According to Alan M. Rapoport, M.D., director of The New England Center for Headache in Stamford, Conn., migraine sufferers who exercise regularly report fewer and less severe headaches. But how they approach exercise can make a critical difference in whether they experience relief or risk triggering an attack.

Common psychological triggers include stress, depression and anger. Altitude, humidity and sun exposure are common environmental triggers. Physical triggers can range from lack of sleep to premenstrual hormonal fluctuations to certain foods, such as red wines, hot dogs, citrus fruits, cheeses and foods containing caffeine.

When started too quickly, exercise can be another physical trigger. Portuguese researchers discovered that sudden heavy physical exertion releases high levels of nitric oxide into the bloodstream of migraine-prone individuals, prompting the dilation of blood vessels and the onset of a migraine headache within the next several hours. Most experts agree that an adequate warm up can prevent such episodes and that exercise can be a helpful tool for decreasing the severity and frequency of migraine headaches. The key is to perform a slow and thorough warm up each and every time and if you're new to exercise, build your program slowly.

The following head isolation is a great way to relax the neck muscles. It can be performed during a warm up, cool-down, or throughout the day whenever you need to release some tension. Stand or sit tall. Place your hands on your hips and relax your shoulders. Slowly tilt your head to the right, and hold the position for 10 to 15 seconds as you breathe naturally. Slowly tilt your head to the left, and hold for another 10 to 15 seconds. Continue by alternating sides for a total of 5 to 6 repetitions on each side.

How can exercise help in headache management?

Here's how exercise makes a difference if you are dealing with headaches.

  • Reduced muscle tension You know, all that tension that makes you feel tired out all the time, that makes you not want to exercise in the first place? Another headache and exercise link.
  • Reduced anxiety which makes it easier to cope with any kind of pain
  • Toned up blood vessels, a place where an important part of the migraine and headache chain-reaction takes place.
  • Increased relaxation in general
  • Increased blood and lymph circulation That means more oxygen in (an important headache-fighter), and more toxins out!
  • Reduced fatigue Some people believe that fatigue itself is a migraine trigger, or perhaps the lack of exercise that results.
  • Improved sleep, more sleep Very important for the migraineur for a number of reasons!
  • Improved digestion This means more nutrients that your body needs, and quick removal of toxins.
  • Muscles less likely to spasm and trigger a headache.
  • Blocking of "bad" chemicals Exercise causes complex chemical changes in the brain. Some believe that when some of these "good" chemicals start flowing, they actually block the "bad" chemicals that can be part of the migraine chain-reaction.
  • Increased endomorphins in the body. Endomorphins are your body's natural painkillers. They also help you feel better overall. The problem is that endomorphin levels often seem to be low in migraineurs, and frequent use of painkillers can lower the level still further. If you can increase the endomorphins through exercise, you're decreasing your need for other painkillers and ending the downward spiral. Endomorphins are a huge headache and exercise bonus.

Tips to add more exercise to life

For some people, exercise virtually eliminates their headaches. Others just find them to be less frequent, or far less intense. If you're thinking about getting a bit more exercise in your life, here are a few things to consider:

Warm up: Take the time to start with a walk, or better yet some stretches. This will keep your muscles from getting sore, and keep your body from getting "shocked" into a headache.

Avoid the exercise induced headache: If you're afraid of getting a headache because of exercise, try the tips on our page about exercise induced headache.

Watch the pain: If you already have a headache, take it easy at first. If the headache gets worse, stop and rest for a while. Try putting a cool cloth on your head. (Note: some people find that some gentle exercise early on during a headache can stop the pain before it starts. Give it a try, but if it doesn't help don't push it.)

Moderate daily exercise: If nothing else, try to get about 30 minutes of moderate exercise almost every day. Go for a walk, vacuum the carpet, go for a swim. If you have a bad headache, and need to take a day off, try again the next day - no problem.

Busy? Try small bites: That 30 minutes doesn't have to be all at once. Take it in 10 minute chunks. Research shows that this type of exercise can be just as good as 30 minutes all at once.

Talk to your doctor: If you want to start a new headache exercise program, talk to your doctor first, especially if you're over 40, or have an injury or have had heart problems.

Aerobics: Ideally you need more than just the "moderate" exercise mentioned above. To really get the headache exercise benefits, you need to get your heart pumping at least 20 beats a minute faster than it beats when you're resting. You probably don't need to take your pulse - if you're breathing hard and fast, your heart is getting exercised. Try to get about 20 minutes (all at once) of this type of exercise 3-4 times a week. (this is a good tip for headache exercise or any exercise) Aerobic exercise includes things like biking, basketball, and badminton...

Add variety: Don't do the same thing all the time. Keep it interesting, try new things!

Combinations: When all is said and done, you'll get the best benefits by doing a combination of aerobic exercise and stretches or weight training. WF health experts suggest doing both 3-4 times a week for 30-40 minutes. Try to build up to little by little. Don't get discouraged, just take one small step!

Cool down: After you're done, be sure to cool down by taking a walk or doing some more stretches.

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