Best Exercises for Ankylosing Spondylitis! Video 11 — Transcript

Hi guys, my name is Kami and I'm a doctor of physical therapy. In this video, we are talking about exercises we can do to help with a condition called ankylosing spondylosis. So if you already landed on this video, it means that you've probably been diagnosed by your doctor with this condition. I'm only going to give you a quick overview of what the condition is, and then we're going to jump into the exercises. I'll make sure to put the minutes to that on the side of this video. And as always, make sure to read the indications, contraindications, and red flags before you do any of these exercises. And don't forget to subscribe to our channel. This condition is a systemic inflammatory issue that hits especially our spine, our SI joint, or pelvis. And what ends up happening is that the inflammation in the joints eventually causes the joints to fuse together. And that means that eventually you have that, you know, bent forward posture. The range of motion is lost in our upper back, on our neck, and our lower back, in our pelvis. And the biggest problem we'll end up having aside from lower back pain is going to be with breathing, right? Because if you imagine your ribs are kind of attached to your spine, and if your spine is stuck, their ribs are stuck. Then you can't really open and close your chest as you're breathing. Now, this is a progressive condition, meaning that we can't really cure this problem with exercises, but we can definitely try to improve or maintain the range of motion that we currently have at whatever stage we're on, and we can slow down the progress of that loss of function. Okay, so you have to make sure that you try to incorporate, and if not all, some of these exercises into your daily routine. I promise they'll be super simple ones. So as I mentioned, the first thing we want to do is to be able to maintain that range of motion, especially with extension. That is the movement that helps us stay up tall. And so what I want you to do is go ahead, lie on your mat. We are going to go into an extension, so all you're doing here is propping up on your elbows. Your glutes are super relaxed. Squeeze your shoulder blades back and look forward. So you want to try to maintain this posture throughout the day for at least 10 to 15 minutes. And you know, you can maybe even start playing video games so you can stay like this or watching TV in this position. And again, you can hold this posture for between 5 to 15 minutes. The second movement I want you to incorporate is a press-up. And so again, I'm relaxing my glutes, so shake your bum left to right. Make sure your glutes are super relaxed. Hands are a little more forward than where if I were to do an actual push-up, so my hands are a little more forward. I'm taking inhale. As I exhale, come all the way up. Now here, squeeze your shoulder blades back and down. Look forward. Relax that bum. Feel that nice extension in your lower back. So feel super tight. That's okay. We're just going to hold it and exhale. Relax your belly and come all the way back there. So these ones can repeat 10 of them. We'll relax your bum, relax the belly, calm down. So inhale up. As you exhale, relax the belly, let those muscles go. So the gravity will even create more of a curve in your lower back. Look up and back down. So from this position, now we are going to go up into a quadrupedal. So again, that's going on all fours. Make sure that your wrist is right underneath your shoulder. Your knee is right underneath your hips, so you're not here. Okay? And all we are going to do is to do a couple of cat and cows. Okay? Supporting those of you who don't know what that is, that's just when we curve all the way down and then look all the way up. Okay, so let's do a couple of those. And this is to kind of warm up your spine. After you do like, let's say, three, four, we are going to now do segmental cat and cows. That means that we are going to think about where our spine sits. So that says your lumbar spine, your lower back, your upper back is your thoracic spine, your neck is your cervical spine. We are going to move our lumbar spine first, then thoracic spine, then cervical, and then back down. So it won't be like what I did at the beginning when you move the whole spine at the same time. So let's go to that neutral spine first. Then you're going to hurt your lower back all the way down. Okay, so I'm all the way down. Then I'm going to move to my upper back here. I want to squeeze my shoulder blades together, drop my chest all the way down. Lastly, I'm going to bring my neck all the way up. Then we are going to do exactly the opposite of this. So first bring your neck all the way down, then push your body up, carve your upper back. But you guys look at my elbows. I'm not cheating. I'm not bending my elbows. Elbows are straight. I push into the mat, create that curve in my upper back, and then I create that curve in my lower back. And you can repeat this. So press my lower back one vertebrae at a time, then my upper back, then I slowly bring my neck up and reverse. Neck all the way down, the thoracic spine up, then I'm bringing my lumbar spine in. Okay, and you can repeat this exercise about ten times. From there, we are going to turn around, lie on our back. The first movement is going to be rotation. So far, we've done the extension movements. Now we are going to incorporate some rotation. Now you might tell me that you don't have that range of motion to go all the way down. That's okay. You guys just go as far as you can. Back to center, then to the other side. You can either do this ten times going side to side, or you can just drop your knees to one side, hold. But you want to make sure that your shoulders are glued to the mat. You come up, go to the other side, hold again. You can hold between five to ten seconds. Repeat it five to ten times on each side. Then after our rotations, we are going to move into our flexion movement. So have one leg out, bring the other knee all the way up towards your chest. You can either hold on top or go underneath and pull that knee up towards your chest. So this is a great glute stretch. That's the muscle right here, but also it's stretching your lower back. It's creating that arch in your lower spine. You can hold this for 30 seconds, then switch to the other side. Again, hold 30 seconds. I would like to do these about three times if I'm holding them for thirty seconds. And the last one is a double knee to chest. So again, bring both knees to your chest. Again, hold on top or underneath. You can always interlock your fingers, bring your knees apart, pull your knees with your biceps into your chest, and you can even go side to side. So this is an amazing flexion stretch. You're still stretching your glutes too and giving your lower back a massage. Again, you hold this 30 seconds, repeat 3 times. The next exercise will be a posterior pelvic tilt. Take your hands, put it right on your pelvis, so the two bones we have on either side. Grip those two bones. You want to rotate your lower back, so your lower back tucks in. Okay, from here I'm going to go down one, two, three, four, five, relax. One, two, three, four, five, relax. Again, two, three, four, five, relax. So every time I'm rotating, I'm pushing my lower back into the mat, holding that spot for about five seconds, relaxing it. Can you repeat this exercise three sets of ten? Now we are going to add our bridge to our posterior pelvic tilt. So what I'm wanting to do is first of all make sure that your feet are close to your bum. Feet are hip-width apart. Knees are hip-width apart. You're creating that tilt first, so I'm tilting my lower back into the mat first. Squeeze your glutes, lift up. Two, three, four, five, and down. And then you guys just like the posterior pelvic tilt, so you're going to repeat this three sets of ten. This is again a great extension exercise, creating that mobility in your lower spine. The next two exercises we're going to do on the mat are going to help us open up our chest. So I'm going to be using a roller for this exercise. And now the size of the roller doesn't really matter. You guys pick whatever you're comfortable with. If you don't have a ro-

