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What if exercise is not simply good or bad for migraine, but a powerful tool whose effect depends on timing,
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intensity, and what your body is already carrying that day?
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Welcome to Migraine Heroes, a podcast for people living with chronic migraines with years of pain,
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misunderstanding, and lack of answers.
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I'm Diane Ducarme. I've helped more than a thousand people reduce the burden of migraines and feel more in control.
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My mission in life? To help a million people.
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Each episode brings you grounded insight into what your body might be asking for and what can truly help.
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Just to keep you fully supported, this podcast is educational. For diagnosis or medication,
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always work with your doctor.
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Now, take a breath and let's dive in.
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In this episode, you will learn why regular exercise can reduce migraine frequency,
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even when a single workout sometimes seems to trigger an attack.
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The warning signs that exercise is exceeding your current capacity,
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so you can adjust before your body reaches its limit. And a simple migraine-friendly movement plan
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you can try today at home without pushing,
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punishing, or trying to prove anything.
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Stay with me till the end, because at the end of this episode, you will have a practical method for deciding whether today is a
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movement day, a gentle recovery day, or a genuine rest day.
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So let me start with the story of Sophie.
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So Sophie was a personal trainer in her mid-40s, and she had built a very successful career helping other women feel
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stronger, healthier, and more confident in their bodies.
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And she trained several times a week. Ate well, slept carefully, and knew exactly
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how to push herself without going too far. And for years, she trusted her body completely.
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She was nailing it.
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perimenopause arrived. And at first, the changes were sort of subtle. Her sleep became slightly lighter,
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her recovery took slightly longer, workouts that once left her feeling energized began to leave her exhausted.
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Then, the migraines became more frequent, much more frequent.
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And suddenly, exercise, the thing that had always made her feel powerful,
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started to feel unpredictable.
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Some sessions were sort of fine, others seemed to trigger a migraine that could wipe out the rest of the day. And she began questioning
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everything she knew, not only about fitness, but about herself.
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So for Sophie, this was not simply a health problem. It affected her confidence, her work, and her identity.
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She was the person others came to her for answers, yet
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she could no longer understand what her own body was asking for. And Sophie was not the only one. Over the years at Migraine Heroes,
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I've met more personal trainers with remarkably similar stories.
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Successful, disciplined women in excellent physical shape whose bodies seemed to change almost
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overnight during perimenopause. The routines that had supported them for years
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stopped working. Migraines appeared or
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intensified and their whole world felt turned completely upside down. And so their stories remind us of something important.
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Being fit does not make you immune to migraine, hormonal change, or nervous system overload.
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Sometimes, the strongest thing you can do is stop fighting your body and begin learning its new
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language. So I want to acknowledge how confusing this topic can feel. If that is confusing for a
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professional like Sophie, it certainly is for the vast majority of the population. Perhaps you've been told that
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exercise is essential for your health, and you may even have been told that it will help with your migraines.
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But then you go for a run, or you take a demanding fitness class like a heavy lift weight, or you simply walk quickly
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on a hot day. And a few hours later, you're in pain.
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And you know it came from the exercise. And that experience can leave you feeling as though you have failed at something
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that was supposed to help you. So the relationship between exercise and migraine contains an important paradox.
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Regular exercise may help prevent migraine over time, while strenuous exercise may trigger an attack in the moment. And both
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statements can be true.
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So exercise is not one single exposure. A gentle 20-minute walk is not physiologically identical to sprinting a pill.
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Strengthening your legs with slow, controlled movements is not the same as holding your breath while lifting the heaviest
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weight possible. Moving after a good night of sleep and a proper meal is not the same as exercising while dehydrated,
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overheated, sleep-deprived, or already experiencing early migraine symptoms.
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So the effect is going to depend on the dose, on the context, on the timing, and on the individual sensitivity.
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So there was a major review in the Journal of Headache and Pain in 2018, and it describes this two-sided relationship.
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The authors found evidence that regular physical activity may have a preventative effect, while acute exertion could trigger
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migraine in some people. And they propose that prevention and triggering may involve different physiological processes.
