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6 Daily Stretches for Ankylosing

Spondylitis that Can Help Ease Pain
Besides seeing your doctor regularly and following your
treatment plan, staying active is probably the best thing
you can do to manage your AS.

Back pain is typically one of those aches that worsens when you bend or walk and
feels better when you rest or recline. That’s not the case with ankylosing
spondylitis. This inflammatory disease causes pain and stiffness in your lower
back and hips — especially in the morning or after prolonged periods of not
moving. (Read more about the difference between inflammatory and mechanical
back pain (https://creakyjoints.org/symptoms/inflammatory-vs-mechanical-back-
pain/) here.)
 ) )
Here’s why your back hurts when you have ankylosing spondylitis (AS), and

how stretching and exercise helps relieve symptoms.
 

How Ankylosing Spondylitis Affects Your Spine

Ankylosing spondylitis (AS) is a form of arthritis that causes inflammation in
the joints in your spine, or vertebrae. As the disease progresses, it impacts the
sacroiliac joints (which connect the base of your spine and your pelvis), and
can lead to severe and chronic pain, stiffness, and discomfort in your lower
back and hips.
Inflammation may also occur in the connective tissue in your spine where
tendons and ligaments attach to bone (caused the entheses); in the cartilage
between your breastbone and ribs; the back of your heel; as well as your hip
and shoulder joints. (Here are other symptoms of ankylosing spondylitis
(https://creakyjoints.org/symptoms/ankylosing-spondylitis-symptoms/) to be
aware of.)
In more severe cases of AS, new bone forms in the spine as part of the body’s
attempt to heal from the inflammation. The extra bone bridges the gap
between vertebrae, reducing flexibility in your back. Eventually, bone grows at
the sides of the vertebrae, causing sections of the spine to fuse together and
become immobile, which can reduce your ability to turn your head, stand up
straight, or bend. Bony fusions can also stiffen your rib cage, making it tough
to take deep breaths.
Less often, fusion of the spine can cause it to curve forward, resulting in a
hunched-forward posture.
There’s no cure for ankylosing spondylitis, but treatments — including
medication (such as non-steroidal anti-inflammatory drugs, or NSAIDS, and
biologics) and physical therapy — can lessen pain and stiffness, and possibly
slow the progression of the disease.
 

How Exercise Helps Ankylosing Spondylitis

Besides seeing your doctor regularly and following your treatment plan, staying
active is probably the best thing you can do to manage your AS. “Physical
therapy and exercise can help relieve pain, maintain flexibility, and improve
mobility posture and strength ” says Pranjali Sathe PT DPT an Ohio based
mobility, posture, and strength, says Pranjali Sathe, PT, DPT, an Ohio-based
board certified orthopedic physical therapist. In fact, most people with AS say

pain improves after exercise or activity.
The best time to exercise: when you wake up. “Morning stiffness is very
common with AS,” explains Dr. Sathe, who is also certified in the McKenzie
Method of Mechanical Diagnosis and Therapy. Start with flexibility and range-
of-motion exercises (https://creakyjoints.org/diet-exercise/range-of-motion-
exercises-for-arthritis/), and continue to stay active and exercise throughout
the day.
The types of exercises your doctor or physical therapist may recommend
include:
Posture training: Practicing good posture techniques helps you avoid
slouching forward so you reduce the amount of strain on your spine.
Flexibility exercises: Gentle range-of-motion and stretching exercises help
keep the spine and other joints from getting stiff, improve mobility in your
joints, and help keep your back flexible.
Deep-breathing exercises: The goal is to expand your chest so you can
breathe better.
Strengthening exercises: Making your back and core muscles stronger can
help maintain proper posture and keep your body stable. Strengthening back
muscles also provides better support to bones and joints, which may reduce
pain.
Balance exercises: “Loss of balance is seen in advanced AS,” says Dr.
Sathe. Poor posture can make you less steady on your feet, which can increase
your risk of falling when you walk.
Aquatic exercises: Water aerobics can help decrease joint pain and improve
mobility. 
 

Stretches Exercises to Help Ankylosing Spondylitis

Pain
If you’re new to exercise, always talk to your doctor before starting. Your doctor
or physical therapist can make sure the exercises are safe for you. Start slowly
and move gently. And if any activity increases joint pain, and if pain continues
for several days after exercise, it’s time to stop. Talk to your doctor about what
pain is normal and when it’s a sign of something more serious
pain is normal and when it s a sign of something more serious.
The following stretches and exercises were recommended by Dr. Sathe, who is
the author of the APTA’s “Physical Therapist’s Guide to Ankylosing Spondylitis
(https://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?
cid=ecf13e37-b094-48bf-af52-8da048f8bdab).”

1. AS Exercise: Back Against a Wall

Maintains posture

Stand against a wall, with your heels and buttocks touching the wall.
Squeeze your shoulder blades together.
Hold for 5 seconds, then relax. Repeat.

2. AS Exercise: Prone Lying

Improves posture
 Lie on your stomach.
Slowly prop yourself up on your elbows so your chest is off the ground. 
If you’re able, straighten your arms.
Hold for 10 to 20 seconds, then return to start position. Repeat.

3. AS Exercise: Seated Thoracic Extension

Stretches chest muscles

Sit upright in a chair, with your feet at on the oor.

Place your hands behind your head for support, with your elbows out to
the sides.
Keeping your head still, slowly roll the top of your spine over the back of
the chair.
Hold for 5 to 10 seconds, then return to start position. Repeat.
4. AS Exercise: Quadricep Stretch

Stretches the front of your thigh

Lie on your stomach.

Loop a strap, belt, or sheet around the top of one foot.
Gently pull the strap over your shoulder until you feel a stretch through
the muscle.
Hold for 10 to 20 seconds, then return to start position. Repeat on the
other side.

5. AS Exercise: Seated Figure Four Stretch

Improves hip mobility

Sit upright in a chair, with your feet at on the oor.

Lift your right leg and place your right foot on top of your left thigh, just
above your knee.
Keeping your spine as straight as possible, slowly hinge forward. For a
deeper stretch, apply gentle pressure on the right thigh.
Hold for 10 to 20 seconds, then return to start position. Repeat on the
other side.

 
 

6. AS Exercise: Plank
Helps stabilize your core
 
Lie on your stomach with your forearms on the oor and elbows directly
below your shoulders.
Tighten your stomach muscles and lift your hips off the oor.
Squeeze your buttock muscles, and left your knees off the oor.
Keep your body straight, without letting your pelvis sag toward the oor.
Hold for 10 to 20 seconds, then return to start position. Repeat.
 
 

Keep Reading
 

7 Exercises for Hip Arthritis Pain (https://creakyjoints.org/diet-

exercise/exercises-arthritis-hip-pain/)
How Doctors Diagnose Ankylosing Spondylitis: What to Expect at the
Rheumatologist (https://creakyjoints.org/doctor-patient/how-ankylosing-
spondylitis-is-diagnosed/)
A New Genetic Test Can Predict Who’s Likely to Get Ankylosing Spondylitis 
(https://creakyjoints.org/acr-2018/genetic-risk-score-ankylosing-
spondylitis-earlier-diagnosis/)