8 Exercises for a Healthier Backby Megan McMorris Health Writer
Move it or lose it: If you’re living with ankylosing spondylitis (AS), that’s literally the case. Affecting roughly 1.1 million Americans, this form of chronic inflammatory arthritis can greatly affect spine mobility. “The inflammation from AS, which occurs where ligaments or tendons attach to the bone, results in pain, stiffness, and loss of mobility—particularly in the spine,” says John M. Davis, III, M.D., a rheumatologist at the Mayo Clinic in Rochester, MN. “That’s why exercises that help maintain the range of motion for the spine and joints are particularly important.”
The best exercises for AS are those that increase both stability and mobility in your spine and surrounding areas. “AS by definition is a mobility problem, but increasing stability is also important to reduce postural distortion,” explains Ted Forcum, a strength and conditioning specialist in Portland, OR, who designed this eight-move routine especially for those with AS. The simple workout requires a chair, mat, and large pillow. Start by doing these moves twice a week, building up to four times a week. Round out your fitness with low-impact cardio activities like swimming, biking, and walking.
AS limits mobility in your thoracic spine (which runs from the base of your neck to lower back) and can cause your neck to get out of alignment, says Forcum. This move improves both mobility and neck alignment.
How to do it: Sit with large pillow behind your back. Bend elbows and place hands on either side of your neck; lean back over pillow (it should be large and firm enough that your back arches over the pillow and you feel the stretch in your chest). Hold for 30 seconds.
Limited rotation in your spine forces other areas of your body—like your lower back and hips—to overcompensate, says Forcum, leading to injury. Spinal rotation is also key for functional movements like reaching and bending.
How to do it: Start on your hands and knees; sit back onto your heels. Reach your right arm out in front of you, palm on floor. Bend your left arm, placing left hand behind ear. Raise your left elbow, twisting to gaze at the ceiling. Return to start. Repeat for 8-12 reps; switch sides.
Tight hip flexors, a common issue for people with desk jobs who sit all day, pull your spine out of alignment, says Forcum.
How to do it: Kneel on your left knee, right knee bent in front of you. Raise your arms and press hips forward, feeling the stretch in the front of your left hip. Press and release gently for 8-12 reps. Reach your left arm across chest to the right and pulse for 8-12 reps. Lift arm up and over your body for 8-12 pulses. Switch sides.
This three-part move loosens your entire neck area, especially important for those with AS because tight muscles here can cause alignment issues.
How to do it: Sit in a chair. Turn your head to the left, gazing downward, feeling stretch behind neck. Hold 30 seconds. Face front. Bring your left ear to left shoulder, feeling stretch along side of neck. Hold 30 seconds. Face front. Turn your head to look up to the right, feeling stretch in front of neck. Hold 30 seconds; switch sides.
Changes in posture from AS can limit mobility in the Achilles tendon, which helps you flex your feet as you walk. In turn, this adds strain to your hips and lower back, says Forcum.
How to do it: Place hands against a wall. Step right foot about a foot behind left. Lean into wall, feeling stretch in right calf. Hold for 30 seconds, keeping both heels on ground. Now bring right foot forward, toes against wall, heel on ground. Lean into wall . Hold for 30 seconds; switch sides.
This move increase shoulder mobility, while strengthening muscles to prevent shoulders from rolling inward versus down and back, says Forcum.
How to do it: Lie on your stomach, arms in front of you. Raise upper body and arms off floor in a straight line (the “I” position) and hold for 5 seconds. Widen arms into a V-shape (so your body forms a “Y”) for 5 seconds. Now, open arms out to sides to make a “T” shape; hold 5 seconds. Relax. Repeat 3-5 times.
Strength-building squats help with tasks like getting up from a chair or in and out of a car. “They also serve as an overall system check for your body,” says Forcum. “If you have lack of mobility, you’ll detect it with this exercise.”
How to do it: Stand with feet hip-width apart, arms behind head, elbows bent. Bend knees and sink back like you’re sitting in a chair. Lower for 4 counts, then return to standing in 2 counts. Do 8-12 reps, making sure knees don’t extend past toes.
The loss of thoracic spine mobility also affects your ability to breathe deeply through your diaphragm. “You start to use other muscles to breathe which is inefficient and can cause neck pain and headaches,” says Forcum. “Breathing properly increases thoracic extension—important for those with AS.”
How to do it: Sit on a chair or floor with one hand on your chest, one hand on your belly. Breathe in for a count of four, then hold for four seconds. Breathe out for six seconds. Repeat 10 times.