6 Ankylosing Spondylitis Exercises to Ease Pain and Stiffness
Key takeaways:
Ankylosing spondylitis is an inflammatory, autoimmune form of arthritis. It mainly affects the spine and sacroiliac joints at the pelvis.
Gentle stretching, strengthening, and low-impact cardio exercises can help improve symptoms like pain, stiffness, and inflammation.
Limit high-impact activities and strenuous exercises that can worsen joint pain and irritation. Avoid any exercise that involves placing weight directly on the spine and shoulders.
Living with ankylosing spondylitis can be challenging. This inflammatory, autoimmune form of arthritis may cause chronic lower back pain, inflammation, and stiffness that limits everyday activities. It mainly affects the spine. But it can also affect the hips and other joints.
There isn't a cure for ankylosing spondylitis. However, treatments like regular exercise can help manage symptoms. Low-impact exercises can build core strength, increase joint mobility, and reduce pain.
Learn more about ankylosing spondylitis exercises, including specific moves and tips to get started.
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What are the best exercises for ankylosing spondylitis?
The best exercises for ankylosing spondylitis should include low-impact cardio, stretching, and strengthening moves. Exercise may be one part of your treatment plan to manage ankylosing spondylitis.
When performing any exercise with ankylosing spondylitis, the focus should be on slow and controlled movements. Gentle motion can help ease inflamed, irritated joints.
Check with a healthcare professional before starting a new exercise plan, and ease into it. Walking, cycling, and swimming are good places to start for low-impact cardio. Gentle yoga, stretching, and strength training with light weights are all part of a well-rounded exercise program.
1. Cat-cow
Experts recommend gentle exercises to improve mobility in the spine. Cat-cow is a yoga move that gently moves your spine through bending and arching, which can help ease back pain and stiffness.
Step 1: Start on all fours on your hands and knees. Align your wrists under your shoulders and your knees under your hips. Keep your back flat.
Step 2: Without shifting your body forward or backward, round your back and pull in your belly, lifting your hips. Bend your neck down to look at your thighs. Hold this position (cat) for a few seconds.
Step 3: Then, sink your belly down to arch your spine and extend your neck up to look at the ceiling. Hold this position (cow) for a few seconds.
Step 4: Alternate between the cat and cow positions 20 times, moving slowly between each pose.
2. Lower trunk rotation
Lower trunk rotation gently rotates your spine and hips. This stretching exercise is another way to increase spinal mobility to reduce pain and stiffness.
Step 1: Lie on your back with your knees bent and feet flat on the floor.
Step 2: Keep your back pressed into the floor, and slowly rotate your bent knees over to one side, bringing your knees closer to the floor. Keep your knees and ankles squeezed together.
Step 3: Keep your legs rotated to one side for a few seconds. Then, slowly rotate your legs to the other side, bringing your knees closer to the floor. Hold for a few seconds.
Step 4: Alternate between both sides 20 times, moving slowly.
Medication can improve ankylosing spondylitis symptoms. Learn the best ankylosing spondylitis treatment options.
Helpful medications include biologics. Get a pharmacist's take on the best biologics for ankylosing spondylitis.
Restful sleep and other self-care practices can help too. Try ankylosing spondylitis self-care tips to manage symptoms and feel better on a daily basis.
3. Standing spinal extension
Ankylosing spondylitis often causes stiffness in the spine, which can limit range of motion. Spinal extension exercises work on bending the spine backward to improve movement and posture.
Step 1: Stand tall. You may want to press the back of your body against a counter, table, or other sturdy support.
Step 2: Place your hands on your hips or across your chest. Slowly lean your body back as you push your hips forward, moving into a slight backbend.
Step 3: Bend back as far as you comfortably can and hold for a few seconds. Then, move your body forward to return to an upright position.
Step 4: Repeat 20 times.
4. Pelvic tilt
The pelvic tilt exercise is the basis of core strengthening. This move activates the deep abdominal muscles that support and stabilize the spine.
Step 1: Lie on your back with your knees bent and feet flat on the floor.
Step 2: Gently press your back into the floor and tilt your pelvis up toward the ceiling. You should feel tightness in your abdominal muscles as if you’re doing a mini crunch. Your back and hips should be pressed into the floor.
Step 3: Maintain this contraction for 5 seconds, then relax.
Step 4: Repeat 20 times.
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5. Dead bug
The dead bug exercise further challenges your core strength by adding arm and leg movement.
Step 1: Lie on your back with your knees bent and feet flat on the floor.
Step 2: Contract your abdominal muscles and press your lower back and hips into the floor.
Step 3: Lift your arms toward the ceiling with your hands aligned over your shoulders. At the same time, lift your legs from the floor, keeping your knees bent and aligned over your hips. This is the starting position.
Step 4: Slowly lower one arm and straighten and lower the opposite leg toward the floor. Hover your arm and leg an inch above the floor. Then, return to the starting position.
Step 5: Repeat with your other arm and leg. Then, return to the starting position.
Step 6: Alternate between both sides 20 times, moving slowly.
6. Bird dog
The bird dog also stabilizes your spine as you move opposite arms and legs. This exercise is performed on your hands and knees, challenging your core differently.
Step 1: Start on all fours. Align your wrists directly under your shoulders and your knees under your hips. Keep your back flat.
Step 2: Slowly lift one arm and straighten and lift the opposite leg without shifting your body forward or backward. Don’t arch your back, and keep your abdominals contracted to keep your back flat.
Step 3: Lower your arm and leg and repeat for your other sides.
Step 4: Alternate between both sides 20 times, moving slowly.
What exercises should you avoid with ankylosing spondylitis?
High-impact exercises can strain already-irritated joints, especially if your body isn't strong enough to properly support them. Activities like running, jumping, and playing sports may worsen ankylosing spondylitis symptoms. They’re best avoided, especially if you’re new to exercise.
Strength training can benefit many people, including those with ankylosing spondylitis. But using heavy weights, especially when your body isn't ready, can increase strain on your joints. If you do strength training, avoid any exercise that involves placing weight, like a barbell, directly on top of your spine and shoulders. This increases compression on the spine, which can worsen pain and stiffness.
The bottom line
While ankylosing spondylitis can’t be cured, gentle exercise can help manage pain and other symptoms. Ankylosing spondylitis mainly affects the spine. So, gentle spine stretches and core-strengthening exercises are your best options to improve mobility and stability. Low-impact cardio and gentle strength training can also help manage symptoms. Avoid high-impact activities and strenuous exercise to reduce further irritation to joints.
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References
Agrawal, P., et al. (2024). Diagnosis and treatment of ankylosing spondylitis. Cureus.
AskDoctorJo. (2017). Trunk rotation stretch - Ask Doctor Jo [video].
Children’s Hospital Colorado. (2017). Core exercise: Dead bug [video].
Perrotta, F. M., et al. (2021). To move or not to move: The paradoxical effect of physical exercise in axial spondyloarthritis. RMD Open.
Pina Gonçalves, N., et al. (2023). The effects of physical exercise on axial spondyloarthritis - A systematic review. ARP Rheumatology.
Virginia Mason. (2015). Standing back extension [video].
Ward, M. M., et al. (2016). American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis & Rheumatology.
