Pilates and Ankylosing Spondylitis

Medically Reviewed By William C. Lloyd III, MD, FACS
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Pilates can help improve flexibility and reduce pain for many people who live with ankylosing spondylitis (AS) or spinal arthritis.

AS is marked by chronic inflammation in the joints where the spine attaches to the pelvis (sacroiliac joints), as well as other segments of the spine, the hips, and shoulders. Symptoms ebb and flow and can include low back pain, stiffness and fatigue. In severe cases, the spine can become fused into a fixed, stooped position, according to the Spondylitis Association of America.

Exercise may be the last thing you feel like doing when AS is flaring, but it’s actually one of the best things you can do.  And research shows that Pilates—with its gentle stretching and strengthening—may be the way to go.  In one study, individuals with AS who did Pilates three times a week for one hour showed improvements in pain, function and overall quality of life after three and six months, when compared with their counterparts who did not. Another study showed that people with low back pain who practice Pilates need less medication to control their pain than those who didn’t do Pilates.

So what is it about Pilates that makes it so good for your back?  Pretty much everything from the muscles it targets (namely your core) and the focus on controlled breathing and balance to its ease on inflamed joints. Regular exercise including Pilates also helps boost energy and fight fatigue.

Start Slowly

Make sure you get clearance for your doctor before changing up your exercise routine. If you have never taken Pilates before, find out if there are any local beginner classes or instructional DVDs to teach you the basics.  Consider a session with a personal trainer or physical therapist who has knowledge of AS to learn the ropes. You don’t want to jump into an advanced class on day one.

Some basic moves

Always warm up with some gentle stretches before you begin your Pilates session. Here are some Pilates moves that may help improve the symptoms of your AS:

Neutral Spine

Lie on your back with your arms by your sides, preferably on a mat. Bend your knees and make sure that your legs and feet are parallel and hip-distance apart. Inhale. Next, exhale and use your abs to press your lower spine into the mat.

Why it helps AS: This gentle stretch will help improve your posture and relieve some of the stress on your spine.

Hip Extensions

Stand on one leg and then move the other the leg back in a straight line. Switch leg and repeat.

Why it helps AS: This stretch improves range of motion in your hip joints, which may be inflamed, stiff and painful.

Basic Cat Stretch

On all fours, inhale and arch your back upward Next, pull your belly button in toward your spine and squeeze your lower buttocks. Now, let your head to drop forward in a slow and controlled fashion.

Why it helps AS: The cat stretch can improve flexibility in your back and stabilize your core. Strengthening the core helps protect your lower back.

Always listen to your body. If something hurts or you are having a bad day, stop. The goal of Pilates is to get stronger and improve your range of motion and posture.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 16
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Altan L, et al. Effect of Pilates training on people with ankylosing spondylitis. Rheumatol Int. 2012 Jul;32(7):2093-9. doi: 10.1007/s00296-011-1932-9.
  2. Natour J, et al. Pilates improves pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial. Clin Rehabil. 2014 Jun 25. Epub ahead of print. http://www.ncbi.nlm.nih.gov/pubmed/24965957
  3. About AS. Spondylitis Association of America. http://www.spondylitis.org/about/as.aspx