What to expect from exercise therapy for ankylosing spondylitis

Ankylosing spondylitis can make the spine, hips and rib joints feel stiff, particularly after rest. A physiotherapist may observe spinal movement, hip flexibility, posture, chest expansion, balance and how symptoms change during activity. The aim is to preserve useful movement, support upright posture and make ordinary tasks easier; exercise does not replace medical treatment for inflammation.

Sessions may include gentle spinal and hip mobility, extension work, core and leg strengthening, and breathing exercises that encourage rib-cage movement. The plan should respect fatigue and flare-ups rather than push through marked pain.

Begin with the technique and amount demonstrated by your therapist. Short, regular practice is often easier to manage than one demanding session. Warm up gradually, change position during long periods of sitting, and use comfortable breathing throughout. Record which movements ease stiffness and which provoke symptoms so the programme can be refined.

During a flare, ask how to modify intensity, range or position. Progress may involve smoother movement, better tolerance for walking or improved posture rather than a dramatic change in symptoms. Pair home exercises with the medicines and appointments already recommended for your condition.

Stop an exercise that causes sudden severe pain, new weakness, loss of balance or symptoms that continue to worsen after rest. Seek urgent medical assessment for new loss of bladder or bowel control, numbness around the saddle area, or rapidly developing weakness. Contact your clinical team when a flare is changing your usual function or you cannot follow the programme safely.

Ask which movements are appropriate during a flare, how to protect posture at work and sleep, and how breathing exercises should feel. Also ask how progress will be assessed and when the plan should be reviewed.