If you live with migraine, I can almost guarantee that at some point someone—maybe a doctor, maybe a friend—has said something like:

“You need to exercise more.”
 “You wouldn’t feel so sick if you didn’t lay in bed all day.”

Migraine is one of those diseases that is incredibly easy to dismiss and gaslight. Why? Because it’s invisible.

We live in a society that ties self-worth to productivity and movement. When someone isn’t active, the assumption is often laziness or lack of motivation, not illness. Rarely does anyone stop and think, “I wonder if Deena’s low mobility is caused by her chronic illness.”

Because migraine is invisible, we’re blamed for what our bodies can’t do instead of supported for what they’re enduring.

This blog will walk through what science actually says about exercise and chronic illness, but more importantly, it will focus on how to introduce exercise safely and realistically when you live with chronic migraine, without shame, pressure, or unrealistic expectations.

Research shows that regular, appropriately paced physical activity can support people with migraine in several ways:

• Exercise may help regulate neurotransmitters involved in pain processing

• It can reduce stress hormones like cortisol

• Movement supports cardiovascular health and circulation

• Consistent low-impact activity may reduce migraine attack frequency for some people over time

But here’s the part that often gets left out: Most of these benefits are observed when exercise is introduced gradually and sustainably.

The research does not say that intense workouts, sudden routines, or pushing through symptoms is helpful, especially for people with chronic or intractable migraine. In fact, for many of us, exercise itself can be a trigger if introduced too quickly.

Science supports movement but it also supports pacing, adaptation, and respecting the body’s limits.

Exercise does have benefits. But when you’re living with a disease that is unpredictable, neurological, and capable of hijacking your entire nervous system, movement is not simple.

For the first half of my 20s, exercise wasn’t an option. I was stuck in survival mode. By the end of the day, I was done. I was lucky if I made it through a full workday without needing to go home early.

This is where my frustration with wellness culture and even medical professionals really deepened. Telling someone they need to exercise, without living in their body, without understanding their disease, and while making assumptions based on weight, is dismissive.

During this period of my life, I lost all my muscle mass. I weighed under 100 pounds. I wasn’t healthy, not just because of migraine, but because my body was barely surviving.

Just because science says something is good doesn’t mean every person is capable of doing it in the same way.

Threshold theory is one of the most important concepts to understand when living with migraine. It replaces self-blame with compassion.

Imagine an empty cup when you wake up in the morning. As your day goes on, that cup fills every time you encounter a trigger:

• High stress

• Skipped meals

• Strong fragrances

• Poor sleep

• Hormonal changes

Once the cup fills past its limit, a migraine attack begins. Some triggers fill the cup instantly. Others add just a little.

Now pause and ask yourself: How full is your cup today?

When it comes to exercise, especially if you don’t currently have a routine, this question matters. Exercise places stress on the body. Even gentle movement adds water to the cup. How much it adds varies from person to person.

Understanding this allows room for self-compassion instead of frustration or anger.

If you take nothing else from this post, take this: starting too fast is the fastest way to fail.

Your body does not currently have an exercise threshold. That threshold has to be built.

When I started, I walked on a treadmill for two minutes. That was it. And yes, those two minutes triggered migraine attacks at first. But I stayed there. I didn’t increase. I didn’t push through. I let my nervous system learn that movement wasn’t a threat.

If your cup is already full, even gentle movement will add water. Starting slow gives your body a chance to adapt without overflowing.

Helpful guidance:

• Start with 1–5 minutes, not 20–30

• Choose something that feels almost “too easy”

• If you think, “This can’t possibly help,” you’re probably starting in the right place

Progress starts where your body is, not where you wish it were.

One of the biggest mistakes people make is changing too much at once: more time, more intensity, more frequency.

Instead, increase only one variable at a time: Time or Intensity or Frequency

Never all three.

For me, once two minutes no longer triggered attacks, I stayed there for another week before increasing by two more minutes. I allowed my body to own that level before asking for more.

Helpful guidance:

• Wait 7–14 symptom-stable days before increasing

• Increase by 1–5 minutes max

• If symptoms worsen, go back to the last stable level

Regression isn’t failure, it’s data.

