Including yoga in your exercise routine can be helpful if you’re living with the symptoms of ankylosing spondylitis (AS), like pain and stiffness in your back.
“We don’t have a cure for AS, so yoga and other nonimpact exercises are great options,” says Melvyn A. Harrington Jr., MD, a professor of orthopedic surgery at Baylor College of Medicine in Houston.
“Folks who have milder disease and don’t have significant stiffness can do more yoga poses than someone who has advanced disease,” Dr. Harrington notes.
For people with AS, though, the expression “no pain, no gain” does not apply here: You don’t want to add to any pain you’re already feeling, so you’ll want to start slowly and tailor the yoga poses to your abilities.
Stretching and Breath Work Offer Benefits for Ankylosing Spondylitis
“The movement and stretch that yoga offers are helpful and can sometimes alleviate some of the low back pain associated with AS,” says Lauren Harris, a New York City–based yoga instructor. “People need to practice mindfully, of course, and listen to their own bodies. If a pose causes pain in any way, it should not be used.”
The deep breathing of yoga also offers benefits. “Yoga offers gentle stretching and flexibility, but the breath work can be incredibly helpful for people with AS because it improves chest expansion,” says Diana Zotos, a certified yoga instructor and physical therapist in New York City. “Some people with AS have slumped posture. Yoga’s deep, diaphragmatic breathing supports posture.”
Zotos suggests discussing yoga with your doctor before giving it a try. Then, once you get started, always listen to your body. “If it feels like a stretch, that is a good thing, but if it hurts, the pose may not be right for you,” she says. “Go to a beginner’s class and use props such as blocks or blankets if you need them.”
A yoga teacher can help you tailor yoga poses, or asanas, to your needs. “This is your pose — it is not a competition,” says Zotos.
Both the Spondylitis Association of America (SAA) and the Arthritis Foundation recommend yoga specifically as a way to manage and reduce the pain from AS, with the SAA offering a number of free get-started resources and videos.
Here are eight expert-approved yoga poses that can be particularly beneficial for people with ankylosing spondylitis.
Child’s Pose With Variations
“Child’s pose is a really gentle and easy way to stretch the lower back,” says Harris. Get into the pose by dropping down onto your knees, spread your knees wide, and bring your big toes together. Sit your hips back onto your heels and reach your arms forward onto the ground.
Child’s pose can be modified in many ways:
- Rather than spreading the knees apart, keep the knees and thighs parallel as you rest your torso forward.
- Rather than reaching your arms forward, reach them back toward your feet, or clasp your hands behind your back.
- If your head doesn’t easily reach the ground, rest your forehead on a yoga block or two, or on a large pillow or rolled-up blanket.
Ankylosing Spondylitis Benefit Improves flexibility and stretching of the spine and hip flexors.
Cow Pose
Get on all fours — on your hands and knees — with your hands shoulder-width apart, your wrists right under your shoulders, and your fingers spread wide. Your knees should be apart, right under your hips. Allow your belly to drop toward the floor as you tip your sitting bones toward the ceiling. At the same time, bring your chest forward and up while drawing your shoulder blades down your back.
Ankylosing Spondylitis Benefit Improves flexibility and stretching of the spine.
Angry Cat
To do the Angry Cat pose, start on all fours as you did for Cow pose. Pull your navel in and up and round your spine toward the ceiling, allowing your head to curl down toward the floor. Think of increasing the space between each vertebra of your spine.
Alternate between Angry Cat pose and Cow pose, exhaling as you move into Angry Cat, and inhaling as you move into Cow pose.
Ankylosing Spondylitis Benefit This pose may help stretch and lengthen the spine and improves flexibility and possibly your posture, according to Harris.
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Supine Twisting
“Gentle twisting should be beneficial, but as with any other pose, if the twist causes any pain, come out of it immediately,” says Harris. Lie on your back, draw your knees toward your chest, and wrap your arms around your legs, giving yourself a little hug. Rock a bit from side to side or back and forth.
Now take your arms out into a T, scoot your hips to the right, and move your bent knees up and over toward your left elbow, taking your gaze to the right. Hold the pose and breathe into the stretch. Then gently bring your knees back to center. To switch to the other side, scoot your hips a bit to the left, take your bent knees up and over to the right, and gaze to the left.
Ankylosing Spondylitis Benefit A “massage” for the spine, according to Harris.
