Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group exercise

I have read that a lot of people on this sight exercise. In what way does this help the AS? does it slow it down? And how do people do it? my biggest problems are in my lower back and feet. even if I walk for 10 minutes at the grocery store my back is killing me. I have tried yoga but that hurts my feet and my WHOLE back. Im tired of feeling like a slug but im not sure what exercises I can do. Also is it possible that exercise will do MORE damage? Thanks for the input!

Sasha

Exercise is a delicate balance. For me especially.

Exercising during a flare causes me to get worse. But some stretching can help, but many days I cannot even do that. I end up hobbling around as best I can. For as long as I can.

Sometimes it helps me loosen up & I have a great day. Other times, I cannot get loose & end up curled on the couch most of the day.

So, from what I've learned...

exercising during a flare causes damage. Flares (high, active pain) in general are already doing damage.

Not exercising causes damage too because fusion can happen when things are not kept moving.

Do what you can, when you can. Don't stop moving. Push thru what you can & rest when needed. Pray the flare passes quickly.

The idea is to keep out of flares to keep you from the most damage possible.

I have no idea if it's possible to do damage while in a flare.
I love to run and play soccer. Those are my exercises so to speak. We also have weights that I use as well. I have learned to listen to my body and what it's telling me. I know when to keep pushing myself and when to stop. It's something you have to learn, but as for some of us, can be extremely beneficial to you.

Sarah

Hi Sasha and welcome to KA!

Exercise is a key component of our treatment. It helps keep us mobile, quite literally. Stretching is especially important, as it helps us keep our range of motion, as well as keeping our tendons and ligaments supple. Since AS inflamation is generally located where the ligaments/tendons that surround the joint attach to the bone, you can see why this would be important. There is a reason why we have a saying: Use it or fuse it. Exercise isn't the be all, end all cure, but it's alot harder for bones to fuse when they are being used fully and properly.

Yoga is especially good, but you might have been too aggressive with it. I also highly recommend pilates. Both involve deep breathing and both will work range of motion and stretching. Pilates, however, also serves to strengthen your ab muscles whose job is to support our spines, and done properly, it is also a great upper body workout. For that reason, I am firmly in the Pilates camp.

You have to be careful with exercise when you have AS. It's far too easy to do too much and cause yourself more pain. Start with stretches. This is important. Be very gentle with yourself at first. And work up to a full stretching regime. When you can do 15 minutes of stretching in one go, then it's time to work in strengthening (weight training). That's because when you can do 15 minutes at once, your ligaments, tendons and muscles will be supple enough to handle the pressure of strengthening. Again, start extremely slowly. You can buy 1 or 2 lb weights, or start with a 500ml water bottle and partially/fully fill it according to your current capabilities. Work up to 15 minutes of strengthening and when you can do both that and 15 minutes of stretching, it's time to add cardio (walking, swimming, dancing, jogging if you're up to it). Once again, start slowly ... start where you are now, not where you think you should be ... and work up to 15 minutes of cardio in one go.

You might find that you cannot do 15 minutes in one go of any of the three types of exercise. So, if necessary, do 15 one-minute sessions in a day, or 3 five-minute sessions, and build your time very slowly until you are doing the full 15 minutes in one go. Listen to your body. It will never lie to you about what you are doing to it. Exercise should leave you feeling tired (and yet energized - it's weird that way) and your muscles should feel as if they've been worked. A certain amount of pain often accompanies exercise, but it should only last a few hours. If it lasts longer than that, or sends you into a flare, you did too much for your body's current ability and you need to pull back on it. Do less, or don't push it so much. Here's a link to The Arthritis Society's exercise page for some suggestions on gentle exercise.

Arthritis Society Exercises

I would take a good look at the shoes you are wearing when walking. Make sure they support your whole foot properly. When it comes to yoga, it's possible that in doing the poses your lower back wasn't being protected. Yoga teachers are not always great about making sure people are doing the poses properly and safely. Pilates is based in yoga, so many of the poses are the same, but the emphasis is on having the abdominal muscles activated properly so that, for instance, if you are doing Cobra (which I believe is Swan in Pilates), your lower back is protected by activating the transverse abdominus, as well as the pelvic floor (that's a very loose description of it). It's a movement similar to a pelvic tilt, but not done on a surficial level like a pelvic tilt. It's much more subtle than that and involves the deepest of the ab muscles.

