Analysis of 19 rodent studies reveals that voluntary wheel running, swimming, and strength-based exercises consistently improve colitis outcomes, while forced treadmill running shows mixed results and may potentially worsen inflammation in some cases. The distinction appears linked to stress responses, with forced exercise triggering cortisol elevation that could counteract anti-inflammatory benefits. This finding challenges the assumption that all exercise equally benefits inflammatory bowel disease patients. The research landscape has long recognized exercise's therapeutic potential for IBD through improved gut barrier function, enhanced microbiome diversity, and reduced systemic inflammation. However, this systematic analysis suggests the psychological component of exercise—whether it's perceived as enjoyable versus stressful—may be as crucial as the physical activity itself. For adults managing IBD, this implies that sustainable, self-directed activities like recreational walking, swimming, or gym workouts might deliver superior anti-inflammatory effects compared to rigid, high-intensity regimens. The limitation lies in translating rodent stress responses to human motivation, though the core principle aligns with emerging research on exercise adherence and psychoneuroimmunology. This represents an important refinement rather than a paradigm shift in exercise prescription for inflammatory conditions.