Regular exercise is a critical part of managing symptoms and disease progression for anyone with ankylosing spondylitis (AS), a type of arthritis that causes pain and stiffness in the spine. As the inflammation that causes AS progresses from the sacroiliac joints of the lower back (where the spine meets the hips) up the spine over time, it can lead to fusion of the vertebrae. As a result, a person with AS may develop a hunched-forward posture.
“Exercise helps to keep your posture upright and the joints as mobile as possible,” says Karena Wu, a board-certified clinical specialist in orthopedic physical therapy at ActiveCare Physical Therapy in New York City and fellow of the American Academy of Orthopaedic Manual Physical Therapists. “It can help keep control of the symptoms, manage the inflammation, and give you a sense of control.”
The Spondylitis Association of America recommends an exercise program that incorporates balance, cardio, strength, and flexibility exercises.
Strength exercises keep the muscles around the joints strong, while flexibility exercises increase your range of motion, says Wu. She recommends a minimum of 30 minutes of physical activity per day, three times per week. Even several 5- to 10-minute sessions spread throughout the day count.
“A little exercise is always better than nothing, since this is a chronic and inflammatory condition,” says Lauren Shroyer, a certified athletic trainer with the American Council on Exercise who specializes in training clients with chronic injuries and conditions.
Don’t have access to a gym or workout equipment? Just look around: You likely already have plenty of objects right in your own home you can use.
Household Objects to Use for Workouts
Working out at home became a popular way to stay fit during the COVID-19 pandemic, and that’s likely to continue. An annual survey of fitness trends from the American College of Sports Medicine identified online training designed for at-home workouts as the number one fitness trend for 2021. At home, you may not have access to all the equipment you’re used to when working out at the gym, but with a little creativity, you can still get in an effective sweat session.
Just be careful not to overdo it on the weight. You’ll know you’ve picked the right weight when you can maintain proper form for every repetition, the weight becomes difficult to lift after 10 to 15 repetitions, and you have no joint pain, Shroyer says.
Here are a few items by category you can use for basic exercises.
Items that double as sliders
Sliders, also called glider discs, can intensify body-weight exercises by challenging your stability and increasing muscle engagement. If you don’t have sliders, try one of these options:
- Dish towel: Place it under one foot and glide along the floor in single-leg reverse or side lunge, and then repeat with the opposite leg.
- Paper plates: Put them under your hands as you do a plank. Slide alternating hands a few inches in front of you to give your abs and arms an extra challenge.
Items that double as weights
“Anything with weight will add resistance as you lift against gravity while holding the item,” says Wu. A few ideas:
- Laundry detergent bottle: Hold the handle to use it as a kettle bell for squats, dead lifts, or bent-over rows.
- Milk jug: Use it for exercises involving your abs or lower body.
- Soup cans or water bottles: Hold one can or bottle in each hand to use as light hand weights for biceps curls, triceps extensions, or overhead presses.
- Tote bags: If you’re a more experienced exerciser, fill a sturdy tote bag with a few cans or rocks to do dead lifts or plié squats.
- Backpack: Fill it with dry goods and use it as a weighted vest for lower-body exercises.
- Bag of flour or sugar: Cradle it against your chest while doing squats or lunges.
- Bag of potatoes, dog food, kitty litter, or mulch: Looking for a bit more resistance? Any of these can weigh 10 pounds or more.
- Cast-iron skillet: This hefty kitchen staple can weigh 10 pounds or more, depending on the size. Hold the edge for biceps curls or triceps extensions.
- Textbooks or coffee table books: Hold one overhead while doing walking lunges or squats.
Items that double as a bench
Don’t have a weight bench at home? Try one of these instead:
- Chair: Place your hands on the edge of a chair for triceps dips or modified planks. Or use it for thoracic extensions to help keep your spine flexible: Sitting with your feet on the floor, place your hands behind your head with your elbows out to the side. Lean back into the chair as far as possible, keeping your elbows wide and your chest open.