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And it's interesting because you discover once more that Eastern medicine and philosophy is in perfect agreement with the
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most recent Western science. So what does the research actually tell us? So there was one particularly useful analysis
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published in the journal Headache in 2025, and the researchers brought together 15 studies examining aerobic exercise in
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people with migraine. And the overall finding was quite encouraging. They found that regular aerobic exercise was
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associated with reduction in both migraine frequency and pain density. And so the most helpful results appeared after people
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had accumulated approximately 950 minutes of exercise across the full program. That may sound like a lot, but spread over time,
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it works out roughly like 30 minutes, three times a week, for 10 or 11 weeks. And that is the important point.
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Exercise did not behave like a quick fix. Its benefits appeared through repetition, consistency, and gradual adaptation.
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The body needed time to respond. So how could exercise help? So far, scientists do not believe there is one single mechanism.
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Regular exercise may affect several systems that are involved in migraine regulation. So it may increase the activity of the
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body's own pain-modulating chemicals, including things that are called beta-endorphins and endocannabinoids.
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And these substances may help the nervous system regulate pain and stress responses more effectively.
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Exercise, they found, may also influence brain-derived neurotrophic factor, a protein involved in the health, adaptation,
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and communication of nerve cells. And so over time, regular movement can support sleep, can support mood, glucose regulation,
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cardiovascular health, muscle endurance, and confidence in the body. And these benefits may help make the nervous system
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less vulnerable to accumulation of multiple migraine stressors. So one useful way to imagine this is through the idea of a migraine threshold.
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Your threshold is not a fixed wall. It can move. Poor sleep, fasting, hormonal change, emotional stress, bright light,
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heat, dehydration, infection, or an approaching attack may lower it. Gentle, consistent movement may gradually support a more stable threshold.
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But a demanding workout, added on top of several other stressors, may be the final load that pushes you across it.
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So when is exercise more likely to trigger more symptoms? So the first one is when the intensity of exercising is going to rise too quickly.
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So if you do a sudden jump from rest to intense activity, it's going to create a rapid demand on your cardiovascular, metabolic, and nervous systems.
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And your heart rate is going to rise, your breathing is going to become faster, your blood vessels are going to need to respond,
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your muscles produce and use energy more rapidly, and so your body temperature is going to increase.
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And so for a sensitive nervous system, that speed of transition may matter. This is why a gradual warm-up can be more than a fitness ritual.
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It gives your system time to adapt. Now a second reason why it can backfire is when you hold your breath.
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So when you do things like heavy lifting or straining or bracing while holding your breath,
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it can sharply increase pressure inside the chest and affect blood flow and pressure in the head.
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And so strength training is not automatically harmful. In fact, it may be beneficial, but the way you perform it matters.
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Slow breathing, controlled loads, longer rest periods, and stopping before maximum strain may be more migraine-friendly than pushing to complete one final repetition while holding your breath.
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The third reason why exercise can backfire is when you're hot or when you're dehydrated.
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So exercise is going to already increase heat production and therefore fluid loss.
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So hot weather, a warm studio, heavy clothing, or insufficient fluid intake can add another layer of stress.
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So the International Classification of Headache Disorders notes that primary exercise headache occurs particularly in hot weather or in high altitude.
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So for some people, water alone may not solve the whole problem. Long or sweaty exercise can also affect sodium and energy availability.
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And this does not mean everyone needs a special drink. It means the conditions around exercise deserve attention.
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And again, here the East would see the same. Hydration is understood and you would discover that in the migraine heals up in a completely different lens.
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The West is going to talk about dehydration, but here we're talking about liquids in the name of brain, bone marrow, lymphatic system, intracellular hydration.
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So those deep, deep liquids that just water alone cannot always fill.
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Now the next reason why exercise could backfire is when you're under-fueled.
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So exercising after skipping meals may create a mismatch between the energy your body needs and the energy available.
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Now you may tolerate fasted exercise perfectly on one day and poorly on another.
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Migraine is influenced by a combination. So fasting plus poor sleep plus emotional stress plus an intense workout may produce a very different result from the same workout after food, rest, and hydration.
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And that's where it makes things so confusing at times. And this is where I see people lose the trust they have in their body.
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Keep it. Keep your trust. Keep your intuition.
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Now another reason why exercise may backfire and give you migraine is when the migraine attack has actually already started.