you've probably been diagnosed by your doctor with this condition I'm only going to give you a quick overview of what the condition is and then we're going to jump into the exercises I'll make sure to put the minutes to that on

the side of this video and as always make sure to read the indications contraindications and red flags before you do any of these exercises and don't forget to subscribe to our Channel this condition is a systemic inflammatory issue that hits specially

our spine our SI joint or pelvis and what ends up happening is that the inflammation in the joints eventually causes the joints to fuse together and that means that eventually you have that you know bent forward posture the range

of motion is lost in our upper back on our neck and our lower back in our pelvis and the biggest problem we'll end up having aside from lower back pain and it's going to be with breathing right because if imagine your ribs are kinda

to your spine and if your spine is stuck their ribs are stuck then you can't really open and close your chest as you're breathing now and this is a progressive condition meaning that we can really cure this problem with

exercises but we can definitely try to improve or maintain the range of motion that we currently have at whatever stage we're on and we can slow down the progress of and that loss of function okay so you have to make sure that you

try to incorporate and if not all some of these exercises into your daily routine I promise they'll be super simple ones so as I mentioned the first thing we want to do is to be able to maintain that range of motions

especially with extension that is the movement that helps us stay up tall and so what I want you to do is go ahead lie on your mat we are going to go into an extension so all you're doing

here is propping up on your elbows your glutes are super relaxed squeeze your shoulder blades back and look forward so you want to try to maintain this posture throughout the day for at least 10-15 minutes and you know you can maybe even

start playing video games so you can stay like this or watching TV in this position and again you can you can hold this posture for between 5 to 15 minutes the second movement I want you to incorporate is a press up and so again

