Blue Turtle Yoga

Ankylosing spondylitis (AS) is an inflammatory autoimmune disease that causes severe chronic pain in the spine. In advanced cases, AS can cause the spinal joints to fuse together, limiting mobility.

The main symptoms of AS are pain and stiffness in the lower back and/or hips. However, people with AS may also experience pain and inflammation in the shoulders, arms, legs, fingers, and toes, along with other symptoms such as reduced breathing capacity.

Treatment for ankylosing spondylitis includes medications such as non-steroidal anti-inflammatories (NSAIDs) like Advil (ibuprofen), steroid injections, and biologics such as Rituxan (rituximab), surgery to restore mobility, and exercise.  

Remaining mobile, active and flexible can help reduce the symptoms of AS and delay the progression of the disease.

Any exercise program for AS aims to prevent and control stiffness, ease pain, and improve cardio function. Exercise therapies like yoga have been used in combination with other types of exercise such as swimming to achieve these goals.

In this article, you will learn how yoga can help with ankylosing spondylitis, the best poses and types of yoga for AS, whether yoga is better than Pilates for AS, and how to get started with yoga.

How Does Yoga Help Ankylosing Spondylitis?

Ankylosing spondylitis is a chronic illness that can affect the quality of life, causing severe pain and fatigue that interfere with daily activities, stress about future health and pain, lack of interest in engaging in social activities, and difficulties with breathing.

Yoga is a mind-body practice that can help with the physical symptoms of AS and the mental state of living with a chronic illness like AS. Yoga has been found to increase the quality of life, reduce stress, and help create a positive outlook.

Physically, the practice of yoga can reduce inflammation and increase range of motion, flexibility, strength, and coordination.

Yoga can also help reduce painful symptoms, which may reduce the need for pain-modifying medications like NSAIDs.

While yoga poses can be beneficial to managing AS, other aspects of yoga, such as pranayama, which focuses on breath, can also help address AS’s effects on lung capacity.

 

What Is the Best Type of Yoga for Ankylosing Spondylitis?

There are many types of yoga. Finding the best type of yoga for AS comes down to finding the best type of yoga for each individual:

• Yin and restorative yoga focus on flexibility and holding poses in a gentle way to increase flexibility, release stress, and relax the body. For anyone with advanced pain or limited or impaired mobility, Yin and restorative yoga could be really good for the body.
• Hatha yoga may be a great place to start for those new to yoga. Hatha moves through the poses at a slower pace.
• Iyengar yoga is similar to Hatha yoga and will use props such as blocks to help move into the poses with ease.
• Vinyasa yoga may be the right choice for those who seek a more cardio-focused practice that can help build strength.

Is Yoga or Pilates Best for Ankylosing Spondylitis?

Both yoga and Pilates can be beneficial to people living with AS. However, finding which one is best for the individual may take some trial and error.

Pilates focuses on strength and flexibility in a therapeutic manner. Pilates has been shown to improve strength, range of motion, and balance in people with AS. Though similar to yoga in the physical aspects of improving strength and flexibility, Pilates has less of a mind-body focus.

Depending on the individual’s needs and tolerance to the exercises, one may be better than the other. On the other hand, someone may also find that the combination of yoga and Pilates can help with the symptoms of AS.

They may need the breathing and meditation aspects of yoga to help address the mental stress that comes with living with AS. The movements of Pilates could be a better choice for strengthening the muscles and improving flexibility.

Best Yoga Poses for Ankylosing Spondylitis

Yoga poses for AS focus on spinal strength and mobility. While most yoga classes include these poses in a full sequence, these poses can also be done on their own to help with pain, build strength, and maintain or improve movement capabilities.

Child’s Pose

Child’s pose can be great for lengthening the spine and improving mobility in the hips. To do it:

1. Start on hands and knees.
2. Bring big toes together and spread knees apart.
3. Sit hips back onto tops of feet, drop the belly towards the ground and place the forehead on the floor.
4. Arms can be extended forward or alongside you.

Downward Facing Dog 

Downward facing dog, affectionately known as down dog, can improve strength in the core and arms and stretch the spine and back of the legs. To do it:

1. Start on hands and knees.
2. Tuck the toes under and press into the hands to lift hips up and back, forming an upside down “v” shape.
3. Press evenly into the hands as you reach the heels toward the ground. They do not have to touch the floor.
4. If the stretch is too intense in the backs of the legs, bend the knees.

Bird-Dog Pose

Bird-dog pose can help strengthen the muscles alongside the spine and throughout the core. To do it:

1. Start on hands and knees.
2. Lift one leg and extend it backward.
3. Flex the lifted foot as though trying to step on a wall behind the body.
4. Pull abs into the spine to find balance.
5. Slowly lift the opposite arm and reach it forward.
6. Repeat on the other side.

