Stretch with Emily for your axial spondyloarthritis — Transcript

Hello, my name is Emily Clark. I'm one of the physiotherapists with the Bath Mass Group. Throughout the lockdown period, I've been doing some regular Zoom sessions with the Bath Group, just incorporating exercises, particularly stretches, that I thought would be very beneficial for them. They seemed to really enjoy it, so I thought I would share with you what would be a typical session and just hopefully you will find that beneficial. I obviously know the Bath Group really well. I've helped screen them, and I know their past medical history, so I'm confident they're able to do the exercises very well. I might not have met you before, so just if you're worried at all, just watch the video through first, just so you know what you're in for. And if you have any concerns, please have a chat with your health professional and just check that you're safe to do the exercises. There is a little bit of a cardiovascular component at the beginning, just to get your heart and lungs working. Then we're going to do mostly exercises in standing. They do require some balance, so you can adapt them and hold on to something to enable you to do the exercises. Make sure it's something sturdy that's not going to move, and just leave out any ones that you're not sure about. You can always return to them or work up to those exercises as well. I'm doing a series of videos, so I have some separate chair-based exercises for your neck and your trunk that you can use perhaps after this exercise session, just to act as a bit of a wind down as well, or you can use it separately. Okay, we're going to get going with a warm-up, so find a bit of space and do have something you can hold on to if you need to, and just marching your feet. Hopefully you can see my feet. Yes, okay. So I am doing this in one take, so apologies if there's any noise in the background or any kids wandering in. Hopefully it will go according to plan. So try and get those knees a little bit higher, relax your shoulders, swing your arms, just adding a little tuck through your tummy muscles to support your posture, and relax your neck muscles. Try and feel like your head is nice and light and lifting up to the ceiling. Okay, go a little bit higher with those knees now. Again, hold on if you need to. And then touching opposite hand to knee in front, just to warm up those hips and knees. If you want to go a little bit upper level, you can. You can bring your opposite elbow to knee across your body, but think of twisting through those shoulders, so you're rotating through your spine. And then let's go for another 10, 9, 8, 7, 6, 5, 4, 3, 2, 1, and take it back to marching. Right, I want you to think about really pushing down through your feet as you march, trying to get a nice bit of impact through the floor. Try and get those knees straight. Lovely. Okay, so now we're going to do some heel dips, so just bending that supporting leg or one supporting leg and then touching the other heel on the floor. You should be able to see her. Yeah, okay. Just going up and down, bending and straightening that supporting leg. Go lower if you can. Good, warming up those knees. Good. Let's go 10, 9, 8, 7, 6, 5, 4, 3, 2, 1. Good. Now we're going to do some toe taps to the side, one and then the other. So bend that supporting leg, stretch out the other one, tap those toes to the side, bring it together, then opposite side. Good. So one and then the other. Go at the pace that you're happy with. Go faster if you want to. If I'm too slow, that's fine. I'll take it down a level and go a little bit slower if that's easy for you. But try to feel that your lungs are working a little bit and your heart's pumping a little bit faster. Okay, let's go for another ten. Nine, eight, seven, six, five, four, three, two, one. Same thing and those knees, but tap your toes behind you. Okay, so stay nice and low and alternating your legs. Straighten that back leg, tapping the toes on the floor behind you. Use those tummy muscles to support your posture and yeah, work at the pace that gets you a little bit out of breath without bringing you out in a full sweat. So we're just working at kind of moderate level of exercise intensity. Okay, another ten. Nine, eight, seven, six, five, four, three, two, one. Feet together and after you come to shake those legs out. Hopefully you're feeling your thighs a little bit warmer now and the blood is flowing a little bit. It's quite important to just warm up those muscles before you stretch them. Okay, don't go straight into stretches. You'll find that those muscles won't thank you for it, so warm up in some way first. Okay, now we're going to combine the heel and the toe taps. We're going to do the right leg first, then the left leg. So again, this requires a bit of balance, so hold on to something, have a chair in front of you if you need to, and you're going to go into a little bit of a squat. So it can be a mini squat for you or go lower if you're really keen. Relaxed upper body and then tap your heel in front, toe to the side. I've got enough space. Toe behind. Come forwards a bit. So heel, toe, toe, and back. Stay nice and low. So heel, toe, toe, and back. Stay at the same—sorry, heel, toe, toe, heel, toe. Difficult talking and exercising at the same time, but I'm getting the hang of it. And again, stay nice and low into that mini squat and same again other side if I've got room. Yes. So heel, toe to the side, toe behind and back. Stay low. Heel, toe, toe behind and back. Heel, toe, toe behind and back. Heel, toe to the side, toe behind, back. Two more. Heel, toe, toe, and last one. Heel, toe, toe, together and back up. Well done. Good. Tough on those knees a little bit, but it's good strengthening for those knees. And again, just marching, keeping the blood flowing, keeping a little bit of a pace, and try and roll those shoulders. Let's warm up those arms a little bit now, so rolling shoulders and then drawing circles with those elbows, trying to keep your feet moving. It's a bit of a coordination challenge in itself. So nice big circles with those elbows now and feet moving a bit like tapping your head and rubbing your tummy. Good. Nice big circles. Good. And back down. Okay, now some combined stretches in standing. Hopefully you can see me and hopefully you can see my feet. I think you can. Okay, so starting off just getting some air into your lungs and moving those ribs around, getting some nice deep breaths. If you interlace your fingers and press your palms up to the sky, try and take a slow deep breath in through your nose to the base of your lungs. Press your ribs out as you breathe in. Good. Breathe out. Press your palms a little bit higher and again slow deep breath in. Push your ribs out as you breathe in and breathe out. Palms a little bit higher. Last one. Slow deep breath in through your nose. Press your ribs out to the side as you breathe in. Breathe out. Palms up to the sky and then circle those arms around back down to the floor. Good. We can do the same again. You're going to come up onto your toes. So to make it a little bit more challenging for your hips, I'm going to get you to bring your toes together if you can for balance. You know, if you need to for balance, take your feet apart. That's the most important thing. They're not going to fall over, but to want to challenge your balance a little bit, try and bring those feet together and then if you can your feet apart. It's all your toes apart so your heels are together like a ballerina. Do I say it? Let's just put off all the guys in the audience. Okay, so press those palms up to the sky then come up onto your toes if you can. Lift those heels. Good. Tuck your tummy in to support your spine and to help keep your balance. Good. Deep breath in, out, palms up higher and again slow deep breath in through your nose, out through your mouth. Stay on those toes if you can. If that's too challenging, just take those heels to the floor. Last one slowly and your nose out. Reach up nice and high and circle those arms down. Squash those heels together as you come back down. Well done. I'm just going to do a few more of those foot series, those foot movements, just to work on t—