I'm relaxing my foots so shake your bum left to right make sure your glutes are super relaxed hands are a little more forward than where if I were to do an actual push-up so my hands are a little

more forward I'm taking inhale as I exhale come all the way up now here squeeze your shoulder baby's backing down look forward relax that bump feel that nice extension in your lower back so feel super tight that's okay we're

just gonna hold it and exhale relax your belly and come all the way back there so these ones can repeat 10 of them will relax your bum relax the belly calm down so inhale up as you exhale relax the

belly let those muscles go so the gravity will even create more of a curve in your lower back look up and back down so from this position now we are going to go up into a quadrupedal so again

that's going on all fours make sure that your wrist is right underneath your shoulder your knee is right underneath your hips so you're not here okay and all we are going to do is to do a couple of cat and cows okay

supporting those of you who don't know what that is that's just when we curve all the way down and then look all the way up okay so let's do a couple of those and this is to kind of warm up

your spine after you do like let's say three four we are going to now do segmental Kanin cows that means that we are going to think about where our spine sets so that says your lumbar spine your lower back your upper back is your

thoracic spine your neck is your cervical spine we are going to move our lumbar spine first then thoracic spine then cervical and then back down so it won't be like what I did at the beginning when you move the whole spine

at the same time so let's go to that neutral spine first then you're going to hurt your lower back all the way down okay so I'm all the way down then I'm going to move to my upper back here I

want to squeeze my shoulder base together drop my chest all the way down lastly I'm going to bring my neck all the way up then we are going to do exactly opposite of this so first bring your neck all the way down then push

your body up carve your upper back but you guys look at my elbows I'm not cheating I'm not bending my elbows elbows are straight I push into the mat create that curve in my upper back and then I create that curve in my lower

back and you can repeat this so press my lower back one vertebrae at a time then my upper back then I slowly bring my neck up and reverse neck all the way down the thoracic spine up then I'm

bringing my lumbar spine in okay and you can repeat this exercise about ten times from there we are going to turn around lie on our back the first movement is going to be rotation so so far we've done the extension movements now we are

going to incorporate some rotation now you might tell me that you don't have that range of motion to go all the way down that's okay you guys just go as far as you can back to Center them to the other

side you can either do this ten times going side to side or you can just drop your knees to one side hold but you want to make sure that your shoulders are glued to the mat you come up go to the

other side hold again you can hold between five to ten seconds repeat it five to ten times on each side then after our rotations we are going to move into our flexion movement so have one leg out bring the other knee all the way

up towards your chest you can either hold on top or go underneath and pull that knee up towards your chest so this is a great glute stretch that's the muscle right here but also it's stretching your lower back it's creating

that arch in your lower spine you can hold this for 30 seconds then switch to the other side again hold 30 seconds I would like to do these about three times if I'm holding them for thirty seconds and the last one is a double knee to

chest so again bring both knees to your chest again hold on top or underneath you can always interlock your fingers bring your knees apart pull your knees with your biceps into your chest and you can even go side to side so this is an

amazing flexion stretch you're still stretching your boots too and giving your lower back a massage again you hold this 30 seconds repeat 3 times the next exercise will be a posterior pelvic tilt take your hands put it right on your

pelvis so the two bones we have on either side grip those two bones you want to rotate your lower back so your lower back the man's okay from here I'm going to go down one two three four five relax

one two three four five relax again two three four five relax so every time I'm rotating I'm pushing my lower back into the mat holding that spot for about five seconds relaxing it can you repeat this exercise three sets of ten now we are

going to add our bridge to our posterior pelvic tilt so what I'm wanting to do is first of all make sure that your feet are close to your bum feet are hip-width apart knees are hip-width apart you're creating that tilt first so I'm tilting

my lower back into the mat first squeeze your glutes lift up two three four five and down and then you guys just like the posterior pelvic tilt so you're going to repeat this three sets of ten this is

again a great extension exercise creating that mobility in your lower spine the next two exercises we're going to do on the mat are going to help us open up our chest so I'm going to be using a roller for this exercise and now

