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Don't Get Burned

Is annoying heartburn derailing your workouts? These five tips will help remedy your reflux.

Don't Get Burned

That burning sensation you feel in your muscles during a grueling high-rep set or HIIT cardio session is a good thing. But a burning in your esophagus due to gastroesophageal reflux disease (GERD)? Not good. Better known as heartburn, this uncomfortable occurrence can impede your performance in the gym and blunt training intensity. Not to mention, it's just downright annoying. Unfortunately, GERD is a common problem for those who hit the weights hard.

A study from the University of Oklahoma comparing reflux in runners, cyclists and weightlifters found that seven out of the 10 lifters tested had reflux that was considerably worse than the other athletes. The researchers explained that this high incidence of heartburn in weightlifters is due primarily to the high pressure that builds up in the abdominal cavity as you "push your guts out" on a set and perform a Valsalva maneuver, which entails holding your breath while exhaling against a closed glottis (the opening between the vocal chords in the throat).

While the Valsalva maneuver is beneficial when lifting to provide better spinal support and greater overall stability to help generate more strength and power, that increased abdominal pressure can literally push stomach acid into your esophagus. This is especially common during exercises where the torso is horizontal, such as bench press and bent-over rows.

Jim's Take-Home Points

If heartburn is affecting your workouts or your life at any other time, try these tips to minimize GERD attacks:

Nix the weightlifting belt. I generally promote the use of a weight belt, at least for heavy sets, because it causes an increase in abdominal pressure, which is great for increasing strength and power. But it's also bad for heartburn sufferers, as it can increase gastric reflux.

Don't forget to breathe. While holding your breath to perform a Valsalva maneuver during a heavy set can boost your strength and better protect your spine, if you frequently suffer from GERD, you may want to focus on exhaling normally during the positive portion of reps.

Keep a six-pack. Extra fat in the abdominal area puts extra pressure on your stomach, which can increase reflux. Recent evidence suggests that overweight individuals have less parasympathetic nervous system activity than leaner people, which may make the lower esophageal sphincter more relaxed and allow more stomach acid to enter the esophagus and cause heartburn.

Eat well in advance of training. Have a whole-food meal about 2-3 hours before your workout, as opposed to right before, which can make you more susceptible to reflux. Taking Pre JYM and Pro JYM closer to your training session won't cause heartburn for most.

Use acid-reducing medicines. Over-the-counter products like Tums, Zantac or Prilosec can be a big help when symptoms strike or if GERD is a recurring issue. The goal of these products is basically the same, but they vary in how they work inside the body. Antacids like Tums use calcium carbonate to buffer the acid in your esophagus and stomach. Medications like Zantac use the active ingredient ranitidine, which is a histamine H2-receptor antagonist that inhibits the production of stomach acid; this ingredient not only helps when symptoms strike, but it can also prevent them when taken 30-60 minutes before mealtime. Proton pump inhibitors (PPI) such as Prilosec, Nexium and Prevacid can be taken daily to prevent GERD by working to block the active stomach pumps that produce acid.

Reference:

Collings, K. L., et al. Esophageal reflux in conditioned runners, cyclists, and weightlifters. Medicine and Science in Sports and Exercise 35(5):730-736, 2003.

Devendran, N., GERD and obesity: is the autonomic nervous system the missing link? Crit Rev Biomed Eng. 42(1):17-24, 2014.


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