Here's a tricky conundrum: If you experience heartburn, aka acid reflux, exercising regularly will help with prevention and could reduce the severity of a flare. But certain types of activity can actually make a flare worse or even cause one.
So, how can you get the benefits of exercise without tipping over toward worsening your issue? Choosing the right kind of exercise for acid reflux.
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Here's a look at how exercise can be a benefit, which types to do and which types to avoid, so you can manage your acid reflux better — and improve your overall health along the way.
First, Why Does Exercise Help Acid Reflux?
If you've struggled with balancing your reflux symptoms and fitness before, it may be tempting to opt for couch time instead. But that can put you at even greater risk for exacerbating the condition, according to Anjali Mone, MD, gastroenterologist at Lenox Hill Hospital in New York City.
"Consistent physical activity is essential for reducing acid reflux," she tells LIVESTRONG.com. "That's because exercise can help with increasing your muscle mass and reducing body fat, which have both been shown to improve acid reflux."
Plus, Dr. Mone adds, it's well known that exercise offers a breadth of health benefits, including lower cancer risk, better heart health and improved immune function. Also key is the mood boost that comes from regular exercise. That's a major deal, considering gastroesophageal reflux disease (GERD) can cause difficulty with emotional health, particularly anxiety and depression, according to a November 2019 study in the Cureus Journal of Medical Science.
The Best Exercises for Acid Reflux
Moderate- and low-impact exercise is the way to go for both prevention and flares, Dr. Mone says. That will allow you to get your heart rate up to reap the benefits of cardiovascular exercise without triggering symptoms. This includes a range of options, such as:
- Easy running
- Tai chi
- Rock climbing
- High-rep, low-weight strength training
Anything that feels like gentle motion is preferable, says California-based trainer Rocky Snyder, CSCS, author of strength training guide Return to Center. Walking, in particular, is one of the best ways to stay active without aggravating symptoms, he adds.
One cautionary note from this list is the inclusion of Pilates and yoga. In both, there are many types of moves that involve frequent forward folds and inversions — poses that create more abdominal pressure.
"When this happens, it can increase the amount of acid coming back up due to strain on the abdomen," says Atif Iqbal, MD, medical director of the Digestive Care Center at MemorialCare Orange Coast Medical Center. "A simple forward fold is fine, especially if it feels restorative, but if you're doing crunches or creating contraction in the abdomen, it may cause a flare."
The Worst Exercises for Acid Reflux
In addition to skipping ab crunches, it's best to avoid any high-impact movements that involve jumping and sprinting. Running, in particular, can often trigger acid reflux, Dr. Mone says. So can strength training with heavier weights, which is why the focus should be on more reps with lighter weights instead of increasing your load and volume.
It's all connected to the way you're creating pressure in the abdomen, Dr. Mone adds, and you need to be particularly cautious if you're in an active flare.
"During an episode of acid reflux, the lower esophageal sphincter — which is a muscle that serves as a barrier between the esophagus and stomach — opens and allows stomach acid to travel into the esophagus, leading to acid reflux symptoms," she says. "Exercises that increase abdominal pressure, including high-impact workouts, running, heavy lifting and abdominal crunches, can trigger heartburn."
What to Do If You're in a Flare
You want to stay active, but you're feeling on the edge of a flare or you're in the midst of one. What now? According to Dr. Mone, the ways to minimize acid reflux during exercise include:
- Avoiding exercise within 2 or 3 hours of eating
- Eating slowly
- Staying hydrated
- Avoiding normal food triggers of acid reflux
- Dressing in loose, comfortable clothing rather than tight-fitting options that put pressure on your abdomen
Also important: Avoid lying flat. That's true not only after eating but also during exercise, which means you may want to skip weight training that involves lying on a bench or doing a yoga or Pilates practice where you'll be stretched out on the mat for several moves.
"It's also helpful to keep a log to help identify if there are specific exercises, workout routines and dietary choices that triggered the acid reflux," Dr. Mone says.
If you're doing the right kind of moderate exercises and following the suggestions for avoiding a flare, but you're still having issues, Dr. Mone suggests talking with your healthcare provider on more strategies that can help.