Exercise for Ankylosing Spondylitis

4 ways to be active even when your the joints in your back or neck hurt

Written by Stewart G. Eidelson, MD

Exercise may seem unappealing—even dangerous—when you have joint pain and stiffness associated with ankylosing spondylitis (AS). But, that couldn’t be further from the truth. If fact, people who don’t exercise may experience more fatigue and pain because a lack of movement leads to decreased joint motion, stiffness, and muscle weakness. Staying active will not only help you manage the symptoms of AS but also help strengthen your spine for years to come.

Shortly after you are diagnosed with AS, your doctor may recommend you meet with a physical therapist who will craft an exercise program that allows you to strengthen your body without aggravating your joints. Back-strengthening and stretching exercises that help improve your posture, aerobic movements that promote rib joint flexibility, and spine-friendly aquatic activities are all ideal for people with AS.

Optimal Activities to Help Manage Ankylosing Spondylitis
When it comes to exercising with AS, the “no pain, no gain” philosophy is the wrong approach. Low- or no-impact activities, such as yoga, tai chi, swimming, walking, or cycling are best for people with joint pain.

Exercises for AS may be done at home or in a gym, or in a group or individual physical therapy program. The activities below may be incorporated into your AS exercise program, but your doctor or physical therapist’s specific recommendations should be followed first and foremost.

Breathing exercises
These movements may not cause a sweat, but they are invaluable at maintaining flexibility in your rib joints to keep you breathing easy. Breathing exercises are a great way to begin and end your workout. One example of a breathing exercise is below:

If you do yoga or tai chi, those exercises also focus your attention on deep breathing.

Flexibility exercises
Speaking of yoga and tai chi, they are among the top exercise programs to improve spinal flexibility. These activities use isometric training—that is, you strengthen muscles while holding a position rather than moving between different positions—to increase range of motion. Flexibility exercises gently stretch and extend your spine, keeping joints flexible and warding off stiffness.

Strengthening exercises
Strengthening exercises cannot be overvalued to spinal health. Strong back muscles support your posture, which is important for anyone with AS. Also, keeping your spinal muscles strong allows them to support your joints. You don’t have to lift heavy weights to effectively strengthen your back muscles—light hand weights and resistance training using your own body weight (eg, yoga) are effective.

Cardiovascular exercises
Low-impact cardiovascular exercises, such as walking or cycling, are great for joint health. But few exercises are as widely recommended for AS as aquatic activities, such as swimming or water aerobics. Water offers an anti-gravity environment that is easy on your joints, and the pool provides gentle resistance to help you comfortably build cardiovascular health.

Special Exercise Precautions for People with Ankylosing Spondylitis
As you consider an exercise program to manage your AS, keep in mind these two points: Regular exercise reaps the rewards, and gradually increasing your physical activity will help keep you injury-free.

Protecting your joints while being physically active is a key consideration for people with AS. Exercise safely with the tips below:

Ready to Get Started?
Exercise is central to any ankylosing spondylitis treatment program and an investment in your long-term health. To get the most benefit, take things slowly and be dedicated to the practice of regular physical activity.

Before starting your exercise program:

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Ankylosing Spondylitis and Posture