very beneficial for them they seemed to really enjoy it so i thought i would share with you what would be a typical session and just hopefully you will find that beneficial i obviously know the bath group really well i've

helped screen them and i know their past medical history so i'm confident they're able to do the exercises very well i i might not have met you before so just if you're worried at all just watch the video through first

just so you know what you're in for and if you have any concerns please have a chat to your health professional and just check that you're safe to do the exercises there is a little bit of a cardiovascular component at the

beginning just to get your heart and lungs working then we're going to do mostly exercises in standing they do require some balance so you can adapt them and hold on to something to enable you to do the exercises make sure

it's something sturdy that's not going to move and just leave out any ones that you're not sure about you can always return to them or work up to those exercises as well i'm doing a series of videos so i have some separate

chair-based exercises for your neck and your trunks that you can use perhaps after this exercise session just to act as a bit of a wind down as well or you can use it separately okay we're going to get going with a

warm up so find a bit of space and do have something you can hold on to if you need to and just marching your feet hopefully you can see my feet yes okay so i am doing this in one take

so apologies if there's um any noise but in the background any kids wandering in hopefully it will go according to plan so try and get those knees a little bit higher relax your shoulders swing your arms just adding a little

tuck through your tummy muscles to support your posture and relax your neck muscles try and feel like your head is nice and light and lifting up to the ceiling okay go a little bit higher with those knees now again hold on if you need to

and then touching opposite hand to knee in front just to warm up those hips and knees if you want to go a little bit upper level you can you can bring your opposite elbow to knee across your body but think

of twisting through those shoulders so you're rotating through your spine and then let's go for another 10 9 8 7 six five four three two one and take it back to marching right i want you to think about really

pushing down through your feet as you march trying to get a nice bit of impact through the floor try and get those knees straight lovely okay so now we're going to do some heel dip so just bending that

supporting leg or one supporting leg and then touching the other heel on the floor you should be able to see her yeah okay just going up and down bending and straightening that supporting leg go lower if you can

good warming up those knees good let's go 10 9 8 7 6 5 four three two one good now we're going to do some toe taps to the side one and then the other so bend that supporting leg stretch out the

