The largest gland in the human body, the liver plays a vital role in digestion, metabolism and disposing of harmful or toxic substances from the body. But modern lifestyles - with irregular eating habits, higher consumption of junk food and rising alcohol consumption - have led to a rise in the number of people living with liver ailments globally.

World Health Organization data show that in 2017, liver disease was the 10th leading cause of all deaths in India. And one in five Indians has a liver problem today.

Globally, too, there has been a spurt in non-alcoholic fatty liver disease: a study published in the United European Gastroenterology Journal said that about 75% of obese individuals have fatty liver, which is one of the causes of liver problems.

Liver diseases like fatty liver and hepatitis affect people in different ways. While there are a variety of medical treatments available for the different types of liver diseases, medical professionals always advise living a healthier lifestyle that includes regular exercise to prevent and manage symptoms.

Exercising with an ongoing illness is never easy, but the overall benefits of physical activity, when done with all the precautions and with the help of a trained therapist, far outweigh the burdens or drawbacks. Exercises may be easier for a healthy individual to commence, a person suffering from liver disease can also perform a collection of exercises, at a lower intensity.

Read more: Foods to improve liver health

  1. Ways to counter liver disease
  2. Exercises for liver health
  3. Takeaways for exercises to improve liver health
Doctors for Exercises for Liver Disease

One of the leading causes of liver problems is obesity. Diseases like fatty liver are caused primarily due to the excessive storage of fat in the liver. Improving the functioning of the liver depends greatly on maintaining a healthy weight, consuming a healthier diet as well as including exercise as a daily activity. Here's how they help:

  • Weight loss: Obesity is one of the main risk factors for a type of fatty liver known as non-alcoholic fatty liver disease. Exercise, along with a balanced diet, can help in weight loss and in reducing the symptoms of this condition.
  • Healthy diet: Foods that contain saturated fats, refined grains, added sugar and high-calorie foods are generally harmful to the liver. Instead, eating lighter meals rich in dietary fibre is better for the liver. Black coffee, green tea and fruits and vegetables rich in antioxidants - such as grapes, cranberries and beetroot juice - are also considered hepatoprotective (they protect the liver).
  • Exercise: A combination of physical activities, including aerobic and strength-training exercises, help maintain a healthy weight and aid in digestion and metabolism. This puts less stress on the organ and improves liver function.

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Physical activity is highly recommended for people suffering from conditions affecting the liver such as fatty liver. It is important to check with your doctor before you start any fitness regime if you have a preexisting condition.

Walk for liver health

Not only is it the most natural physical activity, walking doesn’t cost any money if done outdoors. Accessing a treadmill is also easier these days, as most neighbourhood gyms and physiotherapy clinics have a few different types.

Walking is recommended for improved resistance to infection and better health outcomes in people living with hepatitis - a viral infection that affects the liver- and even liver cancer.

Walking has several benefits, even outside managing an individual’s disease, as it helps maintain body weight, improves blood flow and promotes bone and muscle health, as well as reduces stress and improves heart health.

Aerobic exercises to reduce liver fat

Aerobic activities can have a positive effect on liver function. Especially in people suffering from type 2 diabetes and fatty liver, which is considered to be a precursor to more severe liver diseases such as liver cirrhosis, liver failure and even liver cancer. A study conducted in 2011 showed cardio workouts can improve the liver’s insulin sensitivity. This, in turn, helps to lose liver fat.

Aerobic exercises are typically performed at a lower intensity over a longer period of time. They include walking, cycling, swimming, jogging, dancing, and workouts like Zumba, among other things. Aerobic exercises are also known to improve the body’s immune system, helping us counter infections besides having a positive impact on our overall heart health.

Resistance training for liver fat reduction

Studies show that resistance training in the gym helps to reduce liver fat (hepatic steatosis) in non-alcoholic fatty liver disease. Experts recommend 40-45 minutes of resistance training, three to four days a week for at least 12 weeks to see results.

Resistance training is primarily training with external weights or strength training exercises. The focus of these exercises is to slowly build strength, as opposed to increasing the heart rate which is the objective of cardiovascular exercises.

A study published in the Journal of Hepatology in 2017 compared the effects of aerobic as well as resistance exercises in people suffering from non-alcoholic fatty liver disease and found that resistance training had a positive effect on lowering the parameters of the disease with less energy consumption as compared to aerobic exercise.

Exercises to massage your liver

In addition to performing various exercises - both aerobic and anaerobic in nature - there are a few more exercises that can directly impact the liver. Various liver diseases occur due to the organ's decreased ability to process fat or to promote blood circulation. Directly massaging the liver while lying down is one of the good practices to stimulate the organ. Here are two ways to do it:

1. Liver press

  • The liver sits right under the rib cage and spreads from left to right of the upper abdomen. Place your dominant hand over this area.
  • Lie down on your back with your knees bent, feet on the floor.
  • Gently press from under the rib cage in the upwards direction.
  • You can start with 15-20 repetitions. Increase the repetitions gradually, as your discomfort reduces.

