Medications, diet and stress relief are a few incredible tools for dealing with IBD.  I am so excited to talk with you about WHAT YOU CAN DO to fight for your health using exercise.  I see a huge range of clients, current age range of 20-78, a huge spectrum of occupations, athletes and individuals that have never exercised, clients that are disease free and ones that have IBD and/or other serious disorders.  As a population it is true that our disease and common medications to treat us put us at a much higher risk for secondary conditions such as cardiac issues, osteoporosis, muscular atrophy, poor sleep habits and mental/emotional stability.  But one common thread all my clients, both patients and non-patients, share is the absolute truth that regular exercise can addresses these types of concerns.
Some very common reasons I hear people skip activity are a lack of time, being tired, a lack of knowledge, a lack of motivation.  These are all very valid reasons to prioritize numerous other things in life over our health and fitness.  I recognize that chronie’s have numerous hurdles on top of the ones I mentioned to clear such as anemia, inconvenient appliances, washroom access, sore joints, stomach pain, poor nutrition etc.  I really get it and it’s not easy. 
I am here to tell you that this disease has not put you on a slippery slope with inevitable secondary health concerns and that it’s worth it to prioritize your fitness.  Dig your heels in.  I’m talking about using EXERCISE and GOOD NUTRITION as tools in your toolbox to address some of the issues this disease brings. 
Below are 10 very common fitness related questions I hear from IBD patients.   
1) How do I start?
Do something.  Anything.  Go for a walk.  Go for a swim.  Do yoga in your living room.  Ride a stationary bike.  Go pool running.  Power walk.  See a personal trainer that understands your condition(s).  You must resistance train, it is the very best way to strengthen your bones and one of the best ways to strengthen your cardiovascular system.  *If you are recently out of surgery consult your physician for guidelines so you don’t overexert and cause a hernia.
2) When do I start?
Unless you are freshly out of surgery, TODAY.  You should be exercising 4-6 days a week.  Sound like a lot?  We are evolved from incredible humans that ran the sahara for food.  We all evolved from those genes.  Just as a german shepard NEEDS to run for 1-3 hours a day every day to be happy and emotionally stable, we need to exercise 4-6 days a week for 30-60 mins at a time. 
3) I’m so tired!  Should I still exercise?
Even patients that are in full on remission can experience exhaustion as an inconvenient symptom.  If you are flaring chances are you will be tired a lot, your body is in a battle right now.  But you are going to be tired if you exercise and are being proactive about long term secondary conditions, or if you choose not to exercise.  In fact, on average after 2-3 weeks regular exercise will give you energy.
4) Should I experience a flare up of symptoms after I exercise?
Absolutely not.  If you are experiencing exercise induced flare ups you are working too hard or your activity choice is inappropriate.  Stress makes IBD worse.  Exercising too hard is a stress.  This is not a time in your life to take up crossfit and laying off the impactful activities is helpful. 
5) Should I increase my workouts quickly?
The key to this process is PROGRESSION.  This means to increase your weights, to add more intensity to your cardiovascular workouts, to add in new exercises that are more vigorous as your fitness levels increase.  Again, the intention is to have exercise as a stress relief and not a stress.
6) I love to run but it’s hurting my stomach right now, what else can I do?
Power walk on the treadmill.  When the incline is set to 10%, speed of 3.8 MPH it replicates running at an elevation of 1% and speed of 6.0 MPH in terms of heart rate.  Adjust as necessary to your fitness levels!  The impact of running can cause discomfort and ‘urgency’, keep it low impact.
7) How hard should I be working?
I strongly encourage using the “talk test” when you’re exercising.  If you are with someone you should be able to hold a broken conversation (3-5 words at a time), if you’re alone you can talk out loud (haha, I caught you off guard didn’t I?!).  Imagine having a conversation, if your best friend was there could you hold a broken conversation with them?  This will ensure you are working at a rate you can keep up for a period of time without causing your body stress.
8) What should I eat to have energy for my workout? 
You should eat a smaller balanced meal before you workout.  Ensure you have a tolerated fruit in this meal as the sugar from the fruit will give you a natural energy boost without turning to workout boosters, these contain some form of a caffeine type substance that will absolutely aggravate your tummy.
9) How long before my workout should I finish eating?
I recommend finishing your meal 1-2 hours before you workout.  You will have your own individual preferences about how empty you like your stomach to be before you workout so pay attention to your body and how you feel when you workout.  If you are too full you may feel quite nauseous, this will require an adjustment in how you’re fueling your body pre workout.
10) What should I eat after I workout?
This depends on what you did for your workout.  If you are doing some form of resistance training it is imperative that you have a quickly absorbed protein, some natural sugar and no fats.  My fav is lactose free, plain, low fat yogurt with a piece of fruit like a banana.  If you are doing only cardio all you need is a source of carbohydrate to refuel your energy stores.  My diet is primarily grain free so I’ll have a piece of fruit.
Liz Joyce is a self-employed Personal Trainer living with IBD since 2009.  She works alongside her husband running Joyce Training in Vancouver Canada.  Through good lifestyle choices and proper medication Liz enjoys good health and an excellent quality of life.  You can find her on Instagram @lizjoycefit, on Facebook

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