Ankylosing Spondylitis Exercises: Stay Mobile and Reduce Stiffness

What Is Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is an inflammatory arthritis primarily affecting the spine. Over time, inflammation can lead to new bone formation, potentially fusing vertebrae together.

Symptoms include:

Key principle: Movement is medicine for AS. Regular exercise is one of the most important treatments.

Why Exercise Is Essential

For AS specifically, exercise:

Skipping exercise accelerates the very problems AS causes.

The Exercise Prescription

Daily Non-Negotiables

1. Spinal Mobility (10-15 minutes)

Every direction, every day.

2. Stretching (5-10 minutes)

Focus on tight areas.

3. Posture Awareness

Throughout the day.

Regular Addition

4. Strengthening (2-3x/week)

Back extensors, core, hips.

5. Cardiovascular Exercise (Most days)

Swimming, walking, cycling.

Spinal Mobility Exercises

Cervical Spine (Neck)

Chin Tucks

1. Sit tall

2. Draw chin straight back

3. Hold 5 seconds

4. 10 repetitions

Neck Rotation

1. Turn head to look over shoulder

2. Hold 5 seconds

3. Return, repeat other side

4. 10 each side

Neck Lateral Flexion

1. Tilt ear toward shoulder

2. Don't raise shoulder

3. Hold 5 seconds

4. 10 each side

Thoracic Spine (Mid-Back)

Thoracic Extension

1. Sit in chair

2. Clasp hands behind head

3. Arch upper back over chair back

4. Return to neutral

5. 10 repetitions

Thoracic Rotation

1. Sit with arms crossed

2. Rotate upper body to one side

3. Hold 5 seconds

4. Return, repeat other side

5. 10 each side

Cat-Cow

1. On hands and knees

2. Arch back up (cat)

3. Drop belly, lift head (cow)

4. Slowly alternate

5. 10 cycles

Lumbar Spine (Lower Back)

Pelvic Tilts

1. Lie on back, knees bent

2. Flatten lower back into floor

3. Then arch lower back

4. Alternate between positions

5. 10 cycles

Knee Rolls

1. Lie on back, knees bent together

2. Let knees fall to one side

3. Return to center

4. Repeat other side

5. 10 each side

Prone Press-Ups

1. Lie face down

2. Place hands under shoulders

3. Press chest up, keeping hips down

4. Only go to comfortable range

5. 5-10 repetitions

Chest Expansion

AS can restrict rib movement, affecting breathing. Practice daily:

Deep Breathing

1. Stand tall

2. Inhale deeply, expanding ribs in all directions

3. Hold 3 seconds

4. Exhale completely

5. 10 breaths

Corner Stretch

1. Stand facing corner

2. Forearms on walls

3. Lean into corner

4. Breathe deeply while stretching

5. Hold 30 seconds

Doorway Stretch

1. Stand in doorway

2. Arms on frame at 90°

3. Step forward to stretch chest

4. Hold 30 seconds

Posture Exercises

AS tends to pull the spine into flexion. Counteract this:

Wall Stand

1. Stand with back against wall

2. Try to touch head, shoulders, buttocks, heels to wall

3. Hold 30 seconds

4. Practice 3x daily

Prone Lying

1. Lie face down on firm surface

2. Rest 10-20 minutes

3. Daily if possible

4. Counteracts forward posture

Scapular Squeezes

1. Stand or sit tall

2. Squeeze shoulder blades together

3. Hold 5 seconds

4. 10 repetitions

Strengthening Exercises

Back Extensors

Bird Dog

1. On hands and knees

2. Extend opposite arm and leg

3. Hold 5 seconds

4. Return, repeat other side

5. 10 each side

Prone Back Extension

1. Lie face down, hands at sides

2. Lift chest slightly off floor

3. Hold 5 seconds

4. 10 repetitions

Core

Dead Bug

1. Lie on back, arms up, knees at 90°

2. Lower opposite arm and leg

3. Keep back flat

4. Return, repeat other side

5. 10 each side

Side Plank (Modified)

1. Lie on side, knees bent

2. Lift hips, supporting on elbow

3. Hold 15-30 seconds

4. 3 each side

Hips

Bridges

1. Lie on back, knees bent

2. Lift hips toward ceiling

3. Hold 5 seconds

4. 10 repetitions

Clamshells

1. Lie on side, knees bent

2. Keep feet together, open top knee

3. 15 repetitions each side

Cardiovascular Exercise

Swimming

Walking

Cycling

Aquatic Exercise

Avoid or modify: High-impact activities may stress spine. Discuss with your rheumatologist.

Managing Morning Stiffness

AS stiffness is typically worst in the morning. Strategies:

1. Before getting up: Gentle bed stretches

2. Hot shower: Heat loosens stiffness

3. Morning exercise: Move early

4. Stay warm: Cold increases stiffness

Bed Mobility Routine (5 minutes):

Sample Daily Routine

Morning (15-20 minutes):

Midday:

Evening (10-15 minutes):

Throughout Day:

When to Modify

During flares:

See your rheumatologist if:

The Bottom Line

With AS, exercise is not optional—it's essential treatment. The disease wants to stiffen you; exercise keeps you mobile.

Focus on:

1. Daily spinal mobility in all directions

2. Chest expansion for breathing

3. Posture exercises against flexion tendency

4. Regular strengthening and cardio

5. Never stop moving

Your spine's future mobility depends on what you do today.

Foundational Rehab provides mobility and posture programs to help maintain function with spinal conditions.