Cervical Isometric Exercises: A Helpful Tool in Controlling My Migraine
Last updated: July 2023
As I have written on here before, my migraines seem to have a basis in cervical (neck) pain and instability.
I have Ehlers Danlos Syndrome (EDS), a connective tissue disorder, which means I have a deficiency in collagen. As a result, my joints are "too loose" or hypermobile. This can lead - and in my case, had led - to premature degenerative changes in the spine, including the cervical spine. People with EDS are more likely to have cervical instability due to the wear and tear in the cartilage in and around their spine. And related to that, vertigo and headaches.
My headaches were initially flagged as "cervicogenic" in nature by the doctors I sought out treatment from. This was before I also started developing related symptoms of (sometimes severe) vertigo.
How has my vestibular therapy helped?
I've previously covered some of my experiences with attending vestibular rehab. I thought I would now take the time to delve in-depth into some of the the aspects of vestibular PT that to me was the most helpful in reining in my vertigo episodes (at least to date). In particular, I benefited enormously from isometric exercises. To back-up just a bit, I want to say that everyone is different. Even people with the same diagnoses can have different reasons for those diagnoses, and something that may work for one patient may not work for the other.
What did my physical therapist do?
For my rehab evaluation, we dedicated most of the session to trying to ascertain what the primary culprit was of my particular vestibular episodes. I was grateful that the PT didn't just try to apply a blanket regimen. She also listened and took it seriously when I shared my suspicion that my neck problems and pain played a role (it's not hard to come to this conclusion as serious neck pain/strain often precedes my migraines and vertigo episodes, respectively).
She then prescribed some simple isometric exercises to attempt to stabilize and strengthen my cervical spine. I want to say, that I have over the years, attended countless rounds of PT for a slew of physical problems (again having EDS as well as endometriosis, it lends itself to a lot of problems throughout my body). I have usually had mixed results, and quite a few bad ones. So I am generally pretty skeptical about PT. But I knew these vestibular episodes were ruining my life and I needed to get them under control and reduce their frequency and severity. So I did the exercises as she prescribed - slowly at first, every other day, and then ramping up to every day.
What are isometric exercises?
Isometric exercises work to tighten a specific muscle or set of muscles without disturbing or moving the joint (which can further aggravate the pain). They are usually gentle resistance exercises. For my neck these were the steps of the exercises she suggested:
- Place the tips of my finger or flat of my palm against the middle of my forehead and then very gently, press against it while offering some (again gentle) resistance with my hand.
- Hold for 5-10 seconds.
- Stop and roll neck for about 5 seconds.
- Repeat (originally 5 sets of these for 5 seconds each; nowadays I do 3-4 sets, at 10 seconds each).
- Place the palm of my hand against the back of my skull and also gently push back while my hand offers gentle resistance for 5-10 seconds, for several sets, also employing the other interim steps above.
- Then apply this same tactic to each side of my head with the palm of my hand as well.
How did these exercises feel?
When I first started doing these exercises, my pain was pretty severe and I often would press too hard. I had to keep reminding myself to be very gentle (the PT said to start off so I am "barely" pressing my hand into my hand and it is hardly pushing back) and back off on the pressure. The goal is to also not let the neck actually move, but to keep it still with the pressure. I also couldn't do it if I was already in a serious flare.
Did the exercises help?
I started off doing them every other day. It took a week or two, but then I started noticing results, first minor and then major. I worked myself up to some firmer pressure and longer holds and then was undertaking them daily.
These were not the only exercises the PT gave me. I also had some visual exercises to "retrain" my vestibular system, such as looking at a certain fixed point, like a yellow Post-It affixed on a wall with a dark "X" mark on it. I was to keep my eyes trained on it while moving my head back and forth and up and down for up to 30 seconds at a time. These were also helpful. But undoubtedly, the isometric exercises for my neck seemed to reap the most benefits. I still try to do them daily or at least once every other day or two. I notice if I slack off longer than that, I seem to start getting more neck pain and headaches again. I even find when I feel a flare coming on, a few sets of these exercises can help calm it down. I have not had a major vestibular episode since completing this rehab a year ago.
Please check with your own doctor or PT before starting any new exercise regimen and note that since vestibular migraines have different culprits you may be prescribed a different set of exercises if you seek out vestibular rehab.
Have you tried isometric exercises for your neck? Have they helped your neck pain/migraines or related dizziness? Please feel free to share your experiences in the comments section below!
Have others downplayed your migraine pain?