Working out with headache

Thinking about working out with a headache? Working out is a great way to protect your overall health. Through regular exercise, you help maintain a healthy weight, build muscle and support your body However, there are times when exercising is not the best idea.

If you experience chronic headaches, you’ve probably missed a gym day or two. It can be tempting to try to “work through the pain” and do your best regardless. Still, you should be careful. In many cases, exercising can make a headache worse.

“Should I Exercise if I Have a Headache?”

Headaches have many causes. The most common type of headache is the tension headache. These are linked to muscle tension in the head, neckor elsewhere. However, there are dozens of other possible causes.

Some headaches are created by serious, undiagnosed medical conditions. For example, there may be problems with the blood vessels of the head, the optic nervesor many other body systems. In this case, working out with a headache can be dangerous.

“Does Exercise Help Headaches?”

Exercise can help some headaches – especially those caused by stress.

If you are certain your headaches are caused by stress or other lifestyle factors, you might try light exercise to see how they react. Remember, it can take months before lifestyle changesaffect your headaches.

Try these tipsFor Better Exercise

Maintain Good Posture

No matter what kind of exercise you’re engaged in, you should do your best to maintain the proper form. Good form helps prevent injury and distributes the benefits of exercise more fully throughout the body. As you tire, form gets harder – be sure to pace yourself.

Warm Up First

Never start with the most intense exercise you are capable of. Always warm up for at least five minutes at a slow or moderate pace. As you reach the end of your exercise, it is also a good idea to slow down for five to 10 minutes.

Stay Hydrated

Some headaches are transient and caused by issues like dehydration. You can resolve these by drinking plenty of fluids, which will help you perform better when you work out. Be sure to keep water handy when performing any exercise.

Miami Headache Institute

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A good workout is likely to leave you with sore abs, biceps or quads. But for some people, exercise can result in a pain of a different sort.

Yes, headaches may be an unfortunate though common side effect of exercise for almost any type of athlete, but that doesn’t mean you need to steer clear of the gym or field. With a little know-how, headache sufferers can partake of all the benefits of exercise without being sidelined by head pain. In fact, when undertaken wisely, exercise may actually help prevent headaches and migraines in some.

It’s not entirely clear how exercise might trigger headaches. It may be due to a confluence of factors including low blood sugar, dehydration, lack of sleep and improper warm-up. More studies are needed to say anything conclusively. Until then, here are a few simple steps to follow:

Eat Well and Stay Hydrated. Dehydration and low blood sugar are your enemies. An hour and a half before your workout, make sure to eat a solid meal or snack and drink water. Continue to hit the water fountain during and after your workout to replenish fluids lost to sweat. You may also want to eat a piece of fruit or a snack before or during exercise to prevent a sudden drop in blood sugar. Choose wisely and avoid snacks that could trigger headaches.

Warm Up and Cool Down. Carefully warming up and cooling down may feel unnecessary, but the sudden onset or cessation of exercise can trigger a headache in some people. Take five or 10 minutes to stretch or slowly warm up and cool down before and after your session.

Choose Your Exercise Carefully. The most head-friendly workouts are mild aerobic exercises like jogging, swimming, walking and cycling. Exercising for 30 minutes three times per week is a reasonable goal, but tailor your routine to fit what you can handle. Give yourself about six weeks to settle into your new routine before you start evaluating its benefits. If you’re just starting to exercise, slowly ramp up your routine, as sudden increases in workout intensity can be a trigger.

Regular exercise has been shown to reduce headaches by releasing endorphins – the body’s natural painkillers – as well as improving blood flow to the brain and reducing muscle tension and fatigue. However, many common workout mistakes can actually exacerbate the pain, according to an article in the March issue of Fitness magazine.

“Most headaches develop when the blood vessels around the brain are inflamed, which stretches the nerves within and sends shock waves of pain,” Dr. Merle Diamond, the coordinator of the Diamond Headache Clinic in Chicago told Fitness.

Fitness editors suggest being on the lookout for the following exercise pitfalls, and explain how to fix them:

Improper breathing: Straining your core can rapidly increase blood pressure, giving you a headache. If you have to grunt to get through your exercise, make sure you focus on your breathing or reduce intensity.

Sudden sprinting: Easing into your workout can help your body adjust to the increased blood flow and reduce your chances of a headache.

Dehydration: Experts think that too little water can lower the pressure inside arteries that supply blood to the lining of the brain. Make sure to drink at least eight ounces of water an hour before you start your workout, and make sure to replenish.

