a migraine attack or flare.

An exercise specialist, like myself, can help you evaluate your current level of fitness and identify any physical limitations that may affect your ability to exercise. This information will help you develop a plan that is tailored to your specific needs.

In most cases when just starting out it's okay to just start with a program that is easy, but we can also perform submaximal exercise tests to create a better exercise program. Be aware, an testing can trigger a migraine attack.

Submaximal tests could be used assess muscular strength and endurance, cardiovascular endurance, and mobility. Based on results, a more informed exercise prescription can be designed uniquely created based on your current fitness level.

This also makes it easier to observe progression over time when you re-test.

Determine Triggers that will affect exercise

It's important to consider your unique migraine triggers when starting an exercise program. Some triggers can include dehydration, low blood sugar, and lack of sleep.

Other triggers to consider are related to the environment you plan to use when exercising. Gyms can be noisy, visually stimulated with people walking about, have bright light, and use cleaning solutions that are irritants.

If you are going outside for exercise (like walking) think about allergens, sunlight, and weather that may affect your migraine threshold.

Additional triggers along side exercise can make an attack more likely to occur. So be sure to make adjustments to exercise program.

Realistic Goals & Starting Point

Setting realistic goals for your exercise program is important to give direction and purpose. Starting with a realistic starting point is critical!

This starting point gives you a foundation for exercise that allows your to move without fear of triggering a migraine attack with each session. Then as your body makes adaptations to consistent exercise you can gradually increase your activity level.

It's essential to set goals that are achievable. You can always create new goals and set great ambitions when you're ready. And don't forget to celebrate your progress. Even the small victories!

Keep in mind that exercise is not a cure for migraine. Exercise programs can help to manage symptoms and reduce the frequency of attacks.

Exercise Progression

Once you have established an ideal starting point for your graded exercise program, the next step is to progress gradually with frequency, intensity, and duration of exercise.

It's important to pace yourself early on in exercise programs as a beginner or out of a recent migraine flare. Overexertion lead to fatigue and overuse. While this doesn't mean a migraine attack will happen it certainly can increase your risk.

Here are some tips on how to progress a graded exercise program:

To progress your exercise program, gradually increase the frequency, duration, and intensity of your workouts. Start by increasing the frequency of your workouts every 2-4 weeks. For example, if you are currently exercising two times a week for 15 minutes per session, add a third day of exercise.

Once you have increased the frequency of your workouts, gradually increase the duration of each workout. Add an extra 5 minutes to each workout each week. This will help your body adapt to the increased workload gradually.

Finally, once you have increased the frequency and duration of your workouts, you can start to increase the intensity of your workouts. This can be done by increasing the resistance of strength training exercises, or increasing the incline or speed on the treadmill or elliptical

It's important to note that progression should be gradual and individualized. Be sure to listen to your body and make adjustments your workouts accordingly.

Continue to manage triggers for migraine attacks, such as dehydration, stress, and lack of sleep, throughout your exercise program. Your sensitivity to these stressors can decrease over time with habitual exercise.

Tracking Program Progress for Graded Exercise Exposure in Chronic Migraine

Tracking your progress when participating in an exercise program for migraine can be helpful in visualizing progress, minimizing triggers, and achieving your goals.

In this section, we will discuss the importance of keeping a journal or record of exercise progress and any changes in migraine symptoms.

Keep A Journal

Keeping a journal or record of your exercise progress can help you stay motivated and accountable. It allows you to track your progress over time and see how far you have come. It can also help you identify patterns and trends that could be impacting your progress, such as an increase in migraine attacks after a particular exercise.

In your exercise journal, you can track the frequency, duration, and intensity of your workouts, as well as any other relevant details, such as the type of exercise you did, the weather, and how you felt during and after the workout.

Adjusting Exercise Plan Based on Progress and Symptoms

Tracking your exercise progress and any changes in your migraine symptoms can help you adjust your exercise plan as needed. If you notice an increase in migraine attacks after a particular exercise, you may need to adjust the frequency, duration, or intensity of that exercise.

On the other hand, if you are making progress without triggering migraine attacks, you may continue progressing your exercise program. It's important to remember that progress may not always be linear, and there may be setbacks along the way.

It's important to remember that progress may not always be linear, and there may be setbacks along the way. Keeping a journal or record of your exercise progress and any changes in your migraine symptoms can help you stay on track and make adjustments as needed.


Graded exposure to exercise has several benefits for those with chronic migraine. It can help improve cardiovascular health, reduce stress, improve mood, and potentially reduce the frequency and severity of migraines.

However, it is important to work with a healthcare provider or physical therapist to develop a personalized exercise plan that takes into account individual needs and limitations.

By taking small steps towards a more active and healthy lifestyle, individuals with chronic migraine can improve their overall health and well-being. This may include starting with gentle exercises like walking or yoga, gradually increasing intensity and duration, and tracking symptoms to monitor progress and adjust the exercise plan as needed.

It is also important to acknowledge the challenges of living with chronic migraine and to seek support from healthcare providers, friends, and family members as needed. With a personalized exercise plan and a supportive network, individuals with chronic migraine can take control of their health and work towards a more active and fulfilling lifestyle.

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