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Can exercise help migraine or trigger one?
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Welcome to Migraine Heroes, a podcast for anyone living with migraine and wondering
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why nothing has fully worked yet.
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I'm Diane Ducarme.
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Over the past 7 years, I've helped hundreds of people living with migraine.
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What I've learned?
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No two migraine stories are exactly the same, and none of them are simple.
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That is why, in this podcast, we explore migraine from many different angles.
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Food, hormones, stress, sleep, the nervous system, emotions, and much more, through the
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lens of both modern science and traditional Chinese medicine.
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A quick note before we start.
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What we talk about here is educational.
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For anything related to diagnosis or medication, please keep working 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, even
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when a single workout sometimes seems to trigger an attack.
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The warning signs that exercise is exceeding your current capacity, so you can adjust before
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your body reaches its limit.
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And a simple, migraine-friendly movement plan 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
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method for deciding whether today is a movement day, a gentle recovery day, or a genuine rest
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So let me start with the story of Sophie.
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Sophie was a personal trainer in her mid-40s, and she had built a very successful career
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helping other women feel stronger, healthier, and more confident in their bodies.
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She trained several times a week, ate well, slept carefully, and knew exactly how to put
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herself without going too far.
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And for years, she trusted her body completely.
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She was nailing it.
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Then peri-menopause arrived, and at first, the changes were sort of subtle.
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Her sleep became slightly lighter, her recovery took slightly longer, workouts that once left
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her feeling energized began to leave her exhausted.
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Then the migraines became more frequent.
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Much more frequent.
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And suddenly, exercise, the thing that had always made her feel powerful, started to
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feel unpredictable.
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Some sessions were sort of fine, others seemed to trigger a migraine that could wipe out
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the rest of the day.
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And she began questioning everything she knew, not only about fitness, but about herself.
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And so for Sophie, this was not simply a health problem, it affected her confidence, her work,
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She was the person others came to her for answers, yet she could no longer understand
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what her own body was asking for.
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And Sophie was not the only one.
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Over the years at Migraine Heroes, I've met more personal trainers with remarkably similar
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Successful, disciplined women in excellent physical shape whose bodies seemed to change
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almost overnight during peri-menopause.
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The routines that had supported them for years stopped working.
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Migraines appeared or intensified and their whole world felt turned completely upside
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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
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So I want to acknowledge how confusing this topic can feel.
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And if that is confusing for a professional like Sophie, it certainly is for the vast
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majority of the population.
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Perhaps you've been told that exercise is essential for your health, and you may even
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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
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you simply walk quickly 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.
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And that experience can leave you feeling as though you have failed at something that
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was supposed to help you.
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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
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an attack in the moment.
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And both statements can be true.
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So exercise is not one single exposure.
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A gentle 20-minute walk is not physiologically identical to sprinting uphill.
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Strengthening your legs with slow, controlled movements is not the same as holding your
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breath while lifting the heaviest weight possible.
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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
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individual sensitivity.
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So there was a major review in the Journal of Headache and Pain in 2018, and it described
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this two-sided relationship.
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The authors found evidence that regular physical activity may have a preventative effect, while
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acute exertion could trigger migraine in some people.
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And they proposed that prevention and triggering may involve different physiological processes.
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And it's interesting because you'll discover once more that Eastern medicine and philosophy
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is in perfect agreement with the most recent Western science.
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So what does the research actually tell us?
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So there was one particularly useful analysis published in the journal Headache in 2025,
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and the researchers brought together 15 studies examining aerobic exercise in people with migraine.
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And the overall finding was quite encouraging.
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They found that regular aerobic exercise was associated with reduction in both migraine
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frequency and pain density.
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And so the most helpful results appeared after people had accumulated approximately 950 minutes
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of exercise across the full program.
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That may sound like a lot, but spread over time, it works out roughly like 30 minutes,
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three times a week, for 10 or 11 weeks.
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And that is the important point.
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Exercise did not behave like a quick fix.
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Its benefits appeared through repetition, consistency, and gradual adaptation.
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The body needed time to respond.
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So how could exercise help?
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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.
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So it may increase the activity of the body's own pain-modulating chemicals, including things
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that are called beta-endorphins and endocannabinoids.
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And these substances may help the nervous system regulate pain and stress responses
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Exercise, they found, may also influence a brain-derived neurotrophic factor, a protein
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involved in the health, adaptation, and communication of nerve cells.
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So think about your own exercise days for a moment.
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When movement seems to trigger a migraine, what else was happening that day?
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Had you slept badly, skipped a meal, felt overheated or dehydrated, or noticed that
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an attack might already have been starting?
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These are exactly the kinds of patterns we help you explore in the Migraine Heroes app.
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Because the goal is not simply to label exercise as good or bad, it is to understand what your
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body can handle, what lower your threshold, and when movement may be helping you, rather
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than adding one stressor to many.
