How I Exercise with Ulcerative Colitis — In and Out of Remission

IBD symptoms can make you want to retreat to the couch. Here’s how — and why — to keep moving.

I grew up being active and participating in sports: track, softball, soccer, swimming, rock climbing. You name it, I played it.

Then, I was diagnosed with ulcerative colitis (UC) at the age of 19, and I had no idea if I would be able to be active again. I thought my life as I knew it was over. Little did I know, I would go on to run a marathon (and many half marathons!), get back to swimming, learn to enjoy yoga, and become an avid CrossFitter.

Over time, I discovered that movement is actually important in managing inflammatory bowel disease (IBD), so I’ve found ways to exercise that work well for me and my body — both during remissions and flares.

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The importance of exercise for IBD

It’s well-known that regular, moderate exercise improves overall health for most people in the general population.

For people with Crohn’s disease or UC, exercise has the added benefit of decreasing the chance of a flare. It also helps increase bone mass density, which is important for those with IBD who are at greater risk for developing osteoporosis.

In a more general sense, exercise also helps people with IBD have a better quality of life by improving sleep, mood, and fatigue.

Challenges with exercise

People living with IBD often limit their exercise due to factors, such as:

• fatigue
• joint pain
• abdominal pain
• the need to have a bathroom nearby

However, it’s entirely possible to continue moving your body throughout all stages of IBD with just a little bit of strategy.

Exercising during a flare

The first thing to know is that your exercise routine mid-flare is going to look different from your exercise routine during a remission.

During an IBD flare, your body works overtime to fight building inflammation. You may experience diarrhea, urgency, abdominal pain, rectal bleeding, and fatigue. With these symptoms, it’s understandable if you don’t exactly feel like rushing off to the gym.

Even so, it’s not a good idea to avoid exercise altogether. After all, it still has the same benefits — increasing quality of life, reducing stress, and keeping your muscles and joints active — that it has at other times.

I know from personal experience how hard it can be to work out during a flare when I only feel like laying on the couch. I switched my language from “working out” to “moving my body,” which has helped me shift the way I view exercise when I’m sick.

Now, when I’m in a flare, I challenge myself to move my body for 10 minutes every day. If you can only do 5 minutes on a given day, that’s great too! I usually commit to stretching and walking every day, but other low impact exercises, such as yoga, biking, and swimming, are also good options during a flare.

For motivation, I talk with friends on the phone or listen to a favorite podcast while going for a slow walk around the neighborhood. On a day when I’m experiencing less pain or fatigue, I challenge myself to walk a bit further.

On the other hand, you shouldn’t try to do your usual workout. I used to force myself to push through the fatigue and weakness and jump back into a hard workout when my body wasn’t in a healthy enough state. Without fail, my weakened body couldn’t handle it, and made my flare worse.

It’s also important to incorporate more rest days between workouts to allow your body to recover. In addition to daily walking and stretching, I recommend planning for 1 to 2 days per week for biking or swimming, if you’re feeling up to it.

Exercising while recovering from a flare

Whether your flare-up was a few days, weeks, or months ago, you may need to ease back into a more vigorous exercise routine. You’ve likely been spending a lot of time in bed or on the couch, being more sedentary than usual.

Plus, your body has been working hard to recover from the IBD flare, and it may still be in a weakened state. So it’s important to not jump right back into that high intensity interval training (HIIT) or CrossFit class right away.

For years, I returned to my intense workout schedule the second I felt better, no matter how much residual weakness or fatigue I felt. Like clockwork, I would regress into a flare within weeks of restarting my intense workouts.

For this reason, I recommend starting with low-impact cardio activities, like walking, and gradually increasing the time or distance. I usually start by walking 20 minutes every day. Once I’m comfortably walking 30+ minutes each day, I add in bodyweight exercises, such as pushups, lunges, and squats.

I do my bodyweight workouts two to three times per week, for only 5 to 10 minutes at a time. From there, I gradually begin to increase the difficulty by adding time or weights.

In the beginning, it’s important to avoid jumping movements, like box jumps or jumping lunges, as they can be irritating to the gastrointestinal (GI) tract and joints. Keep repetitions low, and allow for plenty of rest time between movements.

Go slow. Don’t feel like you need to rush through a workout. Your body is getting used to working your joints and muscles again, and it needs time to rebuild strength.

Modify your workout when needed; if you can’t go all the way into a squat, go as far as you can while maintaining the proper form, and then come back up.

Exercising while in remission

Remission looks different for everyone. As a result, exercising during remission may look different as well. As your health continues to improve, really listen to your body.

I recommend taking a daily inventory of your energy and overall health status and then planning your workout accordingly.

If you’re only recently in remission or just beginning to get into exercising, I recommend starting with low impact cardio and bodyweight movements to learn proper form. Then, begin adding light weights to the movements and slowly work your way up to heavier weights.

When I’m in remission, I personally include a variety of workout styles each week. I do 3 or 4 days of strength training, plus one or two HIIT workouts per week and my daily walks.

Most importantly, pay attention to how your body responds. If you’re extremely sore or in pain after a workout, try reducing the amount of weight you’re lifting, or even go back to just doing bodyweight exercises the next time.

The takeaway

Moving your body is incredibly important in managing IBD. That being said, you may need to modify how you move your body depending on the state of your disease.

If you’re going through a flare, focus on low impact and gentle movements. If you’re in remission and feeling healthy, you can expand your exercise routine and add in higher intensity workouts a couple of times per week.

Every body is different, and you should always listen to your body and what it needs.