Poor posture: As many as 75 percent of tension headaches originate from poor posture, according to medical experts. Bad form in the gym can make it worse. Consider adding yoga to your routine – the skills you learn will help you during other exercises.

For more tips, check out the current issue of Fitness, now on newsstands.



The therapeutic effects of exercise are well documented. Regular physical activity will improve your overall health and reduce the risk of developing diseases like high blood pressure, diabetes, depression and obesity. Benefits also include reducing stress, reducing cholesterol levels, improving the quality of sleep patterns and producing a feeling of wellbeing.

If you are prone to migraine you may have found that strenuous exercise can provoke an attack. This may have led you to avoid exercise as you have identified it as a trigger. If this is the case then you are missing out on the benefits that exercise can bring to your overall wellbeing.

The research evidence

Headache researchers are now finding evidence that suggests that moderate exercise can reduce the frequency and severity of migraine attacks in some people. They have found that regular exercise can be effective in preventing migraine.

Recent studies have shown that exercise changes the levels of a wide range of body chemicals. Exercise stimulates your body to release natural pain controlling chemicals called endorphins and natural anti-depressant chemicals called enkephalins. This could mean that embarking on a well planned exercise program could enable you to reduce your drug intake, particularly drugs taken daily to prevent migraine (prophylactic medicine).

Exercise as a trigger

You may well feel that all this talk about exercise and its benefits are wasted on you as you are one of those people who find that exercise gives you migraine.

If you have found that exercise has triggered an attack it could be due to the following reasons:

  • You start exercising suddenly with no prior planning which means that your body has a sudden demand for oxygen.
  • You have not eaten properly before exercising so that your blood sugar level falls as you become very hungry.
  • You have not taken sufficient fluids before and during exercising so your body becomes dehydrated.
  • You start a strenuous ‘keep fit‘ programme at the same time as ‘healthy’ new diet . If not managed properly, these changes to your lifestyle can act as an additional trigger.
  • You undertake strenuous infrequent exercise which causes stiff, aching muscles which can then act as a trigger.
  • You experience a minor blow to your head during sport, for example you may be hit by or head a football. This can trigger an instantaneous migraine aura.
  • A headache can be brought on by and occur only during or after strenuous exercise. This is called exercise headache (previously referred to as exertional headache) and may last from 5 minutes to 48 hours after the exercise. It tends to occur in hot weather or at high altitude.

Choosing the right type of exercise

Previous studies have suggested that mild regular aerobic exercise offers the most benefits to those with migraine. Remember, it is important to choose an exercise activity that you enjoy. It could be:

  • Jogging
  • Swimming
  • Dancing
  • Cycling
  • Brisk walking.

At the start of your new exercise regimen it is best to avoid activities which are too strenuous or competitive until you are fitter, but moderate intensity (equivalent to brisk walking) is fine.

You should try to exercise for at least 30 minutes of moderate intensity, 3 times a week. Give yourself at least 6 weeks to see if there is any beneficial effect.

You may find your local gym offers short introductory classes and can also give advice about what exercise is right for you and the types of warm up exercises you could try.

You don’t need to join an expensive private gym as most places have local leisure centres with discounts for people on low incomes, students and people over 60.

Keeping a diary

It is worth keeping a migraine and exercise diary, recording both your migraine attacks and exercise you have undertaken. This will give you an idea of the affect aerobic exercise has had on your migraine and any steps to take to help ensure that exercise is not a trigger for you. It will also act as a record of whether you are decreasing or increasing migraine medication. Details to record include the date and time of your exercise, how you prepared, and the type and duration of exercise. Further information on keeping a migraine diary can be found here.

Preparing to exercise

Preparing for exercise is as important as the exercise itself.

If you have any concerns about your health, or if you have not exercised for a long period of time you should inform your GP who can give you a basic health check prior to starting your program.

You should begin your exercise program gradually, building up the momentum over several weeks. It is best to do short, frequent sessions.

You should always:

  • Eat – at least an hour and a half before exercising, leaving time for your body to digest the food – this will avoid a low blood sugar level which can trigger a migraine. You could also take glucose sweets to maintain blood glucose levels prior to exercising.
  • Drink – fluids before, during and after exercise. You not only lose fluid through sweating but also as water vapor in the air that you breathe out. If fluid is not replaced quickly you will become dehydrated – and this is a major migraine trigger. You should always have a bottle of water available. You may also find isotonic drinks help. Isotonic drinks are widely available in health shops. They are drinks in which the mineral salts and glucose are equal to those in the blood. Therefore they will help keep your body in balance.
  • Warm up – this is really important and should be done before and after exercise.

