The third episode of Beyond Migraine, a six-part podcast series created for people living with migraine in Ireland, is brought to you by the Migraine Association of Ireland and Teva Pharmaceuticals Ireland and focuses on the effects of exercise on migraine.

Tony Cascarino, former international soccer player for Ireland, who lives with migraine, is joined by Julie Sugrue, Clinical Specialist Physiotherapist, the University of Limerick Hospital Group and Dr Edward O’Sullivan, Director of the Cork Migraine/Headache Clinic. Tony Cascarino talks about the impact of migraine on his sporting career with a wider discussion on how exercise can both trigger a migraine but importantly can also be part of the overall holistic management of migraine.

Migraine and its link to exercise

As we know, migraine is a neurological disorder. “It affects 10%-12% of the population and about 20% of those patients get the typical, visual aura symptoms, which consists of flashing lights and blurred vision or other vision changes which can last for 15-20 minutes. This is followed by a headache, or other aura symptoms such as numbness, pins and needles, or difficulty with speech. These symptoms can be disabling for anyone who experiences them”, summarises Dr O’Sullivan.

It may seem that we know a lot about migraines, but unfortunately, according to Dr O’Sullivan “There still remains a lot of mystery. Different people have different triggers: exercise, hormones, diet, sleep hygiene. I think certain types of exercise will make individuals more susceptible to a migraine attack and I would say anaerobic exercise involving a lot of breath holding, weightlifting, working out in the gym, will make you more vulnerable to a migraine attack than other forms of mild to moderate exercise.”

Migraines and stress

Tony was 19 years old when he first experienced a migraine attack, and since then, he noticed a pattern – he tended to experience migraine after a big event, like an important match. “Migraines were always far more stress-related for me. I found there wasn’t a lot of stress before the game, but there’s nerves, there’s concerns of what’s confronting you. Afterwards, I found it more stressful because there’s a massive comedown. It was very, very draining, and I think, sometimes, I felt more stressed after games than before them.”

While migraines create obstacles to exercise, ironically, exercise is the perfect preventative measure. As a physiotherapist, Julie Sugrue finds that routinely taking part in gentle exercise will alleviate the worst of migraines. “Aerobic exercise is the most researched piece of preventative exercise therapy. The World Health Organisation guidelines is for 150 minutes of moderate intensity exercise per week, and whether you do that in five 30-minute walks or in ten-minute blocks is irrelevant, as long as you reach that number. Different research papers have looked at people undertaking 40 – 45 minutes of exercise three to four times a week with really impressive results of reducing migraine frequency and intensity.”

If you don’t like long walks, or don’t live in an area where it’s possible to stroll around, yoga is also great. “Yoga is probably very under-utilised as an exercise approach that has huge benefits”, according to Julie. “It’s not just a physical fitness benefit that comes from it but also relaxation, mindfulness and peace that’s often linked to it.” Over the last ten to fifteen years, there has been a dramatic increase in the number of people using complementary techniques to treat migraine. Many Irish migraine sufferers have gained at least some relief through complementary therapies such as yoga. [1]

For those that experience migraines during exercise, the advice is firstly – treat it immediately, with the medication given to you by a GP. Should you also stop exercising? According to Dr O’Sullivan, if it is migraine, you’ll have no choice. “Now, migraine will not be pushed to the back of your head. If you experience a migraine attack, it’s going to disable you to the point where you can’t function, you will never conquer it. It’s not a strength of wills, it’s about what can you can do to manage it in terms of taking effective treatment.” According to Dr O’ Sullivan, “once your migraine subsides and you are returning to exercise, it is important to prepare for this return, you need to ensure you’re well hydrated and that you’ve fuelled your body. Also start with a mild form of exercise such as a walk and gradually build up your exercise intensity.”

You can listen to the Beyond Migraine episode featuring Dr Edward O’ Sullivan, Tony Cascarino and Julie Sugrue here.

The series can be streamed via the Migraine Association of Ireland website as well as wherever you listen to your podcasts.

If you experience migraines, speak to your GP. For more information about migraines, visit www.migraine.ie.

People living with migraine can also check out Life Effects. Life Effects is an initiative shaped by patients, for patients. It explores the latest science and thinking around your condition, it contains tips and patients share stories about the reality of living with chronic conditions. Find out more about migraine on lifeeffects.teva/eu/migraine.

This article is part of a sponsored series linked to each Beyond Migraine podcast episode brought to you by the Migraine Association of Ireland and Teva Pharmaceuticals Ireland.

The Beyond Migraine podcast is supported by funding from Teva Pharmaceuticals Ireland. Speakers have received an honorarium for their contribution to the podcast.

[1] Ref: Some other treatment options. Migraine Association of Ireland. https://migraine.ie/other-treatment-options/#mindfulness-and-relaxation