Flexibility and strengthening exercises for ankylosing spondylitis

Exercises for ankylosing spondylitis should be gentle and frequent. The exercises shown here are good to do twice each day. Don't do them first thing in the morning, when you may feel more stiff. In the morning, take a walk to get loosened up for the day. Then try doing these exercises around lunch time and in the evening. Or, do one or two exercises at a time and spread them out through the day. You can do the exercises in any order that you like.

Back stretches

1. Get down on your hands and knees on the floor.
2. Relax your head and allow it to droop.
3. Round your back up toward the ceiling until you feel a nice stretch in your upper, middle, and lower back.
4. Hold this stretch for as long as it feels comfortable, or about 15 to 30 seconds.
5. Return to the starting position with a flat back while you are on all fours.
6. Let your back sway by pressing your stomach toward the floor. Lift your buttocks toward the ceiling.
7. Hold each position for 15 to 30 seconds.
8. Repeat 2 to 4 times.

Chest expansion

1. Stand comfortably with your feet shoulder-width apart. You can also do this exercise sitting in a chair.
2. Look straight ahead and do not allow your head to tilt back. As you take a deep breath, open your arms out to the sides and roll your arms back. Your palms will turn out and you will feel a stretch across your chest.
3. Breathe normally as you hold this stretch for 15 to 30 seconds.
4. Lower your arms to your sides and let your palms turn back toward your legs as you slowly let your breath out.
5. Repeat 2 to 4 times.

Upper back and shoulder stretch

1. Sit in a firm chair, or stand up straight.
2. Looking straight ahead, breathe in as you raise both arms over your head and reach toward the ceiling. Do not allow your head to tilt back.
3. Reach back with your arms to stretch your shoulders.
4. Breathe normally as you hold this stretch for 15 to 30 seconds.
5. Return to the starting position.
6. Repeat 2 to 4 times.

Neck stretches

Turning the head

1. Sit in a firm chair or stand up straight.
2. Keep your chin straight, turn your head to the right, and hold for 15 to 30 seconds.
3. Turn your head to the left and hold for 15 to 30 seconds.
4. Repeat 2 to 4 times to each side.

Tilting the head

1. Sit in a firm chair or stand up straight.
2. Keep your chin straight, tip your right ear to your right shoulder, and hold, and for 15 to 30 seconds.
3. Tilt your head to the left and hold for 15 to 30 seconds.
4. Repeat 2 to 4 times to each side.

Hip and back stretches

1. Lie face down on the floor with your elbows bent and your hands under your shoulders. Put a small pillow under your abdomen for comfort, if needed.
2. Gently press down with your arms to raise your shoulders off the floor.
3. Hold this position for 5 seconds.
4. Repeat 2 to 4 times.

1. Get down on your hands and knees on the floor.
2. Keeping your back and neck straight, lift one leg straight out behind you. When you lift your leg, keep your hips level. Don't let your back twist, and don't let your hip drop toward the floor.
3. Hold for 5 seconds. Repeat 2 to 4 times with each leg.
4. If you feel steady and strong when you do this exercise, you can make it more difficult. To do this, when you lift your leg, also lift the opposite arm straight out in front of you. For example, lift the left leg and the right arm at the same time. (This is sometimes called the "bird dog exercise.") Hold for 5 seconds, and repeat 2 to 4 times on each side.

If you are unable to lie face down on the floor or are unable to straighten your hip(s), try this alternative exercise:

1. Stand facing a wall with your feet about shoulder-width apart.
2. Place your hands on the wall in front of you.
3. Keep your body upright, and slowly raise one leg backward.
4. Keep your knee as straight as you can.
5. Hold your leg out for 5 seconds.
6. Slowly lower your leg and relax.
7. Repeat the exercise with the other leg.

Talk with your doctor or physical therapist if you have questions about how to do these or any other exercises.