- Couch: Place your feet on the couch and your shoulders on the floor to perform glute bridges. Or use the couch for step-ups with or without weights.
- Bed: Make any prone (stomach-lying) stretch more comfortable by performing it on your bed. Try quadriceps stretches, using a towel as a band around your foot. Or try prone exercises to help improve posture: Lying facedown on your bed with your arms in front of you, lift your shoulders and chest up and hold for 10 to 20 seconds.
Items that double as a resistance band
Resistance bands are elastic bands that can be used during strength-training exercises. The following can be used in place of a resistance band:
- Hand towel: Pull each end of the towel until it’s taut to work your shoulders and arms.?
- T-shirt: Use it the same way you’d use a hand towel.
- Belt: “Straps can be helpful in stretching,” says Wu. For example, while lying flat on your back, place the ball of one foot in the middle of the belt and hold both ends. Gently extend that heel toward the ceiling to stretch your hamstring.
Other household items to use creatively
You may be surprised by what you can incorporate into your exercise routine if you know where to look. For instance:
- Broom or PVC pipe: Open up your shoulders and back with mobility exercises using a broom or PVC pipe. For example, in a standing position, hold one end of a broom or pipe in both hands, and then push it up on one side until you feel a stretch. Hold for 10 to 30 seconds, and then repeat on the other side.
- Stairs: If you have stairs in your home, walk up and down them a few times for a cardio workout.
- Wall: Do wall sits while you’re watching TV or brushing your teeth. Or use the wall for posture exercises. For example, stand with your butt and heels pressed against the wall and your feet under your hips. Squeeze your shoulder blades together and hold for 5 seconds. Release and repeat.
- Pillows: “Pillows can add an element of instability, which makes the muscles fire more to balance,” Wu notes. Try standing on a pillow while you’re doing squats or lunges.
- Blankets: Use a folded-up blanket in place of a yoga mat to give your joints some extra cushion.
More AS Exercise Tips
Before you start a workout program, check with your doctor. They may offer specific workout tips and even refer you to a physical therapist or certified fitness trainer who has experience treating people with AS.
Here are a few tips to keep in mind.
- Warm up. Start by walking in place or doing low-impact knee lifts to get the blood flowing and your joints warmed up, Wu suggests.
- Skip high-impact exercise. If you have an arthritic condition, such as AS, avoid running or jumping. “You could set yourself back if you overdo it and irritate the joints,” Wu says. Instead, choose low-impact exercises, such as walking, biking in an upright position, or swimming.
- Avoid intense twisting or bending. Exercises and activities that involve these movements can inflame the joints, Wu notes. If your spine is fused, avoid all exercises that require you to bend forward or backward.
- Focus on your core. Wu recommends prioritizing exercises that strengthen your abs and back. Since these muscles stabilize your spinal column, you’ll feel more supported when you’re upright.
- Strengthen your lower body. Strengthening the legs and hips is also critical, since the lower body supports the lumbar spine, according to Wu and Shroyer.
- Stretch — especially your lower body. If you have decreased range of motion in your back due to AS, you’ll need more flexible hips and knees to compensate when you need to bend down in your daily activities, Wu notes.
- Reduce exercise during a flare. You may even want to avoid workouts altogether when your AS is flaring, to allow inflammation to calm down in affected areas, Wu says.
- Listen to your body. “If an exercise hurts, stop doing it,” Shroyer explains. “By ‘pushing through,’ injuries are more likely.”
- Try isometric exercises. If exercises that involve movement are painful, you can still work a muscle isometrically by contracting it without movement. “It’s a good alternative to painful movement, as it turns the muscle on in a supportive fashion around a joint. A 10-second isometric contraction has also been shown to have an analgesic effect,” Wu says. Planks are an example of an excellent isometric exercise that strengthens your back and core, she adds.