Tips For Exercising When You Have Acid Reflux

You've probably felt it before — that uncomfortable burning, acid feeling in your stomach and chest after a delicious meal. The words acid reflux, heartburn, and GERD are often used synonymously, but they are technically different things. Acid reflux is when some of the acid in your stomach comes up into your esophagus, while heartburn is the feeling that it creates (via Medical News Today). GERD stands for gastroesophageal reflux disease, which is usually diagnosed if you experience acid reflux and heartburn frequently. GERD is actually the most common digestive issue in the U.S. — 20% of Americans have received the diagnosis. 

So what causes it? Your stomach uses hydrochloric acid to help break down foods, and while the stomach lining is built to tolerate this acid, your esophagus is not. Sometimes the valve that closes off the esophagus from the stomach fails, resulting in acid reflux. There are many different potential causes, including risk factors like being overweight, smoking, certain medications, pregnancy, and lack of exercise. Diet plays a huge role as well, with some known triggers being caffeine, alcohol, fatty or spicy foods, eating too much, carbonated beverages, and more.

According to an article in Sports Medicine, when the length or intensity of a workout goes up, so do the chances of getting heartburn. High-impact exercise, which involves movement that puts a large amount of impact on your joints and body, can trigger acid reflux (via Healthline). This type of exercise generally requires sudden movement that bring both of your feet off the ground simultaneously, putting more force on your body when you return to the ground (via Dynamic Physio). Some types of high-impact work outs that can cause heartburn include running, sprinting, weightlifting, gymnastics, cycling, jumping rope, and stair-climbing. These types of exercise can put extra pressure on the abdomen and trigger symptoms (via Everyday Health).

However, that doesn't mean that you have to swear off these exercises forever. Some people don't experience acid reflux with high-impact movement. Healthline recommends trying low-impact exercise first and observing how you feel — if that doesn't trigger symptoms, slowly try high-impact workouts and see how it goes.

Eating soon before exercise is generally a bad idea when it comes to acid reflux — it's best to eat two to three hours before a workout (via Healthline). Waiting at least two hours after eating before exercise allows your body enough time to digest your food, lessening the chances of workout-induced heartburn. "The less material that's in the stomach, the better. An empty stomach can't reflux, essentially," says Dr. David Levinthal, director of the neurogastroenterology at the University of Pittsburgh Medical Center (via Everyday Health). If you end up hungry before a workout, choose complex carbohydrates, since these are easier and faster for your body to digest, and can give your body an extra energy boost (via Physicians Committee for Responsible Medicine). Complex carbohydrates can be found in unprocessed plant-based foods like beans, oatmeal, quinoa, potatoes, sweet potatoes, and more. You may want to avoid eating foods that commonly trigger acid reflux, including tomatoes and tomato-based foods, citrus, chocolate, coffee, fried or fatty foods, alcohol, mint, and soda (per Healthline). 

Lying down is one of the biggest triggers for acid reflux — it's generally recommended to avoid lying down after eating and to elevate your upper body when sleeping to reduce or relieve heartburn symptoms (via Healthline). This means workouts that involve lying down, like abdominal crunches, are also off the table (phew). Most crunches not only require lying down, but also put additional constant pressure on the abdominal area. However, this doesn't mean you have to give up on your ab dreams entirely. Everyday Health recommends trying crunches on an incline bench. "My general advice for clients who suffer with GERD is to listen to their bodies and start slowly," says online fitness trainer and nutrition coach Ivana Chapman.

You can also shift your focus on exercises that work different parts of your abs, like your transverse abs, which are located deeper in your abdominal wall. Or you can try hypopressive ab exercises, which involve sitting or standing to tone your ab muscles (via Mitsou Magazine). 

Strength training with a lot of weight can trigger acid reflux, as gastroenterologist Dr. Anjali Mone told Livestrong. To avoid heartburn, the best practice is to focus on high reps with low weight so as to put less pressure on the body, including the stomach. 

Also, you'll want to lift weights while standing or sitting, and avoid lying down on a bench. Indeed, being as upright as possible can help — if you're hunched over or putting too much constant pressure on your abdomen, it could trigger a flare. Luckily, many weight exercises can be adapted. For instance, when working your triceps, rather than sitting down and leaning your body forward to extend your arm back behind you, try standing up and lifting the dumbbells up and down behind your head (via Mitsou Magazine). "Adjusting the incline of the body so the head is more elevated than the stomach helps to decrease the pressure. Any exercise can be modified to any upright position so that your head is more elevated than your stomach. This helps in that it doesn't stir up the stomach acid, which can usually leak back into the esophagus, causing further irritation," shares trainer Sonia Renaud via Mitsou Magazine.

One of the reasons high-impact exercising is discouraged for those with acid reflux is because it increases your chances of becoming out of breath and gasping for air, which in turn might relax your lower esophageal sphincter, resulting in heartburn (via Healthline). "Gulping" the air can put too much pressure on the esophagus, causing the valve to malfunction and triggering acid reflux (via GI Society). Plus, swallowing air is believed to cause acid reflux, which can happen when you take shallow, rapid breaths during a workout (via Everyday Health). According to a study published in Townsend Letter, focusing on your breathing patterns can help reduce your likelihood of experiencing acid reflux symptoms. Also, avoid using a water bottle with a straw, as drinking through a straw causes you to swallow air with every sip (via Everyday Health). Skip using chewing gum, too, which has the same effect.

Oftentimes, people find relief from heartburn with lifestyle changes and medications (via the Mayo Clinic). Typically doctors prescribe people with GERD proton pump inhibitors (PPIs) or H2 blockers, although clinical guidelines from The American Journal of Gastroenterology suggests taking these medications for only a short time period to reduce the chances of developing negative potential side effects. For those that only experience heartburn on occasion, over-the-counter medications like antacids should do the trick. One scientific study showed that diet changes can be just as effective as medications like PPIs. In this study, those that followed a plant-based diet or the Mediterranean-style diet saw similar results as those who took medication. Other beneficial lifestyle changes to help soothe or prevent heartburn include working on improving your posture, keeping a healthy weight, not smoking, consuming fiber in your diet, not eating right before bed, and elevating your upper body when sleeping (via Medical News Today).