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So sometimes what appears to be an exercise-triggered migraine was actually an exercise-revealed migraine.
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So the attack process may have begun hours earlier.
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There was this sort of subtle neck discomfort, uncontrollable yearning, irritability, cravings, difficulty concentrating, light sensitivity, or an unusual change in energy that may already be present.
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And you begin exercising because you do not yet have head pain.
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Then the movement intensifies symptoms that were already developing.
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So the distinction is going to matter because it changes the question from, why does all exercise cause migraine?
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To, was my nervous system already entering an attack before I exercised?
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And then finally, an exercise can backfire and give migraine when the environment adds sensory load and sensory stress.
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So it can be bright sunlight or flashing light, loud music, strong perfume, heat, crowded room, and visually busy surroundings that will accompany exercise.
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And so the workout itself may not be the only variable.
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A calm walk in a soft morning light may feel very different from a loud class under flashing lights when your heart reaches the same rate.
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So a calm walk in a soft morning light may feel very different from a loud class under flashing lights.
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And that's true even when your heart reaches just the exact same rate.
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Now I'm going to add one to this list.
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And this belongs more to the East.
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And this is going to be the final one, is when you have a blockage.
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If there is a blockage in your body and you're pushing through, that can hurt.
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And that will trigger a migraine, according to everything that we've seen so far.
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That is, again, very individualistic.
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And actually, yes, it is very individualistic because sometimes the movement will take away the blockage.
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So here, again, I'm really appealing to your intuition.
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And so the most effective exercise is not necessarily the workout that burns the most energy or looks the most impressive.
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For migraine, the best exercise may be the one you can complete consistently, calmly, and without repeatedly paying for it afterwards.
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You may begin with walking, cycling gently, swimming at a comfortable pace, slow dancing.
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Dancing is super fun.
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It's one of my favorites.
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I'm still working on convincing my husband to take dancing classes with me.
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Controlled resistance exercise can be nice.
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One of my loved ones.
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So use the conversation test.
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At a moderate intensity, you should normally be able to speak in full sentences, even though your breathing is deeper than at rest.
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So begin below the level you believe you can tolerate.
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This can feel frustrating, especially if you were an athletic person where migraine became more frequent.
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But beginning below your limit allows you to gather useful information without repeatedly crashing.
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So increase only one variable at a time.
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Increase duration.
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Then increase frequency, resistance, or intensity.
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So do not increase all four together.
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And judge the workout not only by how you feel during it, but by what happens over the following 24 hours.
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Did the head pain increase?
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Did you feel unusually tired, depleted, nauseated, or light-sensitive?
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Or did you feel steadier, clearer, and pleasantly tired?
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Your response afterward is part of that exercise exploration.
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Now, something really important.
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Seek, do seek, urgent medical assessment when an exercise-related headache is sudden, explosive, reaching maximum intensity within moments, or the first headache of its kind you have ever experienced.
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And especially if it's accompanied by fainting, by confusion, weakness, by difficulty speaking, loss of coordination, chest pain, or unusual shortness of breath.
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If it's associated with fever, a stiff neck, or persistent vomiting.
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Or clearly different from your established migraine pattern.
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So this is not about fighting you.
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It's about respecting a new symptom rather than automatically assuming it is harmless.
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Now, let's go east.
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Traditional trisomy scene begins with a question that is slightly different from the Western question.
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Instead of only asking, is exercise scientifically effective for migraine?
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It may ask, what kind of movement does this person need today?
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And what kind would create more imbalance?
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It's interesting because before I mentioned to you the story of Sophie, there was also the story of Jasmine.
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And for Jasmine, who was in exactly the same situation, there was a slight nuance.
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She would say, I only have the migraine triggered if I do upper body workout.
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So here we think about the traditional trisomy scene question.
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What kind of movement does this person need today?
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And what kind would create more imbalance?
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And so how do I correct it?
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So traditional trisomy scene does not describe the migraine as one uniform condition.
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It's going to interpret symptoms through patterns.
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And so to name some of these patterns, one person may be described as having what is called the liver yang rising migraine
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with throbbing pain, irritability, heat, tension and symptoms that move upward.
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That's what we call the state of tension overload in the Migraine Heroes app.