other one tap those toes to the side bring it together then opposite side good so one and then the other go at the pace that you're happy with go faster if you want to if i'm too slow that's fine

i'll take it down a level and go a little bit slower if that's easy for you but try to feel that your lungs are working a little bit and your heart's pumping a little bit faster okay let's go for another ten

nine eight seven six five four three two one same thing and those knees but tap your toes behind you okay so stay nice and low and alternating your legs straighten that back leg tapping the toes on the floor behind you

you use those tummy muscles to support your posture and yeah work at the pace that gets you a little bit out of breath without bringing you out in a full sweat so we're just working at kind of moderate level of exercise

intensity okay another ten nine eight seven six five four three two one feet together and after you come to shake those legs out hopefully you're feeling your thighs a little bit warmer now and the blood is flowing a little bit

it's quite important to just warm up those muscles before you stretch them okay don't go straight into stretches you'll find that those muscles won't thank you for it so warm up in some way first okay now we're gonna combine the heel

and the toe taps we're gonna do the right leg first then the left leg so again this requires a bit of balance so hold on to something have a chair in front of you if you need to and you're going to go into a little bit

of a squat so it can be a mini squat for you or go lower if you're really keen relaxed upper body and then tap your heel in front toe to the side i've got enough space toe behind come forwards a bit so heel toe

toe and back stay nice and low so heel toe toe and back stay at the same sorry heel toe toe heel toe difficult talking and exercising at the same time but i'm getting the hang of it and again

stay nice and low into that mini squat and same again other side if i've got room yes so heel toe to the side toe behind and back stay low heel toe toe behind and back heel toe toe behind and back

heel toe to the side toe behind back two more heel toe toe and last one heel toe toe together and back up well done good tough on those knees a little bit but it's good strengthening for those knees

and again just marching keeping the blood flowing keeping a little bit of a pace and try and roll those shoulders let's warm up those those arms a little bit now so rolling shoulders and then drawing circles with those

elbows trying to keep your feet moving it's a bit of a coordination challenge in itself so nice big circles with those elbows now and feet moving a bit like tapping your head and rubbing your tummy good nice big circles good

and back down okay now some combined stretches in standing hopefully you can see me and hopefully you can see my feet i think you can okay so starting off just getting some air into your lungs and and moving those ribs around getting

some nice deep breaths if you interlace your fingers and press your palms up to the sky try and take a slow deep breath in through your nose to the base of your lungs press your ribs out as you breathe in

good breathe out press your palms a little bit higher and again slow deep breath in push your ribs out as you breathe in and breathe out palms a little bit higher last one slow deep breath in through your nose

press your ribs out to the side as you breathe in breathe out palms up to the sky and then circle those arms around back down to the floor good we can do the same again you're going to come up onto your toes

so to make it a little bit more challenging for your hips i'm going to get you to bring your toes together if you can for balance you you know if you need to for balance take your feet apart that's

the most important thing they're not going to fall over but to want to challenge your balance a little bit try and bring those feet together and then if you can your feet apart it's all your toes apart so your heels are

together like a ballerina do i say it let's just put off all the guys in the audience okay so press those palms up to the sky then come up onto your toes if you can lift those heels good tuck your tummy in to support your

spine and to help keep your balance good deep breath in out palms up higher and again slow deep breath in through your nose out through your mouth stay on those clothes if you can if that's too challenging just take those heels to the floor

last one slowly and your nose out reach up nice and high and circle those arms down squash those heels together as you come back down well done i'm just going to do a few more of those uh that foot series those foot movements

just to work on the balance and also it can help to open up those hips so upper body now to relax and yeah hold on something if you need to again keeping those toes apart heels together in your comfortable range

just come up onto those toes balance keep that upper body nice and relaxed and then push those heels together as you come back down lovely again up onto those toes balance and then squash those heels together as you come back down you'll feel it in

your glutes here which is good they're the muscles that look after your hips so again come up onto your toes feel those thighs working feel those glutes working and then push your heels together as you calm back down

two more coming up onto those toes relax floppy arms heels together coming back down and one more coming off onto those toes and down with those heels together well done shake those legs okay challenging those hips a little bit

more but always work in your comfortable range all of these exercises are designed to be ideally a bit of a challenge out of your comfort zone hopefully but they should not be agony and um you should certainly shouldn't be

