Speaker A
- Hi, I'm Bob Schrupp, physical therapist.
Top 3 physical therapy exercises to improve mobility and breathing for ankylosing spondylitis patients.
Key Takeaways
- Maintaining spinal mobility and chest expansion is crucial for ankylosing spondylitis management.
- Regular measurement of chest expansion helps track disease progression.
- A combination of stretching and strengthening exercises supports better posture and breathing.
- Minimal pillow use during sleep helps prevent spinal tightening.
- Exercise difficulty should be adapted to individual capability and disease stage.
Summary
- Bob and Brad, physical therapists, discuss ankylosing spondylitis, an inflammatory arthritis affecting the spine and chest.
- They emphasize the importance of maintaining range of motion and breathing capacity to combat stiffness and posture issues.
- Measuring chest expansion monthly is recommended to monitor disease progression.
- The first exercise is chest expansions, performed seated or lying down, focusing on deep breathing and shoulder mobility.
- The second exercise involves lying on a rolled towel between shoulder blades to promote spinal extension and breathing.
- A wall or corner stretch is demonstrated to stretch chest muscles and improve shoulder flexibility.
- Strengthening exercises include raising arms and legs while lying down to strengthen back and core muscles.
- They advise minimal pillow use during sleep to avoid promoting poor posture.
- Exercises should be done without causing sharp pain and tailored to individual flexibility and disease severity.
- Some exercises may be too advanced for those with severe ankylosing spondylitis.
Full Transcript — Download SRT & Markdown
Speaker A
- Brad Heineck, physical therapist.
Speaker A
- And together we are the most famous physical therapists on the internet.
Speaker A
- Well, in our opinion, of course, Bob.
Speaker A
- Brad, today, we're gonna talk about the top three exercises for ankylosing spondylitis. This is-
Speaker A
- That's a mouthful, Bob.
Speaker A
- It is, but I'm assuming that since you've come to this video, you probably know what it is.
Speaker A
- It's, you know, a type of arthritis, inflammatory arthritis that can affect your spine, your shoulders, your rib cage.
Speaker A
- And it tightens you up. And like Brad and I were talking, the people we've seen, they've ended up like this.
Speaker A
- You know, everything's tightened down on them. It gets to the point where they have difficulty breathing.
Speaker A
- So this is where we want to, you know, from the time that you discover that you have this, you're gonna be kind of in a battle to keep your range of motion and breathing ability, so.
Speaker A
- Right, so we gotta loosen up that trunk, expand, work on that posture is really what it boils down to.
Speaker A
- Yeah, one thing they actually recommend, even, is that you measure yourself every month to make sure you're not shrinking, pulling over.
Speaker A
- And even measure your chest expansion. So you measure it with you at rest and then measure, take a deep breath as you can, and you'd like to see a good inch and a half to three inch expansion.
Speaker A
- Right, so just use a tape measure just like you do if you're fitting yourself for an overcoat.
Speaker A
- Yep, all right, let's show you the exercises. There's a lot of them, and obviously you don't need to do all of them, but you know, we're just gonna throw a whole bunch of them out there and you can see what you can do.
Speaker A
- All right, the first one of the three is chest expansions. Basically what we're trying to do.
Speaker A
- And you can do this seated or laying down. You're gonna put your hands behind your head like this.
Speaker A
- So you get a little shoulder range of motion, too. Just take the deep breath, (they inhale) expand, pull the elbows back (they exhale) and then you go like that.
Speaker A
- (They inhale and exhale) Now you can do that laying on your back, too.
Speaker A
- Right, you might find if you're, the gentleman I last worked with this, he was so far into it, he wasn't able - He couldn't even do that one
Speaker A
- to get his hands back. So that would not be for that person.
Speaker A
- Right, and some of these people, you're gonna be too far along.
Speaker A
- Another one, rolled towel, Brad put some of his famous duct tape there.
Speaker A
- You better believe it
Speaker A
- Handy man.
Speaker A
- Lay flat on your back. And by the way, you want to use as little pillow as you can when you're sleeping at night.
Speaker A
- You wanna try to adapt to the point where you actually use very little pillow at all.
Speaker A
- And the reason for that is, if you do this cause it feels more comfortable, it just promotes that poor posture.
Speaker A
- And tightening up of the spine. So again, I got a rolled towel between my shoulder blades, and now, the same thing, you can do this.
Speaker A
- And again, if you can do it without a pillow go ahead and do it without a pillow.
Speaker A
- And you're gonna go ahead, breathe in. (Bob inhales and exhales) (Bob inhales and exhales again)
Speaker A
- Good. So he's breathing in as he comes up, exhales as the arms go down.
Speaker A
- And Bob, can you just roll over this way? Cause I don't know if everyone knows.
Speaker A
- Here's where that towel roll is, right between the shoulder blades, right on the spine.
Speaker A
- And you'll know it's in the middle cause it's very sensitive to tell.
Speaker A
- Very good. Okay, now the other thing you wanna do is keep these muscles stretched out.
Speaker A
- So Brad's gonna show a wall stretch or a, well, you can do it in a corner or you can do it in a doorway.
Speaker A
- So if you're in a doorway you gotta make sure it's about the right width.
Speaker A
- And you may start with your hands here and depending how your shoulder flexibility is, and you're simply gonna lean in gently and get that stretch.
Speaker A
- You should not create any sharp pain, but a nice stretch. And typically you're gonna feel that across here.
Speaker A
- And you can your arms up, if you tolerate it. Whatever you feel good. You're gonna hold that for 15 to 20 seconds, up to 30 seconds if you can.
Speaker A
- Okay, and you're gonna do that three times. You can go to the corner of a wall if you don't have a door, a corner works good.
Speaker A
- This would be a wall here. But if you get the idea, your face goes towards the corner and your arms are out on the wall.
Speaker A
- [Bob] Cause yeah, most houses don't have doors. So, we gotta make sure we gotta account for that. (Brad laughs) Okay. The next one we're gonna do is actual, the second exercise is really more for strengthening.
Speaker A
- Cause you wanna strengthen the back muscles to help hold you straight. Keeping the spine as straight as possible, that's our goal.
Speaker A
- So Brad's gonna go ahead and lay down. Why don't you lay flat on the pillow, Brad, with the pillow underneath here.
Speaker A
- You want the pillow kind of right over here, in the abdomen.
Speaker A
- So here,
Speaker A
- Right there, yeah.
Speaker A
- And simply lay on it.
Speaker A
- So we can start off by just doing arm exercises, too.
Speaker A
- Where's that towel roll gone?
Speaker A
- Oh yeah, the towel for the forehead works out really good, doesn't it, Brad?
Speaker A
- Yeah.
Speaker A
- So he can put his head, his forehead on the towel. Now you can start off by even just raising both arms like this, and you can see how that's strengthening the upper back there, and starting to help keep that spine straight,
Speaker A
- by having the muscles strengthen the core and the upper back. Now a little more difficult is to start, maybe why don't you raise one leg, Brad?
Speaker A
- Good. And the same thing, that's now strengthening the lower back and some of the upper back too.
Speaker A
- And then you can even do alternating, right, Brad? One leg, one arm. There you go.
Speaker A
- This is pretty advanced.
Speaker A
- This is advanced.
Speaker A
- This is not easy.
Speaker A
- Brad's making it look easy, it's not that easy to do.
Topics:ankylosing spondylitisphysical therapyexerciseschest expansionspinal mobilitypostureback strengtheningstretchingbreathing exercisesarthritis
