Ankylosing spondylitis: Exercising safely

When ankylosing spondylitis — a type of arthritis that affects the spine — is causing back pain and stiffness, exercise might seem impossible. But exercise plays an important part in keeping your range of motion and managing your symptoms — even when your medicines are already working well. Exercise helps strengthen your muscles, increase your flexibility, improve your posture and, eventually, lessen your pain.

The key to achieving the benefits of exercise is to do specific exercises for ankylosing spondylitis that are approved and supervised by your health care provider or physical therapist. Following a few tips may help too.

Exercising on your own can be good for you, but when you have ankylosing spondylitis, research shows that working with a physical therapist or following a guided exercise program is most helpful. To get the most out of your exercises, and to ensure you're doing them correctly and safely, start by talking to your health care provider or a physical therapist. Ask the provider or therapist to help you design an exercise program appropriate for your specific situation.

Examples of exercises your health care team might suggest include:

• Deep breathing and aerobic exercises to improve your overall health and keep your chest and ribs flexible.
• Strength-building exercises to help maintain function.
• Range-of-motion and stretching exercises to help keep your joints and spine flexible.
• Water exercises, known as hydrotherapy, to help keep your back, neck, shoulders and hips flexible.
• Abdominal and back exercises to improve and maintain your posture, which can be affected by a stiffening neck and spine.

According to the Spondylitis Association of America, one example of a posture exercise involves lying face down on a firm surface, if you're able to. To help you lie flat, use a pillow to support your chest and a towel to support your forehead. Start slowly, warming up your muscles beforehand with a hot shower and holding the position for just a minute or two. You may gradually work your way up to holding this position for 20 minutes.

To help you stay on track:

• Talk to your health care provider or a physical therapist before you start an exercise program.
• Warm up before you start exercising.
• Choose a time that works for you — if you're stiff in the morning, exercise may help loosen you up, or you can do shorter rounds of exercises throughout the day.
• Choose a comfortable spot to exercise, such as a carpeted surface or an exercise mat.
• Exercise every day.
• Don't overdo it — ease yourself into exercise, gradually increasing your efforts over time.

By choosing the right exercises and taking steps to ensure you're doing them safely and correctly, you'll be on your way to managing your ankylosing spondylitis symptoms.