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Exercise

Exercise is an integral part of any spondylitis program. Fitting exercise into your day can be tough, but it needs to be done. Exercise is such a high priority that you must make time for it each day (even five to10 minutes during a work break is helpful). If you do, many benefits will follow from your efforts. A spondylitis exercise program will help you maintain good posture, flexibility and eventually help to lessen pain.

In many cases, good posture and mobility can even be regained with proper doses of medicine and proper exercise. Most people with spondylitis say they feel much better after exercise.

Posture

Practicing good posture techniques impacts the way a person with spondylitis looks and feels.

Individuals with spondylitis often are painfully aware of the strains imposed by gravity. A vicious pain/poor posture cycle begins because of a tendency to bend over when experiencing pain in the spine, further increasing the amount of strain on the spine.

Bone fusion does not occur in everyone with spondylitis, yet fusing in a non-upright position is a valid concern. It is encouraging to know that the pattern of fusion can be influenced through good postural habits.

Exercise Guidelines

Having an exercise program that accomplishes your goals can often help you to stay the course. While sports and other physical activities are beneficial, they cannot be totally relied upon to assure erect posture and flexibility. Spondylitis-specific exercises can help to fill in any gaps.

Before beginning any new exercise program, consult your physician or physical therapist, who can help provide modifications to suit specific needs. These professional can explain which exercises should be done and how to do them correctly.

How to Get Started

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Spondylitis Exercise DVD

Exercise at a time of day that is convenient for you. Many people with AS are stiff in the morning. This may be a time to start loosening up to lessen the stiffness. Some people are more comfortable exercising at midday or in the evening.

It may be necessary to split up exercises during the day. For example, exercises while lying down can be done in the morning, while neck stretches or deep breathing for chest expansion can be done at work.

Exercises should be done daily and begin with “warm-up/loosen-up” exercises. Above all, you should “listen” to your body and learn to emphasize areas that need exercise the most, whether it be stretching or strengthening.

Exercises should be done in a comfortable area on a carpeted floor or mat. An exercise mat, which can be purchased at a sporting goods store, provides comfort and protection by cushioning the spine. Beds typically have too much “give,” but a firm mattress can be used if you cannot easily get onto or off of the floor. Music can also create a more relaxing mood while exercising.

It is normal to feel some discomfort or tolerable pain when beginning an exercise program. Even so, many people tend to overdo at first. Don’t assume that more is better. Approach any new routine cautiously, beginning with low repetitions regardless of your ability to do more. Severe pain after exercise is almost always a sign of overdoing it, calling for a reduction in intensity and number of repetitions.  In addition, rereading instructions will help to ensure that all steps are being followed correctly. 

Think Tall

While performing exercises specific to spondylitis:

  • • Hold your head in a balanced manner over your trunk in a sitting or standing position
  • • The chin should be horizontal and parallel to the floor, drawn back slightly and centered
  • • Try to stand, walk and sit "tall" at all times

Prone Lying

This is the best exercise for maintaining erect posture.

  • • Lie face down on a firm surface, such as the floor or a firm bed. If unable to lie flat in this position, place a pillow under your chest and a folded towel under your forehead
  • • Start slowly, accomplishing prone lying at first for a minute or two. It's often helpful to do this posture training after a warm bath or shower or whenever the body is warmed up
  • • The head may be positioned directly downward, resting on the hands, turned to the left or right, or alternated during the course of 20 minutes.

Back Against the Wall

To help maintain posture:

  • • Stand against a wall, within view of a full-size mirror, to check posture
  • • Place heels about four inches away from the wall, with your buttocks and shoulders as close to the wall as possible, even touching it lightly; don’t strain
  • • Hold this pose for five seconds, relax, and do it again
  • • Keep a record of spine alignment, measuring from the back of the head to the wall and report any changes to your doctor.

Additional Tips

  • • Give someone close to you permission to nag. Agree on a code word. Soon reminders to not slouch will not be needed.
  • • Try sleeping on a firm, but not hard, bed to maintain a good, non-bent resting posture at night. Avoid using a pillow, if possible, to prevent pain from over-extension of the neck and spine. Some people find that a small folded towel can take the place of a pillow.
  • • Splints, braces, and corsets are generally not advised for spondylitis patients.
  • • Restorative sleep is most important. This may mean side sleeping for some people. If this is your experience, daily prone lying is even more critical to your good posture.

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