Bridge Pose
Lie on your back on the floor, bend your knees, and set your feet on the floor. Allow your arms to rest on the floor alongside your body.
Exhale and press your feet and your arms into the floor. Push your tailbone up, firm your buttocks, and lift them off the floor, keeping your thighs and feet parallel to one another and your knees directly over your heels.
Don’t clench your buttocks, but rather, think of lengthening your tailbone toward the backs of your knees.
Ankylosing Spondylitis Benefit This pose can help with posture.
Downward-Facing Dog
Start on all fours, with your knees directly beneath your hips and your hands slightly in front of your shoulders. Spread your palms and tuck your toes under, so that the bottoms of your toes touch the floor. Next, exhale and push your knees away from the floor. Lift your sitting bones toward the ceiling, and focus on lengthening your entire spine.
If your hamstrings (along the backs of your thighs) are tight, bend your knees slightly so your spine can lengthen and your sitting bones can rise high. Let your head hang freely, and gaze back at your shins as you hold the pose for several breaths.
Ankylosing Spondylitis Benefit Improves flexibility and stretching of the spine.
Crescent Lunge
“This is a great stretch for the hip flexors, which may be tight in people with AS,” Zotos says.
For a basic Crescent lunge, begin in Downward-Facing Dog pose, and step your left foot forward between your hands. Bend your left knee so your shin and thigh make a right angle; try to keep your left knee directly over the heel of your left foot as much as possible, which reduces stress on the knee. Then return to Downward-Facing Dog, pause and stretch, and repeat the pose with the right leg forward.
For a more advanced version, you can also try a High Crescent lunge, once you are comfortable with the basic pose. To do High Crescent lunge, come up onto the ball of your right foot and straighten your right leg. Keep your hips square to the front of your mat. Raise your torso to an upright position and sweep your arms up over your head. Gently gaze upward toward your hands. Return to the starting position and then repeat on the other side.
For a Low Crescent lunge, drop your right knee to the floor and untuck your right toes, so the top of your right foot rests on the mat. Keep your left knee over the heel of your left foot while you lift up your arms and torso. Return to the starting position and then repeat on the other side.
Ankylosing Spondylitis Benefit Improves flexibility of the hip flexor muscles.
Pelvic Tilt
Lie on your back with your knees bent and your feet on floor. Inhale, then flatten your back into the floor as you slowly exhale, feeling your tailbone lift slightly. Inhale as you relax into the floor.
Ankylosing Spondylitis Benefit This pose helps stretch the back and can be beneficial for some people with AS, says Carrie E. Demers, MD, the medical director of the Himalayan Institute Total Health Center in Honesdale, Pennsylvania.
- Yoga for AS. Spondylitis Association of America.
- Nondrug Therapies and Lifestyle Changes to Ease Back Pain. Arthritis Foundation.
Alison Ozgur, RDN
Medical Reviewer
Alison Ozgur, RDN, is a wellness expert with advanced training in whole-food, plant-based nutrition. She is also an adjunct instructor of nutrition at Jersey College in Teterboro, New Jersey, and a board-certified lifestyle medicine professional through the American College of Lifestyle Medicine.
In 2012, she coauthored her first book, Go Beyond Good: The Trail to a Lifetime of Health and Vitality! That same year, she joined the online instructor team at the T. Colin Campbell Center for Nutrition Studies, ultimately becoming the director of wellness programs. Ozgur has led numerous lectures and workshops at the Miraval Arizona Resort and Spa in Tucson.
She is pursuing a third master’s degree in global health from Arizona State University.
Denise Mann
Author
Denise Mann is an award-winning health journalist in New York. Her articles regularly appear in Healthday, Wall Street Journal, Health.com, Newsday, American Profile, and other consumer health portals. She is the chief editor of Plastic Surgery Practice and a feature writer for WebMD. She writes about women's health, cancer, diabetes, heart disease, diet and fitness.
Her first foray into health reporting was with the Medical Tribune News Service where her articles appeared regularly in such newspapers as the Detroit Free Press, Chicago Sun-Times, Dallas Morning News, and the Los Angeles Daily News. She received the Journalistic Achievement Award from the American Society for Aesthetic Plastic Surgery in 2004 and 2011.
She lives with her husband, their miniature schnauzer, and their two sons. An avid indoor cycler, Mann is always up for a Soul Cycle class. In her spare time, Mann is working on a fiction novel loosely based on her extended family.