Anyway, just to make sure you know, I am not a doctor, or a personal trainer or even a pilates instructor, just another patient like you who's had to learn a few things over the years.

I strongly suggest you talk to your doctors about starting any exercise regimen, as well as working with a trainer to find the best program for you at your current level of fitness. As for Pilates, there are numerous videos/DVDs out there that claim to be good. However, I strongly suggest you go to a class, preferably a 'Pilates for Dummies' type class where you learn how to do the breathing properly and how to activate the muscles safely and properly.

Hugs,

For me, I'm sore after I excercise, if I'm able to exercise, and I'm sore if I don't exercise. Near as I can figure, for me, it does more harm than good.

thank you very much for all the great info!!

Trudi, exercising in flare is something I forgot to talk about. You never want to put pressure on a flaring joint. Extremely gentle stretching is OK, but if you have frank pain in, say, your knee, then walking or leg presses are not a good idea. A gentle hamstring/quad/calf stretch can be helpful, but very gentle. The idea is not to exacerbate an already bad situation. You only want to do aggressive exercise on areas not in pain or flaring.

When I'm flaring, I always adapt my routine to take that into account. Thanks for the reminder.

Warm Hugs,

Pete, you might have to adjust the type/amount/aggressiveness of your exercise. If you're in pain in an area, doing more than gentle stretches is not advisable. If you're in full flare, the same applies. Also, are you taking into account your current level of fitness? If you haven't been able to do a full exercise program in several years, but are starting with the full Jane Fonda Workout (as an example) and expecting yourself to do the whole thing at the highest difficulty level, you're asking too much. And if you hurt for days after exercising, you've done too much. It's a fine line we tread in this area, but since exercise is intrinsic to our physical well-being, it's one we have to learn to walk - safely.

Hugs,

If you are in any kind of pain or flare, Swimming in a warm pool is the best. My local YMCA has classes and equipment for those suffering with arthritis and the pool is kept warm at about 85 - 87. They have belts you can wear and do deep water walking. Its fantastic to be able to move with no pressure on the joints. Check you local YMCA or my local hospital also has a physical therpay pool, so check in your area too. They also sell aqua suits for the pool, or a jacket that you can wear to keep warm here:

http://stores.piamedia.com/Merchant2/merchant.mvc?Screen=CTGY&Store_Code=h2o&Category_Code=cover

for me, aerobic exercise that gets the blood flowing does help me.
i have to be careful at times; if i have a tendon or ligament that is not doing so well, the exercise can bother it.
if my SI is really bad, i have to rest it and ice it, but if its just medium bad, the aerobic exercise seems to help.

most of the time, i can walk, bike on a regular bike outside, and bike on a seated bike inside (the kind with a "chair" type of seat). even when my SI is irritated by the walking, the biking doesn't seem to bothering it too much because i'm not moving the SI joint. but if the SI is really bad, then even the sitting would bother it.

if the SI is just a tad bad, then walking will bother it initially, but once i get walking, it will actually start to feel a little better. blood flow? endorphins?

when i can, i like to swim in a warm pool (above 85 degrees; closer to 90 best). but a good tendinitis / tendon pull / tendon strain will keep me out of the pool for months. i even went for pool PT, but after just a few sessions, had to stop because we reirritated my wrist, my hamstrings, and my upper back, and the high stepping and kicking was really making my SI very unhappy. but if i have no tendon strains at the time and my SI is OK at the time, then swimming in a warm pool helps get and keep things strong.

as for the walking. yesterday is a good example. when i got back from the grocery store (which i'm lucky my hubby usually does, but his back is bad right now), my SI, feet, and wrist were all really achy. that slow walking / standing / walking is the worst for me. but shortly after getting home, i went for a walk (about a 20 minute mile, so not too brisk, but enough to get the heartrate up and the blood flowing) and then i felt a lot better. standing kills my feet, but walking on the soft ground helps (most of the time, unless they are really bad).

that is my story, everyone seems a little different,

sue