Exercise for Ankylosing Spondylitis

Reviewed by Michael W. Smith, MD on November 24, 2020

Exercise for AS

Exercise is one of the best things you can do to help manage symptoms of ankylosing spondylitis, or AS.

It can lessen pain and keep you more mobile and flexible. It also seems to help with symptoms related to posture, stiffness, fatigue, and breathing capacity.

That's why it's a good idea to look for ways to work exercise into your daily routine.

In general, doctors suggest four main types of physical activity for people with AS:

  • Stretch and move (range of motion)
  • Strengthen (muscle building)
  • Exercise your heart (cardio)
  • Balance

Combine these kinds of exercises into a routine for at least 20 minutes a day to help with your AS symptoms like pain, stiffness, energy, mood, and the overall function and health of your body.

Work with your doctor to set goals that make sense for you and your life. Together, you can choose activities that are both safe and enjoyable for you.

Certain activities help with a combination of cardio, strength, flexibility, and even balance. Some of these include:

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Ask your doctor or physical therapist before you try any new activity with AS. If you go to a group class, be sure to tell the instructor about your condition beforehand.


You can also ask your health care provider to help you design a workout routine to focus on your unique issues and avoid your pain points.

Balance

These exercises can help make your body more stable and balanced.

You typically move certain parts of your body while keeping one or both of your feet planted on the ground.

These might be especially good if you’re less active, because they’re easy to do and help prevent falls. This becomes more important if you’re older because your bones often get more brittle and easier to break.

Your doctor or physical therapist can give you specific exercises. Activities like yoga, tai chi, and Pilates can also improve balance.

Try some kind of balance exercises three to five times per week.

Stretch and Move

You stretch to lengthen and maintain your muscles, tendons, and ligaments. You move to remind your limbs and joints of their full range of motion. Together, these exercises help make your body less stiff and prone to injury, and more flexible and user-friendly.

It’s a great way to warm up before cardio or strengthening exercise. It can also help with problems specific to AS.

For example, some stretches could lessen the chance that the bones of your spine (vertebrae) fuse together, a common problem with AS.

In addition, people with AS tend to avoid using parts of their bodies in certain ways. But less use can actually worsen both pain and disability.

For example, say your muscles start to tighten around a joint inflamed by AS. If you don’t stretch the muscle and move the joint, the area will get more stiff, tight, and painful.

Shoot for some type of stretching and range-of-motion exercise every day for the best results.

Strengthen

Here, you use your muscles to hold, move, or push against something resistant: Weights, resistance bands, body weight. Think of pushups, pullups, and weightlifting. All of it helps strengthen your muscles.

This helps your muscles do their job better and your body move more easily and safely. It will also improve your posture, supporting your body in the proper positions when you sit, stand, and walk.

For people with AS, certain muscles are more important to strengthen than others, such as the ones in your stomach and back. These are called “core muscles” because they help support your spine.

Strong core muscles can lessen the stress on your spine and even ease your back pain.

It also seems to help improve your posture over time, which will further help keep your muscles and joints from getting stiff and weak.

To see the best results, do strengthening exercises two to four times a week.

Cardio

Doctors call this aerobic exercise. It raises your pulse and breathing rate to give your heart and lungs a good workout. Typical cardio exercise include:

  • Swimming laps
  • Riding a bike
  • Jogging
  • Walking

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Your heart pumps harder to get more oxygen-rich blood through to the muscles and tissues that need it. This will also help your lungs bring more oxygen into your bloodstream.

All this improves your breathing at rest, as well as your mood and your energy levels. Over time, you’ll be able to walk longer distances without getting as tired or sore.

Aim to get out for some cardio on most days of the week. It doesn’t have to be for long. It should add up to 75 to 150 minutes total for the week -- 30 minutes a day, 5 days a week, gets you to 150 minutes.

Breathing Exercises

Try adding a simple breathing exercise to your routine. It can expand your chest and make your body more mobile. Here are four steps:

  • Breathe in as much air as possible so that your rib cage expands fully.
  • Hold your breath and count to three.
  • Breathe out slowly, as if gently blowing out a candle.
  • Pause to rest as you count to three, and repeat the steps again.
WebMD Medical Reference

Sources

SOURCES:

UpToDate: “Patient education: Arthritis and exercise (Beyond the Basics).”

Spondylitis Association of America: “Spondyloarthritis & Exercise.”

Versus Arthritis: “Living with ankylosing spondylitis: Keeping Active.”

Arthritis Foundation: “Axial Spondyloarthritis.”

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