the size of the roller doesn't really matter you guys pick whatever you're comfortable with if you don't have a roller at home you can always just roll a towel and use the towel instead what I want you to do is put them over on the

floor and you kind of want to make sure that you give your neck a support so you can either put pillows underneath your head or you can make sure that your head kind of lands on the roller as well I'm

going to try to rely on the roller okay now I'm definitely feeling this stretch what you're going to feel is your chest is opening that you might feel some tech stretches those are the muscles right over here bring your arms down and then

to reach up so make a circle if you guys have shoulder issues you're gonna need to go this far you can keep your hand here it will still do the same thing and you want to try to align on this roller

for a while so what I'm really focusing on is trying to create that stretch in between my ribs some stretching my intercostal muscles I'm stretching my diaphragm I'm opening up my chest how often do we get in this position

throughout the day right and we're gonna focus on our breathing so deep deep breathing through your belly try to open up your diaphragm now after you lie on this for a while you can always just add our movement so you can reach overhead

or again you can create that semi circular movement and get a stretch in your pecs - good and slowly come off of it no another way we can try to use the roller is to move the roller seg

mentally up up on our spine you can use a peanut ball for this - what I want you to do is bring your feet on the mat your glutes out of the mat and I'm planting the roller right underneath my scapula

the scapula is that bone you have like your shoulder blade um I have it right under the shoulder blade to start with going to interlock my fingers behind my neck keep my elbows together and I'm gonna go back and forward use my legs to

go down one vertebrae so they're rolling up on my spine one burger wave okay go back and come up and go down one more great I think you just do this movement up and down your spine again you guys I

have and making a description for you guys to how I do the exact same thing using a peanut ball and I'll make sure to share that with you guys in the description also to where I usually get my rollers

fun in case you guys are interested ok the last exercise we are going to do in this position it's going to be a breathing exercise that helps open up our chest it is called a lateral costal bleeding again I have a video just on

breathing exercises in the description definitely check it out remember I said at the beginning one of the biggest problems you'll have eventually is with your breathing so we want to make sure we keep those two ribs moving you're

going to take both hands put it right on either side of your ribs okay I had you take an inhale I want you to push with your ribs into your hand expand your ribs as you exhale with your

hands push in and try to get all that air out okay so hands are here inhale exhale so as you guys can see I'm making an audible sound with my breathing and it's just I'm trying to constrict the back of

my throat a little bit it actually helps me make those inhales and exhales a longer and more controlled and also I'm just reading through my notes so we're doing deep breathing through our notes inhales and exhales again let's try it

one more time hands are on both sides inhale [Music] again you guys you can incorporate these breathing exercises maybe start doing ten and everyday you make it a little bit longer or add more reps into your breathing okay guys so I'm going to go

over some standing stretches now and that can be very helpful for this condition the first one is a fascial stretch for our upper back neck and shoulders it also helps with and stretching your shoulders and your pecs what I want you to do is create the

posterior pelvic tilts we just sit on the floor okay so you guys look at my lower back this is extension this is the bike moving this in and my lower back becomes more straight so we're gonna do that on the wall but you might just have

to bring your feet a little more forward and bend your knees a little so your back is glued to the wall the second thing you do is try to push your neck back so now the back of my head is on

the wall my lower back is on the wall my knees are bent right now sometimes you might not even be able to get here you can definitely put a pillow behind your head so your head is resting on that

pillow so if we're in this position and we're stuck here it's going to be so hard to try to move into that standing position but you guys if you work at it eventually we can improve it so my lower

back is glued I'm pushing my head into the mat outside and pushing my head into the wall then if that wasn't hard enough I'm going to ask you to bring your elbows and plant them on the wall now

from here we are going to bring our arms all the way up and I already feel this stretch it's like my body doesn't want my back to be glued to them and to the wall anymore and I feel like right in

between my shoulder blades for those of you who have shoulder issues you might be here that's okay you work your way up maybe your hands are not even reach maybe your hands off that well that's okay you guys eventually you'll get

there then slowly you're going to bring your arms all the way up if you have that range of motion and slowly down now if you don't have this range of motion and you can do this movement what I want

