Headaches. They’re a pain. There are numerous causes of headaches, which makes this topic challenging to summarise. Today we will start by talking about the common types and what can be done to help manage the pesky things. It is important to start off by stating that headaches and migraines are two different diagnoses and can be treated quite differently. Whilst giving similar sensations and so are often confused, there are some defining characteristics between the two.

There are two categories of headaches, these being primary and secondary headaches. Primary headaches are more common and are often categorised as tension type headaches or migraines, these types of headaches also are more frequent. Tension headaches gives the sense of a band tightening around your head, a constant ache on both sides or can be as a result of pain being spread from the head or neck. Migraines often only impact one side of the head, but the associated symptoms can be more life effecting. These symptoms include blurred vision, light headiness, nausea and sensory disturbance. Alternatively, less common, are secondary headaches. These are associated with an underlying medical condition and are more one-off episodes.

Within the differing symptoms of both headaches and migraines, it is best to look further than just the symptoms that present. Here are a few different things worthwhile thinking about


There’s a growing popularity in the discussion of sleep. From books such at Matthew Walker’s Why We Sleep to numerous TED talks on the matter. You may have read something on sleep or listened to a podcast on it. Or you may just have heard me harp on about the importance of sleep. But sleep also specifically relates to headaches. While it is slightly misunderstood as to how sleep and headaches are linked, a high proportion of people who experience headaches and/or migraines also mention a lack of sleep. It is also mentioned that lack of quality or quantity of sleep can also lead to increased sensitivity within the musculoskeletal system. This means that a mild tension headache which is normally relatively tolerable, increases in severity due to a lack of sleep.

Sleep is one of those things that we have always done, without really knowing why. But with growing research and insight into the area of sleep, we are starting to see the links from not getting enough or poor sleep quality and how impactful it can be on our bodies.


Or to be more specific, dehydration. With up to 60% of our body being made up of water, we have high water demands, and it sometimes doesn’t take much for us to become dehydrated. A slightly warmer day. Not getting adequate water intake after hitting the gym. Simply leaving your water bottle on the kitchen bench as you rush out the door. When we lack enough water in our system, our muscles become more stressed, as does our organs. For example, our brain temporally shrinks due to fluid loss, resulting in the brain very subtly pulling on the surrounding structures and, subsequently, putting pressure on the skull.

The age-old rule is that we should have eight glasses of water a day. Whilst this can be correct, we also need to think about what other sources we get fluid from. And before you think too quickly, coffee doesn’t count. While coffee is fluid, it also is a diuretic which means that the more coffee you have, the more water you should also be drinking.


It seems that everyone is aware of the importance of “good posture” but what is often missing is the discussion is to why. From a starting point, we have what is called the ‘anatomical position’. This is when our hard structure is in a neutral position, meaning that we are standing, with arms and palms facing outwards and feet facing forward. In this position, our muscles are in a neutral position and relaxed. However, as we go throughout our lives, we continue to perform different tasks that puts more pressure onto our musculoskeletal system which moves us away from the anatomical position. This change will alter the way that we move which can result in an increase in tension, loss of strength, and increased muscular tone. Just to name a few. The song Dem Bones by James Weldon Johnson says it well, “Your back bone connected to your shoulder bone, Your shoulder bone connected to your neck bone, Your neck bone connected to your head bone”. This is true and because everything is connected when one body part moves, inevitably the connecting bone will be impacted. This is why you can get issues such as a forward head posture, sway back or pelvic tilt when the issue is really coming from a different but connected part. They are all results of changing posture.

When looking at this from a massage perspective, we are looking at improving tissue tone, length and overall muscular health. With the strong correlation between muscle tightness and tension headaches, we can look at improving the way the body moves and feels to help reduce the symptoms that headaches create. While the reason the muscles get tight are multifactorial, we look at working through these reasons and how we can make long term change rather than just treating the symptoms.

While headaches can be something that we feel in our heads, hopefully this blog has started the conversation on all the other things that we think about when someone comes into the clinic complaining of headaches. They are something that must be treated holistically, rather than just focusing on the site of where someone gets pain.

Luke McCallum is a Sports Lab Massage Therapist. He’s all about recovery and the impact that this has on performance, and looking at the way that someone presents in a multifactorial way.