Avoid Exercise-Related Migraines

From the WebMD Archives

Talk about a double-edged sword. There are so many benefits to exercising if you're prone to migraines. But for some people, a sweat session can actually trigger one of these painful pounders. On the plus side, "Exercise is a potent stress reliever, and stress is commonly linked to migraine attacks," says Timothy Houle, PhD, associate professor in the Pain Mechanisms Lab at Wake Forest School of Medicine.

Whether it's due to its ability to tame tension or some other benefit, regular exercise has been shown in studies to both prevent migraines and make those you do get less severe.

You should be able to get some comfort from that if you get these headaches. Why? Because other aspects of exercise -- not the physical activity itself -- may be causing your headache.

"There could be other variables at play that aren't managed well," says Lucy Rathier, PhD, clinical associate professor in the department of psychiatry and human behavior at the Warren Alpert Medical School of Brown University. For instance, you may not have warmed up or eaten properly or taken enough fluids before working out. "I treated a runner once who kept getting migraines because she wasn't well hydrated," Rathier says. But when she started drinking enough water, her migraines disappeared.

If you've been avoiding exercise to prevent a migraine, consider a workout routine that follows these tips. With a little luck, maybe your headaches will disappear too.

Drink Up

Our bodies are 60% water. It's important to keep them that way. If you deal with migraines, you're more prone to the effects of not enough fluids. "Most people are not well-hydrated to begin with, and when you add the stress of exercise, it can push you over the edge," says Noah Rosen, MD, director of the Headache Center at North Shore-LIJ Health System's Cushing Neuroscience Institute.

In one study, people who drank 4 more cups of water a day than they normally did had 21 fewer hours of migraine pain during a 2-week period. They also noticed that their headaches weren't as bad.

To be sure you're well hydrated, check your urine. If it's consistently colorless or light yellow, you're most likely drinking enough. Dark yellow or amber-colored urine is a sign you need to drink more.

Talk with your trainer or doctor about other ways, such as weighing yourself before and after exercising, to know whether you're getting enough fluids.

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Eat Properly

If you roll out of bed and hit the gym before eating, that's a no-no. "Your blood sugar lowers when you exercise and the drop can bring on a migraine," Rathier says. Plan to eat at least an hour-and-a-half before exercising. That'll leave time for your body to digest the meal.

Avoid sugary junk food, which can cause a sudden drop in blood sugar. It's also important to refuel after your workout. A protein shake and fruit is a good recovery meal. Fiber-rich fruit supplies sugar and glycogen (the body's main energy sources) while keeping blood sugar stable.

Ease Into Exercise

If you're a newbie at the gym, here's something you need to know. "Beginning an exercise plan with only subtly increased levels of exertion -- like starting a very modest walking program -- is important ... so you can prove to yourself you're able to exercise without experiencing a migraine attack," says Timothy Houle, PhD, associate professor in the Pain Medications Lab at Wake Forest School of Medicine.

Once you find a safe level of exercise, slowly work up to a more challenging one. That'll help you avoid injury and lower your risk of headache.

If you're no stranger to the Stairmaster or weight room, you may need to modify your routine. Don't work out too hard. Pace yourself by switching to more moderate exercise. Instead of powering through that boot camp class at an intensity level of 7 or 8, dial it down to a 5 or 6.

Exertion headaches can occur from strength training. So, if you're prone to headaches, trade in your heavy weights for lighter ones that allow you to do 15 to 40 reps. That's enough to get a good workout, but not so high that it'll trigger a headache. "If your face is turning red and you're getting super sweaty or hot, the weight is too heavy," says Matthew Kohn, an exercise physiologist and personal trainer in New York City.

Whatever your fitness level, never start your session without warming up for 10 to 15 minutes. The sudden demand for oxygen can trigger a migraine. The best warm-up is the exercise you're about to do taken down a notch. And remember, stretching for 5 to 10 minutes at the start and end of your session will prevent muscle tension -- another possible trigger.

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Finally, realize that even after taking all these precautions, you might still get a migraine when you exercise. This doesn't mean your workout caused it. In fact, many people have multiple triggers, so consider keeping a migraine diary to help you pinpoint yours. Nor does it mean you have to stop exercising. Talk to your doctor about taking a daily preventive medicine.

"No one gets a pass on exercise," says Rathier, who notes that not working out means missing out on many health benefits. Exercise can boost weight loss, improve glucose metabolism (a plus for those with diabetes), enhance sleep, and reduce other forms of chronic pain.

"And since each of these issues is linked to migraines, targeting them with exercise could be a big help," Houle says. That sounds like a good reason to strap on your running shoes.

WebMD Feature Reviewed by William Blahd, MD on December 22, 2015

Sources

SOURCES:

Timothy Houle, PhD, associate professor in the Pain Mechanisms Lab at Wake Forest School of Medicine.

Lucy Rathier, PhD, clinical associate professor in the department of psychiatry and human behavior at the Warren Alpert Medical School of Brown University.

U.S. Geological Survey: "The Water In You."

Noah Rosen, MD, director of the Headache Center at North Shore-LIJ Health System's Cushing Neuroscience Institute.

Spigt, M. G., European Journal of Neurology, published online September 2005.

Familydoctor.org: "Hydration: Why It's So Important."

The Migraine Trust: "Exercise and Migraine."

Matthew Kohn, exercise physiologist and personal trainer in New York.

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