If you’re not in the habit of working out regularly, it may be challenging to get into a good exercise routine. But no matter what your physical fitness level is, how comfortable you are with regular workouts, or even how busy you are, there are ways to incorporate physical activity into your daily routine. Here are some tips for how to find the best exercises for your needs that you’ll actually enjoy, plus how to overcome any barriers to staying active with nr-axSpA.
How a Physical Therapist Can Help
When you’re first diagnosed with nr-axSpA, your doctor may refer you to a physical therapist to learn exercises that can help you manage your condition. How many sessions you’ll have will depend on factors such as your fitness level and exercise habits. “If I have a younger patient who is reasonably fit and already knows what they need to do, I’ll [recommend] a session or two with a physical therapist to talk about the right exercises,” says Eric Ruderman, MD, a rheumatologist and professor of medicine at Northwestern University Feinberg School of Medicine in Chicago. Physical therapy may be more important for older people who are newly diagnosed with nr-axSpA, says Dr. Ruderman. “I find it helpful particularly for people who aren’t used to exercising and staying fit,” he notes, adding that it may take several sessions with a physical therapist to develop a routine that works. When developing an exercise routine for someone with nr-axSpA, it’s essential to learn the particulars of the disease and that person’s physical abilities, says Frank van Kouwen, PT, CMP, a physical therapist at Orlando Health in Florida who often sees patients with spine conditions. For someone with nr-axSpA, the goal of physical therapy is to help maintain “the muscles that maintain spine extension, a straight posture, over the whole spine, from the pelvis up to the neck,” says van Kouwen. Maintaining hip flexibility is also important. A physical therapist may teach you exercises that involve:
Lying facedown over an exercise ball and lifting or extending your shoulders, your head, and the top of your backLying on your back with your knees bent and lifting your hips into the airLying on your back with your knees bent and rotating your knees inward to stretch your hipsAquatic exercises aimed at improving your strength and range of motion
Great Exercises for nr-axSpA
There are four main types of exercise that are important for people with spondyloarthritis, according to the Spondylitis Association of America:
Stretching or range of motionAerobic or cardiovascularStrength or muscle buildingBalance
An ideal exercise program will incorporate each of these areas. That doesn’t mean they all need to be done in one session or even on the same day — although stretching, in particular, is important for people with nr-axSpA to do daily if possible. But it’s also true that any physical activity is better than none for most people, and choosing activities you enjoy may make it easier to follow through. “What I usually say is, do what works for you,” says Ruderman. Rather than having someone follow a program perfectly, he says, “I’m much more interested in making sure that they do some exercise, that they stay fit.” Consider incorporating some of these nr-axSpa-friendly activities into your day. Walking Going for a walk can be an easy way to get some cardiovascular activity and keep your hips and back flexible. Just make sure you keep your posture as straight as possible when you walk so you’re not putting pressure on your hips or spine in a harmful way, says van Kouwen. Biking Riding a bike can be a great low-impact activity for people with nr-axSpA, but not all forms of biking are equally helpful. “I would be careful about going on a bike where people are hunched forward, whether it’s a Spinning class or a bike ride,” says van Kouwen. Instead, make sure you’re in an upright position on your bike, or invest in a recumbent model. Rowing exercises For most people, actually rowing a boat isn’t an option, but there are many indoor activities that simulate this activity, which van Kouwen says is especially great for back strength. Most gyms have rowing machines, or you can buy one for your home. Another option is to use elastic bands or straps and your own body weight to achieve the same type of motion and resistance. Pull-down exercises This type of strength training is great for the large muscles that connect your shoulders and lower back, says van Kouwen. You can use machines for pull-downs at your gym or simply use elastic bands at home by fixing them on or around something above your head. Swimming and aquatics Swimming is a great low-impact cardiovascular exercise, says van Kouwen. Bonus: With aquatic classes or self-guided activities, “You can do a lot of exercises with minimal fear of falling and injury,” he notes. Yoga or tai chi These activities can help improve strength and range of motion, which is particularly important for nr-axSpA. Online or in-person classes can guide everyone from beginners to advanced practitioners through movements, which often include options that take physical limitations into account, such as chair-based forms of yoga and tai chi.
Overcoming Barriers to Exercising With nr-axSpA
While a physical therapist can teach you helpful exercise techniques, you’ll need to regularly do them on your own to achieve maximum health benefits. This can be difficult for a number of reasons. For one thing, many people with nr-axSpA have pain or a limited range of motion that can make it difficult to engage in regular exercise. As the Spondylitis Association of America notes, it’s your doctor’s job to make sure your disease is well controlled so that pain, inflammation, and stiffness aren’t barriers to physical activity. It’s important to work with your rheumatologist to come up with a treatment plan that helps reduce your symptoms. Another common barrier to getting enough exercise is a lack of time or an irregular or stressful schedule. It doesn’t help that certain tricks for fitting exercise into your day, such as exercising first thing in the morning, may not be practical for someone with nr-axSpA because of symptoms such as morning stiffness. Still, you may be able to fit more exercise into your day by trying the following tips.
Go for a walk while taking work-related or social phone callsUse dictation software to “write” emails or early drafts of documents while you walk or do other exercisesFollow a stretching routine every time you get out of the shower, which may be helpful in the morning or eveningExercise or stretch during commercial breaks when watching TVRun errands on foot or bicycle if it’s safe and practicalSchedule a walk or another type of activity with a friend, ideally on a regular basisSet reminders on your phone to take regular breaks from your day to exercise or stretch