Cat-Cow Pose

Cat-cow is a flowing pose that increases flexibility and movement in the spine. To do it:

1. Start on hands and knees.
2. On an inhale, drop the belly towards the ground and lift the chest.
3. Look slightly up and relax the shoulders away from the ears.
4. On an exhale, press into the hands to round the back, drawing the navel towards the spine.
5. Continue flowing through these movements with the breath. Inhale, drop the belly. Exhale, round the spine.

Cobra Pose

Cobra is a gentle backbend that can strengthen the muscles around the spine, increase mobility in the back, and stretch the chest area. To do it:

1. Lie flat on the ground, face down.
2. Place the hands on the ground next to the lower ribs so that the elbows are stacked over the wrists.
3. On an inhale, press into the hands and lift the chest off the ground.
4. Relax the shoulders away from the ears.
5. Imagine pulling the chest through the arms.

Sphinx Pose 

Sphinx pose is similar to Cobra in that it stretches the front of the body and strengthens the muscles around the spine. However, it is less of a backbend and may feel better for anyone with lower back pain as it will help avoid compression in that area. To do it:

1. Lie on the ground, face down.
2. Bend the arms and place the forearms on the ground so that the elbows are next to the lower ribs.
3. On an inhale press into the forearms and hands to lift the chest.
4. Drop the shoulders away from the ears.
5. Imagine pulling the chest through the arms.

Half-Kneeling Thoracic Twist

Half-kneeling thoracic twist can help with mobility and strength in the spine as well as stretch the hip flexors and front of the legs. To do it:

1. Kneel down on both knees.
2. Take one foot and set it flat on the ground in front of the hip with the knee bent.
3. Take arms straight out to the sides and begin to twist towards the bended knee.
4. A wall or chair can be used for leverage and balance to help twist further.
5. Repeat on the other side.

Thoracic Rotation 

Thoracic rotation can help with flexibility and mobility in the spine and shoulders. To do it:

1. Start on hands and knees.
2. Take one arm straight out to the side and thread it under the other shoulder to rest on the ground beneath the torso.
3. Press into the hand that’s flat on the ground to intensify the stretch in the upper back.
4. Try to keep hips even by pressing the hip on the side of the threaded arm towards the back wall.

Bridge Pose

Bridge pose is a backbend that also strengthens the glutes and muscles around the spine. To do it:

1. Lie flat on the back with knees bent and feet planted, hip’s width apart. Place your arms flat alongside the body, palms face down.
2. Press into the feet to lift the hips off of the ground.
3. Continue pressing into the arms to lift the hips higher, or rock the shoulders towards one another to interlace the fingers underneath the glutes.

Locust Pose

Locust pose is a strengthening exercise for the muscles surrounding the spine. To do it:

1. Lie flat on the belly.
2. Place arms alongside the body, palms face down.
3. On an inhale, using the muscles of the back and glutes lift the chest and arms off the ground.
4. Feet can remain on the ground or they can be lifted.
5. If feet are lifted, engage the thighs to lift the legs higher.

How to Get Started With Yoga 

To get started with yoga, try choosing one or two poses to begin with. Think about where your limitations lie and where you’re currently experiencing pain or stiffness. Then choose a pose that either avoids those limitations or addresses the painful and stiff areas.

For example, you may know that a twisting motion in the spine feels terrible in your body, so a kneeling thoracic rotation pose could be out. However, your spine could also feel stiff and tight, and a flowing pose like cat/cow could provide relief.

There is no right or wrong way to do yoga. The shape you make with your body does not have to look exactly like the picture of the pose.

Everybody is different and learning to adjust and adapt your body to each pose is part of the practice. Some days, certain poses might be a welcome respite, and other days they may not feel good at all.

Over time you will learn what works best for you.

Summary

Ankylosing spondylitis is a chronic painful condition mainly affecting the spine. Movement and exercise like yoga are often part of the treatment plan. Yoga is a mind-body practice that can help ease symptoms and improve mental state.

Yoga poses to help with AS address pain, stiffness, flexibility, and strength. Starting slow can help each individual begin a yoga practice.

A Word from Verywell 

Yoga has many benefits for life with AS. However, yoga is not a substitute for a healthcare provider’s treatment plan. It should be used as a complementary practice, not a cure-all. Remember that while movement is good for AS, not all movement will feel good in your individual body.

If any of the poses cause further pain, do not continue them. Seek an alternative pose or exercise type to strengthen and stretch your body.