battling through pain throughout them so modify it take it down a level or leave some out if you need to and build up okay so hopefully hopefully you can see my feet yeah i'm going to have toes facing

forwards to start with check i've got enough space and what we're going to do is just start opening up those hips so you're going to lunge from side to side i'm going to probably go a little bit wider

so i'm going to go that's why this is fairly comfortable for me so lunging one side and then the other so straightening my knee i'm pushing my weight across good i'm going to push my heel down with that leg

to shift my weight over and straighten this knee and then stay again the other side really drive that heel into the floor to shift your weight over right i'm going to try and keep my head on the same level it's helpful to see

myself actually i'm going to try and keep nice and low as i shift my weight over from side to side so that pelvis should stay on the same level as well good nice and slow nice and controlled which

actually makes it more difficult i also have very slippy socks on so that's an extra challenge for me good and then push and shift your weight over to the side getting that knee straight and once more gliding across

a lot on this side so you drive that hail into the ground shift your weight over and then come back to the center so straighten both knees look where your feet are sometimes they creep further and further apart so bring

them in if you need to okay well done keep rolling those shoulders to just ease off the tension that tends to gather in our shoulders when we do most things i'm going to do the same thing again we're going to add

in some arm movements now so again work in your comfortable range or if you want to challenge yourself take those legs a little bit further apart and then same thing again you're going to lunge over to the side

and then reach up and over with the other arm so you're kind of trying to get a diagonal get a nice stretch all the way through that right side for me now pushing heel to floor reaching with the

the same arm good come back to the center circle arm down and glide across shifting your weight over and keeping that heel on the floor reach up and over with the other arm really trying to point those fingers

and get all of this in line good push and shift your weight over again circle that arm down circle the other one up reaching up as high as you can over to the side pushing that heel to the floor

and again shift your weight back circle that arm reach up and over remember to breathe and take a deep breath in in this position actually expanding those ribs breathe out circle down shifting back to the center one more time the other side shift your

weight over to the other leg circle that arm up and over and reach deep breath into your ribs to expand that ribcage on the right side and as you breathe out a little bit of extra stretch and then shift your weight

back to the center good stuff wiggle those feet together bring those hips in and shake those legs out you can do a little micro kind of circle with those hips like hula hooping i haven't actually ever hula hoops but i

imagine it's a bit like this i shake those legs i check out the muscle tension in your upper body another series that can be good for your balance and also incorporates quite a nice stretch through your body this one

starts off in a squat position so feet hip width apart looking down on your toes just make sure those knees aren't coming over your toes when you bend into a squat and think about pushing your bottom out as you come down

into a squat and again you can start in with just a little mini squat you could start in a full squat it's really depending on on you and your and picking your level okay so i'm going to go mid level

just so i can actually do it going to a squat yeah knees are not over my toes they're in line with my feet arm towards counterbalance as well and i can feel it yes certainly my glutes so i'm gonna challenge myself some more

i'm gonna lift my heels so i'm on my toes if that's too much for you just stay in a normal squat and then reach up in a v-shape up towards the sky so straighten those elbows chest up if you can stay on your toes and then

see if you can take those elbows to the side and just touch your ears and shrug your shoulders up to your ears take them down reach up circle your arms down to the side and sink your heels to the floor good

and again down into your squat maybe go lower if you want to lift those heels reach up in a v-shape touch your ears shrug your shoulders down reach up circle those arms sink your heels and one more down into

that squat we're going to go slowly now because it is much more difficult reach up in our v-shape good ears shoulders down reach up circle those arms sink your heels back down well done shake it out i think a nice little series that

okay we're just going to now do a few of our traditional leg stretches um particularly your hamstrings and inner thighs and get really quite tight with axe bar so they can be quite stubborn and take a little bit of stretching out so they are

quite long stretches um but you can abridge them and just but do make sure you go to the end of range with all the stretches so all you need is a chair if um if you want to you can just use the

floor it's a bit more challenging on the chair but um see how you go and if it's too much if it puts your balance then just use the floor so looking at your chair you're going to start off stretching your hamstrings

let's go a bit further back so you can see me so starting off right here on the chair keep that right knee straight and fold forwards from your hips pushing your bottom out okay go go close to something if you

need to hold on balance and then folding in those hips keeping that chest up take a deep breath in pushing your ribs out as you breathe in breathe out and lean into this stretch a little bit more so bottom out

chest forwards feeling the stretch on the back of your thigh on those hamstring muscles again deep breath in i'm reminding you that we need to stretch and slow deep breath in breathe out a little bit further take that leg off the chair well done

