Ankylosing spondylitis is both a systemic inflammatory disease and autoimmune disease that can pull you into a more flexed (bent forward) position over time.

Exercise can help with managing this symptom.

To make exercise part of your daily routine, choose a time of day that works for you. Create an exercise space that works well for you and wear clothing that’s comfortable when you’re exercising.

Begin with the easiest exercises and warm up slowly.

While you may feel some tension, do not overdo it if you experience pain and it’s increasing.

Try reducing the number of repetitions and sets you’re performing and reduce your program’s intensity until you can complete the exercises comfortably.

If working out makes your condition worse, discontinue your routine and report it to your healthcare provider.

Always consult with your healthcare provider before beginning a new exercise program.

You should perform this exercise in front of a full-length mirror. Start by standing with your heels about 4 inches away from a wall.

Keep your shoulders and buttocks as close to the wall as possible without straining. Hold this position for 5 seconds.

Check your posture in the mirror and think about how it feels to stand straight and tall. Relax, then repeat 10 times.

You should perform this exercise on a firm surface like the floor.

Place a towel or a yoga mat on the floor for comfort. You can also use a firm mattress — one that doesn’t dip with your weight —- as well.

Lie face down for 15 to 20 minutes. (If you can’t do this comfortably, you may use a pillow under your chest and place your forehead on a folded towel.) You may keep your head downward, turn it to one side, or alternate sides.

You may not be able to do this for 20 consecutive minutes. That’s fine. Begin with whatever feels comfortable and increase the time as you gain strength.

Inflammation due to AS can cause decreased chest expansion. The breaststroke specifically can help build and maintain chest expansion.

Swimming, in general, is a great way to increase flexibility in your spine without jarring it.

It also helps to increase flexibility in your neck, shoulders, and hips. You may find it easier to perform aerobic exercises while in the pool.

Deep breathing helps you increase and maintain your lung capacity. It also helps prevent your rib cage, thoracic spine (upper back), and surrounding back and chest muscles from getting too stiff.

To start, sit or lie down and observe your normal breath. Take a slow, deep breath.

You should feel air enter through your nose and move toward your lower belly. Allow your abdomen as well as the sides and back of your rib cage to expand fully.

A good way to make sure you’re deep breathing correctly is by blowing up a balloon. This deep breathing technique is known as diaphragmatic breathing.

Breathe out slowly through your mouth or nose. With one hand on your abdomen, feel it rise as you inhale and fall as you exhale. Alternate regular and deep breaths a few times.

Yoga can help ease pain and increase flexibility. Many people find that yoga also helps reduce stress and tension and promote restful sleep.

If you’re new to yoga, don’t attempt to learn on your own. Find a class for beginners and stick with gentle poses. As your range of motion increases, you may want to try more advanced levels.

Pay attention to how you walk. Aim to keep your spine as straight as possible, with your shoulders squared, and your head held high. In other words, think tall!

You can test and correct your posture throughout the day by standing with your back against a wall. Your head, shoulders, buttocks, and heels should touch the wall at the same time.

If your job requires you to sit at a desk all day, it may be worth it to invest in an ergonomic chair. Make sure it’s well designed and doesn’t encourage a slumped or stooped position.

Just like your walking posture, try to sit with your spine as straight as possible. Keep your shoulders squared and your head held high.

Check and correct your sitting posture throughout the day.

Sleep with your spine straight, if possible. A firm mattress can help to encourage this position, but it shouldn’t be too hard. Try not to sleep on your stomach; doing so could add pressure on your lower back.

Try sleeping on your back and use a thin pillow or one designed to support your neck. If it’s uncomfortable to sleep on your back, you can put a thin pillow under your knees to alleviate some of the tension.

Avoid sleeping with your legs curled. Keep them as straight as you can.

Keep these tips in mind for best results:

  • It might be easier to exercise or perform deep breathing after a warm bath or shower.
  • Check on and correct your posture throughout the day.
  • Don’t perform strenuous exercises when you’re having a flare-up.
  • Always begin with gentle exercises and increase the intensity only if you’re not in pain.
  • Increase exercise frequency as tolerated.
  • If pain increases because of your workout, discontinue and consult with a healthcare provider.