Early on, unpredictability is a trigger. Choose movements that are: low impact, controlled, repetitive, and easy to stop immediately.

Good starting options:

• Slow walking

• Recumbent bike

• Gentle yoga or stretching

• Light resistance bands

• Floor-based mobility work

High-intensity, jumping, fast transitions, or workouts with loud music and bright lights can overload the nervous system quickly.

This isn’t about avoiding challenge forever, it’s about earning tolerance first.

Exercise doesn’t start when you move, it starts before you move.

Before exercising, ask:

• Have I eaten recently?

• Am I hydrated?

• Is the room cool enough?

• Am I wearing comfortable clothing?

• How full is my cup today?

Blood sugar drops, dehydration, overheating, and restrictive clothing can all stack triggers before exercise even begins.

Helpful guidance:

• Eat a small snack with protein + carbs

• Drink water before and after

• Keep the room cool or use a fan

• Avoid exercising during known high-trigger windows if possible

These steps protect your threshold.

Exercise doesn’t have to look like sweat, exhaustion, or soreness.

Stretching counts.
Mobility counts.
Gentle walking counts.
Five minutes counts.

If it supports circulation, strength, or nervous system regulation without triggering symptoms, it counts.

This mindset shift removes shame and keeps you consistent.

Setbacks don’t mean you did something wrong. Migraine is not linear.

Build flexibility into your plan:

• Have “low-energy” movement options

• Allow rest days without guilt

• Scale back during flares, hormonal shifts, or high stress

Consistency over time matters more than intensity on any single day.

This process is slow, because your nervous system needs safety, not force.

It took me a full year to reach an hour on a treadmill. And that was after years of survival mode, muscle loss, and severe limitation.

Your timeline may look different. That doesn’t make it wrong.

Patience isn’t giving up, it’s choosing a path your body can actually sustain.

Even if you already exercise, introducing a new type of movement often requires building a brand-new threshold.

Your body doesn’t automatically generalize tolerance from one activity to another. Walking, Pilates, strength training, and yoga all place different demands on your nervous system, muscles, and posture. That means each new routine may temporarily add more water to your cup, even if your overall fitness has improved.

When I first started Pilates, it consistently triggered migraine attacks. That was frustrating, especially because I was already exercising regularly. But instead of assuming Pilates “wasn’t for me,” I treated it like I was starting from zero again. I scaled back, shortened sessions, and gave my body time to adapt.

Over time, Pilates stopped triggering attacks and eventually, it became supportive. It helped with strength, stability, and body awareness without immediately filling my cup.

Helpful guidance:

• Treat every new exercise like a fresh start. You don’t have to start at ground zero again, but allow time for your body to adjust.

• Expect temporary symptom flares while a new threshold is built

• Reassess after several weeks, not a single session

Early symptoms don’t always mean an exercise is harmful. Sometimes they mean your body is learning. Building a new threshold takes time and that time is part of the process, not a setback.

Exercise and migraine exist in a complicated relationship, one that can’t be reduced to motivation, discipline, or willpower. When you live with a neurological disease, movement is not a moral issue. It’s a physiological one.

The problem isn’t that people with migraine don’t want to move. The problem is that our nervous systems are already carrying more than most bodies ever have to. When your threshold is constantly being tested by pain, sensory overload, hormonal shifts, stress, and fatigue, even small amounts of movement can feel overwhelming.

That doesn’t mean your body is failing. It means it’s protecting you.

Reintroducing exercise with migraine isn’t about pushing harder, it’s about listening better. It’s about learning when to rest, when to try, and when to pause without shame. It’s about letting go of who you used to be and making space for who your body needs you to be right now.

Progress with migraine doesn’t look dramatic. It looks quiet. It looks slow. It looks like two minutes on a treadmill that eventually becomes five, then ten, only when your nervous system is ready.

And if exercise isn’t accessible to you right now, that doesn’t make you lazy, weak, or unmotivated. It makes you someone living with a real, complex disease in a world that doesn’t always understand it.

Your body is not the enemy.
Your limits are not character flaws.
And honoring your threshold is not giving up, it’s how healing actually begins.

You are allowed to move at your own pace.