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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.
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And these benefits may help make the nervous system less vulnerable to accumulation of
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multiple migraine stressors.
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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.
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Poor sleep, fasting, hormonal change, emotional stress, bright light, heat, dehydration, infection,
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or an approaching attack may lower it.
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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
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pushes you across it.
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So when is exercise more likely to trigger more symptoms?
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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
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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
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blood vessels are going to need to respond, your muscles produce and use energy more rapidly,
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as your body temperature is going to increase.
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And so for a sensitive nervous system, that speed of transition may matter.
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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.
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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
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So strength training is not automatically harmful.
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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
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may be more migraine-friendly than pushing to complete one final repetition while holding
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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
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So the International Classification of Headache Disorders notes that primary exercise headache
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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.
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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.
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It means the conditions around exercise deserve attention.
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And again here, the East would say the same.
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Hydration is understood and you would discover that in the Migraine Heroes app in a completely
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The West is going to talk about dehydration, but here we're talking about liquids in the
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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
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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.
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So fasting plus poor sleep, plus emotional stress, plus an intense workout may produce
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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.
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And this is where I see people lose the trust they have in their body.
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Keep your intuition.
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Now another reason why exercise may backfire and give you migraine is when the migraine
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attack has actually already started.
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So sometimes what appears to be an exercise triggered migraine was actually an exercise
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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,
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difficulty concentrating, light sensitivity, or an unusual change in energy that may already
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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
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exercise cause migraine to was my nervous system already entering an attack before I
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And then finally, an exercise can backfire and give migraine when the environment adds
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sensory load and sensory stress.
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So it can be bright sunlight or flashing light, loud music, strong perfume, heat, crowded
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room, and visually busy surroundings that all 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
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light 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
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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, and this belongs more to the East, and it's going
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to be the final one, is when you have a blockage.
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If there's a blockage in your body and you're pushing through that can hurt, and that will
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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, I say it's very individualistic because sometimes the movement will take away
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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
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energy or looks the most impressive.
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The best exercise may be the one you can complete consistently, calmly, and without repeatedly
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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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Yoga, one of my loved ones, Tai Chi, I'm starting it, or mobility work.
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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
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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
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But beginning below your limit allows you to gather useful information without repeatedly
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So increase only one variable at a time.
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that increased 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
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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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The 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,
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reaching maximum intensity within moments, or the first headache of its kind you have
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And especially if it's accompanied by fainting, by confusion, weakness, by difficulty speaking,
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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, or clearly different
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from your established migraine pattern.
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So this is not about fighting you, it's about respecting a new symptom rather than automatically
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assuming it is harmless.
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Now, let's go east.
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Traditional transmedicine begins with a question that is slightly different from the Western
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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
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the story of Jasmine.
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And for Jasmine, who is 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 transmedicine question, what kind of movement does this
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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 transmedicine 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
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called the liver yang rising migraine with throbbing pain, irritability, heat, tension
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and symptoms that move upward.
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That's what we call the state of tension overloading the migraine hills up.
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Another may show stagnation of qi and blood with sort of fixed pain, tightness, frustration
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in the sense that the body is not flowing.
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Another one may show deficiency with more exhaustion, dizziness, paleness, weakness
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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,
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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 and they should not replace a neurological
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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-what.
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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 this perspective, gentle rhythmic movement may help circulate the qi
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Walking, tai chi, qigong, flowing stretches and calm breathing can encourage movement
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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
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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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Good movement should often leave you feeling calmer, warmer, clearer, more present in your
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Excessive movement may leave you buzzing, shaky, overheated, irritable, depleted, light
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sensitive or unable to settle.
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And traditional Chinese thought often emphasizes a balance 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
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with Pitta, while regular, fast, overstimulated movement may disturb the mobile and changeable
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qualities associated with Vata.
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So from that lens, a migraine-sensitive person may benefit from movement that is regular,
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cooling, grounded and predictable, 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, then, when your system trusts the activity, explore
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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
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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.
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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
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an early migraine sign.
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Then, spend 5 minutes walking slowly around your home, or gently moving your shoulders,
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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, at an intensity that
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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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And afterwards, you record the activity, the intensity, your symptoms before and after,
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and how you feel later that day.
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It can help if you develop rapidly increasing head pain, aura, unusual dizziness, chest
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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
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body feeling safer, steadier, and more capable.
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That's all for today.
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I hope this episode added another piece to your migraine puzzle.
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If you'd like to apply what we've discussed to your own life, you can find us by searching
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Migraine Heroes in the App Store or Google Play.
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Look for the green icon with the love heart in the brain.
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Migraine is complex, but it's not random.
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And every step forward brings us closer to lasting relief.
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Your body has a story to tell.
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Let's keep listening.
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I will be back with you soon.
