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Avoiding Exercise-Related Migraines

Warming up, knowing your triggers, and staying hydrated are key.
By Karen Blum
WebMD Feature

Being active is a key part of healthy living. But for some people with migraines, exercise can be tricky. For some, exercise can be a migraine trigger.

Terrell Davis, a former Denver Broncos running back, sat out most of the second quarter of Super Bowl XXXII in 1998 because of a migraine. Yet after taking his medication, he came back to the game and was named Most Valuable Player.

The good news is that there are steps you can take to make exercise-related migraines less likely. Here are four ways to do that.

Ease Into It.

During a migraine headache, blood vessels in the head dilate and stretch nerve endings, causing them to send pain signals. Exactly how exercise can trigger migraine headaches isn't known. But sudden, extreme exercise is usually to blame, says Stephen Silberstein, MD, director of the Jefferson Headache Center at Thomas Jefferson University in Philadelphia.

Don't start high-intensity exercise suddenly. Always warm up first and cool down slowly afterward, says Jessica Ailani, MD, director of the Georgetown Headache Center at MedStar Georgetown University Hospital in Washington, D.C.

People who get exercise-related migraines "need to start gradually, not go from 0 to 100," Silberstein says. "Like everything else in life, you should avoid extremes. A program of gradual conditioning exercise will help."

Drink Up.

It's important to hydrate before and after exercise, Ailani says.

How much should you drink? That depends on what you're doing. There's no exact science to how much you need. It depends, in part, on your workout. If it's very intense or lengthy -- like running a marathon -- a bottle of vitamin-enhanced water or a sports drink before and/or during exercise may help. But if it's moderate, drinking a little water periodically during your activity may be enough.

Taking an anti-inflammatory over-the-counter medicine like naproxen or ibuprofen before exercising also can help. But if you take those regularly, tell your doctor and follow the dosing guidelines on the label. And of course, you should take any medicines your doctor has prescribed to help prevent migraines. You may also want to talk with your doctor about alternative treatments for migraines, including acupuncture, stress management, and certain herbal extracts.

Know Your Migraine Triggers.

Migraine triggers vary from person to person. For Helen French, a 36-year-old computer programmer in Washington, D.C., migraine triggers are dehydration and bright sun. "When you put those two together," she says, "if I'm not careful about hydrating, then I can really get myself in trouble." Flickering light, such as when she rides her bike down a wooded path, is a particular problem.

A few years ago, French got dehydrated while kayaking. The dehydration, plus the sun sparkling on the water, led to chronic migraine that occurred daily for six weeks.

So French now takes precautions when she exercises outside. She wears sunglasses, eats healthy food before she heads out, and wears a backpack-style water carrier. She also takes medicines daily to help prevent migraines. And she knows what not to do. "I avoid hot yoga -- that's just an automatic migraine for me," French says.

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