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Another may show stagnation of qi and blood with sort of fixed pain, tightness, frustration in the sense that the body is not flowing.
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Another one may show deficiency with more exhaustion, dizziness, paleness, weakness after exhaustion and headaches that worsen when the body is depleted.
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Another one may show accumulation traditionally described as darkness or phlegm with heaviness, fogginess, nausea and a weighted sensation in the head.
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And so these are traditional organizing concepts.
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They're not anatomical structure or laboratory diagnosis.
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And they should not replace a neurological assessment, but they offer a really useful insight.
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The same exercise can support one person and drain another.
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And so here we go at a deeper layer.
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And within these conditions and these patterns, there's also sub-ones.
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So if you have darkness, where is that in the body?
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And therefore, what sort of exercise is going to trigger what sort of pain?
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How do we get rid of such a trigger?
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And so from all of these perspectives, gentle rhythmic movement may help circulate the qi and the blood.
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Walking, Tai Chi, Qigong, flowing stretches and calm breathing can encourage movement without creating exercise force.
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But intense exercise may produce too much.
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Too much upwards, too much outwards, too much heating energy.
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It may consume fluids, strain the body's reserves and using traditional language, steer internal wind or drive yang toward the head.
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So this creates a beautifully simple question.
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After movement, do you feel more rooted or more scattered?
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Helpful movement should often leave you feeling calmer, warmer, clearer, more present in your body.
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Excessive movement may leave you buzzing, shaky, overheated, irritable, depleted, light-sensitive or unable to settle.
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And traditional Chinese thought often emphasizes the imbalance between movement and stillness.
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Too much stillness can create stagnation and too much movement can create exhaustion.
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So the answer is not in endless rest and it's not in relentless effort.
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It's the ability to move between the two.
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There's a Chinese principle that can be paraphrased as when there is flow, there is less pain.
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And when flow is obstructed, pain appears.
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But the flow does not need to be forced.
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A river moves because there is continuity.
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It does not improve because someone violently pushes the water.
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And Ayurveda, so from India, offers a related perspective.
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Excessive heat, competitiveness and intensity may aggravate the fear qualities associated with Pitta.
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While regular, fast, overstimulated movement may disturb the mobile and changeable qualities associated with Vata.
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So from that lens, a migraine-sensitive person may benefit from movement that is regular, cooling, grounded and predictable,
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rather than punishing, overheated or chaotic.
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It does not mean that slow exercise is always superior or that intense exercise is forbidden.
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It means intensity should emerge from stability.
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First, build rhythm. Then, build duration.
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Then, when your system trusts the activity, explore greater challenge.
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Eastern medicine also reminds us to notice the quality of the mind during exercise.
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Are you moving because you enjoy inability inhabiting your body?
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Or are you moving from self-criticism?
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Or are you breathing?
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Or are you tending your jaw, lifting your shoulders and silently fighting yourself?
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Your nervous system does not experience those two workouts in the same way.
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The deeper lesson is that exercise should not become another battlefield between you and your body.
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It can become a conversation.
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Your body speaks through breath, heat, pressure, fatigue, steadiness, nausea, tension, recovery.
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Practice is not merely to move. The practice is to listen while you move.
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So today, you can try a migraine-friendly movement experiment rather than a workout.
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You can first check whether you've eaten, had enough fluid, slept reasonably and noticed an early migraine sign.
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Then, spend 5 minutes walking slowly around your home or gently moving your shoulders, your spine, your hips, your ankles while breathing continuously.
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And if your body feels stable, you continue for another 10 minutes.
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Add an intensity that allows you to speak in complete sentences.
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You finish with 3 or 5 minutes of slower movement instead of stopping abruptly.
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Not only record the activity, the intensity or symptoms you went after and how you feel later that day.
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Stop if you develop rapidly increasing head pain, aura, unusual dizziness, chest pain, faintness, weakness or symptoms that feel different from your normal pattern.
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The goal today is not to test how much you can endure.
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The goal is to discover, to rediscover how little movement may be needed to leave your body feeling safer, steadier and more capable.
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And remember, every small step you take moves you closer to freedom.
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You are powerful, you are resilient and you are not alone.
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Keep rising, Migraine Hero.
