Before her vestibular migraine diagnosis 10 years ago, Alicia Wolf, creator of The Dizzy Cook, loved high-intensity interval training, cycling, and traveling abroad to take international cooking classes with her husband. But once her symptoms started – dizziness, vertigo, and head fullness – she was sidelined for a while.
"I was super active before I was diagnosed," she says. "And then once this hit, I could barely function some days."
Over time, Wolf says she learned to adjust, adapting her hobbies and activities to her abilities. She even found a new creative outlet through her website and cookbooks, helping others living with migraine learn how to cook nourishing, delicious food that supports migraine health.
"I had to get over this mental hurdle of what I used to do and start creating new goals of what my body is capable of now," she says.
Migraine attacks can be unpredictable and create anxiety about what's possible in your daily life. But there are ways to continue the activities you enjoy and get the exercise and fulfillment you need while living with the condition.
Exercise and Migraine
The relationship between exercise and migraine is nuanced, says Leon S. Moskatel, MD, a clinical assistant professor in the Division of Headache and Facial Pain at Stanford University.
"Exercise has been known to both trigger migraine attacks for some people and also exacerbate ongoing attacks," he says.
At the same time, he says, research consistently shows that regular aerobic activity may reduce how often migraine attacks happen and how severe they are.
Scientists are still studying if and how exercise can trigger attacks. Very hard exercise may affect a brain chemical linked to sleep, called hypocretin, which is also related to the early phase of a migraine attack. If you work out during a migraine, it may make the pain feel worse because your heart is beating faster and blood flow increases, which can lead to more head pressure or throbbing.
Another idea is that exercise releases certain substances in the body called lactate and calcitonin gene-related peptide (CGRP) that can trigger migraine in some people.
But research is also clear that consistent exercise can improve sleep, reduce stress, and stabilize your mood, all of which help prevent migraine. Plus, the hormones your body releases with exercise (endorphins) are natural painkillers.
The key is to exercise in a way that supports migraine prevention.
Smart Exercise Habits for Migraine
If you're relearning how to be active again after a migraine diagnosis (or even for the first time), break your goals into small pieces. Instead of jumping back into intense workouts after her migraine disorder diagnosis, Wolf started with short walks.
"My goal was to just walk down the street to our mailbox and back," she says. "I would try that maybe one or two times a day, and that was enough."
Moskatel says the ultimate aim is to get about 20 minutes of aerobic exercise a day, but he says that 20 minutes doesn't have to happen all at once.
"This can start as just a few minutes a day and build over time," he says.
Consistency is more important than intensity. Sudden spikes in activity such as going from no activity for a few days to a high-intensity boot camp are more likely to cause symptoms than steady, moderate movement done regularly.
As for what kind of exercise is best, that depends on your ability and interest. There's no single "migraine-proof" workout. What works varies from person to person. Find something you enjoy so you'll want to keep it up.
Overall, a mixture of weight training and cardio workouts (walking, cycling, running, swimming) is best for general health. Wolf eventually built strength training into her routine with guidance from a trainer who understood her limits.
"We’d pick things that were hard enough to build strength but not so much that I felt completely wrecked afterward," she says.
Take time before exercising to gently warm up your body, and keep water on hand to stay hydrated. Fuel yourself well throughout the week so you've got gas in the tank, too.
Wolf also learned to plan for post-exercise recovery. If she felt slightly off after a session, she allowed herself extra time to rest before driving home or jumping into another task. That buffer prevented minor symptoms from snowballing.
As for exercising during a migraine attack, Moskatel says that for some people, it's not even a question. The pain is too much. But it's not clear that working out while having migraine symptoms would cause you harm.
"There haven’t been studies documenting worse outcomes when exercising during a migraine attack," he says. "The worsening pain, though, may be a sign from your body saying that exercising another time would be a better idea."
Reclaiming Hobbies You Love
Exercise isn't the only activity migraine disrupts. Hobbies often fall away when pain and unpredictability take over. Along with her newfound passion for cooking, Wolf reconnected with an old love of dance.
"My therapist told me to make a list of all the things that brought me joy, to try to find myself again," she says. "Growing up, I was really into ballet, so I started going to beginner adult ballet classes."
With the barre for stability, Wolf started learning short combinations that challenged her brain in a positive way. She moved more slowly and relied on modifications, but her instructor and classmates were supportive, which helped her rebuild confidence and balance.
"It gave me the confidence to move into the next, more difficult thing, which was weight training," she says.
With guidance from her neurologist and vestibular therapist, she gradually retrained her body to tolerate certain movements, building strength and resilience over time.
You can use this strategy for almost any hobby. Read in short spurts instead of longer sessions. Garden for 15 minutes instead of all afternoon. Paint with planned rest breaks and make sure you have good ventilation, because strong odors trigger migraines for some people.
Taking part in meaningful, enjoyable activities can reduce stress hormones in your body and improve overall well-being, which works to prevent migraine attacks.
