Exercise is an integral part of treating spondyloarthritis. A holistic approach to spondyloarthritis – which treats the whole person, includes exercise and wellness practices – and is the gold standard.
Exercise can counteract some of the impacts of spondyloarthritis, helping you maintain more of your mobility and flexibility. According to doctors and patients alike, exercise is effective in controlling pain. In fact, in no other type of arthritis is the role of exercise more important.
Exercise has been shown to optimize physical and mental health in everybody. In addition to directly increasing strength, endurance, balance, and flexibility, some of the other physical benefits of exercise include improving cardiovascular endurance, reducing high blood pressure, increasing good cholesterol (HDL), maximizing bone density, helping weight management and possibly even enhancing response to medications.
For those with spondyloarthritis, regular exercise can help improve posture, stiffness, pain, fatigue, breathing capacity, and therefore overall function. Remember that it is your doctor’s job to help control the pain, inflammation and stiffness so that you can maintain a healthy exercise program. It is often difficult to exercise or participate in physical activity if pain persists due to active inflammation. A good treatment plan must include exercise/physical activity. A physical therapist can help you craft an individualized stretching and strengthening program to fit specific needs.
SAA has developed a number of exercise resources, including a video of workouts and routines designed specifically for those with spondyloarthritis. We also offer a plethora of other information and resources, including a free downloadable PDF demonstrating helpful stretches and strengthening moves.
There are 4 main types of exercises recommended:
An ideal exercise program will incorporate each of the types of exercise noted above.
These exercises are done without weights to move the muscles and joints through their full range of motion. Range of motion exercises improve flexibility and reduce stiffness, swelling, and pain, as well as minimize the risk of fusion. These are often done as warm up exercises before sports. Range of motion or stretching exercises are critical in spondyloarthritis because people tend to limit movement and use of an area when there is pain, swelling, and/or stiffness around a joint, such as when there is active inflammation. Lack of movement can lead to loss of mobility and increase the risk of fusion of the joints. In addition, when a joint is inflamed, surrounding muscles tighten to control motion, resulting in even more stiffness and pain. Therefore, it is recommended that range of motion or stretching exercises be done daily for all joints that are stiff or that have the potential for becoming stiff.
This exercise consists of activities performed for a sustained period of time that increase blood flow through the heart. Aerobic exercise improves heart and lung function and overall health. Studies show that people with spondyloarthritis who do aerobic exercise have better breathing function, endurance, and mood, and less disease activity, pain and fatigue than people who do not exercise. The current aerobic exercise recommendations include performing aerobic exercise between 3 to 5 times per week for a total of 75 to 150 minutes per week.
These exercises use your muscles to move or hold against a weight or resistance. Strengthening exercises improve the performance of muscles that help you move efficiently and safely and support good posture. Some of the most important muscles to strengthen in spondyloarthritis are the “core muscles,” which are the abdominal and back muscles that act like a “corset” to support the spine. Having strong core muscles has been shown to reduce stress in the spine and therefore can minimize back pain. It is common for a person who has back pain from spondyloarthritis to change their posture to ease the pain. Over time, these postural changes may lead to stiffness and weakness of the muscles and joints, and more pain. As such, “core strengthening” is key to managing back pain in spondyloarthritis. Strengthening exercises should be performed 2 to 4 times per week for best results.
Focus on improving your stability when you are still and moving. These exercises are especially important for people who are less active and as we age. Balance exercises can help reduce the chances of falling, which is especially important for people with lower bone density, and thus at greater risk for fracture during a fall. Balance exercises should be performed 3 to 5 times per week for best results.
Consistently performing a program that addresses flexibility, aerobic conditioning, strength and balance for 20 minutes a day has been shown to significantly improve pain, stiffness, fatigue, function, and mood. By working with your physician and physical therapist, you can set realistic goals for yourself, choose exercises/physical activities that are safe and enjoyable, and stay with the program that optimizes your health.
Workouts and routines designed specifically for those with spondyloarthritis
Alex Levine, personal trainer and fitness nutrition specialist, talks about his personal journey with spondylitis and how to build a fitness and movement routine that works for you.
Advanced Practice Physiotherapist Angelo Papachristos discusses the role of physical therapy in managing spondyloarthritis.
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