Dr Betsy Seng, a psychologist and researcher in neurology, presented on migraine and exercise at the wonderful 2024 Migraine World Summit. It’s taken me a while, but here are my notes from her interview.
It was agreed that exercise is good for everyone, however, when you have a migraine it is often difficult to get out of bed, let alone exercise. She suggests “are you kidding me” is the general response to exercise suggestions. Moreover, she understands that the lived experience of chronic pain should be taken into account when deciding on an exercise approach. She noted that if it is hard to move safely (eg. due to dizziness), we should be careful that exercise does not do more damage than good.
Dr Seng noted, it is NOT irrational to fear for your safety, but at the same time, you generally ARE safe to be exercising when you’re unwell.
She noted that some exercise, such as ‘downward dog’ in Yoga can be hard for migraine people, as is anything which involves high flexibility or ‘jiggly’ head movements. She said there is no harm trying things – just listen to your body and stop if you feel unwell. She suggested that a ‘slip and slide’ approach is good; working out when you can, and missing (without feeling guilty) when you can’t. This is better than giving up altogether and having to restart the routine again later.
Ideally, the most useful exercise is anything that makes your heart beat faster and causes you to run out of breath. This is when endorphins are released, and these ‘happy hormones’ help you to feel better. Strength training and swimming, although not so huffy-puffy (my words) are still beneficial to your long-term health as well as your migraine-brain.
Alongside exercise, stress management was another way to regulate the stress hormones [hello my new friend mindfulness!]
She acknowledged that whilst many people draw a distinction between movement and exercise, all movement IS exercise. So, if you are starting your exercise routine with a low benchmark that is ok. If you’re unwell, a brisk walk might be enough to make you out of breath. When you become fitter, then you can aim to go running.
The “best” exercise is the one we’re prepared to keep doing. She suggested setting the goal low enough that you can 100% achieve it. That way, you’ll be more inclined to do it. Then slowly increase the goal to a new level, that you can 100% achieve. You’ll be prouder and stay motivated. She cautioned against ‘stretch’ goals when you’re sick, or anything that makes you anxious, as you will be more likely to scan for triggers rather than stay calm.
[This is similar to what I noted in my post about “walking for migraines“, and why I ditched the step tracker – instead of enjoying the fresh air and stretching my muscles, I was always worrying about how far I still had to go to achieve my target.]
Dr Seng noted that exercise alone won’t prevent migraines or fix the underlying neurological issue, it is just one part of a complex equation – but that some movement – any movement – is better than none. It’s all about getting our body fit and strong to navigate what life throws at us.
Fresh air, she noted, is also a great healer – so get outside and do things.
She reminded listeners that there are lots and lots of professionals out there who are interested in helping you exercise and ended by saying: “If you’re watching this, you’re already doing an amazing job trying to manage your migraine”.
Thanks Dr Seng, and thank you everyone for reading.
Take care taking care, Linda x
PS – I was recently sent this link about exercise for migraines which gives a great overview of how to set realistic goals to get you moving: Exercising for Migraine Relief: A Structured and Safe Approach (kelosphysicaltherapy.com)
PPS – this morning I found out it’s “World Meditation Day” – oops – I should have done a whole post for it – but alas, I realized too late. Instead, I did a morning meditation to honor the difference it has made in my life, and I highly recommend you give it a go if you haven’t already; there is nothing nicer than making a little clearing in your mind, as it were. I’ve got some meditations that have worked for me, saved here on the Blog, but also as Youtube and Spotify playlists… enjoy!
The Mindful Migraine 
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