make a rest okay shake those legs out then we're going to do the same thing other side so left heel on the chair now keep their knees straight forward forwards from those hips bottom out chest up so you're feeling the stretch in the

back of your thigh keep that knee straight and then take a slow deep breath in through your nose all the way to the base of your lungs and then fold a bit further into the stretch as you breathe out

good slow deep breath in again as you breathe out go further into the stretch so folding from those hips and again slowly into your nose breathe out folding forwards into the stretch and hold it there then soften that need to take the

stretch off get your balance clear foot off the chair hold on shake out okay same principle again just use the floor for this one we're going to do the inner thigh stretch this is how we tend to do it using the

chair and then in the last group and so right foot on the chair and then you're bending your supporting leg to increase the stretch so you feel the stretch on the inside of your thigh that is quite a big stretch and it's

quite a challenge for the supporting leg so hold on if you need to good slow deep breath in try and expand your lower ribs as you breathe in breathe out lower into the stretch again slowly into your nose

breathing to those ribs breathe out come down a bit lower and again slowly into your nose breathing out this leg should be working really hard go down into the stretch hold it for a little bit longer good hopefully this leg is wobbling a

little bit that means it's working hard so slowly come up out that stretch slowly bend this knee to take the stretch off and wiggle that foot off the chair as you go now if you're feeling the strain on the inside of your knee

during that stretch just think of turning those feet up to the ceiling a little bit more so you should feel it here it's not it's not a knee stretch that one so you can just make these little adjustments so you're feeling it in the

right place okay same stretch other side swap over make sure i've got enough room just about left foot on the chair and then bend that supporting leg to increase the stretch for some people that will be enough of a stretch but if

you want to take it to another level bend that supporting leg so you're feeling the stretch on the inside of your thigh knee straight think of your posture as well then slow deep breath into your nose pushing your ribs out as you breathe in

breathe out go lower into the stretch and again slowly into your nose breathe out go a little bit lower and again slowly into that nose and out sinking into the stretch hold it and then slowly come up have a

stretch when you're ready i'll wiggle that foot off the chair something that i need to get your balance good shake it out shake those legs give them a pat they've worked hard so last set of muscles we're going to

stretch are your hip flexor muscles so really important set of muscles to stretch these ones they go from your lower back to your thigh bone if your hip flexors are tight or shortened they can pull you forwards so keeping them nice and lengthened and

stretched can improve your posture or maintain your posture so this is how you do it using the chair you can put your knee on the chair then start pass with the other leg if your knee gets sore and i've got a

cushion on my chest because my knee does get a little bit sore and yes so cushion it if you need to so i'm stretching my right hip flexors now you can also just do this in step standing so i would do it like this in

steps i think you get a bit of a stronger stretch with the chair so step past with your left leg and then think of pushing those hips forwards as you lunge onto that front leg try and keep that weight back

getting this stretch through your hips okay now i'm feeling it down the front of my right thigh for sure okay so deep breath in push those ribs out as you breathe in and breathe out lunging a bit further

into the stretch and again slowly into your nose out through your mouth lunging a bit further keeping those hips facing forwards and again slowly into your nose breathing in breathe out lunge a little bit further leaving that back leg behind

hold it for a little bit longer and then slowly come back onto that back leg to take the stretch off and get your balance good so yeah for sure spinning it down here that's where that's where you should be feeling it

and then same thing are the legs so last one now again just do this in step standing if you want to hold on to something if you need to and left knee on the chest step past the chair with your right leg

and then i'm going to lunge onto that front leg but make sure my weight is back and my hips are facing forwards i'm pushing through that pelvis to feel the stretch down the front of my left thigh good now slow deep breath in through

your nose try and expand your ribcage at the front as you breathe in breathe out lunging forwards onto that front leg pushing those hips as well and again slowly into your nose expand those ribs at the front breathe out come in a little bit lower

to the stretch and last one slow deep breath into your nose and the air all the way to the base of your lungs down expand those ribs as you breathe in breathe out go a little bit lower and hold it there a little bit

then slowly come back onto that back leg to feel the stretch up well done oh you always feel it when you come out of the stretch a little bit more so shake those legs out well done so please have a look at some of the

other videos that i've done um and that should be on the nas website there's a series where i'm doing some neck and trunk stretches and that'd be a nice little follow on from from this video just to complete the

package if you like so good luck and thank you very much for watching