Which Exercises Are Good or Bad for Acid Reflux?
At-A-Glance
There are four types of exercise: Cardiovascular (aerobic), strength training, balance, and flexibility exercises. Some moves or exercises in each can cause exercise-induced reflux with or without shortness of breath.
- What causes exercise-induced reflux? First, exercises that put extra pressure on the stomach like sit-ups and downward facing dog, which compress the stomach and can increase reflux; and second, bouncing exercises like jumping jacks and running.
- Problem exercises can be modified to minimize the risk of reflux. In weight lifting, for example, if you use light weights and can talk during the exercise, it doesn’t cause Valsalva (a forceful attempt at exhalation against a closed airway), which causes high stomach pressure and reflux. In addition, avoiding lying-down lifting exercises can help Good news.
- There are also some preemptive measures that can help reduce exercise-induced reflux including acid-suppressive medications, alginates and chewing gum.
Respiratory Reflux (RR) and Laryngopharyngeal Reflux (LPR) are synonyms and the terms can be used interchangeably. Going forward, I prefer the term RR and so should you; it is easier to pronounce, more intuitive, and implies that RR can affect any and all parts of the respiratory system which it does.
There are basically four types of exercise: Cardiovascular (aerobic), strength training, balance, and flexibility exercise. Some variations of each can cause exercise-induced reflux with or without shortness of breath. Which are good and which are bad depends on two important variables. First, exercises that put extra pressure on the stomach like sit-ups and downward facing dog compress the stomach and can reflux; in medicine-talk, this is increased intra-abdominal pressure. And second, bouncing exercises like jumping jacks also often cause reflux. I have previously related written a post: What Causes Exercise-Induced Reflux and Asthma, and Is This Problem Preventable?
Exercises to be absolutely avoided for you refluxers are sit-ups, planking, and downward-facing dog (a favorite yoga pose). Other problem exercises that cause reflux are bouncing or relatively high-intensity shaking of the stomach such as jumping-jacks, aerobics, and boxing.
I have listed the different types of exercise programs below as good or bad; but remember, not all exercises in a series, such as weight lifting, Pilates, or yoga are bad ― but you should omit the exercises or positions that that increase intra-abdominal pressure or produce excessive bouncing.
Good, Maybe-Good, and Bad Exercises for the Refluxer
Listed and rated below are about three dozen types of exercises. Remember, if you can do any of them without increasing pressure on the stomach or without too much bouncing, they still may be okay.
I have rated each exercise as it is typically performed, but you may be able to do a modified version. With thought, selection, and precautions almost all can be done in a safe-for-reflux way. This list is in no way absolute because if reflux-causing “moves,” exercises are excluded, then the exercise type may be fine. Thus, this list is here more here as “warning” than as an absolute “good-bad” list.
Good
Balance exercises
Couch or chair exercises
Pliers (ballet squats)
Stairs
Stretching
Tai chi
Walking
Water aerobics
Maybe Okay
Rowing
Jogging
Spinning
Yoga
Wall sits
Swimming
Skipping rope
Cycling
Dancing
Bad
Aerobics
Bicycle racing
Boxing
Circuit or interval training
Deadlifts
Hiking, hill, mountain, or rock climbing
Jumping jacks
Pilates (poses that increase intra-abdominal pressure)
Planks
Push-ups
Rowing
Running
Sit-ups
Spinning
Squats with heavy weight
Squats with heavy weight
Strength training with heavy weight
Weightlifting with heavy weight
Yoga (poses that increase intra-abdominal pressure)
Remember, the number one key to avoiding exercise-induced reflux is to avoid exercises that increase intra-abdominal pressure. Just think it through. In my opinion, the best exercises for the refluxer are like walking and elliptical training, but again, most other forms of exercise can be modified and helped with pretreatment; see below. Also, if your reflux is severe, consider doing a less reflux-causing type of exercise altogether. But this is not always possible … then what?
Case example: A 26-year- old, world-class marathoner came to see me with complaints of shortness of breath for the first half hour of running. My examination and reflux testing showed that he had respiratory reflux. Interestingly, during the testing, with the pH probes in place, I had him run up and down two flights of stairs three times, and this caused esophageal and respiratory reflux … and shortness of breath. I put him on a reflux program, and I added a few special therapeutic items for running. These modifications did the trick … I told him to …
Run (exercise) on an empty stomach; take famotidine 20 mg. and Gaviscon Advance Aniseed 2-3 tsp, before running; drink alkaline water (preferably pH 9.5 or higher); and chew gum or suck on a hard candy, especially for the first 45 minutes of running.
Comment: The recommendations in the paragraph above can help you with your exercise-induced reflux. They are all safe and effective. Note: The recommended Gaviscon is “Gaviscon Advance Aniseed,” and it needs to be ordered on line (not available in your drug store).
For more information about diagnosis and treatment, see my books on Amazon: Dropping Acid: The Reflux Diet Cookbook & Cure and Dr. Koufman’s Acid Reflux Diet. And if you would like to schedule a virtual consultation with me, you can book online.