2. Liver press and rub

  • Lie down comfortably on your right side. Now bend your knees and bring them slightly forward. If you want, you can place a soft pillow under your head. You can also place your right hand under your head for cushioning.
  • Place your left hand over the liver area. Use the cushy part of your palms or your thumb to press inwards and downwards.
  • The motion can also be sideways around the region right under the ribs for a couple of minutes.

3. Striking

  • Lie down on your left side. Bend your knees and head to assume a curled up position.
  • With your right hand, make a fist and lightly strike the area under your ribs. The idea is to do this fast but gently.
  • Try to do 20 repetitions in the beginning. Gradually increase the repetitions as your discomfort subsides.

Stretching exercises for liver health

There are many benefits of stretching. Along with reducing muscle stiffness, it can improve blood circulation. Which is why stretching is even more useful for people with a liver condition. Here's how you can do simple stretches to improve liver function:

1. Spinal twist

  • Sitting down on the floor with your legs crossed. If this is not possible, sit upright in a chair.
  • Place your right hand on the left knee and your left hand on the right knee.
  • Now, put your left hand behind your back and twist your upper body towards the left.
  • Hold for 20-30 seconds.
  • Repeat the same exercise on the other side.
  • Perform at least five repetitions on each side.

2. Half Lord of the Fishes Pose or Ardha Matseyndrasana

Half Lord of the Fishes Pose or Ardha Matseyndrasana is twisting pose in Yoga. It is said to improve blood circulation, and massage and detoxify internal organs. Here's how to do it:

  • Sit on a mat with your legs crossed and back straight.
  • Now lift your left knee off the floor. While keeping the knee bent, place your left foot just outside the right thigh. Bring your right foot closer to the left buttock.
  • Now place your right arm over your left knee. Twist from the waist as you take the right arm behind your back and place your right palm on the mat.
  • Hold for 30 seconds before returning to the starting position.
  • Repeat on the other side.

Core Exercises for Strong Liver

In addition to giving you a flatter stomach, ab crunches have a positive impact on the organs in the abdomen area - this includes the liver, of course. Here's a variation of ab crunches you can do to promote liver health:

  • Lie down on your back on a mat. Bend your knees, and place your feet on the mat.
  • Now, lift the left foot off the mat and place the left ankle over your right knee. Adjust the left leg slightly to get more comfortable. Try to push the left knee out as much as possible.
  • Place both your hands behind your head. If this is not possible, place your left arm on the mat beside you for balance.
  • Now, lift your upper body and take your right elbow towards the left knee.
  • Hold for a few seconds.
  • Return to the original position, rest and repeat on the other side.
  • Remember to breathe while performing this exercise.

Modern lifestyles are a major contributor to a variety of liver diseases. Along with medical treatments, physical exercise is necessary for making a recovery. 

Obesity, alcohol consumption, smoking, infections of the body as well as frequent use of over-the-counter painkillers can severely affect liver function and cause serious diseases.

Physical exercise battles all of these factors, reducing your dependency on external factors, besides improving your body’s immunity and creating a protective atmosphere where you live a life free from afflictions of the liver.

Dr. Paramjeet Singh.

Dr. Paramjeet Singh.

Gastroenterology
10 Years of Experience

Dr. Nikhil Bhangale

Dr. Nikhil Bhangale

Gastroenterology
10 Years of Experience

Dr Jagdish Singh

Dr Jagdish Singh

Gastroenterology
12 Years of Experience

Dr. Deepak Sharma

Dr. Deepak Sharma

Gastroenterology
12 Years of Experience

References

  1. healthxchange: SingHealth [Internet] Singapore 10 Tips for a Healthy Liver
  2. American Liver Foundation [Internet] New York, NY, USA. 13 Ways to a Healthy Liver
  3. Windt DJ et al. The Effects of Physical Exercise on Fatty Liver Disease. Gene Expression: The Journal of Liver Research. 2018; 18(2): 89–101. PMID: 29212576.
  4. Aamann L et al. Physical exercise for people with cirrhosis. Cochrane Database of Systematic Reviews. 2017 Jun; 6(CD012678).
  5. Toshikuni N et al. Nutrition and exercise in the management of liver cirrhosis. World Journal of Gastroenterology. 2014 Jun 21; 20(23): 7286–7297. PMID: 24966599.
  6. Hallsworth K et al Resistance exercise reduces liver fat and its mediators in non-alcoholic fatty liver disease independent of weight loss. Gut. 2011 Jun; 60: 1278-1283.
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