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This week we have a complex migraine question, so we’re going to unpack it thoroughly and only answer one question this week.
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My daughter who is 19 constantly suffers from migraines. Is there an exercise she can do to help with this? She is also on medication for anxiety and depression.
I would like her to try alternative methods to help her in the long term.
– Lyn, 55
Disclaimer: The Ask an Exercise Physiologist column has a movement and lifestyle focus, is for educational purposes only, and does not substitute for professional medical advice.
Firstly, your daughter is incredibly fortunate to have you as a supportive mother. Having a helpful loving support system around her is part of the migraine battle.
I often refer to migraine management as a “prevention puzzle”—trying to fit the intricate pieces together is the goal. Let’s chat about the rest of the puzzle.
To answer your specific question (before I divert on a tangent!), I do find preventative exercises helpful (for many of my patients)—focussing on mobility and optimal neck range of movement, then progressing to specific graded strengthening.
Sometimes upper neck facet joint dysfunction can contribute to headaches and provoke migraines. However, it’s only a small part of the puzzle, which I’ll unpack in a moment. I’d highly recommend seeing a team of allied health professionals who can all work together on the migraine puzzle. Before you book an assessment, double-check to make sure they specialise in migraines (exercise physiologist, physiotherapist, chiropractor or osteopath who all communicate with each other).
Here’s a beginner’s neck and shoulder mobility program to help get your daughter started (I haven’t added any strength exercises, as I feel this needs close monitoring):
- Breathing control
- Chin tucks
- Shoulder rolls
- Cervical spine lateral neck stretch
I’ll have a two-minute demonstration IGTV clip for you dropping into Instagram over the next week. Download the PDF here.
I’d highly recommend trialling hydrotherapy for three months (in a controlled environment, not a public pool setting with splashing and loud noises). I’ve seen hydrotherapy work its migraine magic for over 15 years. Again, it’s only part of the puzzle.
The warm water immersion will help improve your daughters quality of life, potentially reduce future episodes, and helps reduce the frequency and severity. The warm water helps with optimal neck movement and function, and facet joint dysfunction. It not only helps with tension reduction and stress control, but it also focuses on alignment and postural stability.
Hydrotherapy can also focus on neck strengthening (if managed well) while being supported by the warm water. At Capital Hydrotherapy we have neck floats which are amazing for migraine management and allows the client to self-manage their pain, which is a bonus.
Empowerment, and having prevention tools is an important part of the puzzle, so your daughter knows she is heading in the right direction.
Here are some other factors to consider:
- Poor Posture. I’d recommend a full-body alignment assessment, by an allied health professional. How we sit, stand and walk all day affects our neck. I must stress, it is only a part of the “prevention puzzle”, but certainly is a contributor.
- Hormonal imbalance. Has your daughter tracked her migraine pattern? Seeing a hormone specialist would be very beneficial. A naturopathic practitioner could help in this domain, too (since you asked for alternative methods). I’m sure in the comments section on social media, we will get many kind people offering you advice for which practitioners have helped them.
- Soft tissue therapy (massage) as a regular preventative measure. I’d recommend Clinic 88 and Myogen for massage management.
- Poor Ergonomics (or working posture). Does your daughter have a proper ergonomic set-up at home? Has she been educated on “text neck” and how to hold a device correctly? I have another article on HerCanberra around this topic, which may be useful (to hear it from an allied health professional, and not her Mum 😉 Here’s the link: hercanberra.com.au/active/wellbeing/what-is-text-neck-and-how-do-you-solve-it
I hope this column helped put some pieces of the puzzle together.
Start with one change, stick with it for a period of time, reassess, then add another piece.
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The information provided by Ask an Exercise Physiologist is for educational purposes only and does not substitute for professional medical advice. Her Canberra advises our community to consult a medical professional or healthcare provider if they’re seeking more specific medical advice, diagnoses, or treatment.