A common worry for those diagnosed with Ankylosing Spondylitis (AS), is “What kind of exercise is safe for me?”
Exercise is an important part of gold standard Ankylosing Spondylitis management. The goals of using exercise in AS management are to maintain flexibility, to improve cardiovascular fitness and to keep body weight in check. However, it’s important to know that different types of exercise are recommended at different stages of the disease process.
These guidelines will help those with AS stay active while minimising their risk of joint and tendon injury and AS flares.
Regular stretching or mobility exercises are important and suitable for all stages of AS. Maintaining an adequate level of flexibility at the hips and spine will allow those with AS to complete their day to day activities as comfortably as possible throughout their lives Things like gardening, lifting and walking are all that bit easier if the joints in your hips and spine are able to move freely.
Stretching at least once a day, targeting the spine and hips, will help improve the flexibility of those who have just started medical treatment or it will ensure the maintainance of movement for those with stable or more advanced AS.
For those with joint fusion or marked spinal stiffness it is important to avoid stretches that require the neck or spine to lean backwards into extension. This is to minimise the chance of fractures.
Exercise that gets that gets the heart rate up, such as brisk walking, weight training and cycling will optimise heart and lung function. This is especially important in the AS population, as they have a higher risk of cardiac complications and have increased physical restrictions to the rib cage.
Higher impact exercises such as contact sports or running are cautioned in the AS population, especially for those who already have areas of spinal fusion. Current research suggests that high impact exercise may increase the chance of tendon injuries for those with AS, as they can have higher amounts of inflammation at tendon sites. Although there is no long term evidence at present, we generally promote lower impact exercise such as swimming, cycling, walking, yoga and weights as better long term choices.
Regular exercise which looks after the heart and lungs will play a part in maintaining a healthy weight range. Fatty tissue is inflammatory in nature, the less fatty tissue there is in the body, the less inflammation there is! Also, keeping a healthy weight means AS medication will work more effectively on controlling symptoms.
Exercise is a form of medicine in AS management and there are plenty of safe options for everyone regardless of the stage of their condition.
Determining what activity is safe and appropriate for the AS population may seem a little confusing, especially to those who have just been diagnosed. At BJC Health, the physio and EP team see people with AS everyday and they have had great successes in getting them back to work and regular exercise. Maybe there is someone you know that can do with our help?