You should never stop or start your session suddenly. Stretching exercises for at least 5 – 10 minutes at the beginning and end of the session will prevent muscle tension which may then act as trigger.

  • Wear the correct clothing – the right footwear is also important so it is worth a visit to a sports shop for some basic trainers. Other clothing depends on the sport you are doing, but the main thing is that you feel comfortable in the clothing you wear.
  • Remember – if at any stage during your exercise program you feel uncomfortable – stop. There is always another day. Note it in your diary so you can see the triggers.
  • Plan ahead – set a regular routine so that you can ensure that exercise is built in to your lifestyle along with regular meals and regular bedtimes. In this way you will also be able to monitor the affect it is having on your migraines.

Exercise and migraine

Regular exercise provides many health benefits, and some research has shown that those benefits extend to migraine. Exercising regularly can reduce the intensity and frequency of migraine attacks. However, some people with migraine also report that exercise or engaging in sports can be a trigger for an attack. This may be due to an increase in blood pressure during exercise. If exercise is a trigger, there are techniques to continue to stay active and reduce the risk of migraine.1,2

Regularly engaging in exercise has multiple health benefits, including:

  • Lowering blood pressure
  • Lowering blood sugar
  • Controlling weight
  • Reduce risk of heart disease
  • Reduce risk of diabetes
  • Reduce risk of some cancers
  • Improve mood
  • Strengthen bones and muscles3

Research on exercise and migraine

Several studies have found that engaging in exercise has benefits for people with migraine. One study published in 2011 compared exercise to relaxation and topiramate (brand name Topamax®). The trial participants were randomly assigned to one of the three groups. The exercise group engaged in activity for 40 minutes three times a week, and the relaxation group listened to a recorded program. The topiramate group took a daily dose of the medicine. At the end of the three-month period, all three groups saw reductions in the frequency of migraine attacks: the exercise group had a 0.93 reduction, the relaxation group had a 0.83 reduction, and the topiramate group had a 0.97 reduction. The researchers concluded that exercise can be an option for preventing migraine attacks, particularly in those who do not want to take medication or for whom medications don’t work.4

Another study looked at the benefits of a combination of exercise and relaxation in people with migraine. The pilot study was published in 2008. The women participants all received standard medical care, and half of them were also randomly chosen to participate in a 6-week, twice-weekly, indoor exercise program, which consisted of 45 minutes of gymnastics and 15 minutes of progressive muscle relaxation. The exercise and relaxation program led to a significant reduction in the severity of migraine attacks, and the women in the exercise group self-reported less pain.2

Researchers have also looked at exercise as a trigger for migraine, with aims of understanding the prevalence and if there are any unique symptoms for exercise-induced migraines. One study published in 2013 found that the lifetime prevalence of exercise-triggered migraine was 38%. Of those who experienced exercise-triggered migraine, neck pain was the most common initial symptom.5

How exercise benefits people with migraine

Many researchers and doctors recommend that migraine sufferers keep a regular schedule, including exercising regularly. Exercise can reduce stress, help with relaxation and help balance many chemicals and functions within the body. Exercise also causes the brain to release endorphins, which act as the body’s natural painkillers. Endorphins and exercise improves mood and decreases the body’s perception of pain.

How to minimize exercise-triggered migraine

According to the American Migraine Foundation, there are several ways to reduce the chance of exercise triggering a migraine attack, including:

  • Warming up before exercising – start slow with stretching, easy walking, and gentle movements
  • Stay hydrated by drinking plenty of water before, during and after exercising
  • Eat healthy food to fuel your body about 1.5 hours before exercising1

Who should not participate in exercise for migraine

Before starting a new exercise regimen, you should check with your doctor.

Exercise may make certain diseases and conditions worse, including:

  • Cold
  • Flu
  • Fever
  • Asthma, recent attack
  • Recent concussion
  • Sharp pains
  • Back pain
  • Osteoporosis

Pregnant women should discuss safe forms of exercise with their doctor first.

Stop exercising immediately if you experience chest pain or any chest discomfort. See your doctor before you resume exercising.


As always, the best source for advice on treating migraine is your own migraine specialist. These descriptions of natural remedies are provided only for informational purposes. You should begin no medication or supplement without first checking with your physician.

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