you to do is again make sure your back is glued do their chin tuck your bat you're at the top of your head is on the wall we'll just do this go up hold ten seconds back down ten seconds up ten

seconds down ten seconds so we're not only stretching our muscles we're also stretching that fashio that's the connective tissue that goes from the top of our leg all the way down to our love our slide to even our feet right we're

just trying to stretch that so again I'm repeating it two exercises the first one is you're here you try to go up and down you can repeat this ten times but do it slower than what I'm doing the second

one is you're here you just reach bring your arms back again one ten seconds to do and peeta ten times the next stretch we are going to do is going to be for our pack again you can put your hand my

elbow on the wall and I'm trying to go forward so if you're doing this at the door it's easier you just put your hand on the wall and you go forward but you can also do it on the wall so my hand is

here and I'm just rotating my body the other way okay then feel a really nice stretch and my pack that's the muscle here you guys that's your chest muscle so right now my hand is at a 90 degree

angle you can also bring your arm up and go forward oh I feel that that chills or you can bring your arm down and then again rotate your button you're hitting different fibers of your PEC when you're doing this again

each stretch you're holding for about 30 seconds repeating three times on each side okay guys now I know that was a lot of exercises but we're almost there so the next couple of exercises I'm going to show you you can

easily do them sitting on your chair and they're going to be again to create and maintain that range of motion in our joints the first one is going to be a performance stretching sitting again wait your ankle right over your knee

sitting on top try to push your knee down and try to reach forward okay you hold that stretch for 30 seconds you should be feeling a really really nice pull from your gluts going to your knees and I'm going forward hold in 30 seconds

switch to the other side this is a great hip opening exercise so it's good for our hips also if you are having lower back and it can be really helpful just make sure your back is straight that you're not slouching squeeze your

shoulder blades back just go forward now you might be here you might be here it's okay work on pressing that knee down leaning forward you shouldn't be sitting all the way back and trying to do this you want the other stretch as much the

next movement is going to be an upper back rotation so you can plant both hands on the side of the chair and try to rotate your body now again we are going to do this segmental starting with the lowest part of our spine moving up

so mid take an inhale guide long in your body exhale rotate just your lower back and he'll get tall try to use your hands to rotate your upper back you can inhale get tall in your body exhale rotate your

neck all the way back and slowly come back to Center and you can repeat it on the other side and the last thing I'm going to show you is going to be a hamstring stretch you guys start and gazillion different ways

I'm doing a hamstring stretch in this video I'm going to show you when it's standing using the chair all I want you to do is bring your leg forward planted the chair make sure it's stable and gently moving forward now a couple of

things with this is that we tend to do this okay I want you to push this head back make sure your hips are level you can use a wall for stability back is straight squeeze your shoulder blades back and just lean forward you should be

feeling a really nice stretch in the back of the hamstring hold it for 30 seconds repeat three times on each side the next exercise I'm going to show you is going to be another thoracic chest opening exercise again I will leave the

thoracic mobilization exercises in a description for you guys you can definitely follow those as well what I want you to do is sit back on your chair bring your arms interlock them behind your head elbows together lean back and

you want to move backwards and then come forward again you can move down a little bit on the chair and again lean back and come forward now if your chair is a little bit lower than the one I have

here you will be able to move more mobilize more segments on your thoracic spine which will be better for you okay guys that is it in terms of exercises I know that was a lot because in this video I'm gonna focus just on the lower

back and because with this condition it's not just that your lower back is involved maybe the condition starts in your lower back but then eventually hits your whole spine so you might as well just start doing range of motion

exercises for all levels and at some point you need to make sure that eventually you start doing strengthening as well again I will leave links in the description for you guys or some low-impact stabilizing exercises that can help your posture so definitely you

want to hit those back muscles do upper back exercises and and if you have access to a pool honestly hydrotherapy again does magic it's definitely one of my favorite means of therapy so if you do have access to a pool get in that

pool you can always contact me I'll try to send you exercises you can do in the water it's not necessarily swimming I'm not asking you to swim I just want you to get in the water and basically move

in water as always if you guys have any questions don't hesitate to leave a comment from me and if you like this video don't forget to Like share and subscribe to our Channel