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Serious Recurring Headaches: Targeted Strengthening Can Help

When it comes to serious headaches, people of think of being still to help them subside or avoiding activity to avoid triggering them. Exercise to prevent headaches may even sound counterintuitive. However, targeted strengthening has a lot to offer.

A number of types of headaches are caused, at least in part, by abnormal muscle tone around the head, neck, and shoulders. Even if this muscle tension is not how recurring headaches got started, the muscle tone becomes part of the pattern later. The types of serious recurring headaches that can have orthopaedic sources include tension, cervicogenic, stress, cluster, and migraine.1-4 [Learn More: Signs that your headache is not coming entirely from your head]

Earlier this year, the International Journal of Environmental Research and Public Health, published an interesting study highlighting the role of exercise therapy in some headache presentations.5 Wonho Choi’s research focused on tension headaches - headaches caused by abnormal muscle tone around the head and neck. Patients additionally had comorbid sleep disorder and presented with forward-head posture. Choi divided patients into two treatment groups. The experimental group received training in isometric strengthening exercises of the deep cervical flexors. The control group received training in targeted neck and shoulder stretches. At four weeks, the stretching group saw no significant improvement in measured outcomes. The strengthening group, however, achieved a 25% improvement in scores from the Headache Disability Inventory and a 30% improvement in Sleep Quality Index scores. Headaches would likely continue to improve over time as muscle balance and posture were restored.

Choi and colleagues note that stretching seemed to provide some relief, but it was only temporary.

Related Article: Over-the-Counter Pain Meds are Not for Long-Term Use!



  1. Solomon S, Lipton RB, Newman LC. Nuchal features of cluster headache. Headache. 1990; 30: 347-349.
  2. Watson DH, Trott PH. Cervical headache: an investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia. 1993; 13:272-284.
  3. Meloche JP, Bergeron Y, Bellavance A. et al. Painful intervertebral dysfunction: Robert Maigne’s original contribution to headache of cervical origin. Headache. 1993;33:328-334.
  4. Olsen J. Clinical and pathophysiological observations in migraine and tension-type headache explained by integration of vascular, supraspinal and myofascial inputs. Pain. 1991;46:125-132.
  5. Choi W. Effect of 4 Weeks of Cervical Deep Muscle Flexion Exercise on Headache and Sleep Disorder in Patients with Tension Headache and Forward Head Posture. International Journal of Environmental Research and Public Health. 2021 Jan;18(7):3410.

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