When you have ankylosing spondylitis, some types of exercise, such as yoga and low impact cardio, can help manage your symptoms and improve your overall health.

Exercise may be the furthest thing from your mind when you’re living with chronic pain and inflammation from ankylosing spondylitis (AS).

But regular physical activity can have benefits for AS and for your whole body.

AS inflammation in your spine and pelvic area can cause your spinal bones to grow together, fusing sections of your spine — but regular exercise may help improve your mobility and quality of life.

Keep reading to learn exercises that may help with AS symptoms, as well as tips for maintaining an exercise routine.

Many people with AS experience back pain, especially in the morning and at night. But you might also have a variety of other symptoms, such as fatigue, loss of appetite, bowel inflammation, and stooped shoulders.

Regular exercise may help relieve some of the symptoms of AS by:

  • increasing your flexibility, strength, and balance
  • improving your range of motion
  • reducing AS pain and stiffness
  • relieving joint stiffness
  • improving your cardiovascular health and endurance
  • lowering high blood pressure
  • improving your bone density
  • supporting weight management
  • improving HDL (good) cholesterol levels

To relieve joint stiffness caused by AS, you can try activities that are designed to help increase joint flexibility and reduce stiffness. Examples include low impact activities like yoga and tai chi, which don’t put too much strain on your spine.

Slowly moving your body into certain positions can help loosen your muscles and joints while improving your balance and posture. Yoga also encourages breath control and meditation, which can help reduce stress and tension.

Try to incorporate a variety of yoga poses into your weekly exercise routine, such as the Cat-Cow sequence. Here’s how to do it:

  1. Start on your hands and knees on the floor.
  2. Facing down, with your head relaxed, stretch your back upward toward the ceiling. Hold this position for 15 to 30 seconds. Relax and return to the starting position.
  3. Push your stomach down toward the floor and your buttocks upward toward the ceiling. Hold this position for another 15 to 30 seconds.

Repeat this sequence (and other yoga poses) several times a day to help improve joint flexibility.

Even if you experience morning stiffness due to AS, including morning stretches as part of your exercise routine may help loosen up your muscles and reduce tension.

If stretching is difficult in the morning, consider doing a stretching routine after showering. The water’s warmth can help relax tight muscles and joints.

Here’s a stretch to try:

  1. Stand with your feet apart and place your hands on your hips.
  2. While keeping your feet facing forward, turn your waist as much as you can to look at the wall behind you.
  3. Hold this position for 5 seconds, and then repeat on the other side.
  4. Complete this stretch 5 times on each side of your body.

Here is another stretch to loosen up your spine and hips. This is called a supine lumbar rotation. To do it:

  1. Lie on your back on a mat with your knees bent and your feet flat on the floor.
  2. Stretch your arms out to the sides and keep your shoulders on the mat at all times.
  3. While keeping your knees together, drop them down to one side and pause for a second. Drop your knees only as far as you comfortably can.
  4. Return to the starting position.
  5. Drop your knees to the opposite side.
  6. Repeat 10 times on each side.

It can be beneficial to vary your stretching routine and perform stretches for 5 to 10 minutes each day.

Cardiovascular workouts get your heart pumping. But if you have AS, it’s best to choose low intensity and low impact workouts. High intensity cardio can potentially make back pain worse.

Low impact workouts for AS can include:

Aim for at least 30 minutes of cardiovascular exercise most days of the week. If you can’t squeeze in one 30-minute session each day, you can break up your activity into 10-minute blocks.

For example, take a brisk 10-minute walk three times per day. This might look like 10 minutes in the morning, 10 minutes on your lunch break, and 10 minutes in the evening after dinner.

Try to get 75 to 150 minutes of aerobic exercise each week, divided into 3 to 5 workouts per week.

Strength training strengthens your muscles and supports your joints to help reduce the pain associated with AS.

But this doesn’t have to mean going to the gym and lifting heavy weights. You can strength train using your own body or with light free weights. Add strength training 2 or 3 days per week.

Pilates is a low impact workout designed to improve your strength and mobility. It incorporates stretching and endurance and involves using your abdomen, lower back, thighs, arms, and legs to strengthen your muscles.

You can check with a local gym to inquire about Pilates classes. Alternatively, you may be able to find streaming workouts or videos online or download an app that offers Pilates workouts.

If you prefer using free weights, start with 3- or 5-pound dumbbells and gradually increase the weight as you can.

Plank exercises are another option for AS. They involve engaging your abdominal muscles to keep your spine in a neutral alignment while bearing weight through your forearms and toes. You should hold the plank position for as long as you can without losing neutral spinal alignment.

This movement uses your body weight and helps strengthen your core, buttocks, and hip muscles. Plank exercises have many variations for different strength levels.

If you’re new to exercising with AS, it’s best to talk with your doctor before starting a new routine.

They may recommend prioritizing or avoiding certain types of physical activity according to your current health and fitness level.

They might also recommend working with a physical or occupational therapist who may be able to provide exercises and guidelines that are specific to your needs.

Here are some tips on exercising with AS:

  • Start slow: Because AS affects your spinal joints and causes back pain, too much activity too soon may worsen pain and inflammation. Start with 5 to 10 minutes per day and gradually increase the intensity as your body adjusts to the new routine. If you’re achy after a workout, allow your joints and muscles to recover before resuming activity.
  • Avoid contact sports: Contact sports may worsen spinal pain. If you enjoy competitive sports, you can try activities that don’t involve contact with other players, such as badminton, volleyball, and table tennis.
  • Avoid high impact exercises: High intensity workouts can worsen pain and inflammation. Stick with low or no impact activities.

While there is no cure for AS, following your treatment plan and getting regular physical activity can help you manage your symptoms and improve your quality of life.

Low impact exercise can help increase joint flexibility and reduce stiffness. If you’re not sure how to get started, consider talking with your doctor about workouts that are safe for you.