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Exercises for ankylosing spondylitis (AS)

Bed rest isn’t recommended as this can speed up the stiffening of your spine. Exercises for your back, chest and limbs will keep them supple. Be careful not to overdo it, but try to do at least some exercise each day. Stretching exercises after a hot bath or shower are especially good for easing morning stiffness. Below are some examples of exercises that could help.

Daily exercise programme

  1. Standing with your heels and backside against a wall, push (but don’t tilt) your head back towards the wall. Hold for 5 seconds then relax. Repeat about 10 times if possible.
  2. Stand in an open space with your feet apart. Place your hands on your hips. Turn from the waist to look behind you. Keep your knees and feet facing the front. Hold for 5 seconds. Repeat to the other side, 5 times each side.
  3. Lying on your back, knees bent, feet flat on the ground:
    (a) Put your hands on your ribs at the sides of your chest. Breathe in deeply through your nose and out through your mouth, pushing your ribs out against your hands as you breathe in. Repeat about 10 times. Remember, it’s as important to breathe out fully as it is to breathe in deeply.
    (b) Put your hands on the upper part of the front of your chest. Breathe in deeply through your nose and then breathe out as far as you can through your mouth. Push your ribs up against your hands as you breathe in – again about 10 times. You can do this exercise at any time in a lying or sitting position.
  4. Lying on your front, looking straight ahead, hands by your sides (if necessary you can put a pillow under your chest to get comfortable):
    (a) Raise one leg off the ground keeping your knee straight, about 5 times for each leg. It helps to have the opposite arm stretched out in front of you.
    (b) Raise your head and shoulders off the ground as high as you can – about 10 times.
  5. Kneeling on the floor on all fours, stretch alternate arms and legs out parallel with the floor and hold for 10 seconds. Lower and then repeat with the other arm and leg, 5 times each side.

Contact sports such as rugby, hockey or basketball aren't generally recommended if you have advanced disease as your joints and spine may be more easily injured, but there are plenty of other activities that are suitable. If you enjoy competitive sports, volleyball and badminton are both low-impact.

Pilates, yoga and t'ai chi may also be useful as these can help with posture and flexibility.

Swimming is one of the best forms of exercise because it uses all of your muscles and joints without jarring them. If you have limited neck movement, breaststroke and front crawl may become more difficult, and if you swim with your head up it can make neck pain worse. Using a snorkel can be helpful. Speak to a physiotherapist for advice if you have discomfort when swimming, as a different stroke or modification to your technique can often help. As an alternative to swimming, ask for a programme of exercises you can do in the pool.


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